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Travel Preparations

By

Christopher Sanford

, MD, MPH, DTM&H, University of Washington;


Alexa Lindley

, MD, MPH, Department of Family Medicine, University of Washington

Last full review/revision Jul 2020| Content last modified Jul 2020
Click here for the Professional Version
Topic Resources

Travel preparation is crucial, even for healthy people. Proper preparations are inexpensive relative to the costs of getting sick or injured while away from home.

Prior to travel, people and their medical providers should review planned itineraries and relevant medical histories, required vaccinations, measures to prevent infections such as malaria and traveler's diarrhea, and advice about avoiding injury. For older travelers, the most common causes of death are heart attack and stroke; for other travelers, the most common cause of death is road traffic crashes.

Travel Medical Kits

Travel medical kits are useful for minor injuries and illnesses. Useful contents include:

  • First-aid supplies (such as bandages, tape, elastic wrap)

  • Pain relievers (such as acetaminophen or nonsteroidal anti-inflammatory drugs)

  • Decongestants (such as phenylephrine)

  • Antacids

  • Antibiotics

  • Antidiarrheal drugs (such as loperamide)

Also, topical drugs such as hydrocortisone 1% cream, an over-the-counter antifungal cream, and an antibiotic ointment should be considered.

Travelers should carry their travel medical kit, prescription drugs, extra eyeglasses or other corrective lenses (as well as a current written prescription for either), and hearing-aid batteries in a carry-on bag in case their checked baggage is delayed, lost, or stolen. People with specific dietary and medical needs should plan carefully and carry their own food and supplies. Major problems can often be prevented with common-sense precautions.

Travel Health Insurance

Health insurance is important for travelers. Even with domestic travel, some plans limit coverage for health care away from home. Thus, travelers should know the limitations of their policies.

Coverage is more often a problem for international travel. Some domestic insurance plans limit coverage for vaccinations and preventive drugs for international travel, even though some vaccinations are required for entry into certain countries. Likewise, Medicare and many commercial health insurance plans are not valid in foreign countries and do not cover the cost of any treatment given outside the United States. In addition, a cash deposit or payment in full may be required in international hospitals before care is provided.

To avoid high costs or inability to obtain care, travelers should determine in advance what international coverage, if any, their health plan offers, how to seek prior authorization for international care, and how to make a claim after an emergency. Travel health insurance, including insurance for emergency evacuation, is available through many commercial agencies, travel services, and some major credit card companies. Travelers may want to purchase insurance for services such as

  • Emergency care (about 1 in 30 people traveling abroad requires emergency care)

  • Transportation, with accompanying medical personnel, equipment, and care, within foreign countries or back to the United States

  • Dental care

  • Prenatal or postnatal care

  • Lost or stolen prescription drugs

  • Medical translators

The International Association for Medical Assistance to Travellers (IAMAT—www.iamat.org), a nonprofit organization, maintains a list of English-speaking doctors in cities around the world. Other directories listing English-speaking doctors in foreign countries are available from several organizations and web sites. United States consulates may help travelers identify and secure emergency medical services.

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Useful Contacts for People Traveling Abroad

Organization

Phone Numbers

Web Site

International Association for Medical Assistance to Travellers (IAMAT)

United States: (716) 754-4883 (Niagara Falls, NY)

Canada: (416) 652-0137 (Toronto, Ontario)

Centers for Disease Control and Prevention (CDC)

United States: Toll-free (800)-CDC-INFO (800-232-4636)

TTY: (888) 232-6348 (Atlanta, GA)

CDC Malaria Hotline

United States: (770) 488-7788 or (855) 856-4713; after hours, (770) 488-7100 (Atlanta, GA)

CDC Zika Pregnancy Hotline

United States: (770) 626-6847 (Atlanta, GA)

U.S. Department of State, Overseas Citizens Services

From United States & Canada: (888) 407-4747

From Overseas: (202) 501-4444

(Washington, DC)

World Health Organization (WHO)

International: (+41 22) 791-2111 (Geneva, Switzerland)

Americas: (202) 974-3000 (Washington, DC)

Vaccinations for Travel

Vaccinations are important for travel to most developing countries and are required by some countries for entry. Ideally, travelers should visit their usual health care practitioners at least 6 to 8 weeks before their travels to get any necessary vaccinations and ensure that they are current on all their routine immunizations. An International Certificate of Vaccination is the best place to document the names and dates of all vaccinations. The certificate is easy to carry and can be obtained from many travel clinics or from the Superintendent of Documents at the U.S. Government Printing Office.

General travel and up-to-date immunization information is available from the Centers for Disease Control and Prevention (CDC) (Travelers’ Health: Vaccinations), and malaria-prevention recommendations are available from the CDC's malaria hotline (855-856-4713) and web site (Malaria and Travelers). (See also Malaria.)

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Vaccines for International Travel*,†

Infection

Regions Where the Vaccine is Recommended

Comments

All low- and middle-income countries

Two doses are given at least 6 months apart.‡

All low- and middle-income countries (hepatitis B is particularly common in China)

This vaccine is recommended for extended-stay travelers and all health care workers.‡

Japanese encephalitis

Rural areas throughout most of Asia and South Asia, particularly in areas with rice and pig farming

Two doses are given 28 days apart. Adults aged 18–65 years can get the second dose as early as 7 days after the first dose. The last dose should be given at least 1 week before travel.

This vaccine is not recommended for pregnant women.

This vaccine is usually not advised for those spending less than one month in an endemic area.

Northern Sub-Saharan Africa from Mali to Ethiopia (the meningitis belt)

Throughout the world, especially in crowded living situations (such as dormitories)

A single dose of quadrivalent vaccine is effective.

Risk of infection in the meningitis belt is higher during the dry season (December through June).

This vaccine is required for entry into Saudi Arabia during Hajj or Umrah.

All countries, including the United States

This vaccine is recommended for travelers at risk of animal bites, including rural campers, veterinarians, people living in remote areas, and field workers.

It does not eliminate the need for additional vaccinations after an animal bite (for added protection).

This vaccine is given during pregnancy only if the risk of infection is high.

See also Rabies Prevention.

All low-income countries, especially in South Asia (including India)

Two forms of the vaccine are available.

Single injection form: It protects for 2 years and is thought to be safer for pregnant women than the pill form of the vaccine.

Pill form: One pill is taken every other day for a total of 4 pills. This form protects for 5 years and is not safe for pregnant women.

Tropical South America and tropical Africa

The disease is rare, but many countries require proof of vaccination for entry.§

This vaccine is not safe for pregnant women.

This vaccine has an increased risk of side effects in older people.§

One dose is protective for life for most travelers.

* In addition to the listed vaccinations, travelers should be up to date on their routine vaccinations, including influenza, measles, mumps, rubella, tetanus, diphtheria, polio, pneumococcal disease, and varicella.

† All recommendations are subject to change. For the latest recommendations, consult the Centers for Disease Control and Prevention (www.cdc.gov or 800-CDC-INFO [800-232-4636]). See also Overview of Immunization.

‡ There is also a combination hepatitis A and hepatitis B vaccine available, which doctors give on either a three-dose or four-dose schedule. (See Hepatitis A Vaccine and Hepatitis B Vaccine.).

§ For travelers over age 60, doctors may consider completing the waiver section of the Yellow Card (International Certificate of Vaccination), instead of administering yellow fever vaccine. Those travelers should then be particularly diligent regarding personal protection measures against insects.

Preparations For Travelers With Medical Conditions

Traveling with a medical condition requires special preparation. People with a medical condition should visit their doctor before departure to ensure that their condition is stable and to determine whether any changes in drugs are needed. Detailed written medical information may be the most valuable thing a person can have in a medical emergency, including information about

  • Vaccinations

  • Drugs

  • Results of major diagnostic tests

  • Types and dates of treatments

People should consider asking their doctor to prepare such information in a letter. Medical identification bracelets or necklaces are essential for people with conditions that can cause rapid, life-threatening symptoms, confusion, or unconsciousness (such as diabetes, seizures, and severe allergic reactions). Travelers with heart disorders should travel with a copy of a recent electrocardiogram (ECG). Travelers should also carry proof of medical insurance.

Drugs

Drugs should remain in their original bottles so that the precise names of the drugs and the instructions for taking them can be reviewed in an emergency. The generic name of a drug is more useful than its brand name because brand names differ among countries.

Travelers should also pack an extra supply of drugs in carry-on bags in case checked bags get lost, stolen, or delayed in transit or the return trip is delayed. Because opioids, syringes, and large amounts of any drug are likely to raise the suspicions of security or customs officers, travelers should have a doctor’s note explaining the medical need for the supplies. In addition, syringes should be packed together with the drugs that are dispensed in them. Travelers should also check with airports, airlines, or embassies to determine what additional documentation is helpful in making travel with these supplies go smoothly. See also United States Transportation Security Administration (TSA) regulations.

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