Travel medicine--prevention based on epidemiological data.

In travel medicine efforts should be concentrated on preventive measures that are necessary, and travellers should be spared the side effects, costs and stress of superfluous measures. Excess mortality abroad is mainly due to traffic and swimming accidents, indicating the need for appropriate control strategies. The morbidity in travellers to developing countries is high, and is primarily due to traveller's diarrhoea. As prophylaxis is ineffective or unrealistic, and as travellers often need fast relief, it is recommended to include loperamide and an antimicrobial agent in the travel kit. Recent studies have shown that the incidence rate per month of Plasmodium falciparum malaria in Africa may reach 24/1000. The most frequently occurring immunizable diseases are hepatitis A (3/1000) and hepatitis B (0.8/1000). For many tourists and some expatriates pre-travel advice (hygiene, measures against mosquito bites, etc.) as well as chemoprophylaxis and immunization can be limited to these infections, but those travelling or staying outside large centres need additional measures.