This content was derived from iJET International’s 2018 Global Forecast

Disease outbreaks such as Zika and Ebola gain significant international media attention and elicit emotional responses, but what are the actual risk for business travelers?

According to a global health forecast prepared by iJET, a provider of travel risk management services and a partner of American Express Global Business Travel, the risk is minimal. While iJET does not negate the ongoing challenges posed by diseases such as Zika, yellow fever, and hemorrhagic viruses, it says the key to remaining healthy abroad (and at home) is to fully understand the health threats posed by disease outbreaks and their transmission, being adequately prepared to prevent infection and understand available treatment options, and taking the necessary mitigation measures.

Mosquito-borne diseases

Zika and other mosquito-borne diseases are still a risk to nonimmune travelers and will remain so in endemic locations until a vaccine is available. Particularly troublesome are the increasing reports of malaria globally.

Earlier in 2017, “super malaria” gained notable media attention, which, although a concern, was somewhat misleading. Drug-resistant strains of malaria (hence the term super malaria) were identified in many areas nearly a decade ago, but were not well publicized. The increase in cases of drug-resistant malaria speaks to a growing concern with all types of drug resistance. Coupled with this, the importation of “competent vectors” (mosquitoes that can carry the disease) and their apparent proliferation has medical authorities concerned. Malaria is being reported in areas previously considered malaria-free or areas where the disease was thought to be eradicated. Some of this vector movement is secondary to insects “hitching rides” with travelers, then biting a victim with no history of travel and being erroneously reported as locally acquired. For other areas, especially those ill-equipped to eradicate these pests or control disease, a larger problem results if true outbreaks occur.

It is important for travelers and locals to stay abreast of these developments to protect themselves against this potentially deadly disease. On occasion, official health reports lag behind incidents as authorities gather data and have publications reviewed. Asking questions about recent developments and ensuring providers do thorough research into the topic can often assist in identifying the best preventive measures against contracting malaria.

Health effects of natural disasters

Climate change, La Niña, and other environmental effects have scientists concerned that the magnitude and frequency of major weather events — and the health-related consequences resulting from these natural disasters — will rise in 2018.

For example, increased insect populations that thrive in bodies of water can cause disease outbreaks as can displaced wildlife in the days and weeks following heavy precipitation, fire or flooding. Infrastructure challenges in refuse management (attracting disease-carrying rodents and pests) to power outages hampering medical care delivery are serious concerns.

Contingency planning for natural disasters, especially for those with chronic health conditions, is paramount. Risk managers should understand the propensity for inclement weather in relation to their global operations or pending travel. Medical response capabilities also should be in place in the event of a disaster; these include understanding how to access care, insurance requirements, proper medical kit contents and necessary medications.

Traveling to new destinations with pre-existing conditions

Business travelers with chronic medical conditions may find that the destination they’re visiting has vastly different means of payment requirements, diagnostic testing, treatment options and drug prescriptions. Researching and understanding what to expect from medical providers pretravel is essential to ensure continuity of care and assurance of medication delivery or appropriate substitution.

Anyone with an ongoing illness needs to arrange the appropriate medical care before departure to avoid potential exacerbation of their condition. The following steps will help ensure consistent treatment:

  • Document necessary prescriptions appropriate for length of stay and in the event refills are needed
  • Carry a medical resumé or summary of chronic conditions, past surgeries, allergies and all medication
  • Have your doctor locate a counterpart at your destination to ensure communication and continuity of care
  • Confirm that insurance coverage is applicable and sufficient
  • Research standards of care and access to routine and complex medical services before you depart. Understanding challenges and likely levels of service can avoid an expensive

Vaccine-preventable diseases

Vaccine-preventable or “old world” diseases were mentioned in the 2017 Health Outlook and are still a growing concern. People opt out of immunization for various reasons, and programs in many areas may be challenged by funding decreases, mass population movements, refugee concerns, and security issues hampering delivery to vulnerable populations. Many individuals are unaware of their vaccine status or new immunizations available on the market. When travel to a new area exposes a vulnerable person to a vaccine-preventable disease, that individual runs the risk of transmitting it to other susceptible populations.

In 2018, it is expected that pockets of diseases such as measles, mumps, pertussis, and diphtheria will emerge in areas where these diseases had seen previous control. Awareness of immune status and pre-travel consultation with a medical professional who understands the destination vaccination rate of the population or current trends in outbreaks, will help prevent this inadvertent spread of disease, especially in children and the elderly. Employers and those managing students can facilitate immunizations by identifying those who may be traveling in advance and ensuring these individuals receive appropriate immunizations. Some vaccines require a series for full protection, so do not delay consultation with a medical professional.


Some existing health challenges may worsen in 2018 without adequate preparation. Among these are conditions that have spread to new locations or increased cases of diseases such as of malaria, measles, and mumps. Contributing factors are more widespread, and frequent natural disasters and vaccination programs that are fraught with challenges. Those with pre-existing conditions should be especially aware of these and other healthcare delivery challenges as they conduct business, education, or recreational travel abroad. Doing contingency planning, understanding risks, and implementing preventive measures can assist in mitigation.