The care of the traveling child has become more complex and specialized as vaccine developments and recommendations have evolved. Differences in the pediatric immune response and the rationale for vaccine use or omission at certain ages must be considered. Protecting children from travel-related disease involves updating routine childhood immunizations and appropriately administering itinerary-specific travel vaccines. Routine childhood vaccinations may need to be accelerated for young infants traveling before the standard primary vaccine series can be completed. Hepatitis A, hepatitis B, Japanese encephalitis, yellow fever, varicella, and tickborne encephalitis vaccinations have pediatric indications, side effects, and uses. This review will address vaccine considerations and current US recommendations particular to traveling children.
Children who travel are at risk of developing the same, well-known illnesses that affect adult travelers. The etiology, treatment, and actual risk of these illnesses are not well defined in children. The limited amount of data available forces clinicians to extrapolate appropriate treatment for children. Recommendations for children have not been standardized. The role and judicious use of antimicrobials in the treatment of pediatric traveler's diarrhea have evolved during recent decades and will be reviewed here. The past 2 decades have seen an unprecedented, sustained growth in travel. The epidemiology related to travel medicine has evolved to describe travelers and their illnesses more specifically. The development of the field of travel medicine has led to greater understanding and improved, targeted treatment of travel-related illnesses. Most of the data available today describe traveler's diarrhea in adults. Children traveling to distant destinations from their home country have not been well studied, yet treatment parameters exist in practice and will be reviewed here.
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