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If you take people to exotic places do you have a duty to provide them with the information necessary for their health? Recent publicity about deep vein thrombosis has brought the risks of air travel to the front of the public mind. What about the risks of visiting tropical and subtropical countries? Should airlines be providing more information? A recent paper (Andreas Sing and colleagues. Communicable Disease and Public Health 2000;3:195–7) suggests that, by and large, airlines tend to avoid the issue on their websites. The websites of 73 airlines which flew to tropical or subtropical countries were identified and 55 were found to have a functioning email address. These 55 were sent an email purporting to be from a traveller and asking for advice about malaria prophylaxis. The traveller was said to be taking an anticonvulsant drug, presumably for epilepsy, and planning to spend four weeks in a rural area of either the airline's home country (if tropical) or Thailand or Kenya. The desired answer was that mefloquine (which would usually have been recommended to non-epileptic travellers to these areas) is contraindicated in people with epilepsy and either doxycycline (in Thailand) or chloroquine and proguanil (in Kenya) should be taken instead. They got 25 replies, 12 of which mentioned malaria. Four of the 12 said that the destination country was free of malaria when it wasn't. Only two airlines gave the wanted answer. Sixty six of the 73 airline home pages gave no medical information. Airlines are not reliable sources of medical information. Whether they should be is perhaps debatable, as might be the use of investigative journalism techniques by doctors.
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