The Pretravel Consultation

Patients who will be traveling internationally should be advised to schedule dedicated pretravel assessments with their primary care physicians. The pretravel consultation is a vital opportunity for physicians to review preventive and risk-reduction strategies with travelers. Critical components of the patient interview include travel itinerary, anticipated high-risk activity, and medical history. This information affects subsequent recommendations for immunizations, malaria chemoprophylaxis, personal protective measures, and risk-reduction measures. Physicians should review whether routine and seasonal immunizations, including those for COVID-19 and influenza, are up to date and determine whether location-specific immunizations are warranted. Malaria prophylaxis and counseling on personal protective measures, including minimizing skin exposure and using insect repellant, permethrin-treated clothing, bed nets, and screens, are recommended for travelers visiting endemic areas. A single dose of antibiotics may be considered for self-treatment of traveler's diarrhea without features of dysentery. Travelers with chronic medical conditions, such as diabetes, should carry documentation of medical issues and enough medications and supplies to last for the duration of travel. Activity-specific concerns include sunburn, motor vehicle crashes, water safety, altitude sickness, and risks associated with sexual behaviors.