Chapter 2The Pre-Travel ConsultationCounseling & Advice for Travelers

Amanda D. Whatley, Candace M. Marshall

OVERVIEW

An important step in preparing for international travel is for travelers to assemble a travel health kit. The contents of a travel health kit should be tailored to the traveler’s needs, type of travel, length of travel, and destination. A travel health kit can help to ensure travelers have supplies they need to:

• Manage preexisting medical conditions and treat any exacerbations of these conditions
• Prevent illness related to traveling
• Take care of minor health problems as they occur

Travel health kits can be assembled at home or purchased at a local store, pharmacy, or online.

TRAVELING WITH MEDICATIONS

All medications should be carried in their original containers with clear labels, so the contents are easily identified. When carrying prescription medications, the patient’s name and dose regimen should be on the container. Although many travelers prefer placing medications into small containers or packing them in daily-dose containers, officials at ports of entry may require proper identification of medications.

Travelers should carry copies of all prescriptions, including their generic names. For controlled substances and injectable medications, travelers should carry a note from the prescribing physician or from the travel clinic on letterhead stationery. Certain medications are not permitted in certain countries. If there is a question about these restrictions, particularly with controlled substances, travelers should contact the embassy or consulate of the destination country.

A travel health kit is useful only when it is available. It should be carried with the traveler at all times (such as in a carry-on bag), although sharp objects must remain in checked luggage. Travelers should make sure that any liquid or gel-based items packed in the carry-on bags do not exceed the size limits. They can consult with the airline for all air-related travel restrictions.

SUPPLIES FOR PREEXISTING MEDICAL CONDITIONS

Travelers with preexisting medical conditions should carry enough medication for the duration of their trip and an extra supply, in case the trip is extended for any reason. If additional supplies or medications are needed to

manage exacerbations of existing medical conditions, these should be carried as well. The clinician managing a traveler’s preexisting medical conditions should be consulted for the best plan of action (see Chapter 8, Travelers with Chronic Illnesses).

People with preexisting conditions, such as diabetes or allergies, should consider wearing an alert bracelet (such as those available from www.medicalert.org) and making sure this information is on a card in their wallet and with their other travel documents.

GENERAL TRAVEL HEALTH KIT SUPPLIES

Although this is not a comprehensive list, basic items that should be considered for a travel health kit are listed below. See Chapters 7 and 8 for additional suggestions that may be useful in planning the contents of a kit for travelers with specific needs.

Medications

• Destination-related, if applicable:
  • Antimalarial medications
  • Medication to prevent or treat high-altitude illness
• Pain or fever (one or more of the following, or an alternative):
  • Acetaminophen
  • Aspirin
  • Ibuprofen
• Stomach upset or diarrhea:
  • Over-the-counter antidiarrheal medication (such as loperamide [Imodium] or bismuth subsalicylate [Pepto-Bismol])
  • Antibiotics for self-treatment of moderate to severe diarrhea
  • Packets of oral rehydration salts for dehydration
  • Mild laxative
  • Antacid
• Throat and respiratory discomfort:
  • Antihistamine
  • Decongestant, alone or in combination with antihistamine
  • Cough suppressant or expectorant
  • Throat lozenges
• Anti-motion sickness medication
• Epinephrine auto-injector (such as an EpiPen), especially if history of severe allergic reaction; smaller-dose packages are available for children
• Any medications, prescription or over the counter, taken on a regular basis at home

Basic First Aid

• Disposable gloves (≥2 pairs)
• Adhesive bandages, multiple sizes
• Gauze
• Adhesive tape
• Elastic bandage wrap for sprains and strains
• Antiseptic
• Cotton swabs
• Tweezers*
• Scissors*
• Antifungal and antibacterial ointments or creams
• 1% hydrocortisone cream
• Anti-itch gel or cream for insect bites and stings
• Aloe gel for sunburns
• Moleskin or molefoam for blisters
• Digital thermometer
• Saline eye drops
• First aid quick reference card

Other Important Items

• Insect repellent (see the Protection against Mosquitoes, Ticks, and Other Insects and Arthropods section earlier in this chapter for recommended types)
• Sunscreen (≥15 SPF)
• Antibacterial hand wipes or an alcohol-based hand cleaner, containing at least 60% alcohol
• Useful items in certain circumstances:
  • Extra pair of contact lenses, prescription glasses, or both, for people who wear corrective lenses
  • Mild sedative (such as zolpidem [Ambien]), other sleep aid, or antianxiety medication
  • Latex condoms
  • Water purification tablets
  • Commercial suture or syringe kits to be used by a local clinician. (These items will require a letter from the prescribing physician on letterhead stationery.)

*Note: If traveling by air, travelers should pack these sharp items in checked baggage, since they could be confiscated by airport or airline security if packed in carry-on bags.

Contact Card

Travelers should carry a contact card with the addresses and phone numbers of the following:

• Family member or close contact remaining in the United States
• Place of lodging at the destination
• Health care provider(s) at home
• Medical insurance information
• Travel insurance and medical evacuation insurance information
• Area hospitals or clinics, including emergency services
• US embassy or consulate in the destination country or countries

See the Obtaining Health Care Abroad for the Ill Traveler section later in this chapter for information about how to locate local health care and embassy or consulate contacts.

Travelers should also leave a copy of this contact card with a family member or close contact who will remain in the United States, in case of an emergency.

COMMERCIAL MEDICAL KITS

Commercial medical kits are available for a wide range of circumstances, from basic first aid to advanced emergency life support. Many pharmacy, grocery, retail, and outdoor sporting goods stores sell their own basic first aid kits. Travelers who choose to purchase a health kit should review the contents of the kit carefully to ensure that it has everything needed. Additional items may be necessary and can be added to the purchased kit.

For more adventurous travelers, a number of companies produce advanced medical kits and will even customize kits based on specific travel needs. In addition, specialty kits are available for managing diabetes, dealing with dental emergencies, and handling aquatic environments. Below is a list of websites supplying a wide range of medical kits. There are many suppliers, and this list is not meant to be all-inclusive.

• American Red Cross: www.redcrossstore.org
• Adventure Medical Kits: www.adventuremedicalkits.com
• Chinook Medical Gear: www.chinookmed.com
• International Medical Center: www.traveldoc.com/products/kits.aspx
• Travel Medicine, Inc.: www.travmed.com
• Wilderness Medicine Outfitters: www.wildernessmedicine.com

BIBLIOGRAPHY

1. Rose SR, Keystone JS. Chapter 2, trip preparation. In: Rose SR, Keystone JS, editors. International Travel Health Guide. 14th ed. Northampton: Travel Medicine, Inc; 2008.
2. Weiss EA, Franco-Paredes C. Travel health and medical kits. In: Keystone JS, Kozarsky PE, Freedman DO, Nothdurft HD, Connor BA, editors. Travel Medicine. 2nd ed. Philadelphia: Mosby; 2008. p. 69–74.
3. World Health Organization. WHO guidelines on hand hygiene in health care. Geneva: World Health Organization; 2009 [updated 2010 Nov 9]. Available from: http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf.