Overview: Why pre-travel interventions matter
Pre-travel health interventions aim to reduce the risk of acquiring infectious diseases and to lessen the chance of transmission during and after international trips. Recent literature reviews spanning nearly eight decades highlight how vaccinations and preventive measures can influence outcomes for travellers, health systems, and communities.
Evidence on cost-effectiveness
A comprehensive scoping review examined 44 economic evaluations published between 1946 and 2023. The focus was on pre-travel interventions against a range of diseases, including hepatitis A and B, influenza, malaria, rabies, travellers’ diarrhoea, cholera, polio, typhoid fever, measles, and Japanese encephalitis.
The findings consistently show that certain interventions—most notably hepatitis A vaccination, malaria chemoprophylaxis, typhoid vaccination for travellers headed to highly endemic settings, and measles–mumps–rubella vaccination—are likely to be cost-effective. In other words, the health benefits and reduced transmission risk justify the costs in many travel scenarios.
However, the cost-effectiveness of other pre-travel interventions is more context-dependent. Variables such as how often people travel, how long they stay, the endemicity of the destination, the purpose of travel (business, leisure, visiting friends and relatives), risk perceptions, adherence to care plans, and vaccination costs all influence economic value. The authors emphasize that robust data on clinical outcomes and costs are essential to reliable analyses.
To translate these insights into policy, the authors advocate for international, collaborative data networks. By pooling data and leveraging new technologies, researchers could better quantify exposures, outcomes, risk perceptions, and costs. This expanded evidence base would support population-specific travel recommendations and more precise health policies for travellers.
Practical implications for common travel risks
Travellers’ diarrhoea and interprofessional care
Travellers’ diarrhoea remains one of the most common travel-associated conditions, particularly when visiting resource-limited destinations. The condition affects a substantial share of travellers, driven largely by bacterial, viral, and parasitic causes. While usually self-limiting, diarrhoea can cause dehydration and, in some cases, serious complications requiring coordinated care.
Recent reviews emphasize a collaborative, interprofessional approach to prevention and management. Prevention includes education on safe food and water practices and the appropriate use of vaccines where applicable. Management focuses on timely assessment, rehydration, and, when necessary, escalation of care. A well-functioning care team—from clinicians to pharmacists and nurse practitioners—can improve outcomes and patient satisfaction during the pre-travel consultation and beyond.
High-altitude travel: preparing for hypoxia and risks
Millions travel to high-altitude destinations each year, exposing themselves to hypoxic stress, reduced exercise tolerance, and the risk of altitude-related illnesses. Pre-travel advice typically covers pre-acclimatization, graded physical conditioning, and, where appropriate, adjustments to pharmacological regimens. The aim is to minimize acute mountain sickness and other high-altitude conditions, while allowing travellers to remain active and safe in challenging environments.
Other key topics shaping travel health advice
Malaria remains a global concern, with ongoing shifts due to climate change, drug resistance, and new vaccines. Clinicians are urged to maintain vigilance for malaria in returning travellers, including recognizing non-classical presentations and seeking specialist input when needed. The evolving malaria landscape underscores the value of up-to-date pre-travel counseling and risk-based prophylaxis decisions.
Skin-related conditions and vector-borne illnesses such as dengue also frequently surface in travellers. Guidance on prevention—covering insect protection, wound care, and sun safety—can reduce health burdens during and after travel. Emphasis on detailed travel histories and exposure patterns remains essential for accurate diagnosis and appropriate management.
Conclusion: informing decisions at the pre-travel visit
Overall, the evidence supports integrating cost-effective pre-travel interventions into routine pre-travel consultations. However, cost-effectiveness is not universal; it hinges on destination risk, travel patterns, and data quality. Health professionals are encouraged to foster international collaboration, incorporate high-quality economic evaluations, and tailor recommendations to individual travellers. By doing so, clinicians can deliver patient-centered care that optimizes health outcomes while considering economic realities.
