Travel Preparation

Aka: Travel Preparation, Pretravel Consultation, Travel Medicine, Traveler's Health, Traveling with Medications

1. See Also
   1. Travel Resources
   2. Air Travel Restriction
   3. Travel Immunization
   4. See International Medical Concerns
2. Precautions
   1. Review specific risks and preparation (e.g. Immunizations) at least 6 weeks before travel
      1. See International Medical Concerns
      2. See Travel Immunization
      3. See Waterborne Illness Prevention
      4. See Foodborne Illness Prevention
      5. See Prevention of Vector-borne Infection
      6. See Malaria Prophylaxis
   2. Avoid excessive risks associated with death
      1. Motor Vehicle Accidents (account for >18% of all deaths in travelers)
         1. Use Seat Belts and Car Seats
         2. Wear Bicycle helmets
         3. Avoid night driving
         4. Avoid riding in open back of pick-up truck (or open bus top)
         5. Avoid motorcycles and mopeds
      2. Drowning
      3. Violence
   3. Avoid other risks
      1. Tattoos or piercing (risk of HIV, Hepatitis C)
      2. Avoid filling medications in low-income nations (risk of adulterated medications)
   4. Protect yourself
      1. See Sun Exposure
      2. See High Altitude Sickness
      3. See DVT Prevention in Travelers
      4. Practice safe sex (Condoms and Contraception)
      5. Consider travel insurance with emergency medical evacuation coverage
         1. Especially for high risk activities (e.g. mountain climbing)
   5. Comorbid Conditions
      1. See Air Travel Restriction
      2. Carry documentation of medical history
         1. Active medical conditions
         2. Medication allergies
   6. Medications
      1. Carry prescribed medications in their original containers when possible
         1. Also bring a list of the medications with both trade and generic names, along with indications
         2. Ideally, have list addended with names in destination language
      2. Bring enough medication supply to cover for extra emergency days of travel (in carry-on luggage)
         1. If medication must be purchased in destination country, review with pharmacist to verify equivalence
      3. Declare potentially suspect medications
         1. Liquid medications >3.4 ounces
         2. Syringes
      4. Inquire about controlled substances and banned substances in destination country prior to travel
         1. Adderall is banned in Japan
         2. Pseudophedrine is banned in Mexico
      5. References
         1. (2022) Presc Lett 29(5): 28
3. Risk factors: Travel related illness
   1. Backpacking trek or adventure travel
   2. Age over 65 years
   3. Immunocompromised state
   4. U.S. Immigrant returning to country of origin
   5. Long-term travel
   6. Pregnancy
   7. Uncontrolled comorbidity
      1. Congestive Heart Failure
      2. Hypertension
      3. Seizure Disorder
      4. Diabetes Mellitus
      5. Mental illness
      6. Coronary Artery Disease (Recent Myocardial Infarction or CABG)
         1. See Contraindications to Air Travel
4. Contraindications: Travel Restrictions
   1. See Contraindications to Air Travel
5. Management: Emergency care while traveling
   1. See First Aid Kit
   2. See Traveler's Diarrhea Prophylaxis
   3. See Travel Resources
6. Management: Returning Travelers
   1. See Fever in the Returning Traveler
   2. See GI Conditions in Febrile Returning Traveler
   3. See Lymphadenopathy in the Febrile Returning Traveler
7. Prevention
   1. See Travel Immunization
   2. See Waterborne Illness Prevention
   3. See Foodborne Illness Prevention
   4. See Prevention of Vector-borne Infection
   5. See Malaria Prophylaxis
   6. See Sleep Disturbance in Travel
   7. See High Altitude Sickness
   8. See Sun Exposure
   9. See DVT Prevention in Travelers
   10. See Motion Sickness
8. Resources
   1. See Travel Resources
   2. CDC Travel
      1. http://www.cdc.gov/travel
9. References
   1. Bazemore (2009) Am Fam Physician 80(6): 583-90 [PubMed]
   2. Powell-Dunford (2021) Am Fam Physician 104(4): 403-10 [PubMed]
   3. Sanford (2016) Am Fam Physician 94(8): 620-7 [PubMed]