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Travel involves leaving the familiar to experience a new environment. Travel
risks exposing oneself to both known and unknown germs, safety hazards,
and unfamiliar health care. Each year, increasing numbers of families
travel regionally and internationally, sometimes adventuring to exotic
locales once thought to be inappropriate for children. The number
of prospective parents who travel abroad to complete an adoption
in a foreign country has also increased.1 While
traveling with children provides excellent opportunities for bonding
and learning, it also places families at risk for anticipated and
unanticipated illnesses. In a cohort study of people traveling to developing countries
or Eastern Europe, more than one third developed health impairment
during the trip.2 Major overseas fatalities during
travel included cardiovascular events (49%) and injuries
(25%).3 For children, the most common
causes of morbidity and mortality while traveling abroad were automobile
accidents and drowning, followed by illnesses caused by leaving
medications behind.4 Pre-ravel preparation for
health care needs can help alleviate unexpected challenges that
may hamper travel.
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Preparation for travel should include evaluation of the traveler’s
overall health, the travel itinerary (location, extended, extreme,
wilderness, diving, climbing, spelunking), conditions associated
with travel, conditions associated with the destination environment, personal
safety and security, available health care, the contents of an emergency
medical kit. Specific health concerns to consider are infection,
accidents, environmental exposures, physician availability, hospitalization, medical
evacuation, and health insurance.5 An excellent
source for information on traveling with children is the Web site
sponsored by the Centers for Disease Control and Prevention (CDC),
Traveler’s Health: Yellow Book at http://wwwn.cdc.gov/travel.
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Routine medical and dental care, including routine booster immunization,
should be reviewed and updated prior to travel. Any recommended
immunization and prophylaxis therapy for travel destinations should
begin at least 6 weeks before departure. Sufficient supply of routine
prescribed medications, medical supplies (inhalers, syringes), sunscreen,
and insect repellents should be packed before departure. Proper
documentation, including birth certificate or passport, immunization
records, health record summary, list of prescribed generic medications,
list of personal physician(s), and health insurance information
should be carried on person during travel. Documentation duplicates
can be packed in checked luggage.1 Families should
learn the location of health care facilities and physician services
in points of destinations and obtain adequate travel and medical
evacuation insurance.
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When traveling, early signs and symptoms of possible severe illness,
such as high fevers, lethargy, sudden irritability, dehydration
(dry mouth, no tears), persistent diarrhea, and respiratory distress,
should alert parents to seek medical attention. Parents should learn
emergency phone numbers and how to contact local medical clinics
prior to arriving or upon arrival at the final destination. Having
personal medical history documentation on hand (preferably signed
by personal physician) will help facilitate timely treatment. If
drug compounding, injection, intravenous catheterization, or blood product
transfusion is necessary, parents should inquire about and/or
observe preparation and procedure to ensure patient safety. If parents seek
alternative care, such as acupuncture, ...