++
KEY CONCEPTS
Travelers should consult practitioners with travel health expertise when going to tropical or developing countries.
For the pretravel consultation recommendations, travelers should be given written material in their language to reinforce and supplement verbal instructions.
The pretravel screening appointment should include a discussion of items that should be contained in a travel medical kit.
Pregnant travelers should consult obstetric and travel medicine experts prior to traveling to developing countries.
Immunocompromised patients may need longer periods of pretravel preparatory time to allow for adequate immunization, given their sometimes blunted antibody responses to vaccines.
Travelers to sub-Saharan Africa, Southern Asia, Central and South America, and the Caribbean experience higher rates of infection than those traveling to other parts of the world.
Prophylactic antibiotic use may reduce the risk of traveler’s diarrhea but is generally not recommended, primarily because of the risk of developing drug resistance or Clostridium difficile infection.
Prevention strategies are essential for limiting vector-borne infections during travel.
The mainstay of therapy in all altitude-related illnesses is descent to a lower altitude (typically at least a 300-meter reduction in altitude).
Patients who have previously been diagnosed with depression should continue their prescribed medications and minimize alcohol consumption while traveling.
++
Preclass Engaged Learning Activity
Design a medication kit for a family of four (2 adults and 2 preteen children) taking a 10-day trip to Aruba.
++
Global (international) travel has increased dramatically over the past 20 years. A sizable proportion of this increased travel can be explained by individuals traveling from developed countries to developing countries.1 Reasons for travel to developing countries are variable, but include work-related travel, leisure travel, medical tourism, adventure travel, medical mission or outreach, and study abroad programs.
++
Travel to distant lands has always been associated with risks to mental and physical health. Twenty-two percent to 64% of travelers experience health problems while traveling.2 Travel to developing and/or tropical countries can be associated with even higher risks to traveler health than travel to developed or temperate countries. Many health problems arising during travel are self-limiting or not bothersome enough for travelers to seek medical care. However, approximately 10% of travelers seek help from physicians either during or soon after traveling.3 In addition to infectious and noninfectious health problems, global travelers face potential dangers from vehicle and pedestrian traffic accidents, drowning, animal attacks, and assaults. This chapter focuses on health risks and diseases that affect global travelers, with primary emphasis on travel from developed countries to developing or tropical countries. Some travel-related information is included in other chapters, and readers will be referred accordingly.
+++
PRETRAVEL PREPARATION
++
Travelers should review information about their destinations and itinerary and consider potential self-care options for health issues that may arise during travel. Pretravel preparation often involves the assistance of ...