Nava Yeganeh, MD, MPH, hadn't always planned to create an international travel clinic at UCLA, but it turned out the need was too strong to ignore.
Dr. Yeganeh, an attending physician in pediatric infectious diseases at UCLA Mattel Children's Hospital, realized that such a clinic would fill an important need within the community. "We were seeing infections from travel, many of which were preventable, but families hadn't always gotten the right kind of prevention counseling," she says. "This realization became a ripe opportunity to provide a service that actually prevents illnesses instead of waiting for patients to get sick."
The result is the International Travel Clinic at UCLA Mattel Children's Hospital, which provides specialized care, such as travel counseling and immunizations, for pediatric patients.
"Our services are tailored to the individual's age, medical history, destination and length of stay," Dr. Yeganeh explains. "We also provide preventive care to young adults who are planning to travel, study abroad, serve in the Peace Corps or engage in internships or employment opportunities."
Vaccinations are a key part of the travel clinic's offerings. According to Dr. Yeganeh, the yellow fever vaccine exemplifies the clinic's expertise. "It's a live vaccine and any doctor who administers it must be certified to give that vaccine," she says. "That doctor must verify that the patient is not too young nor too old to receive it and does not have any issues with the thymus or immune system that would contraindicate the vaccine."
In general, preventing mosquito-borne illnesses constitutes the bulk of the clinic's efforts. In addition to yellow fever, malaria is of course prevalent. "We've also been needing to address other viruses like dengue fever and chikungunya," Dr. Yeganeh says. "All of these give us the opportunity to address prophylactic measures like mosquito nets and repellents."
Other perennial topics include eating safely to prevent diarrhea: Peeling fruits and vegetables, drinking boiled water, avoiding iced drinks and ensuring that foods are cooked through. "We also remind parents about keeping children properly hydrated and when to seek medical care if they do become ill," Dr. Yeganeh says.
She enjoys getting to know each patient and family over time in a series of positive interactions. "It takes multiple visits over several months to protect one child, so we really get to know our patients in the clinic," says Dr. Yeganeh, who has practiced in more than 15 cities around the world.
A diverse clinical load
Dr. Yeganeh enjoys a varied schedule. She spends most of her time on research and teaching, while the rest is devoted to inpatient care and the travel clinic. An average of eight weeks per year are spent on inpatient duty, when she covers the service for a week at a time.
Her own research is based in Brazil, so she travels there three to four times per year for up to two weeks at a time. "We are working on ways to prevent sexually transmitted infections in pregnant women by getting men to prenatal care appointments and switching the care model to focus on the entire family," Dr. Yeganeh says. "We did it with HIV, syphilis, and gonorrhea, all of which also cause poor outcomes in women and children."
Dr. Yeganeh says there's no one specialty that sets the stage for a career in travel medicine — pediatrics, internal medicine and family practice all work well. More importantly, she says, is a genuine appreciation for travel: "This is a wonderful field for someone who really believes that travel is an important part of a child's development," she says, "and understands people will be having all kinds of adventures during their travels."
By Darcy Lewis