Travel Medicine
Michael Daw
Pre-Travel
- Review specific itinerary, activities, accommodations, and healthcare access
- Provide counselling for any high-risk activities:
- Water consumption and water-based activities – avoid contaminated water/ice, drink bottled beverages, frequent handwashing
- Safe sexual practices – barrier protection, prescribe emergency contraception or HIV PrEP
- Wildlife exposures – See chapter on envenomation
- Travelling at altitude – See chapter on altitude disorders
- Compression stockings and regular ambulation for long flights (>5 hours)
- Consider travel medical insurance, and medical evacuation insurance if travelling to remote areas (these are purchased separately)
Infectious Precautions
- Ensure all routine immunizations are up to date:
- The most common vaccine-preventable illnesses in international travelers are influenza and hepatitis A (recommended for any non-immune traveler)
- Destination-specific vaccines may include:
- Hepatitis A and B, typhoid (South Asia), yellow fever (South America and sub-Saharan Africa), Japanese encephalitis (rural Asia), rabies, meningococcal disease, cholera, and tickborne encephalitis
- Malaria chemoprophylaxis should be based on destination-specific resistance patterns
Managing Chronic Conditions
- Heart disease – travel with a recent office EKG and clinic note
- Asthma/COPD - create an action plan for increasing maintenance inhaler or use of corticosteroids
- Peri-transplant patients – contact Transplant ID for recommendations on antimicrobial prophylaxis
- Carry all medications in carry-on luggage, do not store in checked bags
- Bring an adequate supply of medications and avoid buying medication abroad
