- Karin Leder, MBBS, FRACP, PhD, MPH, DTMH
Karin Leder, MBBS, FRACP, PhD, MPH, DTMH
- Section Editor — Travel Medicine
- Head of Infectious Diseases Unit
- Monash University, Australia
- Peter F Weller, MD, FACP
Peter F Weller, MD, FACP
- Editor-in-Chief — Infectious Diseases
- Section Editor — Tropical Medicine
- William Bosworth Castle Professor of Medicine
- Harvard Medical School
- Professor of Immunology and Infectious Diseases
- Harvard T. H. Chan School of Public Health
Medical advice for travelers should include evaluation of the risk for adverse outcomes depending on the traveler's medical conditions, the itinerary, anticipated activities, and potential exposures [1,2]. Risks of illness associated with travel include:
●Development of illness while in transit 
●Exposure to infections endemic to areas visited
●Environmental exposures associated with travel
The pretravel evaluation should provide advice about the risks for vaccine-preventable infections, the appropriate immunizations, and prophylaxis against travelers' diarrhea and malaria . It should also include advice about behavioral precautions and environmental exposures.
- Freedman DO, Chen LH, Kozarsky PE. Medical Considerations before International Travel. N Engl J Med 2016; 375:247.
- Hill DR, Ericsson CD, Pearson RD, et al. The practice of travel medicine: guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2006; 43:1499.
- Mangili A, Gendreau MA. Transmission of infectious diseases during commercial air travel. Lancet 2005; 365:989.
- Centers for Disease Control and Prevention. Health Information for International Travel 2016: The Yellow Book. http://wwwnc.cdc.gov/travel/page/yellowbook-home (Accessed on August 19, 2015).
- Hill DR. The burden of illness in international travelers. N Engl J Med 2006; 354:115.
- Bacaner N, Stauffer B, Boulware DR, et al. Travel medicine considerations for North American immigrants visiting friends and relatives. JAMA 2004; 291:2856.
- Leder K, Tong S, Weld L, et al. Illness in travelers visiting friends and relatives: a review of the GeoSentinel Surveillance Network. Clin Infect Dis 2006; 43:1185.
- Steffen R, Ericsson CD. Special section:travel medicine. Clin Infect Dis 2000; 30:809.
- LaRocque RC, Rao SR, Lee J, et al. Global TravEpiNet: a national consortium of clinics providing care to international travelers--analysis of demographic characteristics, travel destinations, and pretravel healthcare of high-risk US international travelers, 2009-2011. Clin Infect Dis 2012; 54:455.
- Freedman DO, Weld LH, Kozarsky PE, et al. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 2006; 354:119.
- Leder K, Torresi J, Libman MD, et al. GeoSentinel surveillance of illness in returned travelers, 2007-2011. Ann Intern Med 2013; 158:456.
- Harvey K, Esposito DH, Han P, et al. Surveillance for travel-related disease--GeoSentinel Surveillance System, United States, 1997-2011. MMWR Surveill Summ 2013; 62:1.
- Schlagenhauf P, Chen LH, Wilson ME, et al. Sex and gender differences in travel-associated disease. Clin Infect Dis 2010; 50:826.
- Hochberg NS, Barnett ED, Chen LH, et al. International travel by persons with medical comorbidities: understanding risks and providing advice. Mayo Clin Proc 2013; 88:1231.
- Hill DR, Beeching NJ. Travelers' diarrhea. Curr Opin Infect Dis 2010; 23:481.
- Steffen R. Epidemiology of traveler's diarrhea. Clin Infect Dis 2005; 41 Suppl 8:S536.
- Langer BC, Frösner GG. Relative importance of the enterically transmitted human hepatitis viruses type A and E as a cause of foreign travel associated hepatitis. Arch Virol Suppl 1996; 11:171.
- Istre GR, Fontaine RE, Tarr J, Hopkins RS. Acute schistosomiasis among Americans rafting the Omo River, Ethiopia. JAMA 1984; 251:508.
- Meltzer E, Artom G, Marva E, et al. Schistosomiasis among travelers: new aspects of an old disease. Emerg Infect Dis 2006; 12:1696.
- Gautret P, Adehossi E, Soula G, et al. Rabies exposure in international travelers: do we miss the target? Int J Infect Dis 2010; 14:e243.
- Piyaphanee W, Shantavasinkul P, Phumratanaprapin W, et al. Rabies exposure risk among foreign backpackers in Southeast Asia. Am J Trop Med Hyg 2010; 82:1168.
- Hargarten SW, Baker TD, Guptill K. Overseas fatalities of United States citizen travelers: an analysis of deaths related to international travel. Ann Emerg Med 1991; 20:622.
- Ward BJ, Plourde P. Travel and sexually transmitted infections. J Travel Med 2006; 13:300.
- Hynes NA. Sexually Transmitted Diseases in Travelers. Curr Infect Dis Rep 2005; 7:132.
- Matteelli A, Schlagenhauf P, Carvalho AC, et al. Travel-associated sexually transmitted infections: an observational cross-sectional study of the GeoSentinel surveillance database. Lancet Infect Dis 2013; 13:205.
- Silverman D, Gendreau M. Medical issues associated with commercial flights. Lancet 2009; 373:2067.
- Mohr LC. Hypoxia during air travel in adults with pulmonary disease. Am J Med Sci 2008; 335:71.
- Steketee RW, Wirima JJ, Slutsker L, et al. Malaria treatment and prevention in pregnancy: indications for use and adverse events associated with use of chloroquine or mefloquine. Am J Trop Med Hyg 1996; 55:50.
- Milner DA Jr, Montgomery J, Seydel KB, Rogerson SJ. Severe malaria in children and pregnancy: an update and perspective. Trends Parasitol 2008; 24:590.
- Sheffield PJ. Flying after diving guidelines: a review. Aviat Space Environ Med 1990; 61:1130.
- Melamed Y, Shupak A, Bitterman H. Medical problems associated with underwater diving. N Engl J Med 1992; 326:30.
- Zafren K, Honigman B. High-altitude medicine. Emerg Med Clin North Am 1997; 15:191.
- Backer H. Medical limitations to wilderness travel. Emerg Med Clin North Am 1997; 15:17.
- TRAVEL-RELATED INFECTIONS
- PRETRAVEL EVALUATION
- TRAVEL ADVICE
- Vaccinations and prophylaxis
- - Immunizations
- - Malaria prevention
- - Travelers' diarrhea
- Behavioral precautions
- - Food and water
- - Vector avoidance
- - Respiratory infections
- - Swimming and beaches
- - Animal avoidance
- - Traffic accidents
- - Sexually transmitted diseases
- Air travel
- Cruise ships
- SPECIFIC MEDICAL CONDITIONS
- HIV infection
- Diabetes mellitus
- ENVIRONMENTAL EXPOSURES
- High altitude
- Wilderness travel
- INFORMATION FOR PATIENTS