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Prevention & management of travelers
health problems
Travel medicine is medicine that
Counseling
focuses on
Immunizations
Medications
50-75%
% of short-term travelers to
tropics or subtropics report some health
5% require medical attention
impairment:
< 1% hospitalization
Infectious agents account for ~ 10% of
Travel Morbidity illness
~ 1% of deaths due to pathogens
Deaths due to pathogens are most
malaria
com- monthly from
Cardio: 49% deaths
Cardiovascular disease and injuries
Injuries (MVA, drowning, aircraft acci-
while traveling
dents): 22% deaths
Levels of risk for the traveler
Recommended preventive measures to
take at each level of risk
CDC Travel Notices:
level 1: watch
level 2: alert
level 3: warning
Elderly & Chronically ill traveling more
Aerospace Medical Association Air
Transport Medical Committee has sum-
Fitness for flying
mary for Fitness for Flying
Aircrafts pressurized at 2500 m (8000 ft)
above sea level
Airlines restrict pregnant passengers be-
36 weeks
yond
,If O2 < % the pt will need oxygen
92%
therapy on flights
Perform individual risk assessment
Education --> Health risks & prevention
Provide immunizations for vaccine- pre-
Pre Travel consultation
ventable diseases
Medications for prophylaxis, self-treat-
ment, or both
Itinerary, activities, relevant medical his-
tory
-Special Populations: elderly, chronically
ill, pregnant or breastfeeding, immuno-
compromised
Ask about special itineraries
Immunizations for travel
Pre travel assessment/consultation -Routine, Required vs Recommended
Patient Education
-Insect avoidance, animal avoidance,
STIs, Fresh & Salt water, Food & Water
Consumption, Safety & Security
Prevention / Self Treatment:
-Chemoprophylaxis & Self-treatment
-Travel Medical Kits
Tetanus
Diphtheria
Hepatitis A/B
HPV
Meningococcal
Vaccines for preventative healthcare
Polio
re-gardless of travel MMR
Influenza
Pneumococcal
Varicella
COVID
Vaccines medically advised based on
diseases risks of country
, Typhoid Fever
Japanese encephalitis
Rabies
Yellow Fever
-Sub-Saharan Africa or equatorial South
America
-Vaccine given at state-authorized Yellow
Fever Centers
Vaccines that are MANDATORY for entry
into a country
Meningococcal
-Required at specific times of the year
for entrance to Saudi Arabia especially if
taking part in a pilgrimage to Mecca
Insect avoidance
Injury prevention
Safe food and water
Pt education topics
Safe sex
Altitude illness
Medical travel kit
are the most common
Vector borne disease
travel-associated infection
Spread through mosquitos, ticks, flies
Avoid outdoor activities during vector
feeding times
Vector borne disease
Use protective clothing & Insect repel-
lants
Avoid outbreaks & high risk periods
Malaria is transmitted by Anocephles mosquito
In Dec 2023 ~ 249 million cases of malar-
ia worldwide
how many people get malaria
- 619,000 deaths --> mainly (African re-
gion)