Medical Aspects of Travel: Editorial Overview

Interest in tropical medicine began several hundred years ago, when Europeans, primarily, traveled to Africa, Asia, and Latin America in search of land, adventure, and riches. They often returned from their travels with tropical diseases. The diagnosis and treatment of these diseases became an important part of medicine in the late 1800s and early 1900s. Eventually, interest expanded from treating those who returned ill from the tropics to studying the etiology and pathogenesis of tropical diseases. Fortunately, investigations into malaria, yellow fever, filariasis, and other diseases of the tropics gradually included the important goal of providing improved health care for those who live in the developing world. Today there are millions of persons who travel annually from the developed world to Asia, Africa, and Latin America for vacations, business, teaching, research, or missionary opportunities. Although these travelers are still exposed to the many diseases prevalent in those areas, the differences now are that the illnesses are well described clinically, their pathogenesis is being investigated, and, for many of them, therapy and prophylactic measures have been developed. In order to deal with the wide range of preventive measures for the international traveler, the field of travel medicine, or emporiatrics, has developed. Clinicians in this field provide travelers with up-to-date and accurate preventive advice, immunizations , and prophylactic medications and are available to evaluate the traveler who returns ill. The growth of travel medicine has led to the formation of a specialty group within the American Society of Tropical Medicine and Hygiene, an International Society of Travel Medicine, and numerous national and international conferences devoted to providing health care for the traveler [1]. At the University of Connecticut Health Center in September 1990, such a course on travel medicine, entitled "Medical Aspects of Travel," was held. It covered several areas important to those providing advice to the international traveler. Many of these topics are included in this issue of The Yale Journal ofBiology and Medicine, and I am grateful to the Joumal and its editorial staff for their interest and support in bringing this symposium to print. One fact which emerges as one reads the literature of emporiatrics is that it is important to individualize the preventive measures given to each traveler based on age, whether there exist any concomitant medical problems , and on the specific itinerary, including whether urban and/or rural areas will be visited. The first article discusses "Immunizations …