Travel-related diseases: injury and infectious disease prevention

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Abstract
To counsel prospective travelers, physicians should familiarize themselves with risks and exposures associated with travel. The most common causes of travelers’ mortality and morbidity, respectively, are accidents and infections. Precautions to prevent accidents include limiting alcohol use, providing vehicle-specific safety precautions, and recognizing special risks in areas traveled. A knowledge of immunization regulations and endemic diseases can facilitate counseling travelers. Booster immunizations against childhood vaccine-preventable diseases may be needed. Gamma globulin prophylaxis should be used to prevent hepatitis A in areas where fecal contamination of foodstuffs occurs. Since effective immunotherapy for travelers’ diarrhea does not exist, practical advice regarding food and water exposure is essential. Among the elderly, attention should be directed toward the effects of travel on age-specific medical problems (e.g., cardiovascular events) which may occur more often in this age group than do infections. Other recommendations should be tailored to the specific activities of a given traveler.