Angell Sonia Y, Behrens Ron H
Cardiovascular Disease Prevention and Control, New York City Department of Health and Mental Hygiene, New York, NY 10007, USA.
Infect Dis Clin North Am. 2005 Mar;19(1):49-65. doi: 10.1016/j.idc.2004.11.001.
Although VFR travelers are at risk for acquiring infections and experiencing illness while traveling, many of these diseases are preventable. A comprehensive approach to decreasing their travel-related morbidity requires continued surveillance, data collection, systematic analysis, and action. A review of the literature provides few examples of interventions designed specifically to address VFR travel needs. Given the geographic and cultural diversity of these populations, models grounded in health behavior theory provide the best potential for clinically relevant replication. Outreach aimed at improving knowledge and care-seeking behaviors among VFR travelers may be facilitated through community-based campaigns in areas with large foreign-born populations. In developed countries, policies must be reviewed to ensure that travel-related services are accessible, affordable, and appropriate for these diverse populations. In the clinical setting, providers must develop culturally appropriate methods of communicating with traveling populations to influence behavior. In particular, primary care providers should take an active approach through screening for high-risk travel, and increasing their competency in travel medicine. Special attention should be given to illness that is prevented by routine childhood immunization (eg, varicella, measles, and hepatitis B); by disease prevented by travel vaccines (eg, typhoid fever and hepatitis A); and disease that can be prevented by careful avoidance measures or compliance with preventive medication (eg, malaria and tuberculosis). With increased immigration from developing to developed regions and widely affordable travel, the number of VFR travelers is expected to increase. As such, increased efforts to prevent VFR traveler morbidity serve the individual while also contributing to global public health.
尽管探亲访友旅行者在旅行期间有感染疾病和患病的风险，但其中许多疾病是可以预防的。减少与旅行相关的发病率需要采取综合方法，包括持续监测、数据收集、系统分析和行动。对文献的回顾显示，专门针对满足探亲访友旅行者需求而设计的干预措施实例很少。鉴于这些人群的地理和文化多样性，基于健康行为理论的模式最有可能在临床上得到相关复制。通过在外国出生人口众多的地区开展社区活动，可能有助于开展旨在提高探亲访友旅行者知识和就医行为的宣传活动。在发达国家，必须审查政策，以确保旅行相关服务对这些多样化人群来说是可及、可负担且合适的。在临床环境中，医疗服务提供者必须制定符合文化背景的与旅行者沟通的方法，以影响其行为。特别是，初级保健提供者应通过筛查高风险旅行并提高其旅行医学能力，采取积极主动的方法。应特别关注可通过儿童常规免疫预防的疾病（如水痘、麻疹和乙型肝炎）；可通过旅行疫苗预防的疾病（如伤寒热和甲型肝炎）；以及可通过谨慎的避免措施或遵医嘱服用预防药物预防的疾病（如疟疾和结核病）。随着从发展中地区到发达地区的移民增加以及旅行费用普遍可负担，预计探亲访友旅行者的数量将会增加。因此，加大预防探亲访友旅行者发病的力度既有利于个人，也有助于全球公共卫生。
