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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.

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

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.

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, ...

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