Pharmacies across the country are now offering comprehensive travel health consultations with remote travel health specialists, allowing any pharmacy to be a travel health clinic. Since having an on-site travel physician is no longer necessary to provide comprehensive travel health, let’s learn about an important travel health disease, yellow fever, and how you can implement travel health at any pharmacy. 

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What is Yellow Fever?

First, it’s important to understand why yellow fever is a serious travel health disease. Yellow fever is caused by the yellow fever virus and transmitted through the bites of infected mosquitoes. Although most people experience minimal to mild symptoms, approximately 12% of those infected can develop severe illness which, in some cases, may lead to death. Moreover, there are no specific drugs to treat yellow fever. That's why prevention is key!

Who's at Risk?

Mosquitoes carrying the yellow fever virus are found in certain parts of South America and Africa. Travelers heading to these areas are at risk, and that's where the pharmacist comes in! By offering yellow fever vaccinations at your pharmacy, you can help protect those adventurous souls embarking on their journeys.

Vaccination is Crucial

Vaccines are the most effective tool in the fight against yellow fever. Typically, a single dose of the yellow fever vaccine is sufficient to provide lifelong protection. It’s reassuring to know that one shot can save lives and offer peace of mind to travelers. Support from pharmacies in facilitating these vaccinations is pivotal in keeping patients safe. Keep in mind that the yellow fever vaccine should be administered at least 10 days before departure, and proof of vaccination might be required for entering certain countries.

Prevent Mosquito Bites Like a Pro

While the vaccine is essential, we can't forget about the power of bite-prevention. Here are some tips to help your patients avoid those pesky mosquito bites:

1. Arm them with the right repellent: Recommend an insect repellent with active ingredients such as DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. Remember, always apply sunscreen before applying repellent.

2. Cover up: Encourage travelers to wear long-sleeved shirts and long pants. If possible, suggest treating clothing and gear with insecticides such as metofluthrin, ensuring to avoid contact with skin. Clothing that is pre-treated with permethrin is also available. 

3. Snooze under a net: Remind your patients to use a mosquito net while sleeping. Make sure they choose a compact, white net that tucks securely under the mattress.
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Setting Up Your Pharmacy as a Yellow Fever Vaccination Center (In Canada)

Ready to take the plunge and become a designated Yellow Fever Vaccination Center (YFVC)? Here's a rundown of what you need to know:

1. Overview of Responsibilities: As a YFVC, you'll be responsible for vaccinating the public, ensuring quality and safety, and providing necessary documentation for border entry requirements.

2. Personnel: Have a nominated health care practitioner (NHCP) assigned to your site. This person will be responsible for ensuring that the requirements of the YFVC are upheld.

3. Administrative Requirements: Fill out the appropriate application and attestation forms for each designated site, and provide a copy of the nominated healthcare practitioner's current license. Renew your designation every two years and notify the Public Health Agency of Canada (PHAC) of any changes to your site.

4. Order the Yellow Fever Vaccine: You can order the vaccine through Sanofi Pasteur (Customer.ServiceCA@sanofipasteur.com)
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Travel Consultations with MedEssist

Don’t have a travel health doctor on site? No stress! At MedEssist, we're here to support you every step of the way with a customizable booking platform and scheduling system as well as clinical smart-forms to help guide patient assessments. Our platform is also integrated with MD Connected, a virtual care service that will connect pharmacists to a physician specializing in travel medicine within minutes. The physician will review the pharmacist’s consultation documents and provide any necessary prescriptions as appropriate for the patient. This way, the patient is able to receive the consultation, prescriptions, and vaccine all in the same visit! Together, we can make a difference and keep our fellow travelers safe from yellow fever!

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References:

1. Yellow fever. Centers for Disease Control and Prevention. September 22, 2022. Accessed July 4, 2023. https://wwwnc.cdc.gov/travel/diseases/yellow-fever#:~:text=Yellow%20fever%20is%20a%20serious,days%20after%20they%20are%20infected. 
2. Yellow fever. World Health Organization. May 31, 2023. Accessed July 4, 2023. https://www.who.int/news-room/fact-sheets/detail/yellow-fever. 
3. Yellow fever vaccine: Canadian Immunization Guide. Government of Canada / Gouvernement du Canada. March 2023. Accessed July 4, 2023. https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-25-yellow-fever-vaccine.html#a2. 
4. Procedures for Yellow Fever Vaccination Centres in Canada. Government of Canada / Gouvernement du Canada. September 1, 2015. Accessed July 4, 2023. https://www.canada.ca/en/public-health/services/travel-health/yellow-fever/procedures/procedures-yellow-fever-vaccination.html. 
5. Kleiman N. Insect Bites and Stings. In: Minor Ailments. Canadian Pharmacists Association. Updated January 18, 2023. Accessed July 4, 2023. https://www.e-therapeutics.ca