Overview: The Value of Pre-Travel Interventions
Recent literature reviews highlight how pre-travel health measures can reduce the likelihood of acquiring communicable diseases and limit transmission during and after international trips. A scoping review of 44 economic evaluation studies, spanning 1946 to 2023, examined the cost-effectiveness of pre-travel interventions for diseases such as hepatitis A and B, influenza, malaria, rabies, travellers’ diarrhoea, cholera, polio, typhoid fever, measles, and Japanese encephalitis. The findings indicate that certain vaccines and prophylactic strategies are often cost-effective, depending on travel context.
Notably, hepatitis A vaccination, malaria chemoprophylaxis, typhoid vaccination for travellers to high-endemic settings, and measles–mumps–rubella (MMR) vaccination show favorable cost-effectiveness in many scenarios. However, the cost-effectiveness of other interventions varies with factors such as travel frequency and duration, destination endemicity, travel purpose (business, leisure, visiting friends and relatives), risk perception, adherence to care plans, and local costs. The takeaway: cost-effectiveness analyses can inform policy and personal decisions but require high-quality data on outcomes and costs.
Practical Implications for Pre-Travel Consultations
Public health researchers advocate for international collaboration to strengthen the evidence base. Data-gathering networks and novel technologies could capture exposure risks, clinical outcomes, cost trajectories, and travellers’ risk perceptions. This information would support population-specific guidance and health-policy decisions for travellers with differing itineraries and health profiles.
Pre-travel consultations should embrace shared decision making, presenting travellers with realistic expectations about protection, costs, and the practicalities of adherence to preventive plans. When plans are tailored to individual travel plans, the probability that travellers complete recommended interventions increases, enhancing both personal health and broader public health outcomes.
Traveller’s Diarrhoea: Prevention and Management in Practice
Traveller’s diarrhoea remains one of the most common travel-associated illnesses, affecting roughly 40% to 60% of travellers depending on the destination. Bacterial pathogens predominate, though viral and parasitic causes also occur. While usually self-limiting, it can lead to dehydration and complications, underscoring the importance of prevention and prompt management.
A comprehensive review on prevention and management emphasizes coordinated care by an interprofessional team to optimise outcomes in travellers with diarrhoeal illness. Core messages include preparing travellers with practical advice on safe food and water, recognizing warning signs, and ensuring timely escalation to medical care when needed. The review also highlights how coordinated teamwork during pre-travel counselling can enhance decision making and post-travel recovery.
High-Altitude Travel: Preparing for Hypoxia and Cold Conditions
Millions journey to high-altitude destinations each year, exposing themselves to hypoxic stress. The reduced oxygen availability can worsen exercise tolerance and trigger high-altitude illnesses such as acute mountain sickness, high-altitude cerebral edema, or high-altitude pulmonary edema, particularly in travellers who are not pre-acclimatized. In addition to altitude-related symptoms, cold, dry air and increased ultraviolet exposure can compound health risks.
The literature review on high-altitude travel offers a practical checklist for clinicians and travellers: pre-examination, pre-flight advice, and strategies for gradual acclimatization; consideration of pharmacological adaptations if appropriate; and tailored exercise plans. Such preparation helps travellers maintain function and reduce health issues that could spoil travel experiences.
Malaria and Other Endemic Threats: Staying Vigilant on Return
Malaria remains a major global health concern, with transmission spanning 84 countries and hundreds of millions of cases annually. In Europe and other regions, clinicians must stay alert for malaria in returning travellers, recognizing that emerging drug resistance, climate change, and vaccination rollouts are reshaping the landscape. A detailed review outlines common diagnostic pitfalls and emphasizes the importance of travel history, prompt diagnostic testing, and specialist input when needed. Vaccination against malaria is discussed among preventive strategies, though prevention also hinges on accurate risk assessment and education about prophylaxis adherence and symptom vigilance.
Travel-Related Skin Conditions and Dermal Health
Skin issues are a frequent reason for travel medicine consultations. Travellers can present with arthropod bites, sunburn, cutaneous larva migrans, bacterial skin infections, and other dermatologic concerns. A practical review underscores using travel history, incubation periods, and exposure risks to guide diagnosis. It also highlights the importance of differentiating systemic infections that present with skin symptoms and coordinating care with dermatology, infectious disease, and primary care colleagues when needed.
Other Infections and Prevention Considerations
Dengue fever remains the leading cause of febrile rash illness in travellers returning from many regions, while schistosomiasis and hookworm-related dermatitis also feature in differential diagnoses. Clinicians should assess exposure risk—including water contact, outdoor activities, and regional disease patterns—and use a thorough travel history to direct testing and treatment decisions.
Conclusion: Informed, Collaborative Travel Health
The reviewed evidence reinforces that pre-travel health planning, when data-driven and personalized, can reduce disease risk and travel disruption. By integrating vaccination, chemoprophylaxis, education, and interprofessional care, health professionals can better prepare travellers for safe journeys and smoother recoveries upon return.
