[Assessment of travel-associated risks and advice to travelers]

The objective of the pre-travel consultation is to evaluate the risks associated to travelling and to inform the traveler about their nature and severity and how to prevent them. The evaluation of the risks takes into account the visited country, the type of travel and the characteristics of the traveler. The prevention of feco-oral transmitted diseases, namely traveler's diarrhea, relies primarily on the respect of standards of food and beverage hygiene. Information should be given about other general risks (road accidents, STD's and HIV...). This consultation is the opportunity to update the routine immunizations for adults and children, and to give advice about required (yellow fever vaccine for subsaharan Africa and the amazonian region, tetravalent meningococcal vaccine for the pilgrimage el Hadj) and recommended vaccinations (hepatitis A for all travels with low sanitary conditions; according to destinations: typhoid fever, tick-borne encephalitis, japanese encephalitis, rabies...). Malaria prophylaxis includes preventive measures against mosquito-bites at night and chemoprophylaxis adapted to chloroquine resistance level in the country of destination. In any case, a patient with fever occurring within 2 months after returning from an endemic region needs to take a medical advice because of the potential risk of malaria.