International travel requires awareness of the many risks inherent in visiting foreign countries. Many risks are unavoidable, including issues related to weather, transportation, security, and health. For those truly `unavoidable’ risks, I subscribe to the “Prepare For the Unexpected” theory as best as one can, then let your adventure unfold.

As a physician, I am always in favor of minimizing risk by preventing those medical problems that have recognized prevention strategies. As an infection specialist, I strongly support the use of vaccines; I believe the data is convincing that routine childhood vaccinations have dramatically reduced the incidence of common infectious diseases, including measles, mumps, rubella, pertussis, influenza, polio, hepatitis A, hepatitis B, etc. The same argument applies to the international traveler- avoid and prevent common infectious diseases when able. Pre-travel vaccinations are an important consideration for disease prevention.

There are many possible infectious diseases one can encounter with international travel. My position would be to prevent those illnesses where a prevention strategy is available, whether by vaccination, drug therapy. chemical agents, dietary regulation, or by choice of clothing. Examples of specific preventative measures include:

1. Vaccinations to prevent hepatitis A/B, tetanus/diphtheria/pertussis, measles/mumps/rubella, typhoid fever, influenza, polio, rabies, and yellow fever.
2. Drug therapy to prevent malaria and traveler’s diarrhea.
3. Chemical agents as topical insect repellents and antiseptics.
4. Dietary restrictions to avoid contaminated food and water.                                  .
5. Clothing choices to prevent insect bites/stings, skin trauma and excess sun/water exposure.

This list is in no means complete. The goal is to help explain the difference between unavoidable risk and those areas where risk can be managed and possibly eliminated by intelligent decision-making. Do not let a one-time trip turn into a lifelong problem.
I invite you to agree or disagree with me.

Robert Winters, MD