Curriculum · Public Health and Communicable Diseases
Pre-travel health advice and vaccination
What it is
The pretravel consultation is the visit at which healthy travelers are seen ahead of a trip. It covers immunizations, malaria prophylaxis, injury prevention, and traveler's diarrhea. Much of what is said at that visit about traveler's diarrhea is about prevention, and the advice that has been shown to work is not the same as the advice that is considered traditional. The consultation has a second half after the trip. Fever in the returning traveler is assessed in three moves: the incubation period; a travel risk assessment covering vector, living area and potential exposure; and an assessment of severity by symptoms, that is CNS, skin rashes, gastrointestinal and respiratory.
Causes and risk
Traveler's diarrhea is caused predominantly by bacterial pathogens (up to 80%-90%) and is associated with hygiene practices. The main causes of fever in returning travelers are set out with the share each takes: malaria 27%-42%, respiratory tract infection 2.6%-24%, diarrhea or dysentery 4.5%-14%, dengue 2%-8%, hepatitis A 3%-6%, enteric fever 1.5%-3%, UTI or pyelo 2%-4%, rickettsial 0.5%-2%, and tuberculosis 0.4%-1%.