Immunizations and preventative medicines are an important part of travel preparation and reducing the risk of acquiring infections while traveling internationally. Travel prophylaxis for foreign travel should be based on the individual’s risks for exposure to specific travel related diseases, the epidemiology of vaccine-preventable diseases, and the time available before trip departure. Travel prophylaxis includes updating and boosting routine immunizations, administering legally required vaccinations, and prescribing recommended vaccines and medicines to help prevent diseases. A physician also needs to be knowledgeable about the adverse events and contraindications associated with each vaccine and medication.

The first step in prescribing appropriate travel prophylaxis is a thorough assessment of a patient’s risk of travel-related disease. The details of the planned travel are important, including the itinerary, all geographic destinations, type of lodging booked, planned activities, particular season of travel, duration of stay, and anticipated contact with local residents. This information needs to be integrated with an assessment of the patient’s general health, medical problems, allergies, and current medications. It is important to identify travelers at high risk for acquiring travel-related illnesses. Patients considered at high risk are backpackers, those who are immunocompromised, or those currently living in the United States but born in another country who are traveling back to their country of origin. Consultation with a travel clinic may be advisable and early consultation when planned travel is to developing countries is encouraged. Consultations need to be based on current epidemiology and can be obtained from the Centers for Disease Control and Prevention in an annual publication or via their Web site at http://www.cdc.gov/travel. The World Health Organization (WHO) operates a similar Web site: http://www.who.int.easyaccess1.lib.cuhk.edu.hk/ ith/en.