My involvement with the travel industry started in 1979 when a tour operator approached my long term employers, the Public Health Laboratory Service, for help with a problem of gastro-intestinal upsets in tourists in a hotel in Tunisia.
A sample of water had been brought back to the UK and an analysis was requested. The specimen was of no use, due to the time since collection and the inadequate storage conditions, but some pertinent questions were asked and a methodology developed. This was the start of studies that continue to this day.
At the time little was known about stomach upsets in tourists and how the incidence varied with destinations. After much discussion, one operator included a health question in their Client Satisfaction Questionnaire (CSQ).
The study expanded to other operators and has been a key instrument in persuading governments and hoteliers around the world to improve the public infrastructure of destinations.
In the early 1980s the incidence of stomach upsets in tourists at some popular European destinations could be as high as 40-50%. The monitoring of CSQs was key in persuading resorts to undertake novel public health exercises along with major improvements to the public health infrastructure, especially public water supplies.
British package tour operators can be truly proud of the impact they have had on public health in regions in which they arrange holidays. The effects have benefitted not only tourists but also indigenous populations.
The collection, analysis and use of the CSQ health data is something that has been a major factor in the improvement of health in tourists based on facts and trends rather than just fleeting impressions. For example, the results from American destinations are being used by the Pan American Health Organisation in their new initiative on health and tourism.
Safeguarding travellers’ health however is a journey, one which will never be over. Ongoing vigilance is required. Infections and infectious diseases will continue to be a challenge to the tourist industry.
The collection and sharing of health is paramount to a preventative strategy and must be kept under continual review. Although public health authorities have surveillance systems, they are disease-specific and, apart from Legionnaires’ Disease, the results have generally not had major effect on improvements in travel-related health and safety.
Tour operator CSQ results and the incident reports to FTO have been far more instrumental in effecting changes and are highly regarded by Ministers of Tourism and their advisors.
I commend all those who have worked together to control infections and ensure the safety of tourists but give a warning from my own experience that any relaxation in this work will only lead to a resurgence of infections and re-emergence of hazards that we believe to be under control.
As soon as one battle is won another challenge appears. Every day we hear about viruses such as MRSA, Clostridium difficile, Norovirus. The microbes must always be treated with respect and our guard never lowered.
This is a view which I know is shared by the next public health advisor to FTO, Dr Esteban Delgado, to whom I hand over the baton with great confidence.
