| Immunizations |
- Review routine immunizations and those travel immunizations indicated for the specific itinerary and based on the traveler's medical history.
- Discuss utility of titers when records are unavailable or unreliable, particularly for measles, mumps, rubella, hepatitis A, and varicella.
- Screen for chronic hepatitis B for people born in countries with HBsAg prevalence ≥2%.
- Discuss indications for, effectiveness of, and adverse reactions to immunizations.
|
| Malaria chemoprophylaxis |
- Determine if there is a risk of malaria.
- Discuss personal protective measures.
- Discuss risks and benefits of chemoprophylaxis and recommended choices of chemoprophylaxis for the itinerary.
|
| Other vectorborne diseases |
- Define risk of disease in specific itinerary and insect precautions needed.
|
| Respiratory illnesses |
- Discuss areas of particular concern (such as avian influenza in Asia or MERS in the Arabian Peninsula).
- Consider influenza treatment for high-risk travelers.
|
| Travelers’ diarrhea |
- Recommend strategies to decrease risk of diarrhea.
- Discuss antibiotics for self-treatment, adjunct medications such as loperamide, and staying hydrated.
|
| Altitude illness |
- Determine if the itinerary puts the traveler at risk of altitude illness.
- Discuss preventive measures such as gradual ascent, adequate hydration, and medications to prevent and treat.
|
| Other environmental hazards |
- Caution travelers to avoid contact with animals to reduce the potential for bites and scratches that can transmit rabies.
- Advise travelers to avoid walking barefoot to avoid certain parasitic infections.
- Advise travelers to avoid wading or swimming in freshwater where there is risk for schistosomiasis or leptospirosis.
- Remind travelers to apply sunscreen to skin exposed to the sun.
|
| Personal safety |
- Discuss precautions travelers can take to minimize risks, such as traffic accidents, alcohol excess, personal assault, robbery, or drowning.
- Provide information on travel health and medical evacuation insurance.
- Advise travelers to look for security bulletins related to their destination and consider areas to avoid.
|
| Bloodborne pathogens |
- Inform travelers who will provide health care overseas what to do in case of needlestick or bloodborne pathogen exposure.
- Discuss use of postexposure prophylaxis for HIV.
- Sexual health recommendations for travelers.
|
| Disease-specific counseling |
- Remind travelers to keep medications and supplies in carry-on luggage.
- Advise travelers to prepare for exacerbations or complications from underlying disease.
|