Preparing Families With Children for International Travel

Planning for Travel With Children in the Modern World

“…These will be expanded in the pre-travel preparation article, which will include a discussion about the role of additional traveler's health and evacuation insurance. 16 …”

A “Syndromic” Approach for Diagnosing and Managing Travel-Related Infectious Diseases in Children

“…59 One important resource is that US Embassies, as well as the International Society of Travel Medicine (ISTM.org), maintain lists of clinics and hospitals where rabies post-exposure prophylaxis is available, as discussed in the article on preparation for international travel. 6 Children who will spend long periods of time in rabies endemic regions (especially VFR travelers and expatriate residents) should be considered to be at increased risk of exposure, and consideration should be given for pre-travel administration of the 3 dose pre-exposure regimen both for added safety and, though still needing a vaccine booster, avoiding the difficulties of obtaining RIG. 6…”

“…4,5 As stressed in other articles in this supplement, travelers visiting friends and relatives (VFR) have been consistently noted to have both low rates of seeking medical advice before travel, with a resulting large number of serious febrile illnesses appearing on return. 5,6 A substantial burden of this falls on pediatric travelers (children 17 years or younger), who make up an estimated 40% of US travelers who were visiting friends and relatives internationally. 3 A subset of the Geo-Sentinal surveillance data obtained from 1997-2007 was analyzed specifically to look at factors associated with travel-related illness in children 0-17 years of age.…”

Lesson Learned and Practical Advice for Supporting the Pediatric Traveler

“…This is discussed in the pre-travel article, but it might surprise some that the most common immunizations we order in pre-travel planning for children include annual influenza, completion of the human papilloma virus vaccine series, updating tetanus-diphtheria-acellular pertussis, and the new recommendations for updating varicella and pneumococcus vaccines for the older travelers. 10 Also, we frequently identify those children who have not had age-appropriate anemia, lipid screening, or HIV screening as adolescents. 13 Future periodic health assessments may be more difficult after a move to a foreign location for a few years, and the travel visit can anticipate needs that might arise over the duration of time spent abroad.…”

“…A related issue, covered in detail in the preparation for travel article in this supplement, is that quality travel medicine providers must spend adequate time providing realistic anticipatory guidance, and may be teaching them detailed contingency planning including selftreatment plans for diarrheal disease or even non-specific febrile syndromes that could represent malaria, depending on the resources at the travel location. 10 Travel medicine providers must recognize the inability to anticipate all risks. A recent Swiss study of the reliability of the pre-travel history in anticipating risks, when compared with an accurate post-travel survey, found that patients consistently underreported and underestimated the risks they might encounter during travel.…”