Here are a few stats around business travel:

• 20% loss of overall productivity due to travel
• 92% higher risk of obesity for those traveling more than 21 nights per month
• 6.9 hours of productivity lost per trip due to stress
• Strong correlation between frequent business travel and physical and behavioral health risks

Travel Stress Index: The Hidden Costs of Business Travel, CWT

Let’s talk about a few key things that you can do as a business traveler to help reduce stress:

Hydration…Yes, Again
From a personal health perspective, you already know how important staying hydrated is, but are you doing it? The typical water target of half your body weight in ounces is a great place to start, but the key is in actually implementing this so that you are drinking water throughout your day. Make sure that you are drinking purified water, as you want to help your body to detoxify. You either use a filter or you body will become the filter.

Proper Breathing
Proper breathing means that you are breathing deeply, down below your belly button (you might put your hand there as you practice), while keeping your chest relatively still. Try inhaling for 4 seconds, hold for 4 seconds and exhale for 4 seconds. This will help to activate the calming side of your nervous system (called the parasympathetic nervous system) and reduce stress in a big way. In fact, all of the best stress reduction systems (e.g. Tai Chi, Yoga, Qi Gong…) have deep breathing at their core.

Best Fuel Possible
Most people that own an expensive car would never think of putting the cheapest fuel in it. Your body is WAY more valuable than any car, so make sure that you are giving it the best fuel possible. I understand that there are times when it makes sense to cheat and eat the not-so-good-for-you foods, and that’s OK…as long as it’s in moderation. Shoot for the 80/20 rule (80% of the time eating as healthy as you can). 

What does that look like given our culture’s fascination with the diet trend of the month? In general, eat things that grow. My recommendation is the Mediterranean diet as it’s stood the test of time. The trick is to eat:

1. Good quality fruits and vegetables (organic where possible)
2. Whole grains (very small amounts, if any) and 
3. Healthy fats (natural ones – coconut oil, avocado, olive oil, walnuts, macadamia nuts…). Also make sure to get your Omega 3 essential fatty acids from fish, flax or other sources. Whenever you see the word essential with regard to nutrition it means that your body can’t make it on its own…you have to eat it. These particular fats are crucial to building healthy cells in your body.
4. We really don’t need as much protein as you might think (depending on your lifestyle), so add some in the form of beans, nuts, lentils (if vegetarian) and/or good quality meats (organic, grass-fed) or eggs..

Stress Management
The reality is that we cannot control what happens to us, but we do have a big say in how we respond. Your first go-to response to any major stressors should be to breathe deeply. This will go a long way in helping your body process whatever is going on. Each of us has a favorite activity (or non-activity) that helps us to release stress. Examples include yoga, cooking, running, reading, etc. The key is to make sure you have this activity scheduled on your calendar and keep the commitment, as this is a priority, especially these days!

While I list cooking and reading as possible stress reduction activities, please know that movement is a requirement for true stress reduction. While it’s great to rest your brain with these types of activities, your body really wants to move. This doesn’t mean that you have to schedule an hour at the gym (though there are definitely benefits to weight lifting, aerobic exercise…), as simply walking can be all that you need to help with stress reduction. Many events already give us this option as we are walking quite a bit!

The other factor to consider about stress is technology. Yes, there are the typical social media challenges around looking at other people’s highlight reels that can move you toward frustration with your life, but I’m talking about something else. The EMFs (Electro Magnetic Frequencies) that are invisible yet have a HUGE impact on your body. 

Our bodies are way more electrical/energetic than we know and are sensitive to the constant barrage of these waves (think Wi-Fi, cell signals, cordless phones…). Your best approach is to keep your phone away from you as much as possible, and if you must keep it in your pocket, put it in airplane mode. This especially applies at night, where you’ll want to put your phone in airplane mode and keep it at least six feet away from your head. This one thing alone can improve your sleep.

Another great way to balance EMFs and help you body to recharge is to get outside into the sun, with bare feet on the earth. I know this might sound a little strange at first, but there is significant science that shows that we need the frequencies from the planet to function at our best. Give it a try and let me know…just 15 minutes a day can go a long way in helping you balance challenges such as anxiety or inflammation. You might consider doing this at a break when you are at the event.

Clean Your Filters
Your body is designed to filter out the toxins that you encounter in your everyday world. However, your body was NEVER designed to deal with the unbelievable amount of toxicity on our planet today. The main sources of toxicity are from:

1. The food we eat – pesticides, herbicides, GMOs (Genetically Modified Organisms), heavy metals, additives, preservatives, etc.
2. The air we breathe – pollution, huge increase in pollen, mold, artificial scents (think plug-ins, candles…), etc.
3. The water we drink – prescription drug residues, heavy metals, chlorine, fluoride, etc.
4. Prescription drugs – these are often stored in your body for longer than you know

Your body is always trying to cleanse itself, but when it gets overloaded, it can result in issues with your organs of detox (liver, kidneys, colon…). 

Consider working with a natural health practitioner to begin a detox program to get things started on the road to better wellness.

Travel
Travel adds a new level of stress to what we’ve already covered and requires a few more healthy choices. You must plan ahead to reduce as many travel stressors as possible. Some examples include:

1. Bring food/water with you if you can – especially when driving. This helps with the inevitable roadside stops that can result in unhealthy snacks.
2. Be sure to pack some “just in case” supplements that you might need to help with issues around sleep, illness and digestive challenges.
3. If you are driving, consider getting a bottle of good quality peppermint essential oil. This can be very helpful to smell if you start to feel drowsy when driving.

Your body is always trying to heal itself…all the time! Our mission is to make life choices that will support this and give it what it needs (nutrition, air, water, movement…) and take away things that are hurting it (low quality foods, shallow breathing, sitting all day, dehydration). 

When you care for yourself, you are not only looking out for your own health, but you’re also putting yourself in a position to perform best for your team, customers and the overall event success.

The Centers for Disease Control and Prevention estimates that 48 million people or 1 in 6 Americans experience a foodborne illness every year as a result of consuming contaminated food or drink and roughly 128,000 people in the US are hospitalized due to foodborne illness. There are many different pathogens or disease causing microbes that can cause illness. Currently, there are 250 known pathogens that are responsible for 20% of the reported foodborne cases and the root cause of the remaining 80% of all cases are many unknown pathogens. Additionally, chemical contaminates such as pesticides can cause foodborne illness. In the US, the top five pathogens that cause foodborne illnesses are norovirus (58%), salmonella (10%), Clostridium perfringes (10%), and campylobacter (9%). However, salmonella infections are responsible for the most hospitalizations and for the most deaths out of any of the foodborne pathogens.

What is a Pathogen?

Foodborne pathogens can cause several different types of illness. Salmonella and noroviruses can cause illness by consumption of live pathogens that replicate and grow in the intestinal tracks which is called a foodborne infection. An organism like Bacillus cereus (a pathogen found in rice and grains) can cause illness through foodborne intoxication through the production of toxins and the live bacteria does not need to be consumed. These microorganisms typically do not make the food look, taste or smell bad so it impossible to determine if the food is contaminated.

For a pathogen to grow and proliferate, certain conditions must be met. The first one condition is that the pathogen or its toxin must be in the food. Many raw foods have naturally occurring background levels of pathogen contamination. These pathogens can thrive when the temperature and the nutrients are suitable for the pathogenic growth. Foods that are high in protein such as eggs, meat, fish, and milk can provide appropriate nutrient levels for pathogens. Additionally, foods that are slightly acidic (pH levels 4.6-7.6) also support microbiological growth. Additionally, foodborne pathogens grow best in foods that have a temperature of 70-104° F. It is essential that hot foods must be kept hot and cold foods must be kept cold to prevent growth. Common food service foods that have a higher risk of foodborne illness are rice, cooked or raw animal products, cooked or raw vegetables, raw seed sprouts, raw shell eggs or water cooled hard boiled eggs, cut melons, and garlic and oil mixtures.

Once a pathogen has been allowed to proliferate in a food, foodborne illness can set in following consumption of the contaminated food. Most foodborne illnesses can occur with 2-24 hours following consumption of the contaminated food but symptoms have been reported as far out as 30 days post-contaminated food consumption. The time of onset of foodborne illness symptoms can be pathogen dependent. The most common symptom is diarrhea but symptoms can include vomiting, cramping, fever, and flu like symptoms.

Prevent the problem before it happens

To avoid potential problems in foods, it is very important to control or eliminate pathogens in food products. HACCPS or hazard analysis and critical control points are your quality assurance and risk assessment steps. They include coming up with preventative measures; evaluating critical control points and preventing, eliminating or reducing risk; evaluating and establishing critical limits such as cooking temperatures; monitoring CCP’s with temperature measurements; corrective action; record keeping systems; and verification.

SOPs and employee education are essential in preventing foodborne illnesses. The SOPs should address everything from where the product can be ordered from to how it is received, how it is stored, how long it is stored, how it is prepared, where it is prepared, by whom it is prepared, how it is transported and how it is served. Comprehensive SOPs go a long way to not only preventing foodborne illness, but also defending claims. However, that is only if they are adhered to. Employee training should be conducted on a continuous basis and management should continually verify SOPs are being followed. There are also several training certifications in food handling such as those offered through ServSafe and Learn2Serve. These can be done online and provide management with valuable education in developing safe food handling protocols.

Summary

While a foodborne illness outbreak can be devastating to a restaurant there is no restaurant that in a single night can serve as many individuals as a hotel during a large conference banquet or buffet. Many foodborne illness claims originate from that exact setting. Often times there are numerous individuals who become ill. The assumption is that there must have been some adulterated food item they all consumed that made them sick. It could not possibly be a coincidence… but it could be something other than a foodborne illness! Reaction time and record keeping is crucial in defending these claims.

This article is part of our Conference Materials Library and has a PowerPoint counterpart that can be accessed in the Resource Libary.

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Authors

Allison Stock – Principal Consultant/Toxicologist & Epidemiologist, Rimkus Consulting Group
astock@rimkus.com
504-832-8999

Dr. Allison Stock is an internationally known toxicologist and epidemiologist with 25 years of toxicological, epidemiological, regulatory, and environmental experience. Her background is supported by experience in the federal and state government and industry (small and Fortune 500 companies).

Dr. Stock specializes in human health risk assessments combing both toxicological and epidemiological data. She has expertise in petrochemicals, oil and gas, environmental permitting, property transfer, environmental, social, and health impact assessments, inhalation toxicology, renal toxicology, toxicological and epidemiological risk assessment, communicable and foodborne illnesses such as Legionellosis, E. coli infections, and Salmonellosis, rapid needs assessments, emergency response, ambient and indoor air exposure assessments including mold, particulate matter, and asbestos, occupational health and safety plans, drug and alcohol intoxications, and stakeholder communications.

Kari Jacobson – Shareholder, La Cava & Jacobson
kjacobson@lacavajacobson.com
(813) 209-9611

Kari Katzman Jacobson is a shareholder of La Cava & Jacobson, P.A. Born in Miami, Florida in 1967 she graduated from the University of Florida with a B.A. in 1989 and from the University of Miami School of Law with a J.D. in 1992. Ms. Jacobson began her career as a prosecutor, and then went on to defend self-insured companies, insurance companies and those whom they insure.

Ms. Jacobson was admitted to The Florida Bar in 1992 and has been admitted to the U.S. District Court, Middle District of Florida since 1994. She is a member of The Florida Bar Association; American Bar Association, Hillsborough County Bar Association, Collier County Bar Association and the Claims and Litigation Management Alliance. She is also a member of The Federation of Defense & Corporate Counsel. She is A.V. Peer Review Rated by Martindale-Hubbell.

Ms. Jacobson is certified by the Florida Supreme Court as a Circuit Civil Mediator. Her practice is primarily concentrated in the areas of general liability, premises liability, negligent security, construction litigation, professional liability, trucking and commercial freight defense litigation claims.

Vaccines
Last-minute travel can affect which vaccinations a traveler is given prior to departure. Immunity generally takes two weeks to develop after vaccination, so individuals leaving during that window may not be completely protected from disease. Many travelers will have received standard routine vaccinations such as measles-mumps-rubella vaccine, polio vaccine, varicella vaccine, tetanus-diphtheria-pertussis vaccine, and seasonal influenza. However, if travelers are not completely up to date, the first or additional doses of these vaccines can be administered.

Certain vaccines that are given in multi-dose series can be protective after a single dose, which can be administered to last-minute travelers. Travelers can then complete the recommended series for these vaccinations upon return. Furthermore, some vaccines can be administered on an accelerated schedule and some series can be started before travel and completed after travel. Extended stay travelers or expatriates should receive guidance on clinics at the destination where their vaccination series can be completed. Bear in mind, however, that some vaccines do not have an accepted accelerated vaccination schedule.

The yellow fever vaccine is required by many countries in certain situations and must be administered at least 10 days before arrival at the destination country. Travelers may have to rearrange travel to accommodate this time frame or risk difficulty entering their destination. Further, travelers to the Hajj must obtain a visa that requires proof of meningococcal vaccine at least 10 days prior and less than three years before arriving in Saudi Arabia.

Food and Water Safety
Under the umbrella of basic health precautions, food and water safety are critically important. To avoid the risk of general foodborne illness, travelers should follow routine food hygiene practices. Ensure that food is properly handled and prepared. Wash raw produce before eating. Despite the cultural allure of many local cuisines, consider avoiding raw meat dishes, undercooked or raw fish and shellfish, and unpasteurized dairy products, which frequently harbor bacterial and parasitic pathogens. These precautions become even more important in areas where tap water is generally unsafe for consumption. Additionally, even in areas where water is potable, consider drinking bottled or purified water whenever possible, because travelers often develop diarrhea when exposed to the unfamiliar microorganisms in water from a new location.

Insect Precautions
The most common protection against vector-borne diseases is the use of insect repellents, most of which include DEET. Repellent should be applied to the neck, wrists, and ankles, while avoiding contact with the eyes, nose, and mouth. When applied to the skin, these repellents can last from 15 minutes to 10 hours, depending on the climate, the formulation of repellent used, and the effect of the specific repellent on specific vector species. Effects can be longer-lasting when applied to or impregnated into clothing.

Individuals should consider wearing long sleeved, light-colored shirts and pants to protect against mosquitoes, sandflies, and ticks. In tick-infested areas, pant legs should further be tucked into socks and heavy boots when walking through rural or forested areas. Additionally, clothing, bags, and other belongings should be examined thoroughly for ticks before entering the home, and individuals should bathe and conduct a full-body tick check within two hours of returning home, if possible.

Finally, individuals should avoid places and times when vectors are most active. For example, people can stay indoors during peak biting hours, such as dusk-to-dawn for malaria-carrying mosquitoes. Individuals can avoid walking in wooded areas with tall grass or underbrush where ticks are found and avoid contact with fresh water where schistosomiasis occurs. If such freshwater contact cannot be avoided, authorities recommend that individuals wear protective boots. Because several vector-borne diseases can be transmitted by contact with blood, secretions, organs, or other bodily fluids, individuals in affected areas should practice personal precautions and consider the safety of local blood supplies. Furthermore, in areas where Chagas disease or tick-borne encephalitis are endemic, individuals should avoid potentially contaminated food items.

Travel Health Kit
A medical first aid kit will help with minor injuries and give you a supply of common medications that may be difficult to acquire during travel. Medical kits should be easily accessible. If taking air travel, keep your first aid kit in your carry-on luggage; however, you may need to store sharp components in checked luggage due to security measures. Customize your kit to fit your travel (for example, trekking will pose different needs than visiting a city). Be sure to include supplies such as medications taken on a regular basis, over-the-counter pain relievers, antacids, bandages, antiseptic, cotton swabs, tweezers, scissors, disposable gloves, extra pair of eyeglasses or contacts, saline, sunglasses, thermometer, first aid quick reference card, and addresses and phone numbers of area hospitals or clinics. Additional supplies may be needed for outdoor/adventure travel, traveling with children, or other special cases.

Conclusions
Travelers – particularly those on urgent business – may not have the recommended four to six weeks prior to departure to consult with a travel medicine provider for the best preventative measures. Even with only a short window before leaving, travelers should seek advice from a travel medicine specialist. Travel medicine providers can brief the traveler about risks in the country and possible medications, vaccinations, and other precautions to take while abroad. Prior to departure, expatriates or those on extended-stay should consult medical providers for advice about equivalent medical care. Additionally, basic health precautions, insect precautions, food and water safety, and carrying a travel kit can help protect any traveler from health risks and are even more important for last-minute travelers.

With travel, a chock-full agenda and being surrounded by others, it is inevitable that someone is going to get sick during your event. Attendees work hard and play hard when at a meeting, conference or event. This can drain their immune system. Minimize the impact with these quick tips:

• Think of illness and accidents in the site selection phase. Items to consider include access to hospitals or an on-site physician and diseases/viruses impacting the area.
• As part of the registration process, make emergency contact details a requirement. Collect the name, phone number, alternate phone number and email of their designated contact. You should also collect if they need an ADA-compliant room or have any dietary health requirements.
• During the pre-meeting stage, include communication to attendees reminding them to bring any prescription or over-the-counter medications with them. If the meeting is abroad, make sure attendees understand how to legally travel with medications. You should also have attendees check into medical insurance for travel overseas.
• Before you arrive on-site, prepare or purchase a first aid kit.
• It is best practice to become CPR-Heimlich Maneuver-AED certified in case of an emergency situation needing immediate response.
• Try to incorporate some health/wellness initiatives into your meeting or event to minimize the chance of illness. If possible, incorporate immunity-boosting foods into the menu. A juice bar is camouflaged as a trendy, in-the-moment perk, while secretly providing sickness-fighting vitamins.
• When selecting activities, keep your attendees in mind and avoid any activities that have a high-risk for injury or accidents. Work with your DMC or meeting planner to obtain necessary documentation on the activity and its safety level.
• As part of your on-site contact list, include any on-site or on-call medical personnel, addresses and directions to the nearest hospitals and emergency phone numbers. Also locate on-site first aid relief and defibrillators. Include clear instructions on what to do/where to go should an emergency situation arise.
• If after all of this, you still face a medical situation, remember you are the attendee’s friendly face. Do what you can to support them through the illness or injury and get them the medical attention they need.

Sources:

The 3 “A”s of Risk Management

Legal Briefs: 6 Ways to Protect Your Meetings

5 Steps to Managing Meetings Risk

Cabin Pressurization-related Incidents

Cabin pressurization incidents occur on a regular basis around the world, but the majority do not cause injuries. According to reports in The Aviation Herald database, nearly 50 incidents involving some issue with cabin pressure have occurred so far in 2018. Most of the depressurization incidents this year involved a failure to pressurize the cabin as the aircraft climbed or a gradual loss of cabin pressure while the aircraft was at altitude. Only three known incidents caused injuries, most notably, the April 17 incident on Southwest Airlines (WN) Flight 1380 that resulted in the death of a passenger.

Health Effects of Depressurization

Most cabin depressurization incidents do not cause long-term health impacts; however, rare instances can result in severe injury or death. The most serious health threat in cabin depressurization incidents is hypoxia, or a lack of sufficient oxygen. Hypoxia can cause numerous symptoms, including breathlessness, fatigue, and impaired decision-making and physical functioning. Sustained hypoxia can eventually cause loss of consciousness and death.

Cabin depressurization can cause injuries to passengers’ ears due to the sudden change in air pressure. Such injuries can be very painful, but generally, do not cause long-term health impacts. Nausea is another common symptom of cabin depressurization and usually subsides after the aircraft lands.

An explosive decompression that causes a large breach in the airliner’s fuselage can suck an individual out of a plane, either partially or completely. Such instances are very rare on commercial airliners. An individual sucked out of a plane faces a very high probability of dying, though some have survived.

Mitigation Measures to Protect Travelers

Passengers can take several steps to protect themselves in the event of cabin depressurization. The required steps are simple, but passengers must complete them quickly, especially if the aircraft suddenly loses cabin pressure.

Passengers must don oxygen masks quickly after an airliner loses cabin pressure, as the effects of hypoxia may impair their ability to do so after a short time. Studies have shown that hypoxia following a sudden loss of cabin pressure in an airliner at cruise altitude can begin impairing a person’s functioning and decision-making in as little as eight seconds. Within 30 seconds, passengers may become so impaired they are unable to perform simple tasks such as putting on an oxygen mask. Passengers should ensure that the oxygen mask is worn properly so that it covers both the nose and mouth.

One way passengers can ensure familiarity with oxygen masks in an emergency is to pay attention to the preflight safety briefing and review the safety information card provided by the airline.

Passengers should also heed the instruction to put on their own oxygen mask before helping others put on their masks. Passengers who have put on their own oxygen masks will be fully capable of helping others in nearby seats, but passengers who do not may become impaired before they are able to help others or themselves.

In the very rare instance of an explosive decompression, wearing seatbelts increases passengers’ chances of survival. Seatbelts do not provide absolute protection to passengers; media reports indicate that the passenger killed on Southwest Flight 1380 was wearing her seatbelt. However, seatbelts have protected passengers in some explosive decompression incidents. The most notable such incident involved Aloha Airlines (AQ) Flight 243 in 1988, in which all passengers who had their seat belts fastened survived an explosive decompression that blew off a large portion of the aircraft’s forward fuselage.

WorldAware’s Global Intelligence solutions are designed to help you protect your personnel and ensure you can operate globally with confidence. Our Worldcue® Airline Monitor and quarterly Airline Safety Newsletter provide business leaders with two powerful tools to make decisions about airline carrier safety and help reduce travel risk across the organization.

A more in-depth version of this piece was featured in our most-recent Airline Safety Newsletter.

About WorldAware
WorldAware provides intelligence-driven, integrated risk management solutions that enable multinational organizations to operate globally with confidence. WorldAware’s end-to-end tailored solutions integrate world-class threat intelligence, innovative technology, and response services to help organizations mitigate risk and protect their employees, assets, and reputation.

Vaccinations and Herd Immunity
While vaccinations are important to protect individual human capital, they are critical for broader, continued corporate productivity. Vaccinations have a direct effect on individuals by providing them with a defense, or immunity, against disease. Yet, vaccinations also have an indirect protective effect on other individuals in the corporate setting. For example, when a high proportion of employees are vaccinated, they potentially prevent the spread of disease within the workplace by establishing a protective barrier around those who are not vaccinated and/or have not built up sufficient defenses against disease. In the science community, we call this concept herd immunity.

The modern corporate workplace is threatened by local and international infectious diseases. Local disease outbreaks have the potential to expose a high proportion of employees to an infectious disease; therefore, herd immunity is extremely important for maintaining a corporate protective barrier against outbreaks. Corporate health is equally jeopardized by international disease threats when unprotected individual employees travel abroad. Upon return, those employees can threaten productivity by exposing others to the imported infectious agent.

International Travelers & Recommended Vaccinations
International travelers regardless of their destination should ensure that they are up to date on the vaccines listed below. It is important to note that healthcare providers will likely add additional vaccinations to those listed below, such as yellow fever and Japanese encephalitis, if these vaccines are required by the traveler’s host country and/or if the disease is endemic in the destination country. Furthermore, employers should encourage all international travelers to contact a physician who has expertise in travel medicine four to six weeks prior to travel. This will allow enough time for the traveler to complete any vaccine series as well as give their body time to build up immunity.

• Chickenpox (Varicella): Recommended for travelers without a history of chickenpox or evidence of immunity to chickenpox by blood test. This vaccine is administered as a two-dose series.
• Hepatitis A: This vaccine is included in routine children’s immunizations. The Hepatitis A vaccination is most important for travelers who are traveling to countries with an intermediate to high prevalence of Hepatitis A. This vaccine is administered as a two-dose series. A Hepatitis A/Hepatitis B combined vaccine is also available.
• Hepatitis B: Recommended for all unvaccinated persons who might be exposed to blood or body fluids, have sexual contact with the local population, or be exposed through medical treatment, such as for an accident, even in developed countries, and for all adults requesting protection from HBV infection. The Hepatitis B vaccination is most important for travelers who are traveling to countries with an intermediate-to-high prevalence of Hepatitis B. This vaccine is administered as a three-dose series. A Hepatitis A/ Hepatitis B combined vaccine is also available.
• Influenza: Recommended for all travelers over the age 50, very young children, and/or travelers of all ages who have a chronic disease such as diabetes or emphysema. This vaccination is administered annually.
• Measles, mumps, rubella (MMR): Recommended for travelers born after 1957, and those who did not have these diseases as children. People born before 1957 generally acquired immunity to these diseases in childhood. This vaccine is administered as a two-dose series.
• Pertussis (Whooping Cough): This vaccine is included in routine children’s immunizations with tetanus and diphtheria (see below). It is also now available for adults in combination with the tetanus/ diphtheria booster.
• Pneumococcal pneumonia: Recommended for all adults over age 65, and anyone with chronic disease. Physicians in the US also recommend this vaccination for smokers and anyone with asthma.
• Tetanus and diphtheria: A booster is recommended every 10 years after initial immunization series.

Infectious diseases have the potential to greatly impact business productivity by eroding and diminishing human capital on an individual and corporate level. Since infectious diseases are a constant threat to the bottom line of every business, it is imperative that businesses monitor local and international disease threats, and adopt proactive healthcare measures. For that reason, thoughtful proactive disease prevention protocols are key to eliminating threats posed by local and international infectious diseases.

To learn more about how health inelligence can help protect your corporate workplace and global travelers from disease threats, download a copy of our white paper, The Value of Health Intelligence.

What is Seasonal Influenza?

Seasonal influenza, also known as the flu, is a very contagious viral disease that spreads through droplets created when an infected person coughs, sneezes, or talks. There are several viruses that cause influenza – including H1N1, H3N2, and influenza B. Influenza vaccines are available and must be received every year to be protective. Protection against infection typically begins within two-to-three weeks of immunization. It is important to note that the flu cannot be treated with antibiotics since it is caused by a virus.

The Current Trend of Seasonal Influenza in the Northern Hemisphere

The influenza season in the Northern Hemisphere generally begins in October and can last as late as May. According to the most recent influenza report from the WHO, dated Nov. 27, overall disease activity in North America continues to increase while activity in Europe remains low. The dominant circulating virus in North America is influenza A(H3N2), while influenza A(H3N2) and influenza B viruses are the primary strains circulating in Europe. Influenza A(H3N2) and influenza B viruses are covered by the traditional influenza vaccine.

Strategies to Prevent the Spread of Influenza in the Workplace:

1. Raise Awareness about Seasonal Influenza

Employees who believe they are at risk of becoming infected with influenza, and who understand the consequences associated with influenza infection, are more likely to alter their behaviors in order to reduce the risk of infection. Therefore, it is important that employers educate workers about how influenza is spread, what symptoms the flu causes, and the potential complications related to influenza infection. This information should be communicated to employees in a number of ways, such as through emails and by placing flyers or posters in high-traffic areas, to maximize visibility.

2. Encourage Proper Coughing Etiquette and Hand Washing

It is extremely important for employers not only to teach and remind employees the proper way to cover coughs and sneezes but also to remind them to regularly wash their hands throughout the flu season.

3. Keep the Workplace Clean

Since the flu can spread on contaminated surfaces or objects, it is extremely important that employers develop procedures and policies that ensure all commonly touched work surfaces, work areas, and equipment – for example, telephones, doorknobs, lunch areas, copy machines, etc. – are cleaned frequently. Routine cleaning agents are sufficient to disinfect surfaces against influenza, but employers should provide easy access to cleaning supplies.

4. Encourage Annual Flu Vaccinations

Even though the effectiveness of influenza vaccines depend on how well-matched the vaccine is to active influenza viruses, influenza vaccination remains an important additional defense against influenza infection. However, vaccination is arguably the most difficult measure to implement due to misconceptions about the influenza vaccine. For example, many people believe that the influenza vaccine makes people sick. In reality, the standard influenza vaccine contains virus that has been inactivated and is, therefore, unable to make people sick. Furthermore, many non-influenza illnesses have symptoms that can be described as flu-like. As a result, individuals may incorrectly attribute such symptoms to a recent vaccination instead of illness due to another infectious agent.

Employers should consider hosting a flu vaccination clinic at their place of business. The US CDC recommends providing vaccines to employees at little-to-no cost and promoting vaccination within the local community. If hosting a flu vaccination clinic is not plausible, employers should consider notifying their employees of local pharmacies and clinics offering influenza vaccinations. Since many pharmacies and clinics are only open during normal business hours, employers should consider allowing their employees the time to go to these clinics while still on the clock.

Conclusion

The flu can cause widespread business disruptions resulting in financial losses. Employers can mitigate such losses by implementing measures that will help prevent the spread of the influenza virus within the workplace: raising awareness about seasonal influenza, promoting proper hygiene, keeping the workplace clean, encouraging employees to receive their annual flu vaccination, and adopting flexible leave plans.

To help keep your workplace well this flu season, we’ve created this handy infographic: Top 6 Tips for Workplace Wellness this Flu Season. Download it now and share with your colleagues.

Often times, employers tend to focus solely on their duty of care obligations to their employees domestically.  Employers, however, would be remiss not to focus on their duty of care to their employees abroad.  The bottom line is that employers need to be familiar with and sufficiently address the issues facing their workers who travel and/or perform work abroad.  Understanding the legal obligations and preventing the risks associated with employee foreign travel and work assignments is imperative for employers, exclusive of size and industry.

Workplace health and safety is a paramount concern in the United States, as evidenced by the Occupational Safety and Health Administration Act of 1970 (“OSHA”) and workers’ compensation laws.  OSHA establishes the primary standards for workplace health and safety and a general duty of care.  OSHA’s main focus is on preventing workplace injuries by imposing obligations upon employers to maintain a safe work environment.  On the other hand, workers’ compensation laws impose responsibilities on an employer to financially compensate an employee who actually suffers an injury or occupational disease in the course of employment.  Although costly and constantly evolving, OSHA and the workers’ compensation system at least provide some level of certainty to an employer regarding its financial and legal responsibilities when an employee is injured, contracts an illness, or dies on the job.

Once a United States employee steps outside of the United States borders, however, employers find themselves outside the confines of these commonly understood and applied protections and laws.  The result is that an employer finds itself subject to a negligence claim with virtually no level of certainty with respect to liability and damages.

The recent increased emphasis on the duty of care and the idea that an employer is responsible for the health, safety, security, and well-being of its globally mobile employees has proved to a daunting and scary concept for employers to comprehend.  To mitigate risks and provide some level of certainty, employers should strive to understand its legal obligations and to mitigate its liability risk through a travel risk management plan that involves assessing company-specific risks and developing policies and procedures, communicating to and training of employees, and documenting and analyzing incidents.

To learn more about employer best practices and drafting a travel risk management plan, please see the following article entitled “Legal Perspective on the Health, Safety & Security Responsibilities for US Mobile Workforce,” which can be found here.  The article was published in partnership with the International SOS Foundation and the American College of Occupational and Environmental Medicine.

Visit a Travel Medicine Specialist

Health professionals who specialize in travel medicine are typically able to provide a level of care that often surpasses that offered by a general practitioner or family doctor who is not familiar with current, global health threats. An online directory of private travel clinics around the world can be found on the International Society of Travel Medicine website.

It is important to schedule your appointment at least four to six weeks before travel. This will ensure you have enough time to complete any vaccine series you may need and give your body time to build up immunity. During your appointment, be thorough about all potential destinations you may visit and activities you will participate in. Make sure you are apprised of all health issues relating to your itinerary and counseled on specific risks related to chronic medical conditions. And last but not least be sure to ask your healthcare provider if you are up-to-date on all routine vaccinations. These vaccinations include but are not limited to: Chickenpox (Varicella), Hepatitis A, Hepatitis B, Influenza, Measles, Mumps, and Rubella (MMR), Pertussis (Whopping Cough), Pneumococcal Pneumonia, and Tetanus and Diphtheria.

Contact Your Health Insurance Carrier

Illness and injury pose perhaps the most immediate risk while traveling abroad, especially in developing countries. According to the US CDC, more than 50 percent of international travelers to developing countries become ill during their trip. Since medical assistance abroad can be extremely expensive, it is important to ensure you have adequate health insurance.

Contact your health insurance carrier to determine if your policy will provide coverage in a foreign country. It is important to note that you may need supplemental travel insurance to ensure you are adequately covered for medical emergencies and evacuations. While traveling, carry your health providers name and contact information for emergency referral. If you have a chronic or ongoing health problem that may require treatment while abroad, be sure to also have a copy of pertinent health records.

Properly Pack Prescription and Over-The-Counter Medications

Another set of health risks includes pre-existing medical conditions, particularly chronic diseases. Chronic diseases can present challenges for travelers because of the medications required for their management. Medications that are legal in one country may be highly regulated or even wholly prohibited in another country. Failure to follow these laws can result in confiscation of medications, imprisonment for drug trafficking, and even the death penalty.

• Obtain and pack a copy of your prescription and a letter from the prescribing medical practitioner stating the name of the drug, dosage and quantity prescribed, the reason the drug is being prescribed, and the health condition for which the medication is being prescribed. While some countries will allow you to carry a 90-day supply of medication, other countries limit this to a 30-day supply or less. Therefore, a certificate/letter from your prescribing medical practitioner can be a very useful document if you have to obtain a prescription from a local medical practitioner.
• All prescription medications and any related documentation should be either carried on the person or stored in carry-on luggage, since checked luggage can be lost, misplaced, and/or delayed. Travelers should keep all prescription medications in their original, correctly labeled containers/packages with the active ingredients of the medication clearly labeled on the container for easy identification at checkpoints. Different medications should not be combined into one container. Travelers should make sure the name on the prescription, the container, and their passport match. Medications should be packed in a clear bag.
• Over-the-counter (OTC) medications should be kept in their original container and clearly labeled. They can be packed in checked luggage; however, travelers should consider packing OTC medications in their carry-on luggage, especially if the medication is needed while in flight, near the time of arrival, and/or if it is regulated by the destination country. They should be kept in their original container and clearly labeled. Pack the medication in a clear bag.

For a more in-depth look into traveling internationally with personal medication, watch iJET’s free webinar, Traveling with Medication: How to Navigate International Law

On Thursday, February 11, Venezuelan President Nicolás Maduro announced that at least three people had died due to complications related to the mosquito-borne Zika virus. These are the first Zika-related deaths in the South American country. Maduro also confirmed that 68 other people were in “intensive care” due to complications related to the virus. Since November 2015, Venezuela has recorded more than 5,000 suspected cases. The virus is spreading rapidly through South and Central America and is likely to result in some four million new cases this year.

At this stage, at least 20 countries have registered local transmission of the disease. Borne by theAedes mosquito, the disease produces no symptoms in the majority of cases and only mild symptoms such as fever, rash, severe headache and joint pain in other individuals. Despite this, the alarm surrounding Zika’s rapid spread through the Americas has reached fever-pitch in recent weeks as researchers draw correlations between infected mothers and infants born with microcephaly. Several studies are currently underway to conclusively determine the connection between the virus and microcephaly, but so far have been unsuccessful, showing only a strong causality.

In recent days suspicions have been raised by a group of Argentine physicians as to whether or not Brazil’s microcephaly crisis actually has Zika to blame. The World Health Organization (WHO) has been careful not to explicitly link Zika to microcephaly. WHO General Director Margaret Chan stated, “Although a causal link between Zika infection in pregnancy and microcephaly — and I must emphasize — has not been established, the circumstantial evidence is suggestive and extremely worrisome.”

The group of Argentine doctors suspects that, instead, a toxic chemical introduced into Brazil’s water supplies in 2014 to prevent the development of mosquito larvae in drinking water may be the real culprit. The larvicide, known as Pyriproxyfen, was used in a massive government-run program to control the mosquito population in the country. The group has pointed out that in previous Zika epidemics, microcephaly has never been linked to the disease. Further supporting their claim, the Columbian president has announced that, despite there being a widespread Zika outbreak in Colombia, there is not a single case of microcephaly there.

Meanwhile, the virus continues to spread. Russian authorities reported on Monday, February 15, that health officials have detected the country’s first case of the Zika virus in a patient who had recently visited the Dominican Republic. Russian citizens are medically tested upon return from countries affected by the Zika virus. Last week, Queensland’s Department of Health confirmed Australia’s third imported case of the Zika virus within a week, following two patients who contracted the virus in Samoa and El Salvador, respectively. It is also the first confirmed case of the virus in a pregnant woman in Australia. Health authorities in Australia have assured people that the reported cases do not pose a risk to those who have not recently traveled to a Zika-affected territory and that they would continue to enforce stringent monitoring at the country’s ports of entry.

In more encouraging news, the WHO has released a global Strategic Response Framework and Joint Operations Plan to help guide the international response to the frightening spread of Zika and the associated neonatal malformations and neurological conditions. The strategy will focus on “mobilizing and coordinating partners, experts and resources to help countries enhance surveillance of the Zika virus and disorders that could be linked to it, improve vector control, effectively communicate risks, guidance and protection measures, provide medical care to those affected and fast-track research and development of vaccines, diagnostics and therapeutics.”