Sanford Christopher, McConnell Adam, Osborn Justin
University of Washington, Seattle, WA, USA.
Am Fam Physician. 2016 Oct 15;94(8):620-627.
Key components of the pretravel consultation include intake questions regarding the traveler's anticipated itinerary and medical history; immunizations; malaria prophylaxis; and personal protection measures against arthropod bites, traveler's diarrhea, and injury. Most vaccinations that are appropriate for international travelers are included in the routine domestic immunization schedule; only a few travel-specific vaccines must also be discussed. The most common vaccine-preventable illnesses in international travelers are influenza and hepatitis A. Malaria prophylaxis should be offered to travelers to endemic regions. Personal protection measures, such as applying an effective insect repellent to exposed skin and permethrin to clothing and using a permethrin-impregnated bed net, should be advised for travelers to the tropics. Clinicians should offer an antibiotic prescription that travelers can take with them in case of traveler's diarrhea. Additional topics to address during the pretravel consultation include the risk of injury from motor vehicle crashes and travel-specific risks such as altitude sickness, safe sex practices, and emergency medical evacuation insurance.
旅行前咨询的关键内容包括询问旅行者预期行程和病史的问诊；免疫接种；疟疾预防；以及针对节肢动物叮咬、旅行者腹泻和受伤的个人防护措施。大多数适合国际旅行者的疫苗都包含在常规国内免疫接种计划中；只需讨论少数几种特定于旅行的疫苗。国际旅行者中最常见的可通过疫苗预防的疾病是流感和甲型肝炎。应向前往流行地区的旅行者提供疟疾预防措施。对于前往热带地区的旅行者，应建议采取个人防护措施，如在暴露的皮肤上涂抹有效的驱虫剂、在衣物上喷洒氯菊酯，并使用浸有氯菊酯的蚊帐。临床医生应为旅行者提供抗生素处方，以便他们在发生旅行者腹泻时服用。旅行前咨询期间还应涉及的其他主题包括机动车碰撞导致受伤的风险以及特定于旅行的风险，如高原病、安全性行为和紧急医疗后送保险。
