Pre-Travel Health Measures
Although the information in this book can guide the health-care provider and public toward more healthy and safe travel, a risk assessment of every traveller should be performed. To determine the best health advice, it is not adequate to merely know the destination country. Numerous other factors help determine the risk of illness: the entire itinerary; the destination city, town, or village; the style of travel; the length of stay; and the season of travel. The underlying health of the traveller is equally important: medical problems, previous vaccinations, adverse events, current prescription and over-the-counter medications, previous travel, immune problems, and pregnancy issues are just some of these. Thus, travel health advice needs to be tailored both to the individual and to the itinerary. Many primary-care practitioners are comfortable in giving some pre-travel health advice and are encouraged to learn the basics; for the more complicated travel itineraries or for the traveller with multiple medical problems, it is advisable to refer to a travel health specialist.
In general, the risk of becoming ill during international travel depends on the region of the world visited, as well as the many factors listed above. Travellers to developing countries are at greater risk than those who travel to developed countries (e.g., Canada, Australia, New Zealand, Japan, and Western Europe) where the risk to the health of the traveller is no greater than that incurred in the United States. Travellers visiting urban tourist areas and staying in first-class accommodations may have a lower risk for exposure to infectious diseases. Consequently, additional vaccines and protective measures may be recommended for the more adventuresome travellers. Additionally, children, the elderly, pregnant women, and immunocompromised travellers may be particularly vulnerable to certain problems while travelling and may require more specialized counselling.
Health-care providers have available to them a number of vaccinations for protection of travellers. In addition, providers should take the opportunity, while giving advice to travellers, to update them on routine vaccinations as needed, such as diphtheria/tetanus and measles. Other vaccines that may be recommended include pertussis, poliomyelitis, hepatitis A, hepatitis B, varicella, Japanese B encephalitis, meningococcal meningitis, rabies, and typhoid. For diseases for which no vaccines are available, specific preventive behaviours or medications that may be helpful are detailed in this book. Chapters are also included that address the specific needs of potentially high-risk travellers.
International travellers should contact health-care providers who provide pre-travel health advice at least 4-6 weeks before departure for current health information and to obtain vaccinations and prophylactic medications. Being a responsible traveller means taking care of oneself as well as being sensitive to the cultural variability and fragility of the environment in a world that has been made smaller by our ability to travel from one end of the globe to the other in a matter of hours. The goal of this travel health information guide is to better enable individuals to enjoy their international travels safely.
