Hrev_master [Healthcare in Low-resource Settings 2013; 1:e14] [page 53] Application of emporiatrics in minimizing travelers’ health risks Saurabh R. Shrivastava, Prateek S. Shrivastava, Jegadeesh Ramasamy Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, India Dear Editor, Emporiatrics or travel medicine deals with the prevention and management of health problems of international travelers.1 The num- ber of people undertaking international travels is on the rise every year and with that, travel- related risks to their health are increasing.2 Travel on a global scale exposes many people to a range of health risks varying from exposure to different disease agents to changes in the physical/biological environment, all of which can lead to ill-health.2,3 However, many of these risks can be minimized by appropriate travel planning and precautionary measures.2,3 The need of maintaining the health of travelers has been realized in different studies.4,5 The mitigation measures should start right from the assessment of the determinants of the health risks to which travelers are exposed: e.g., health status before undertaking travel (viz. underlying chronic disease/low immuni- ty); place of travel (viz. facility of accommoda- tion/hygiene-sanitation/provision of medical services); purpose and duration of travel and travelers’ behavior.6 Preventive strategies can be planned based on the risks to which travel- ers can be exposed. The travel must be planned well in advance and safeguard measures should be taken before, during and after travel. Actions which the traveler must take prior to the commencement of the journey should be learning about the destination (ascertaining health risks prevalent in the area, climate, availability of health care facilities, etc.); med- ical consultation for necessary immunizations or for an ongoing health concern;7 obtaining special travelers health insurance for destina- tions where health risks are significant and medical care is expensive/not readily available; and carrying a medical/first-aid kit. During travel to the concerned destination, travelers should ensure an adequate sleep before leaving, wear loose and comfortable clothes, and have light meals and plenty of water. During their stay-period, they should be careful about food and water safety, practice safe sex, minimize injuries by wearing closed- toe shoes to prevent cuts/wounds/insect or snake bites/or infection from parasites, prac- tice swimming only in pools filled with clean- disinfected water, abide by local traffic regula- tions to avoid road traffic accidents, and regu- larly use an insect repellent to prevent insect bites.2,3 The active measures should not be confined to the period of travel. Rather, all travelers, after return, must undergo medical examina- tion if they have spent more than three months in a developing country, they suffer from a chronic disease or the existing disease condi- tion has worsened, they consider that they have been exposed to a serious infection dur- ing the travel, and they experience illnesses like fever, persistent diarrhea, jaundice, skin or genital infections, in the weeks following their return.2 In low-resource countries where there are constraints on availability of resources (viz. healthcare services), there is an immense need for advocacy by the policy makers and facilitation of travel medicine as a separate specialty by the Government. Clinicians and private medical practitioners should be made acquainted with the travel medicine/diseases which may occur in patients with a history of foreign travel so that they should be aware of the risks when treating them.8 To conclude, in order to avoid any deviation from healthy status, every traveler has to be proactive. Emporiatrics will have an important role in future years not only in identifying new risks but also in establishing new methods of therapy and prophylaxis for the travelers’ benefit. References 1. Burchard GD. Travel medicine-the next 10 years. Eur J Med Res 1999;4:399-402. 2. World Health Organization. International travel and health. Geneva: WHO ed.; 2010. 3. Park K. Principles of epidemiology and epi- demiologic methods. In: Park K, ed. Text book of preventive and social medicine. 21st ed. Jabalpur: Banarsidas Bhanot Publ.; 2011. p 116. 4. Schlaudecker JD, Moushey EN, Schlaudecker EP. Keeping older patients healthy and safe as they travel. J Fam Practice 2013;62:16-23. 5. Jensenius M, Han PV, Schlagenhauf P, et al. Acute and potentially life-threatening tropical diseases in western travelers. A geo-sentinel multicenter study, 1996-2011. Am J Trop Med Hyg 2013;88:397-404. 6. Zimmermann R, Hattendorf J, Blum J, et al. Risk perception of travelers to tropical and subtropical countries visiting a swiss travel health center. J Travel Med 2013; 20:3-10. 7. Hainsworth T. Travel vaccines: a guide to appropriate use. Nurs Times 2002;98:40-2. 8. Heywood AE, Watkins RE, Iamsirithaworn S, et al. A cross-sectional study of pre-trav- el health-seeking practices among travel- ers departing Sydney and Bangkok air- ports. BMC Public Health 2012;12:321. Healthcare in Low-resource Settings 2013; volume 1:e14 Correspondence: Saurabh R. Shrivastava, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Thiruporur-Guduvancherry main road, 603108 Kancheepuram, India. Tel./Fax: +91.988.422.7224. E-mail: drshrishri2008@gmail.com Key words: emporiatrics, vaccine, risk, travel medicine. Received for publication: 19 March 2013. Revision received: 26 March 2013. Accepted for publication: 31 March 2013. This work is licensed under a Creative Commons Attribution 3.0 License (by-nc 3.0). ©Copyright S.R. Shrivastava et al., 2013 Licensee PAGEPress, Italy Healthcare in Low-resource Settings 2013; 1:e14 doi:10.4081/hls.2013.e14 Non -co mmerc ial us e o nly