Travel medicine or emporiatrics is the branch of

medicine Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...

that deals with the prevention and management of health problems of international

travel Travel is the movement of people between distant geographical Location (geography), locations. Travel can be done by Pedestrian, foot, bicycle, automobile, train, boat, bus, airplane, ship or other means, with or without Baggage, luggage, a ...

ers.

Globalization and travel

Globalization facilitates the spread of disease and increases the number of travelers who will be exposed to a different health environment. Major content areas of travel medicine include the global

epidemiology Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and Risk factor (epidemiology), determinants of health and disease conditions in a defined population, and application of this knowledge to prevent dise ...

of health risks to the traveler,

vaccinology A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified. A vaccine typically contains an ag ...

malaria Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...

prevention, and pre-travel counseling designed to maintain the health of the approximately 600 million international travelers. It has been estimated that about 80 million travelers go annually from developed to developing countries.Supercourse on Travel Medicine

Mortality and morbidity

Mortality studies indicate that

cardiovascular disease Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumati ...

accounts for most deaths during travel (50–70%), while

injury Injury is physiological damage to the living tissue of any organism, whether in humans, in other animals, or in plants. Injuries can be caused in many ways, including mechanically with penetration by sharp objects such as teeth or with ...

and

accident An accident is an unintended, normally unwanted event that was not deliberately caused by humans. The term ''accident'' implies that the event may have been caused by Risk assessment, unrecognized or unaddressed risks. Many researchers, insurers ...

follow (~25%).

Infectious disease An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...

accounts for about 2.8–4% of deaths during/from travel.

Morbidity A disease is a particular abnormal condition that adversely affects the structure or function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical conditions that are asso ...

studies suggest that about half of people from a developed country who stay one month in a developing country will get sick. Traveler's diarrhea is the most common problem encountered.

Disciplines

The field of travel medicine encompasses a wide variety of disciplines including

infectious disease An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...

public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the de ...

, tropical medicine, high altitude

physiology Physiology (; ) is the science, scientific study of function (biology), functions and mechanism (biology), mechanisms in a life, living system. As a branches of science, subdiscipline of biology, physiology focuses on how organisms, organ syst ...

, travel related

obstetrics Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a su ...

psychiatry Psychiatry is the medical specialty devoted to the diagnosis, treatment, and prevention of deleterious mental disorder, mental conditions. These include matters related to cognition, perceptions, Mood (psychology), mood, emotion, and behavior. ...

occupational medicine Occupational and Environmental Medicine (OEM), previously called industrial medicine, is a board certified medical specialty under the American Board of Preventative Medicine that specializes in the prevention and treatment of work-related ill ...

, military and migration medicine, and

environmental health Environmental health is the branch of public health concerned with all aspects of the natural environment, natural and built environment affecting human health. To effectively control factors that may affect health, the requirements for a hea ...

. Special itineraries and activities include

cruise ship Cruise ships are large passenger ships used mainly for vacationing. Unlike ocean liners, which are used for transport, cruise ships typically embark on round-trip voyages to various ports of call, where passengers may go on Tourism, tours k ...

travel,

diving Diving most often refers to: * Diving (sport), the sport of jumping into deep water * Underwater diving, human activity underwater for recreational or occupational purposes Diving or Dive may also refer to: Sports * Dive (American football), ...

, mass gatherings (e.g. the

Hajj Hajj (; ; also spelled Hadj, Haj or Haji) is an annual Islamic pilgrimage to Mecca, Saudi Arabia, the holiest city for Muslims. Hajj is a mandatory religious duty for capable Muslims that must be carried out at least once in their lifetim ...

), and

wilderness Wilderness or wildlands (usually in the plurale tantum, plural) are Earth, Earth's natural environments that have not been significantly modified by human impact on the environment, human activity, or any urbanization, nonurbanized land not u ...

/remote regions travel. Travel medicine can primarily be divided into four main topics: prevention (vaccination and travel advice), assistance (dealing with

repatriation Repatriation is the return of a thing or person to its or their country of origin, respectively. The term may refer to non-human entities, such as converting a foreign currency into the currency of one's own country, as well as the return of mi ...

and medical treatment of travelers), wilderness medicine (e.g. high-altitude medicine, cruise ship medicine,

expedition medicine Expedition Medicine (sometimes known as expeditionary medicine) is the field of medicine focusing on providing embedded medical support to an expedition, usually in medically austere or isolated areas. Expedition medicine provides the physical an ...

, etc.) and access to health care, provided by travel insurance.

Focus

Travel medicine includes pre-travel consultation and evaluation, contingency planning during travel, and post-travel follow-up and care. Information is provided by the WHO that addresses health issues for travelers for each country as well as the specific health risks of air travel itself. Also, the

CDC The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency under the Department of Health and Human Services (HHS), and is headquartered in Atlanta, ...

publishes valuable and up-to-date information. Key areas to consider are vaccination and the seven I's: # Insects: repellents,

mosquito net A mosquito net is a type of meshed curtain or cloth that is circumferentially draped over a bed or a sleeping area to offer the sleeper barrier protection against bites and stings from mosquitos, flies, and other pest insects, and thus a ...

antimalarial medication Antimalarial medications or simply antimalarials are a type of antiparasitic chemical agent, often natural product, naturally derived, that can be used to treat or to prevent malaria, in the latter case, most often aiming at two susceptible target ...

# Ingestions: safety of

drinking water Drinking water or potable water is water that is safe for ingestion, either when drunk directly in liquid form or consumed indirectly through food preparation. It is often (but not always) supplied through taps, in which case it is also calle ...

, food # Indiscretion: HIV,

sexually transmitted disease A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, or ...

# Injuries:

avoidance, personal safety, safety around animals # Immersion:

schistosomiasis Schistosomiasis, also known as snail fever, bilharzia, and Katayama fever is a neglected tropical helminthiasis, disease caused by parasitism, parasitic Schistosoma, flatworms called schistosomes. It affects both humans and animals. It affects ...

# Immunization (pre-travel vaccination) #

Insurance Insurance is a means of protection from financial loss in which, in exchange for a fee, a party agrees to compensate another party in the event of a certain loss, damage, or injury. It is a form of risk management, primarily used to protect ...

: coverage and services during travel, access to

health care Health care, or healthcare, is the improvement or maintenance of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wikt:amelioration, amelioration or cure of disease, illness, injury, and other disability, physic ...

Specific disease problems

Yellow fever is endemic to certain areas in Africa and South America. The CDC site delineates the risk areas and provides information about vaccination and preventive steps. Meningococcal meningitis is endemic in the tropical meningococcal belt of Africa. Vaccination is required for pilgrims going to

Mecca Mecca, officially Makkah al-Mukarramah, is the capital of Mecca Province in the Hejaz region of western Saudi Arabia; it is the Holiest sites in Islam, holiest city in Islam. It is inland from Jeddah on the Red Sea, in a narrow valley above ...

. Detailed information is available on the CDC site.

Malaria Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...

prevention consists of preventing or reducing exposure to mosquitos by using screened rooms, air-conditioning, and nets, and use of repellents (usually

DEET ''N'',''N''-Diethyl-''meta''-toluamide, also called diethyltoluamide or DEET (, from DET, the initials of di- + ethyl + toluamide), is the oldest, one of the most effective, and most common active ingredients in commercial insect repellents. ...

). In addition, chemoprophylaxis is started before travel, during the time of potential exposure, and for four weeks ( chloroquine,

doxycycline Doxycycline is a Broad-spectrum antibiotic, broad-spectrum antibiotic of the Tetracycline antibiotics, tetracycline class used in the treatment of infections caused by bacteria and certain parasites. It is used to treat pneumonia, bacterial p ...

, or mefloquine) or seven days ( atovaquone/ proguanil or primaquine) after leaving the risk area.

Medication kit

The traveler should have a medication kit to provide for necessary and useful medication. Based on circumstances, it should also include malaria prophylaxis,

condom A condom is a sheath-shaped Barrier contraception, barrier device used during sexual intercourse to reduce the probability of pregnancy or a Sexually transmitted disease, sexually transmitted infection (STI). There are both external condo ...

s, and medication to combat traveler's diarrhea. In addition, a basic

first aid kit A first aid kit or medical kit is a collection of supplies and equipment used to give First aid, immediate medical treatment, primarily to treat injuries and other mild or moderate medical conditions. There is a wide variation in the contents o ...

can be of use. Studies have shown there are four main medical problems that travellers develop—diarrhoea or gut problems, respiratory problems, wounds and pain. The medical kit should at least address these common things. Research has also shown that the best treatment for travellers diarrhoea is to take an antibiotic (e.g.

ciprofloxacin Ciprofloxacin is a fluoroquinolone antibiotic used to treat a number of bacterial infections. This includes bone and joint infections, intra-abdominal infections, certain types of infectious diarrhea, respiratory tract infections, skin ...

) plus a stopper (e.g. loperamide). Due to bacterial resistance, different parts of the world require different antibiotics. It is best to consult a travel doctor to sort out the best medical kit for the exact destination and medical history of the person travelling.

References

External links

CDC Travelers' Health
– includes information on destinations, outbreaks, and recommended or required vaccinations
International Association for Medical Assistance to Travellers (IAMAT)

International Society of Travel Medicine

WHO – List of Country Members
– includes information on outbreaks and health profiles (archived 21 August 2004) {{Authority control Medical specialties Travel