Why Pre-Travel Health Interventions Matter
Travellers increasingly seek ways to stay healthy on international trips. A recent scoping review of 44 economic evaluations (spanning 1946–2023) highlights that certain pre-travel interventions can be cost-effective and reduce the burden of infectious diseases during and after travel. These findings matter for travelers planning trips as well as policymakers shaping pre-travel health guidelines.
The core idea is simple: investing in preventive measures before departure can lower the risk of acquiring infections such as hepatitis A and B, malaria, and influenza, and can also reduce onward transmission. The evidence suggests that some vaccines and chemoprophylaxis options provide substantial value in high-risk settings.
Which Interventions Stand Out?
Among the interventions reviewed, several emerged as consistently cost-effective for travelers heading to areas with high endemicity:
- Hepatitis A vaccination: Strong potential for cost-effectiveness among travelers to regions with high hepatitis A transmission.
- Malaria chemoprophylaxis: Particularly relevant for journeys to malaria-endemic destinations, where prophylaxis can prevent costly treatment and complications.
- Typhoid vaccination: Considered cost-effective for travelers to settings where typhoid fever risk is elevated.
- Measles–mumps–rubella (MMR) vaccination: Part of routine immunization strategies that can reduce outbreak-related costs abroad and upon return.
Other pre-travel interventions may be cost-effective in specific contexts, but their value is more sensitive to factors such as how often a person travels, the duration of travel, local disease patterns, and individual risk perceptions. This means the same intervention may be highly valuable for frequent business travelers but less cost-effective for casual vacationers.
Data Gaps and the Role of Collaboration
The researchers conclude that cost-effectiveness analyses can guide decision-making, but their accuracy hinges on robust data about clinical outcomes and costs. They advocate for international, collaborative networks that collect real-world data and leverage modern technologies to better quantify exposure risks, clinical outcomes, and costs associated with pre-travel care. Such networks could tailor recommendations for different traveler groups and inform population-specific health policies.
Travelers’ Diarrhoea and Skin Health: Practical Takeaways
Two other areas receive attention due to their high relevance for travelers. First, travel-related diarrhoea remains a leading travel-associated illness, affecting roughly 40–60% of travelers to certain regions. Although many cases are self-limiting, dehydration and complications can occur. A multidisciplinary approach—encompassing prevention, prompt diagnosis, and coordinated care—can improve outcomes and reduce healthcare burden upon return. Pre-travel consultations that emphasize risk assessment, hygiene practices, and access to appropriate medicines are particularly valuable.
Secondly, skin problems are a common reason people seek care after travel. Common conditions include bites, sun-related injuries, and various infections. Clinicians can improve outcomes by integrating travel history with clinical examination and epidemiological clues (where and how exposure occurred), enabling timely diagnosis and targeted management. High-quality pre-travel advice can also address skin health, sun protection, and safe behaviors to minimize these risks.
Preparing for High-Altitude Travel and Malaria Changes
Other travel health considerations include high-altitude exposure and evolving malaria dynamics. For high-altitude trips, pre-travel advice commonly covers acclimatization, activity pacing, and symptom awareness for altitude-related illnesses. As for malaria, ongoing changes in resistance patterns and climate effects underscore the need for up-to-date risk assessments and, where appropriate, vaccination strategies. Clinicians should stay alert to non-classical presentations of malaria and consider returning travelers with fever or systemic symptoms even if prophylaxis was used.
What This Means for Travelers
For individuals planning trips, the takeaway is clear: engage in a proactive pre-travel health check that weighs the likelihood of disease and the potential savings from prevention. For healthcare providers, the emphasis should be on sharing decision-making, updating travelers about risks at their destinations, and coordinating care across disciplines when travel-related illness occurs. Thoughtful pre-travel planning, especially for high-risk destinations, can reduce health risks and support smoother, healthier travel experiences.
Conclusion
Cost-effectiveness studies of pre-travel interventions inform practical decisions for travelers and policymakers alike. While not every intervention is universally cost-effective, targeted vaccination and prophylaxis strategies for high-risk travelers are consistently valuable. By building robust evidence networks and fostering shared decision-making in pre-travel consultations, we can improve outcomes and safeguard health in an increasingly connected world.
