International travel and health

Assessment of health risks associated with travel

Medical advisers base their recommendations, including those for vaccinations and other medication, on an assessment of risk for the individual traveller, which takes into account the likelihood of acquiring a disease and how serious this might be for the person concerned. Key elements of this risk assessment are the pretravel health status of the traveller, destination(s), duration and purpose of travel, the mode of transport, standards of accommodation and food hygiene, and risk behaviour while travelling.

For each disease being considered, an assessment is also made of:

  • availability of appropriate medical services in the destination, prophylaxis, emergency treatment packs, self-treatment kits (e.g. a travellers’ diarrhoea kit);
  • any associated public health risks (e.g. the risk of infecting others).

Collecting the information required to make a risk assessment involves detailed questioning of the traveller. A checklist or protocol is useful to ensure that all relevant information is obtained and recorded. The traveller should be provided with a personal record of the vaccinations given (patient-retained record) including, for example, intramuscular administration of rabies vaccine, as vaccinations are often administered at different centres. A model checklist, reproducible for individual travellers, is provided at the end of chapter 1.