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About 1/30 people traveling abroad requires emergency care. Illness in a foreign country may involve significant difficulties. Many insurance plans, including Medicare, are not valid in foreign countries; overseas hospitals often require a substantial cash deposit for nonresidents, regardless of insurance. Travel insurance plans, including some that arrange for emergency evacuation, are available through travel agencies and some major credit card companies. Directories listing English-speaking physicians in foreign countries, US consulates who may assist in obtaining emergency medical services, and information on foreign travel risks are available (see Table 1: Medical Aspects of Travel: Useful Contacts for Those Traveling Abroad ).
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Table 1
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Useful Contacts for Those
Traveling Abroad
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Organization
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Phone Numbers
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Web Site
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International Association for Medical Assistance to Travelers
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US: (716) 754-4883
(Niagara Falls, NY)
Canada: (519) 836-0102
(Guelph, Ontario);
(416) 652-0137
Toronto, Ontario)
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http://www.iamat.org
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Centers for Disease Control and Prevention (CDC)
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US: Toll-free (877) FYI TRIP
(877-394-8747)
(404) 639-3311
(Atlanta, GA)
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http://www.cdc.gov/travel
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CDC Malaria Hotline
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US: (770) 488-7788; after hours,
(770) 488-7100
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http://www.cdc.gov/malaria
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US Department of State (Overseas Citizens Services)
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US: (888) 407-4747
(Washington, DC)
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http://www.travel.state.gov
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World Health Organization (WHO)
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International: (+41 22)-791-2111
(Geneva, Switzerland)
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http://www.who.int/en/
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Immunizations:
Some countries require specific immunizations, some of which must be given weeks to months before departure. General travel and up-to-date immunization information and malaria chemoprophylaxis requirements are available from the Centers for Disease Control and Prevention. (See also the Centers for Disease Control and Prevention recommendations on Travelers'
Health and their recommendations on Malaria
and Travelers.)
Injury
and death:
Road traffic accidents are the most frequent cause of death of non-elderly international travelers. Travelers should use seat belts whenever possible and a helmet when cycling. Travelers should avoid motorcycles and mopeds and avoid riding on bus roofs or in open truck beds. To prevent drowning, another common cause of death while abroad, travelers should avoid beaches with turbulent surf and avoid swimming after drinking alcoholic beverages.
Traveler's
diarrhea:
(see also Gastroenteritis: Traveler's Diarrhea) Traveler's diarrhea (TD) is the most common health problem in international travelers. Although TD is usually a self-limited illness, typically resolving in 5 days, 3 to 10% of travelers with TD may have symptoms lasting longer than 2 wk, and up to 3% of travelers have TD lasting over 30 days. TD lasting < 1 wk requires no workup. For persistent TD, a laboratory workup is performed (see Approach to the Patient With Lower GI Complaints: Testing). Self-initiated treatment is with an appropriate antibiotic (eg, a fluoroquinolone for most destinations, a macrolide such as azithromycin for Southeast Asia), loperamide , and replacement fluids.
Problems after
returning home:
Some diseases become evident months after a traveler has returned home; a travel history with exposure risks is useful for patients who present with a puzzling illness. Malaria (see Extraintestinal Protozoa: Malaria), hepatitis A and B (see Hepatitis), typhoid fever (see Gram-Negative Bacilli: Typhoid Fever), sexually transmitted diseases (see Sexually Transmitted Diseases (STD)), including HIV infection (see Human Immunodeficiency Virus (HIV)), amebiasis (see Intestinal Protozoa: Amebiasis), and meningitis (see Meningitis) are the most commonly acquired dangerous diseases.
Last full review/revision November 2005
Content last modified November 2005
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