26,27 During a pre-travel encounter, the travel practitioner provides the traveler with information about risks and best practices to mitigate risks. Most pre-travel encounters advise regarding local conditions (potential for crime, trauma), safe food and water practices, avoiding endemic communicable diseases (vector avoidance and malaria prevention, safe sexual practices, rabies, tuberculosis), and routine, recommended, and required vaccines. Discussion of these

topics can consume and exceed typically allotted time for the pre-travel encounter; yet, there are little data to ensure understanding and adherence. selleck chemicals Priorities for research to facilitate better understanding of what constitutes effective counseling and how LY294002 supplier to maximize adherence are also shown in Table 2. Research questions to fill knowledge gaps in immunization practice are also imperative. Obtaining accurate immunization history, providing advice regarding immunizations, and administering immunizations for vaccine-preventable travel-related infectious diseases are fundamental to a successful pre-travel encounter. Besides traditionally targeted diseases such as hepatitis A, yellow fever, and typhoid, intriguing data are emerging that demonstrate that respiratory tract infections are extremely common among even short-term travelers,28 and are a common cause for seeking medical attention following travel.29 Mutsch et al. reported that influenza

Janus kinase (JAK) may be the most common vaccine-preventable travel infection for travelers visiting tropical and subtropical regions, with an estimated incidence of 1.0 influenza-associated

events per 100 person-months abroad.13 The recent global emergence of novel influenza A H1N1 illustrates the rapidity with which influenza viruses spread, and serves as a reminder of the imperative to protect travelers and also their home communities from imported respiratory viruses such as influenza. Nearly 50% of travelers encounter diarrhea during travel.2,3 Research priorities around the common problem of travelers’ diarrhea (TD) are included in Table 2. Advising and equipping the traveler to avoid malaria is another paramount role for the pre-travel encounter. Malaria was one of the three most frequent causes of systemic febrile illness among travelers from every GeoSentinel region.29 Centers for Disease and Prevention surveillance shows that about 800 cases of malaria are reported in US civilians each year13 and 453 cases of Plasmodium falciparum were reported by TropNet Europe in 2007.31 Topics that are prioritized for research toward improved malaria chemoprophylaxis and treatment are shown. Research questions concerning special populations and types of travel are included within Table 2. The former includes children, pregnant and/or nursing women, immunocompromised, elderly, and the latter including travelers VFRs, on religious pilgrimages such as the Hajj, and participating in medical tourism.