In this issue of the Journal of Travel Medicine, Rossi and Genton

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 Trichostatin A solubility dmso 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 AZD6244 purchase 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 Carnitine dehydrogenase 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).

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