One
third of persons who travel abroad experience a travel-related
illness, usually diarrhea or an upper respiratory infection.
The risk of travelers' diarrhea can be reduced by eating
only freshly prepared, hot foods. Combination therapy
with a single dose of ofloxacin plus loperamide usually
provides relief from travelers' diarrhea within 24 hours.
Using a diethyltoluamide (deet)containing insect repellent
and wearing permethrin-coated clothing can reduce the
risk of malaria, yellow fever and other diseases contracted
from insects. Routine immunizations such as tetanus, measles,
mumps and rubella, and influenza should be updated if
necessary before the patient embarks on the trip. Hepatitis
A immunization should be administered to persons traveling
to places other than Canada, Australia, New Zealand, Japan
and western European countries. Typhoid vaccination should
be considered for travelers going to developing countries.
Yellow fever immunization is indicated for travelers going
to endemic areas of South America and Africa. Malaria
prophylaxis with chloroquine is indicated for travelers
going to Mexico and Central America. Mefloquine is recommended
for those traveling to areas where malaria is resistant
to prophylactic treatment with chloroquine. Medical advice
for patients planning trips abroad must be individualized
and based on the most current expert recommendations.
Resources for Information About Travel Medicine
CDC contacts
Voice
Information Service--888-232-3228; fax: 888-232-3299 (24
hours per day) Malaria section--770-488-7788
Organizations
Association
for Safe International Road Travel (ASIRT), 5413 W. Cedar
Lane, Suite 103C, Bethesda, MD 20814; telephone: 301-983-5252;
Internet address: http://www.asirt.org/
American
Society of Tropical Medicine and Hygiene, 60 Revere Dr.,
Suite 500, Northbrook IL 60062; telephone: 847-480-9592;
e-mail: astmh@aol.com; Internet address: http://www.astmh.org/
International
Association for Medical Assistance to Travelers (IAMAT),
417 Center St., Lewiston, NY 14092; telephone:716-754-4883;
Internet address: http://www.iamat.org/index.cfm
International
Society of Travel Medicine, P.O. Box 871089, Stone Mountain,
GA 30087; telephone: 770-736-7060; e-mail: bcbistm@aol.com;
Internet address http://www.istm.org/
International
SOS, P.O. Box 11568, Philadelphia, PA 31685; telephone:
800-523-8930 (travel insurance abroad)
Wilderness
Medical Society, P.O. Box 2463, Indianapolis, IN 46206;
telephone: 317-631-1745; e-mail: wms@wms.org; Internet
address: http://www.wms.org/
World
Health Organization, CH1211 Geneva 27, Switzerland; telephone:
+41 22 791 2111; fax: +41 22 791 0746; e-mail: info@who.ch;
Internet address: http://www.who.ch
Books
Health
Information for International Travel, 1996-97 ("The
Yellow Book"). Atlanta, Ga.: U.S. Department of Health
and Human Services, Centers for Disease Control and Prevention,
National Center for Infectious Diseases, 1997. HHS publication
no. (CDC) 95-8280.
International
Travel Health Guide, by Stuart R. Rose. 8th annual ed.
Northampton, Mass.: Travel Medicine, Inc., 1997.
Textbook
of Travel Medicine and Health, by Herbert L. DuPont and
Robert Steffen. Hamilton, Ontario: Decker, 1997.
The
Travel and Tropical Medicine Manual, Elaine C. Jong and
Russell McMullen, eds. 2d ed. Philadelphia: Saunders,
1995.
Travel
Medicine Advisor, by American Health Consultants. Atlanta,
Ga.: American Health Consultants (updated annually and
in regular supplements; telephone: 800-688-2421).
Computer
software
Travax/Windows
travel health software--Shoreland, Inc., P.O. Box 13795,
Milwaukee, WI 53213; telephone: 800-433-5256
International
SOS Assistance, Inc., travel health software--Care Ware,
P.O. Box 11568, Philadelphia, PA 19116; telephone: 215-633-6606
Videotapes
and handouts
Good
Sense Health Information for Travelers, P.O. Box 260197,
Madison, WI 53726
Web
sites
CDC
travel health information--Internet address: http://www.cdc.gov
(pick Traveler's Health)
CDC's
Yellow Book--Internet address: http://www.cdc.gov/travel/
CDC
cruise ship sanitation scores--Internet address: http://www.cdc.gov/nceh/vsp/vsp.htm
Magellan's
International Travel Corp.--Internet address: http://www.magellans.com
(telephone: 800-962-4943 or 805-568-6400)
Travel
Health Online, Shoreland, Inc.--Internet address: http://www.tripprep.com
Travel
Medicine, Inc. (travel supplies)--Internet address: http://www.travmed.com
Travel
reference links--Internet address: http://www.saintafpr.com/travel
U.S.
Department of State (travel warnings)--Internet address:
http://travel.state.gov/travel_warnings.html
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