Dtsch Arztebl Int. 2021 May 28;118(21):349–356. doi: 10.3238/arztebl.m2021.0127.
In 2019, 1.5 billion international tourist trips were counted worldwide. Germany, with 70.8 million vacations lasting ≥ 5 days, was one of the populations most willing to travel. These days, even elderly and multimorbid persons regularly travel long-distance, which can be associated with significant health risks. By advising travelers and implementing preventive measures, the risk of illness can be reduced significantly.
A selective survey of PubMed was performed to identify publications on medical advice for travelers between 2000 and 2020. We included guidelines, studies, and recommendations that mainly deal with the preventive aspects of travel medicine and have a high level of practical relevance and the highest possible level of evidence. Previously published guidelines (based on the GRADE criteria) were adopted, and recommendations not based on the results of scientific studies were characterized as Good Clinical Practice (GCP).
Many medical recommendations for travelers still rely on individualized, experience-based, or consensus-based assessments. Apart from a review of medical history and vaccination status, a risk analysis is performed, travel fitness is evaluated individually, and a prevention plan is designed. Particular attention is devoted to malaria prophylaxis, vector protection, and traveler's diarrhea. Medical advice before travel is especially important for the elderly, children, pregnant women, the chronically ill, long-term and adventure travelers as well as migrants from malaria-endemic areas who are returning home.
The health risks associated with travel can be minimized by specialist medical advice. Many recommendations are empirical in nature and require further research.
2019 年,全球有 15 亿人次的国际旅游。德国有 7080 万人的假期时长≥5 天,是最愿意旅游的人群之一。如今,即使是老年和多病的人也经常长途旅行,这可能会带来重大的健康风险。通过为旅行者提供建议和实施预防措施,可以显著降低患病风险。
通过在 PubMed 上进行选择性调查,确定了 2000 年至 2020 年间有关旅行者医学建议的出版物。我们纳入了主要涉及旅行医学预防方面的指南、研究和建议,这些指南、研究和建议具有较高的实际相关性和尽可能高的证据水平。采用了以前发表的指南(基于 GRADE 标准),并将未基于科学研究结果的建议描述为良好临床实践(GCP)。
许多旅行者的医学建议仍然依赖于个体化、经验或共识评估。除了审查病史和疫苗接种状况外,还进行风险分析、个体评估旅行适应性并制定预防计划。特别关注疟疾预防、媒介保护和旅行者腹泻。对于老年人、儿童、孕妇、慢性病患者、长期旅行者和探险旅行者以及来自疟疾流行地区的移民来说,旅行前的医疗建议尤为重要,他们在回国后可能会面临健康风险。
通过专业医疗建议可以将旅行相关的健康风险降至最低。许多建议是经验性的,需要进一步研究。