In this issue of the Journal of Travel Medicine, Rossi and Genton have contributed to our limited understanding of the pre-travel encounter by assessing the effect of actual versus intended travel plans on pre-travel health recommendations.[8] One could interpret their findings in a number of ways, including the following: the pre-travel risk assessment cannot predict actual travel exposures, and thus may not help to manage travel-related
risk, the assessment is sensitive and robust enough to deal with travel-related risk, even if travelers substantially change their itinerary, or the assessment itself may have been part of the intervention, and can lead to alterations in a traveler’s original plans. It is hard to know the correct STA-9090 interpretation, but this research is a good first step. However, there remains much to study to fully understand the complexity of the pre-travel visit. If the encounter is seen more as a conversation, then one
can appreciate the back and forth discussion of uncertainties needed to characterize travel-related risks of a given traveler. These identified risks may be further categorized into three or four groups, as follows: Preventable risks: those risks identified pre-travel that can be completely or nearly eliminated through an intervention, such as immunization or chemoprophylaxis Avoidable risks: those risks identified pre-travel that can be avoided by the traveler through counseling leading to awareness and/or behavior changes, such as safe sex practices or preparedness for Scuba diving Manageable risks: those risks identified pre-travel Epacadostat chemical structure that can be self-managed through standby treatment
for such conditions as traveler’s diarrhea or human immunodeficiency virus (HIV) exposure Unexpected risks: those risks 4��8C that may not be anticipated pre-travel but can be addressed through appropriate contingency planning, such as carrying adequate travel medical insurance and/or medical evacuation insurance. Assessing the need for specific interventions should also not be solely based on a traveler’s current plans, but also on future traveling intentions. Exposures to travel-related hazards may occur in different time patterns resulting in very different types of risks, such as: One-time or singular events [eg, first-time yellow fever (YF) immunization and the risk of YEL-AVD; an involuntary blood exposure and the risk of HIV-1 infection; flight from sea level to altitude >3,000 m and the risk of acute mountain sickness]. Intermittent (eg, malaria risk in rotational business travel with a return to the home country after each tour; island hopping using ferries and risk of drowning; deep vein thrombosis risk during a series of long-haul air flights). Continuous or ongoing (eg, malaria risk in expatriates living in endemic regions; YF infection risk in YF endemic area among unimmunized travelers).