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JAMA Patient Page
December 15, 2015

Safe and Healthy International Travel

JAMA. 2015;314(23):2580. doi:10.1001/jama.2015.15012

In 2013, more than 1 billion tourists worldwide traveled internationally.

International travel can be associated with illness or injury. Travelers should learn about how to stay safe and healthy while traveling.

Illnesses That Can Be Associated With International Travel

Unclean food and water can cause travelers’ diarrhea, a common illness in travelers. Colds and influenza (flu) are common and are spread through the air or by touching surfaces. Contact with sick people also increases the risk of these and other respiratory tract infections. Insects, like mosquitoes and ticks, and other animals including pets can carry diseases. Examples of serious diseases spread through insect bites include malaria and dengue fever. Rabies is a disease that is almost always fatal and is spread through animal bites and scratches.

Other travel-related health considerations:

  • Hepatitis A, polio, measles, and typhoid fever are most common outside of the United States but can be prevented by vaccines.

  • Motor vehicle crashes are a leading cause of death among travelers.

  • Travelers who become sexually active with a new partner may be at risk of sexually transmitted diseases.

  • Long-distance travelers are at increased risk of developing blood clots.

Preventing Travel-Related Illnesses

Before your trip, visit a doctor or other health care provider, ideally 4 to 6 weeks before leaving the country. Your doctor may recommend vaccines and medications based on your medical history, health conditions, and trip itinerary. Learn more about what your health insurance covers while you are abroad.

During your trip, practice food and water safety.

  • Drink bottled or disinfected (boiled, filtered, treated) water and use ice made from bottled or disinfected water.

  • Eat fully cooked foods that are served hot.

  • Eat only pasteurized dairy products.

  • Wash your hands often. If soap and water are not available, use an alcohol-based hand rub containing at least 60% alcohol.

Prevent colds and flu by covering your mouth and nose with a tissue when coughing or sneezing. Avoid close contact with people who are coughing or sneezing. Wash your hands often or use an alcohol-based hand rub, especially after coughing or sneezing.

Avoid bug bites and be safe around animals. Use an insect repellent that contains at least 20% DEET. Wear long-sleeved shirts, long pants, closed shoes, and hats. Do not pet, handle, or feed unfamiliar animals, even if they look safe. See a doctor immediately if you are bitten or scratched by any animal.

Additional tips to stay safe and healthy:

  • Avoid overcrowded buses and cars, wear a seat belt, and wear a helmet when riding a bicycle or motorcycle.

  • Take all of your prescribed antimalarial medicines. They start before your trip and continue after you come home.

  • Stretch and walk often during long flights to prevent blood clots.

  • Practice safe sex if you have a new partner while traveling.

After your trip, see a doctor immediately if you have a fever after returning home. It is important to tell your doctor where you traveled and for how long.

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For More Information

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at www.jama.com. Spanish translations are available in the supplemental content tab. A Patient Page on traveler’s diarrhea was published in the January 6, 2015, issue of JAMA.

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Article Information
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Ryan reports receipt of grants from the Centers for Disease Control and Prevention. No other disclosures were reported.

Topic: Disease Prevention

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