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Couv Rto-Vso Ang.Qxp Couv_rto-vso Ang.qxp 15.02.2007 09:59 Page 1 International travel and health International travel People made more than 800 million international journeys in 2006.This amount of global travel exposes many people to changes in altitude, humidity, disease agents and temperature – all of which can lead to ill-health. Many health risks InternationalInternational can be minimized by precautions taken before, during and after travel.This book explains how travellers can stay healthy, and provides WHO guidance on vacci- nations, malaria chemoprophylaxis and treatment, protection against insects and traveltravel andand healthhealth other disease vectors, and safety in different environmental settings. This book covers all the main health risks to travellers, both during their jour- ney and at the destinations. It describes the relevant infectious diseases, inclu- ding causative agents, modes of transmission, clinical features, geographical dis- tribution, and prophylactic and preventive measures. New and revised contents in this edition include: travel by sea high-altitude illness deep vein thrombosis related to air travel new vaccines and vaccine schedules rabies avian influenza Chikungunya special groups of travellers; including Hajj pilgrims, and immigrants visiting friends and relatives malaria treatment for returning travellers and travellers abroad implications of the revised International Health Regulations (2005); and its updated vaccination certificate. This book is designed for medical and public health professionals who advise travellers, but it is also a standard reference for travel agents, airlines, shipping companies and travellers themselves. Continuous updates are freely available on the Internet: http://www.who.int/ith 2007 ISBN 978 92 4 158039 7 2007 Couv_rto-vso Ang.qxp 15.02.2007 09:59 Page 2 World Health Organization (WHO) WHO publications of related interest Headquarters WHO Regional Office for Europe Weekly Epidemiological Record Ports Designated in Application World Health Organization Regional Adviser Communicable Diseases of the International Health Communicable Diseases 8, Scherfigsvej For more than seven decades, the Weekly Epidemiological Record has served as an Regulations CH-1211 Geneva 27 DK-2100 Copenhagen Ø Situation as on 1 January 1998 Switzerland Denmark essential instrument for the collation and dis- Telephone:(41) 22 791 2111 semination of epidemiological data useful in Lists all ports approved and designated by Facsimile: (41) 22 791 4857 Telephone:(45) 39 17 17 17 disease surveillance on a global level. Priority health administrations, under the Interna- Telex:15348 is given to diseases or risk factors known to tional Health Regulations, for the issue of Regional Offices Cables: UNISANTE COPENHAGEN threaten international health. Deratting Certificates and Deratting Exemp tion Certificates. WHO Regional Office for Africa Facsimile: (45) 39 17 18 18 ISSN 0049-8114; weekly; 2007: 82nd year; Price: CHF 299.--/US$ 269.00 1998, (WHO/EMC/PORTS/98.1), 46 pages, Director, Communicable Disease Prevention Sw.fr. 10.– (WHO Order No. 0930140) and Control WHO Regional Office for the Eastern Bilingual English/French Cite du Djoue, P.O.Box 06 International Health Regulations Mediterranean (2005) Brazzaville Regional Adviser, Disease Prevention and Control International Certificate of Congo WHO Post Office Fourth Annotated Edition Vaccination/Certificat international Abdul Razzak Al Sanhouri Street The purpose and scope of the new de vaccination Telephone:+ 242 839 100 / + 47 241 39100 Nasr City, Cairo 11371 Regulations are "to prevent, protect against, This booklet reproduces the model certificate, Telex:5217 KG and 5364 KG Egypt control and provide a public health response Facsimile: + 242 839 501 / + 47 241 395018 as prescribed by the International Health to the international spread of disease in ways Regulations,for recording vaccination or revac- Telephone:(20) 2 670 2535 that are commensurate with and restricted cination against yellow fever and other vaccina- WHO Regional Office for the Americas Telex:54684 WHO UN to public health risks, and which avoid unne- tions recommended or advised by WHO. Regional Adviser, Communicable Diseases Facsimile: (20) 2 670 2492/2494 cessary interference with international traffic Prices listed apply only to orders sent directly Pan American Sanitary Bureau and trade." This new edition of International to WHO (Please note that Certificates of vac- 525 Twenty-third Street N.W. WHO Regional Office for the Western Pacific Health Regulations (2005) therefore contains a cination are not sold individually. Please see Washington, DC 20037 Communicable Diseases Adviser range of new and unprecedented innova- quantity orders below). Orders for 5000 United States of America United Nations Avenue tions. copies or more can be overprinted with the P.O. Box 2932 2006, 74 pages, ISBN 92 4 158038 0 – 978 92 name of the distributing agency at cost. Telephone:(1) 202 974 3000 Manila 1000 4 158038 0 Number Prices Telex:248338 and 440057 Philippines Cables: OFSANPAN WASHINGTON CHF 20.00/US$ 18.00; Order no. 11504207 of copies (Swiss francs) (US$) 50 25.– 22.50 Facsimile: (1) 202 974 3663 Telephone:(632) 528 8001 100 50.– 45.– Facsimile: (632) 521 1036/526 0279/526 0362 WHO Regional Office for South-East Asia 500 250.– 205.– Coordinator 1 000 450.– 405.– Communicable Disease Control 5 000 2 250.– 2 025.– World Health House 50 000 20 000.– 18 000.– Indraprastha Estate Direct fax for orders: +41 22 791 48 57 Mahatma Gandhi Road Email for orders: [email protected] New Delhi 110002 India Bilingual English/French Order no. 06800000, Trilingual Arabic/ English/French Order no. Telephone:(91) 11 2337 0804 06900000 Telex:3165031 and 3165095 Cables:WHO NEW DELHI Information on WHO publications can be Facsimile: (91) 11 2337 9507 obtained from: World Health Organization, WHO Press, 1211 Geneva 27, Switzerland. Email: [email protected]. Web site and ordering online: http://www.who.int/bookor- ders. International travel and health Situation as on 1 January 2007 INTERNATIONAL TRAVEL AND HEALTH 2007 The information given in this publication is valid on the date of issue. It should be kept up to date with the notes of amendments published in the Weekly epidemiological record (http://www.who.int/wer). Any comments or questions concerning this publi cation should be addressed to: International Health Regulations Secretariat Communicable Diseases World Health Organization 1211 Geneva 27, Switzerland fax: (+41) 22 791 4285 World Wide Web access: http://www.who.int/ith WHO Library Cataloguing-in-Publication Data International travel and health: situation as on 1 January 2007. 1. Communicable disease control. 2. Travel. 3. Vaccination – standards. 4.Risk factors. I. World Health Organization. ISBN 978 92 4 158039 7 (NLM classifi cation: WA 110) ISSN 0254-296X © World Health Organization 2007 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specifi c companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distin- guished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Printed in Switzerland. ii Contents Acknowledgements v Preface viii Chapter 1 Health risks and precautions: general considerations 1 Travel-related risks 1 Medical consultation before travel 3 Assessment of health risks associated with travel 3 Medical kit and toilet items 3 Travellers with pre-existing medical conditions and special needs 5 Insurance for travellers 7 Role of travel industry professionals 7 Responsibility of the traveller 8 Medical examination after travel 9 Chapter 2 Mode of travel: health considerations 12 Travel by air 12 Cabin air pressure 13 Cabin humidity and dehydration 14 Ozone 14 Cosmic radiation 14 Motion sickness 15 Immobility, circulatory problems and deep vein thrombosis (DVT) 15 Diving 17 Jet lag 17 Psychological aspects 18 Travellers with medical conditions or special needs 19 Communicable diseases 22 Aircraft disinsection 23 Medical assistance on board 23 Contraindications for air travel 24 Travel by sea 25 Communicable diseases
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