Preparing Children for International Travel

Hiba Chehab; Philip R. Fischer; John C. Christenson

doi:10.1542/pir.2018-0353

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Hiba Chehab, MD, FAAP*
Philip R. Fischer, MD, FAAP†,‡
John C. Christenson, MD, FAAP*

^*Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, IN
^†Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
^‡Pediatrics Department, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates

AUTHOR DISCLOSURE
Drs Chehab, Fischer, and Christenson have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Abbreviations:

CDC :: Centers for Disease Control and Prevention
DEET N :: N-diethyl-m-toluamide
HACE :: high-altitude cerebral edema
HAI :: high-altitude illness
HAPE :: high-altitude pulmonary edema
MenACWY :: meningococcal quadrivalent conjugate vaccine
MMR :: measles-mumps-rubella
PCR :: polymerase chain reaction
TD :: traveler’s diarrhea

Practice Gaps

Pediatricians may be unfamiliar with agents that are most effective for antimalarial prophylaxis for a young infant traveler.
Pediatricians may not realize that measles-mumps-rubella and hepatitis A vaccines are recommended for infant travelers 6 months and older.

Objectives

After completing this article, readers should be able to:

Select the most appropriate antimalarial prophylaxis agent according to high-risk regions.
Use insect bite prevention strategies to prevent malaria, dengue, and other vector-borne diseases.
Recognize which vaccines are necessary for the young pediatric traveler.

Introduction

Traveling with a child can be emotionally and educationally rewarding but challenging as well. Children are traveling from North America and Europe to most parts of the world, including Sub-Saharan Africa, Asia, and Central and South America. The most common reasons to travel are for leisure and to visit friends and relatives. (1) Children also accompany their families for pilgrimages, study abroad experiences, and parental work. Older children and adolescents travel as part of educational tours and humanitarian mission trips. Similar to adults, children traveling to potentially high-risk regions of the world expose themselves to risks of acquiring malaria, dengue, and diarrheal diseases. These diseases, followed by dermatologic conditions such as cellulitis, bites, and cutaneous larva migrans, are among the most common problems observed in pediatric travelers. Travelers visiting friends and relatives are at a greater risk because most do not visit travel clinics for advice or immunizations. (2)(3) They also tend to visit more remote parts of high-risk countries and stay for longer durations. Although at-risk children may not visit a travel clinic, they may be seen by their primary care health provider. Pediatricians, through setting …