Introduction

What do travelers think about when planning travel to a foreign country? Spectacular scenery, exotic foods, and the opportunity to experience another culture, or diseases, insects, and water safety? Most of us consider both parts of the picture, excited about the good prospects and nervous about the bad and how to get the most out of travel while guarding against any health hazards that might exist. This guide is for those who want to enjoy the opportunities of travel without spending time and energy dealing with preventable problems.

As of early 2020, the threat of infection with coronavirus 2019 (COVID-19)−an acute viral respiratory infection that originated in China in late 2019 and is responsible for a global pandemic causing hundreds of millions of cases and millions of deaths−at the destination or en route has become the primary health threat consideration in planning every trip. Even vaccinated travelers are at risk at certain destinations and very vulnerable travelers, even if vaccinated, should certainly avoid all travel to significant-risk areas.

The threat of disease worldwide, although real, is often different from what many people expect. Ebola virus disease, cholera, avian influenza, plague, and Middle East respiratory syndrome coronavirus may make headlines, but they rarely affect travelers. Other outbreaks, like chikungunya or Zika virus infection, may impact travelers for short periods in very specific places. This doesn't mean that cause for concern is nonexistent; take all reasonable precautions to reduce the chances of becoming ill. However, the problems that are most likely to affect travel plans are much more ordinary: travelers' diarrhea, jet lag, or an auto accident, for example.

Travelers who follow preventive behaviors can avoid most travel-related health and safety problems. This guide provides reliable explanations and practical ideas about the best ways to stay healthy while traveling abroad. Some travelers may choose to follow all the advice carefully, especially if they are traveling in a high-risk area or have existing health concerns. Others may evaluate the risks and decide to follow only some of the precautions mentioned, based on individual needs.

Travelers spending time exclusively in developed countries, in resort areas of developing countries, or within the international hotel circuit will generally have a lower risk of illness.

Adventure travelers and persons staying abroad for extended periods (more than 1 month), spending a good deal of time with local populations or eating and sleeping in rural accommodations, are typically at higher risk, especially if traveling in developing countries.

The illnesses that usually concern travelers are discussed under topics such as vaccines, respiratory illnesses, general health and safety, water, food, insects, and physical contact. Additional illnesses, rare in travelers, are summarized in alphabetical order.

Forms and checklists are available to help travelers evaluate and document their health and safety needs.

Resources: Many resources are available to help travelers find additional information about the areas they plan to visit. Some of the best are:

  • TripPrep.com
  • Centers for Disease Control and Prevention: wwwnc.cdc.gov/travel
  • TravelHealthPro: travelhealthpro.org.uk
  • International Society of Travel Medicine: www.istm.org
  • US Department of State: www.travel.state.gov