Preparation is crucial to ensuring that health concerns do not interfere with travel. Even people who are healthy need to plan appropriately to safeguard their health. Proper preparations are inexpensive relative to the costs of getting sick while away from home.

Travel Kits

Travel kits containing first-aid supplies; pain relievers, such as acetaminophen or non-steroidal anti-inflammatory drugs; decongestants; antacids; and antidiarrheal drugs, such as loperamide, are useful for minor injuries and illnesses. More significant problems can often be prevented with common-sense precautions. Detailed medical information, including written information about vaccinations and medications, may be the most valuable thing a person can have in a medical emergency.

Health and Travel Insurance

Health insurance is important for domestic and international travel. Some plans, however, limit coverage for emergency health care away from home; thus, the traveler should know the limitations of his policy.

Coverage is more often a problem for international travel. Some domestic insurance plans limit coverage for vaccinations and preventive drugs for international travel, even though some vaccinations are required for entry into certain countries. Likewise, Medicare does not cover the cost of any treatment given outside the United States. In addition, most domestic health insurance plans are not recognized in foreign countries. Instead, a cash deposit or payment in full may be required in some international hospitals before care is provided.

To avoid high costs or inability to obtain care, travelers should determine in advance what international coverage, if any, their health plan offers, how to seek prior authorization for international care, and how to make a claim after an emergency. Travel health insurance, including insurance for emergency evacuation, is available through many travel services and credit card companies. Elements of care for which travelers might want to purchase insurance include emergency care, transportation for care within foreign countries, transportation for care to the United States, medical equipment and personnel during transport, dental care, prenatal or postnatal care, lost or stolen prescription drugs, and medical translators.

Travelers can turn to other helpful resources as well. Directories listing English-speaking doctors in foreign countries are available from several organizations and Internet (Web) sites (see Resources for Help and Information). United States consulates may help travelers identify and secure emergency medical services.

Vaccinations

Vaccinations are important for travel to most developing countries and are required by some countries for entry. Common infections for which vaccines are available include hepatitis A and B, polio, and yellow fever. Some vaccines take up to 6 months to achieve their maximum effect, so early planning is necessary. An International Certificate of Vaccination is the best place to document the names and dates of all vaccinations. The certificate is easy to carry and can be obtained from many travel clinics or from the Superintendent of Documents at the U.S. Government Printing Office (see Resources for Help and Information).

Vaccines for International Travel*,†,‡ Infection Regions Where Vaccine is Recommended Comments Hepatitis A Central and South America, Africa, Middle East and Asia, Eastern Europe Requires 4 weeks for full immunity; should be given with hepatitis immune globulin if departure is less than 4 weeks away. Safe for pregnant women. Hepatitis B Alaska, Yukon and Northern Territories; Western Arctic Circle Islands; Southern and Western Pacific Islands; Amazon River Basin; Sub-Saharan Africa; China; Central and Southeast Asia Recommended primarily for travelers anticipating sexual contact with residents or contact with their blood or blood products. Safe for pregnant women. Japanese B encephalitis Central and Southeast Asia, Far East; Torres Strait in Australia Recommended only for people spending 1 or more months in rural areas of Asian countries during transmission seasons. Not recommended for pregnant women. Meningococcus Northern Sub-Saharan Africa Travelers are at low risk even when traveling in epidemic areas, but vaccine adds protection. Required for entry to Saudi Arabia during Hajj. Safe for pregnant women. Rabies All countries, including United States Recommended for travelers at risk of animal bites, including rural campers, veterinarians, field workers, and people living in remote areas. Does not eliminate need for additional vaccinations after animal bite for added protection. Typhoid fever Central and South America, Africa, Middle East and Asia, Eastern Europe Offers good but imperfect protection. Protection is improved with close attention to food, water, and hygiene. Revaccination necessary after 5 years. Available as pill and injection. Pill containing weakened virus is not safe for pregnant women. Yellow fever South America, Africa The disease is rare, but many countries require vaccination for entry. Not safe for pregnant women. *See also Immunization. †In addition to the listed vaccinations, travelers should be up to date on vaccinations for measles, mumps, rubella, tetanus, diphtheria, polio, pneumococcal disease, influenza, and varicella. Influenza vaccine is recommended for all adults who are traveling to the tropics, who are traveling to the Southern hemisphere between April and September, and who are traveling in large groups. ‡All recommendations are subject to change. For the latest recommendations, consult the Centers for Disease Control and Prevention.

Traveling With a Medical Condition

Traveling with a medical condition requires special preparation. People with a medical condition should visit their doctor before departure to ensure that their condition is stable and to determine if any changes in drugs are needed. A letter summarizing the person's medical history, including drug names and doses and dates of treatment, is invaluable in an emergency away from home. A medical identification tag or bracelet serves a similar function. Travelers should also carry proof of medical insurance.

Necessary drugs should remain in their original bottles so that the precise names of the drugs and the instructions for taking them can be reviewed in an emergency. The generic name of a drug is more useful than its brand name, because brand names differ among countries.

Travelers should also pack an extra supply of drugs in carry-on bags in case checked bags get lost, stolen, or delayed in transit or if the return trip is delayed. Because opioids, syringes, and large amounts of any drug are likely to raise the suspicions of security or customs officers, travelers should have a doctor's note explaining the medical need for the supplies. In addition, syringes should be packed together with the drugs that are dispensed in them. Travelers should also check with airports, airlines, or embassies to determine what additional documentation is helpful in making travel with these supplies go smoothly.

Last full review/revision February 2003