Travel medicine 2005

Travel Medicine is a rapidly evolving field of medicine that is becoming ever more important in this era of globalization. Traditionally, medical preparation for individuals traveling to countries outside the United States has focused on traveler's diarrhea prevention and treatment, malaria prevention, and travel vaccination. Now, other concerns such as travel safety must also be considered. New developments in the area of travel medicine include the use of azithromycin instead of quinolones for diarrhea acquired in Southeast Asia. Azithromycin may also be the best option for children and patients who cannot take quinolones regardless of destination. In addition, rifaximin, a non-absorbable antibiotic, has recently been marketed for traveler's diarrhea. The best malaria prophylaxis options currently include atovaquone-proguanil (Malarone) in addition to chloroquine, mefloquine, and doxycycline. Hepatitis A is the most important travel vaccine, and a new combined hepatitis A and B vaccine (Twinrix) is useful for travelers needing protection against both types of hepatitis. A vaccine for typhoid is now available in either oral or injectable versions. Other important vaccines to consider when traveling internationally are those for Japanese encephalitis, influenza, meningitis, rabies, varicella and yellow fever vaccines. These may be warranted depending on duration of travel and destination risk.