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Chapter 1Introduction

Introduction to Travel Health & the Yellow Book

Amanda Whatley Lee, Phyllis E. Kozarsky

Counsel pregnant travelers on the following:

  • Determine beforehand whether blood is routinely screened for HIV and hepatitis B and C at their destination.
  • Pregnant travelers should consider the safety of blood transfusions, if needed, when making plans for international travel.
  • The pregnant traveler should also be advised to know her blood type.
  • Research the prevalence of tuberculosis (TB) at the patient’s destination, along with her planned itinerary. If exposure to TB will be a risk, she should receive skin testing before and after travel.

Counsel pregnant travelers on the following:

  • Determine beforehand whether blood is routinely screened for HIV and hepatitis B and C at their destination.
  • Pregnant travelers should consider the safety of blood transfusions, if needed, when making plans for international travel.
  • The pregnant traveler should also be advised to know her blood type.
  • Research the prevalence of tuberculosis (TB) at the patient’s destination, along with her planned itinerary. If exposure to TB will be a risk, she should receive skin testing before and after travel.

    Counsel pregnant travelers on the following:

    • Determine beforehand whether blood is routinely screened for HIV and hepatitis B and C at their destination.
    • Pregnant travelers should consider the safety of blood transfusions, if needed, when making plans for international travel.
    • The pregnant traveler should also be advised to know her blood type.
    • Research the prevalence of tuberculosis (TB) at the patient’s destination, along with her planned itinerary. If exposure to TB will be a risk, she should receive skin testing before and after travel.

NEW IN THIS EDITION

The Yellow Book reflects the ever-changing nature of travel medicine. Each new edition notes the changes in global disease distribution, vaccine and medication guidelines, and new developments in preventing travel health risks.

Some new sections in this edition include sections covering Travel Medicine Data Collection: GeoSentinel & Global TravEpiNet (later in this chapter) and Last-Minute Travelers (Chapter 8). In addition, sections such as Escherichia coli, Fascioliasis, and Salmonellosis (Nontyphoidal) have been added to the diseases covered in Chapter 3, while Cambodia: Angkor Wat, Thailand, and Vietnam have been added to the select destinations included in Chapter 4.

In addition to the country-specific yellow fever vaccine requirements and recommendations and malaria transmission information and prophylaxis recommendations, other country-specific vaccine recommendations have been added to the section located at the end of Chapter 3.

Perspectives Editorial Sections

A continuing feature from previous editions is the incorporation of editorial sections entitled Perspectives. Some new Perspectives sections include Prioritizing Care for the Resource-Limited Traveler (Chapter 2), Terrorism (Chapter 2), and Malaria in Long-Term Travelers & Expatriates (Chapter 8). Although the body of evidence-based knowledge in the field of travel medicine is growing, there is recognition that the practice of this specialty involves not only science, but art as well. Thus, readers will notice a few sections that contain editorial discussions aiming to add depth and clinical perspective, as well as to discuss some controversies or differences in opinions and practice. Perspectives sections reflect the views and opinions of the authors and do not necessarily represent official CDC recommendations.

Historical Editorial Sections

Four new sections encompass the 2014 debut of a new category of historical editorial sections, entitled For the Record. Learning the background of certain clinical practices can give readers a better understanding of the health topic and prevention or treatment recommendations. Beyond the practical reasons, these sections are included because the editorial team thought they would be interesting for inquisitive readers.

CONTACT INFORMATION FOR CDC

Questions, comments, and suggestions for CDC Travelers’ Health, including comments about this publication, may be made through the CDC-INFO contact center, toll-free at 800-CDC-INFO (800-232-4636) 8 am to 8 pm Eastern (Monday–Friday, closed holidays) or by visiting www.cdc.gov and clicking on “Contact CDC-INFO” to submit your question through an online e-mail form.

Pre-Travel or Post-Travel Clinical Questions

Since CDC is not a medical facility, clinicians needing assistance with patients who are preparing for travel should consider referral to a travel clinic or a clinic listed on the International Society of Travel Medicine website (www.istm.org).

Clinicians with post-travel health questions regarding their patients may consider referral to a clinic listed on the ISTM website, the American Society of Tropical Medicine and Hygiene website (www.astmh.org), or a medical university with specialists in infectious diseases.

Malaria: Because of the clinical complexity of malaria, the CDC Malaria Branch offers clinicians assistance with the diagnosis or management of suspected cases of malaria. Clinicians can contact CDC’s Malaria Branch telephone hotline during business hours at 770-488-7788 or toll-free at 855–856-4713. After hours and on weekends and holidays, a Malaria Branch clinician may be reached by calling 770-488-7100.

Other parasitic diseases: CDC has an online diagnostic assistance service, called DPDx, for laboratorians, pathologists, and other health professionals (see www.dpd.cdc.gov/dpdx/HTML/Contactus.htm). Additionally, clinicians may consult with CDC about evaluation and treatment of patients suspected to have a parasitic disease (404-718-4745; parasites@cdc.gov).

Yellow fever: Clinicians should contact their state or local health department or call 970-221-6400 for assistance with diagnostic testing for yellow fever infections and for questions about antibody response to vaccination.

CDC Emergency Operations Center: CDC maintains an Emergency Operations Center to assist local, state, and federal agencies (770-488-7100) 24 hours per day, 7 days per week. Assistance can also be given to health care providers with questions on emergency or urgent patient care. Note: this line is not intended for the general public.

All other questions for CDC may be directed to the CDC INFO contact center, toll-free at 800-CDC-INFO (800-232-4636) 8 am to 8 pm Eastern (Monday–Friday, closed holidays) or cdcinfo@cdc.gov.

BIBLIOGRAPHY

  1. United Nations World Tourism Organization. UNWTO World Tourism Barometer, Vol. 10 (September). Madrid: United Nations World Tourism Organization; 2012 [cited 2012 Sep 25]. Available from: http://dtxtq4w60xqpw.cloudfront.net/sites/all/files/pdf/unwto_barom12_05_sept_excerpt.pdf.
  2. US Department of Commerce, Office of Travel and Tourism Industries. 2011 United States resident travel abroad. Washington, DC: US Department of Commerce; 2012 [cited 2012 Sep 25]. Available from: http://tinet.ita.doc.gov/outreachpages/download_data_table/2010_US_Travel_Abroad.pdf.
  3. World Health Organization. International Health Regulations (2005). 2nd ed. Geneva: World Health Organization; 2008 [cited 2012 Sep 25]. Available from: http://www.who.int/ihr/9789241596664/en/index.html.
 
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