Travel medicine or emporiatrics is the branch of medicine

Medicine

Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

 that deals with the prevention and management of health problems of international

International

----International mostly means something that involves more than one country. The term international as a word means involvement of, interaction between or encompassing more than one nation, or generally beyond national boundaries...

 travel

Travel

Travel is the movement of people or objects between relatively distant geographical locations. 'Travel' can also include relatively short stays between successive movements.-Etymology:...

ers.

Globalization and travel

Globalization facilitates the spread of disease and increases the number of travelers who will be exposed to a different health environment. Major content areas of travel medicine include the global epidemiology

Epidemiology

Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

 of health risks to the traveler, vaccinology

Vaccine

A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...

, malaria

Malaria

Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...

 prevention, and pre-travel counseling designed to maintain the health of the approximately 600 million international travelers. It has been estimated that about 80 million travelers go annually from developed to developing countries.

Mortality and morbidity

Mortality

Mortality rate

Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...

 studies indicate that the cardiovascular disease

Cardiovascular disease

Heart disease or cardiovascular disease are the class of diseases that involve the heart or blood vessels . While the term technically refers to any disease that affects the cardiovascular system , it is usually used to refer to those related to atherosclerosis...

 accounts for most deaths during travel (50-70%), while injury

Injury

-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...

 and accident

Accident

An accident or mishap is an unforeseen and unplanned event or circumstance, often with lack of intention or necessity. It implies a generally negative outcome which may have been avoided or prevented had circumstances leading up to the accident been recognized, and acted upon, prior to its...

 follow (~25%). Infectious disease

Infectious disease

Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...

 accounts for about 2.8-4% of deaths during/from travel. Morbidity studies suggest that about half of the people from a developed country that stay one month in a developing country will get sick. Traveler's diarrhea

Traveler's diarrhea

Traveler's diarrhea , is the most common illness affecting travelers. An estimated 10 million people—20% to 50% of international travelers—develop it annually. TD is defined as three or more unformed stools in 24 hours passed by a traveler, commonly accompanied by abdominal cramps, nausea, and...

 is the most common problem encountered.

Disciplines

The field of travel medicine encompasses a wide variety of disciplines including epidemiology

Epidemiology

Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

, infectious disease

Infectious disease

Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...

, public health

Public health

Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...

, tropical medicine

Tropical medicine

Tropical medicine is the branch of medicine that deals with health problems that occur uniquely, are more widespread, or prove more difficult to control in tropical and subtropical regions....

, high altitude physiology

Physiology

Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...

, travel related obstetrics

Obstetrics

Obstetrics is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy , childbirth and the postnatal period...

, psychiatry

Psychiatry

Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

, occupational medicine, military and migration medicine, and environmental health

Environmental health

Environmental health is the branch of public health that is concerned with all aspects of the natural and built environment that may affect human health...

.

Special itineraries and activities include cruise ship

Cruise ship

A cruise ship or cruise liner is a passenger ship used for pleasure voyages, where the voyage itself and the ship's amenities are part of the experience, as well as the different destinations along the way...

 travel, diving

Diving

Diving is the sport of jumping or falling into water from a platform or springboard, sometimes while performing acrobatics. Diving is an internationally-recognized sport that is part of the Olympic Games. In addition, unstructured and non-competitive diving is a recreational pastime.Diving is one...

, mass gatherings (e.g. the Hajj

Hajj

The Hajj is the pilgrimage to Mecca, Saudi Arabia. It is one of the largest pilgrimages in the world, and is the fifth pillar of Islam, a religious duty that must be carried out at least once in their lifetime by every able-bodied Muslim who can afford to do so...

), and wilderness

Wilderness

Wilderness or wildland is a natural environment on Earth that has not been significantly modified by human activity. It may also be defined as: "The most intact, undisturbed wild natural areas left on our planet—those last truly wild places that humans do not control and have not developed with...

/remote regions travel.

Basically, travel medicine can divide into 4 main topics: prevention

Preventive medicine

Preventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms...

 (vaccination and travel advice), assistance (dealing with repatriation

Repatriation

Repatriation is the process of returning a person back to one's place of origin or citizenship. This includes the process of returning refugees or soldiers to their place of origin following a war...

 and medical treatment of travelers), wilderness medicine

Wilderness medicine

Wilderness medicine is defined by difficult patient access, limited equipment, and environmental extremes. Today, wilderness or expedition medicine is practiced by Wilderness First Responders, Wilderness EMTs, Remote/Offshore/Wilderness Paramedics and Physicians on expeditions, in outdoor...

 (e.g. high-altitude medicine, cruise ship medicine, expedition medicine, etc.) and access to health care, provided by travel insurance

Travel insurance

Travel insurance is insurance that is intended to cover medical expenses, financial default of travel suppliers, and other losses incurred while traveling, either within one's own country, or internationally...

.

Focus

Travel medicine includes pre-travel consultation and evaluation, contingency planning during travel, and post-travel follow-up and care. Information is provided by the WHO that addresses health issues for travelers for each country as well as the specific health risks of air travel itself. Also, the CDC

Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...

 publishes valuable and up-to-date information. Key areas to consider are vaccination and the six I’s:

1. Insects: repellent
   Insect repellent
   An insect repellent is a substance applied to skin, clothing, or other surfaces which discourages insects from landing or climbing on that surface. There are also insect repellent products available based on sound production, particularly ultrasound...
   
   s, mosquito net
   Mosquito net
   A mosquito net offers protection against mosquitos, flies, and other insects, and thus against diseases such as malaria, dengue fever, yellow fever, and various forms of encephalitis, including the West Nile virus, if used properly and especially if treated with an insecticide, which can double...
   
   s, antimalarial medication
   Antimalarial drug
   Antimalarial medications, also known as antimalarials, are designed to prevent or cure malaria. Such drugs may be used for some or all of the following:* Treatment of malaria in individuals with suspected or confirmed infection...
   
   
2. Ingestions: safety of drinking water
   Drinking water
   Drinking water or potable water is water pure enough to be consumed or used with low risk of immediate or long term harm. In most developed countries, the water supplied to households, commerce and industry is all of drinking water standard, even though only a very small proportion is actually...
   
   , food
3. Indiscretion: HIV
   HIV
   Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
   
   , sexually transmitted disease
   Sexually transmitted disease
   Sexually transmitted disease , also known as a sexually transmitted infection or venereal disease , is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex...
   
   
4. Injuries: accident
   Accident
   An accident or mishap is an unforeseen and unplanned event or circumstance, often with lack of intention or necessity. It implies a generally negative outcome which may have been avoided or prevented had circumstances leading up to the accident been recognized, and acted upon, prior to its...
   
    avoidance, personal safety
   Human security
   Human security is an emerging paradigm for understanding global vulnerabilities whose proponents challenge the traditional notion of national security by arguing that the proper referent for security should be the individual rather than the state...
   
   
5. Immersion: schistosomiasis
   Schistosomiasis
   Schistosomiasis is a parasitic disease caused by several species of trematodes , a parasitic worm of the genus Schistosoma. Snails often act as an intermediary agent for the infectious diseases until a new human host is found...
   
   
6. Insurance
   Travel insurance
   Travel insurance is insurance that is intended to cover medical expenses, financial default of travel suppliers, and other losses incurred while traveling, either within one's own country, or internationally...
   
   : coverage and services during travel, access to health care
   Health care
   Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
   
   

Specific disease problems

Yellow fever

Yellow fever

Yellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....

 is endemic to certain areas in Africa and South America. The CDC site delineates the risk areas and provides information about vaccination and preventive steps.

Meningococcal meningitis is endemic in the tropical meningococcal belt of Africa. Vaccination is required for pilgrims going to Mecca

Mecca

Mecca is a city in the Hijaz and the capital of Makkah province in Saudi Arabia. The city is located inland from Jeddah in a narrow valley at a height of above sea level...

. Detailed information is available on the CDC site.

Malaria

Malaria

Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...

 prevention consists of preventing or reducing exposure to mosquitos by using screened rooms, air-conditioning, and nets, and use of repellents (usually DEET

DEET

N,N-Diethyl-meta-toluamide, abbreviated DEET, is a slightly yellow oil. It is the most common active ingredient in insect repellents...

). In addition, chemoprophylaxis is started before the travel, during the time of potential exposure, and for 4 weeks (chloroquine, doxycycline

Doxycycline

Doxycycline INN is a member of the tetracycline antibiotics group, and is commonly used to treat a variety of infections. Doxycycline is a semisynthetic tetracycline invented and clinically developed in the early 1960s by Pfizer Inc. and marketed under the brand name Vibramycin. Vibramycin...

, or mefloquine) or 7 days (atovaquone/proguanil or primaquine) after leaving the risk area. See detailed CDC site.

Medication kit

The traveler should have a medication kit to provide for necessary and useful medication. Based on circumstances, it should include also malaria prophylaxis, condom

Condom

A condom is a barrier device most commonly used during sexual intercourse to reduce the probability of pregnancy and spreading sexually transmitted diseases . It is put on a man's erect penis and physically blocks ejaculated semen from entering the body of a sexual partner...

s, and medication to combat traveler's diarrhea

Traveler's diarrhea

Traveler's diarrhea , is the most common illness affecting travelers. An estimated 10 million people—20% to 50% of international travelers—develop it annually. TD is defined as three or more unformed stools in 24 hours passed by a traveler, commonly accompanied by abdominal cramps, nausea, and...

. In addition, a basic first aid kit

First aid kit

A first aid kit is a collection of supplies and equipment for use in giving first aid, and can put together for the purpose , or purchased complete...

 can be of use.

Studies have shown there are four main medical problems that travellers develop - diarrhoea or gut problems, respiratory problems, wounds and pain. The medical kit should at least address these common things.

Research has also shown that the best treatment for travellers diarrhoea is to take an antibiotic (e.g. ciprofloxacin

Ciprofloxacin

Ciprofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class.It is a second-generation fluoroquinolone antibacterial. It kills bacteria by interfering with the enzymes that cause DNA to rewind after being copied, which stops synthesis of DNA and of...

) plus a stopper (e.g. loperamide

Loperamide

Loperamide , a synthetic piperidine derivative, is an opioid drug used against diarrhea resulting from gastroenteritis or inflammatory bowel disease. In most countries it is available generically and under brand names such as Lopex, Imodium, Dimor, Fortasec, and Pepto Diarrhea Control...

). Due to bacterial resistance, different parts of the world require different antibiotics. It is best to consult a travel doctor to sort out the best medical kit for the exact destination and medical history of the person travelling.

See also

• American Society of Tropical Medicine and Hygiene
  American Society of Tropical Medicine and Hygiene
  The American Society of Tropical Medicine and Hygiene is a non-profit organization of scientists, clinicians, students and program professionals whose longstanding mission is to promote global health through the prevention and control of infectious and other diseases that disproportionately...
  
  
• Carte Jaune
  Carte Jaune
  The Yellow Card or Carte Jaune, is an international certificate of vaccination . It is issued by the World Health Organisation. It is recognised internationally and may be required for entry to certain countries where there are increased health risks for travellers...
  
   international certificate of vaccination
• Global Infectious Disease Epidemiology Network (GIDEON)
• Health hazards of air travel
  Health hazards of air travel
  -Infection:On an airplane, people sit in a confined space for extended periods of time, which increases the risk of transmission of airborne infections. For this reason, airlines place restrictions on the travel of passengers with known airborne contagious diseases...
  
  
• Institute of Tropical Medicine Antwerp
• International health
  International Health
  International health, also called geographic medicine or global health, is a field of health care, usually with a public health emphasis, dealing with health across regional or national boundaries...
  
  
• Royal Society of Tropical Medicine and Hygiene
  Royal Society of Tropical Medicine and Hygiene
  The Royal Society of Tropical Medicine and Hygiene was founded in 1907 by Sir James Cantlie and George Carmichael Low. Sir Patrick Manson, the Society's first President is generally acknowledged as the father of tropical medicine. He passed the presidency on to the Nobel laureate Sir Ronald Ross ,...
  
  
• Tropical disease
  Tropical disease
  Tropical diseases are diseases that are prevalent in or unique to tropical and subtropical regions. The diseases are less prevalent in temperate climates, due in part to the occurrence of a cold season, which controls the insect population by forcing hibernation. Insects such as mosquitoes and...
  
  
• Wilderness acquired diarrhea

External links

• CDC Travelers' Health - includes information on destinations, outbreaks, and recommended or required vaccinations
• International Association for Medical Assistance to Travellers (IAMAT)
• International Society of Travel Medicine
• WHO - List of Country Members - includes information on outbreaks and health profiles
• Faculty of Travel Medicine of Royal College of Physicians and Surgeons of Glasgow