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Chapter 117. Health Advice for International Travel (Part 1)

Harrison's Internal Medicine Chapter 117. Health Advice for International Travel Health Advice for International Travel: Introduction According to the World Tourism Organization, the number of international tourist arrivals in 2004 reached an all-time record of 763 million. This number represents an increase over the 2003 figure of almost 11%—the highest and the only double-digit percentage increase since 1980, when these statistics were first collected. Not only are more people traveling; travelers are seeking more exotic and remote destinations. . | Chapter 117. Health Advice for International Travel Part 1 Harrison s Internal Medicine Chapter 117. Health Advice for International Travel Health Advice for International Travel Introduction According to the World Tourism Organization the number of international tourist arrivals in 2004 reached an all-time record of 763 million. This number represents an increase over the 2003 figure of almost 11 the highest and the only double-digit percentage increase since 1980 when these statistics were first collected. Not only are more people traveling travelers are seeking more exotic and remote destinations. Studies show that 50-75 of short-term travelers to the tropics or subtropics report some health impairment. Most of these health problems are minor only 5 require medical attention and 1 require hospitalization. Although infectious agents contribute substantially to morbidity among travelers these pathogens account for only 1 of deaths in this population. Cardiovascular disease and injuries are the most frequent causes of death among travelers from the United States accounting for 49 and 22 of deaths respectively. Age-specific rates of death due to cardiovascular disease are similar among travelers and nontravelers. In contrast rates of death due to injury the majority from motor vehicle drowning or aircraft accidents are several times higher among travelers. Figure 117-1 summarizes the monthly incidence of health problems during travel in developing countries. Figure 117-1 100 100.000 . ----- Any health prottiem Travelers diarrhea ---------------------Î------------b 1Û y 10.000 consulted M 0. abroad . . I or back home MalaiJa I----------Stayed iri bed no chemoprophylaxis. West Alnca ------- Incapacity 1u wort Acute lebnie respiratory------- -r-. - V. after return trad infection Hepawis A-------------------------------J------------Ho pitariî i abroad Gonorrhea. ----------------------------i Animai fcùres. with rabies risk -------- ft W Hepatitis y 1 T . J-----------