Principles of pretravel health care

• Advise the patient to plan early—at least 8 weeks beforehand.

• Allow adequate time for consultation, e.g. 30-45 minutes.

• Individualise advice.

• Provide current information.

• Provide written as well as verbal advice.

• Provide a letter concerning existing medical illness and treatment.

• Encourage personal responsibility.

The commonest problem facing travellers is traveller's diarrhoea but other important diseases caused by poor sanitation include hepatitis A, and worm infestations such as hookworm and schistosomiasis. Contamination of food and water is a major problem especially in Third World countries. Reputable soft drinks, such as Coca-Cola, should be recommended for drinking. Indian-style tea, in which the milk is boiled with tea, is usually safe, but tea with added milk is not. The food handlers can be infected and the water used to wash food may be contaminated.

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