Medical Considerations before International Travel

In 2015, international tourist arrivals in all countries exceeded 1.2 billion persons. In 2014, the total number of arrivals in countries with emerging markets nearly surpassed the number in developed countries (www.-e-unwto.-org/-doi/-book/-10.-18111/-9789284416899). Depending on the destination, 22 to 64% of travelers report some illness; most of these illnesses are mild and self-limited, such as diarrhea, respiratory infections, and skin disorders.(1-4) Some travelers return to their own countries with preventable life-threatening infections. 5 Yet 20 to 80% of travelers do not seek pretravel health consultation.(6) Data about the effect of pretravel advice are limited, although such advice has had a positive effect on the prevention of malaria.(7) Travelers visiting friends and relatives in their country of origin constitute the group with the highest morbidity, especially from malaria and typhoid; this group requires special approaches to illness prevention and education.(8,9) Persons who are planning to travel to other countries often ask their health care providers for information about preventive interventions. Nonspecialists can provide information and care to healthy adults traveling to common destinations by following protocols such as those offered in this review. Advice from a specialist(10) is of benefit for persons who are planning high-risk or adventure travel, those who are immunocompromised(11-13) or have underlying chronic disease, those who are planning to live abroad for a long time, women who are pregnant(14) or plan to become pregnant soon, young children, and travelers with complicated itineraries.