453. Understanding Travel Medicine Provider’s Risk Assessment of Travel-Associated Diseases

Background Pre-travel medical consultations attempt to reduce travel-associated risks by behavioral modification, vaccination, and medications. Provider understanding of quantitative risk of commonly discussed travel topics is poorly characterized. We investigated travel medicine provider understanding of quantitative risk of common travel-associated diseases, and explored how providers relay risk estimates to travelers. Methods After institutional review board (IRB) approval, an online anonymous survey was sent to the International Society for Travel Medicine Listserv. Travel medicine experience, practice patterns and demographics were recorded. Respondents estimated quantitative risk of various destination-specific diseases. Descriptive statistics were completed. Results Of 114 respondents, most were experienced travel medicine providers (79% saw >6 travel visits monthly). Overall risk estimates are in Table 1. Compared with published literature, providers gave accurate risk estimates for some diseases (yellow fever, traveler’s diarrhea), but overestimated quantitative risk for others (Japanese encephalitis, hepatitis A, cholera). Interquartile range was greatest for Japanese encephalitis and cholera, reflecting a wider range of risk estimates. Most (81%) providers used general risk descriptions (high, low, none) and a minority (14%) discussed quantitative risk with travelers. Conclusion Experienced travel medicine providers overestimated risk of several vaccine preventable illnesses, though risk estimates for others were close to published estimates. Most providers do not use quantitative risk in pre-travel consultations. Improved quantitative risk understanding may improve the quality of pre-travel consultations. Table 1. Provider’s Risk Estimates for Selected Travel-Associated Illnesses Median Interquartile Range Traveler’s diarrhea (India) 1:3 1:2 – 1:5 Malaria (W. Africa) 1:10 1:5 – 1:85 Hepatitis A (Kenya) 1:100 1:25 – 1:1,000 Influenza (Indonesia) 1:100 1:20 – 1:500 Cholera (Uganda) 1:10,000 1:500 – 1:100,000 Japanese encephalitis (Vietnam) 1:10,000 1:500 – 1:200,000 Tick borne encephalitis (Austria) 1:1,000 1:100 – 1:10,000 Yellow fever (W. Africa) 1:2,000 1:100 – 1:10,000 Yellow fever (Brazil) 1:5,000 1:200 – 1:25,000 Disclosures All authors: No reported disclosures.