Khatibi Sarah, Marchou Bruno
Service des maladies infectieuses et tropicales, hôpital Purpan, 31059 Toulouse.
Rev Prat. 2007 Apr 30;57(8):831-42.
The objective of the pre-travel consultation is to evaluate the risks associated to travelling and to inform the traveler about their nature and severity and how to prevent them. The evaluation of the risks takes into account the visited country, the type of travel and the characteristics of the traveler. The prevention of feco-oral transmitted diseases, namely traveler's diarrhea, relies primarily on the respect of standards of food and beverage hygiene. Information should be given about other general risks (road accidents, STD's and HIV...). This consultation is the opportunity to update the routine immunizations for adults and children, and to give advice about required (yellow fever vaccine for subsaharan Africa and the amazonian region, tetravalent meningococcal vaccine for the pilgrimage el Hadj) and recommended vaccinations (hepatitis A for all travels with low sanitary conditions; according to destinations: typhoid fever, tick-borne encephalitis, japanese encephalitis, rabies...). Malaria prophylaxis includes preventive measures against mosquito-bites at night and chemoprophylaxis adapted to chloroquine resistance level in the country of destination. In any case, a patient with fever occurring within 2 months after returning from an endemic region needs to take a medical advice because of the potential risk of malaria.
旅行前咨询的目的是评估与旅行相关的风险,并告知旅行者这些风险的性质、严重程度以及如何预防。风险评估会考虑到访国家、旅行类型和旅行者的特征。预防粪口传播疾病,即旅行者腹泻,主要依靠遵守食品和饮料卫生标准。还应提供有关其他一般风险(道路事故、性传播疾病和艾滋病毒等)的信息。这次咨询是更新成人和儿童常规免疫接种的机会,并就所需疫苗(撒哈拉以南非洲和亚马逊地区的黄热病疫苗、前往麦加朝圣的四价脑膜炎球菌疫苗)和推荐疫苗(所有卫生条件较差地区旅行的甲型肝炎疫苗;根据目的地不同:伤寒、蜱传脑炎、日本脑炎、狂犬病等)提供建议。疟疾预防包括夜间防蚊叮咬的预防措施以及根据目的地国家氯喹耐药水平进行的化学预防。无论如何,从流行地区返回后2个月内出现发热的患者需要就医,因为存在感染疟疾的潜在风险。