Medical Advice for Travelers.
Journal
Deutsches Arzteblatt international
ISSN: 1866-0452
Titre abrégé: Dtsch Arztebl Int
Pays: Germany
ID NLM: 101475967
Informations de publication
Date de publication:
28 05 2021
28 05 2021
Historique:
entrez:
18
2
2021
pubmed:
19
2
2021
medline:
7
9
2021
Statut:
ppublish
Résumé
In 2019, 1.5 billion international tourist trips were counted worldwide. Germany, with 70.8 million vacations lasting ≥ 5 days, was one of the populations most willing to travel. These days, even elderly and multimorbid persons regularly travel long-distance, which can be associated with significant health risks. By advising travelers and implementing preventive measures, the risk of illness can be reduced significantly. A selective survey of PubMed was performed to identify publications on medical advice for travelers between 2000 and 2020. We included guidelines, studies, and recommendations that mainly deal with the preventive aspects of travel medicine and have a high level of practical relevance and the highest possible level of evidence. Previously published guidelines (based on the GRADE criteria) were adopted, and recommendations not based on the results of scientific studies were characterized as Good Clinical Practice (GCP). Many medical recommendations for travelers still rely on individualized, experience-based, or consensus-based assessments. Apart from a review of medical history and vaccination status, a risk analysis is performed, travel fitness is evaluated individually, and a prevention plan is designed. Particular attention is devoted to malaria prophylaxis, vector protection, and traveler's diarrhea. Medical advice before travel is especially important for the elderly, children, pregnant women, the chronically ill, long-term and adventure travelers as well as migrants from malaria-endemic areas who are returning home. The health risks associated with travel can be minimized by specialist medical advice. Many recommendations are empirical in nature and require further research.
Sections du résumé
BACKGROUND
In 2019, 1.5 billion international tourist trips were counted worldwide. Germany, with 70.8 million vacations lasting ≥ 5 days, was one of the populations most willing to travel. These days, even elderly and multimorbid persons regularly travel long-distance, which can be associated with significant health risks. By advising travelers and implementing preventive measures, the risk of illness can be reduced significantly.
METHODS
A selective survey of PubMed was performed to identify publications on medical advice for travelers between 2000 and 2020. We included guidelines, studies, and recommendations that mainly deal with the preventive aspects of travel medicine and have a high level of practical relevance and the highest possible level of evidence. Previously published guidelines (based on the GRADE criteria) were adopted, and recommendations not based on the results of scientific studies were characterized as Good Clinical Practice (GCP).
RESULTS
Many medical recommendations for travelers still rely on individualized, experience-based, or consensus-based assessments. Apart from a review of medical history and vaccination status, a risk analysis is performed, travel fitness is evaluated individually, and a prevention plan is designed. Particular attention is devoted to malaria prophylaxis, vector protection, and traveler's diarrhea. Medical advice before travel is especially important for the elderly, children, pregnant women, the chronically ill, long-term and adventure travelers as well as migrants from malaria-endemic areas who are returning home.
CONCLUSION
The health risks associated with travel can be minimized by specialist medical advice. Many recommendations are empirical in nature and require further research.
Identifiants
pubmed: 33597073
pii: arztebl.m2021.0127
doi: 10.3238/arztebl.m2021.0127
pmc: PMC8372008
doi:
pii:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
349–356Commentaires et corrections
Type : CommentIn
Type : CommentIn
Références
High Alt Med Biol. 2014 Apr;15(1):28-38
pubmed: 24559431
J Travel Med. 2017 Apr 1;24(suppl_1):S13-S16
pubmed: 28521001
N Engl J Med. 2016 Jul 21;375(3):247-60
pubmed: 27468061
BMC Infect Dis. 2010 Aug 04;10:231
pubmed: 20684768
Ther Umsch. 2016;73(10):573-581
pubmed: 28045366
J Travel Med. 2019 Dec 23;26(8):
pubmed: 31616923
Sleep Med Rev. 2019 Feb;43:47-59
pubmed: 30529430
Lancet Infect Dis. 2006 Jun;6(6):361-73
pubmed: 16728322
Malar J. 2020 Jan 13;19(1):16
pubmed: 31931813
Med Clin North Am. 2016 Mar;100(2):303-16
pubmed: 26900115
Dtsch Arztebl Int. 2018 Oct 12;115(41):687-696
pubmed: 30406755
Wien Klin Wochenschr. 2009;121(13-14):431-9
pubmed: 19657604
J Travel Med. 2017 Apr 1;24(suppl_1):S57-S74
pubmed: 28521004
Expert Rev Vaccines. 2008 Jul;7(5):561-7
pubmed: 18564011
Travel Med Infect Dis. 2019 Jan - Feb;27:11-19
pubmed: 30278238
Infez Med. 2016 Jun 1;24(2):93-104
pubmed: 27367318
J Travel Med. 2018 Jan 1;25(1):
pubmed: 30508133
Travel Med Infect Dis. 2010 Nov;8(6):339-63
pubmed: 21071281
J Travel Med. 2017 Apr 1;24(suppl_1):S2-S5
pubmed: 28520996
Sci Rep. 2019 Aug 15;9(1):11903
pubmed: 31417099
Angiology. 2002 Jan-Feb;53(1):1-6
pubmed: 11863301
J Travel Med. 2017 Sep 1;24(5):
pubmed: 28498921
J Travel Med. 2020 Jul 14;27(4):
pubmed: 32419013
Curr Neuropharmacol. 2017 Apr;15(3):434-443
pubmed: 28503116
Cochrane Database Syst Rev. 2002;(2):CD001520
pubmed: 12076414
Can Fam Physician. 2014 Dec;60(12):1091-103
pubmed: 25500599
J Travel Med. 2017 Sep 1;24(5):
pubmed: 28931136
Dermatol Clin. 2019 Apr;37(2):149-157
pubmed: 30850037
Clin Infect Dis. 2016 Jun 1;62(11):1329-1335
pubmed: 27001804
Cochrane Database Syst Rev. 2013 Jul 05;(7):CD009029
pubmed: 23828581
Infect Dis Poverty. 2020 Jul 29;9(1):106
pubmed: 32727617
J Travel Med. 2014 Jul-Aug;21(4):248-54
pubmed: 24750378
Infect Dis Poverty. 2020 Sep 22;9(1):134
pubmed: 32962765
BMC Psychiatry. 2019 Mar 6;19(1):86
pubmed: 30841930
Eur Respir Rev. 2017 Jan 31;26(143):
pubmed: 28143879
Lancet Infect Dis. 2015 Jan;15(1):55-64
pubmed: 25477022
Travel Med Infect Dis. 2018 Jul - Aug;24:59-64
pubmed: 29787851
Open Med (Wars). 2018 Nov 27;13:575-582
pubmed: 30519635
Clin Appl Thromb Hemost. 2003 Jul;9(3):197-201
pubmed: 14507107
Am J Trop Med Hyg. 2020 May;102(5):1037-1047
pubmed: 32189612
MMW Fortschr Med. 2016 May 12;158(9):44-5
pubmed: 27155706
Ther Umsch. 2013 Jun;70(6):323-33
pubmed: 23732448
CMAJ Open. 2020 Jan 28;8(1):E60-E68
pubmed: 31992561
J Antimicrob Chemother. 2007 Nov;60(5):929-36
pubmed: 17848375
Cochrane Database Syst Rev. 2017 Jun 27;6:CD009761
pubmed: 28653390
MMW Fortschr Med. 2017 Mar;159(Suppl 4):4-11
pubmed: 28244025
J Travel Med. 2019 Jun 1;26(4):
pubmed: 30995308
Thorax. 2011 Sep;66 Suppl 1:i1-30
pubmed: 21856702
Euro Surveill. 2012 Jun 28;17(26):
pubmed: 22790534
JAMA. 2015 Jan 6;313(1):71-80
pubmed: 25562268