Making travel safe

As the Asian tsunami disaster has so tragically shown, travel is not always safe or predictable. Making travel as safe as possible is, however, the goal of travel medicine, which has emerged as a specialised discipline as well as an interesting and challenging part of the work of many general practitioners.

The popularity of the first edition of this Manual of travel medicine, published by the Victorian Infectious Diseases Service in 1999, demonstrated that doctors and other health professionals providing pre-travel health advice were looking for a desktop reference of high quality information. The fact that the manual comes from a group of very experienced and qualified Australian authors is of substantial value, as it complements the information available in other publications such as the Australian immunisation handbook and the WHO publication, International travel and health.

Controversies and differences in opinion, such as whether to recommend hepatitis B vaccination to all or only higher risk subgroups of travellers and the use of bacille Calmette – Guérin (BCG) vaccine in travellers, are discussed, and the recommendations of key authorities, and the authors’ own opinion are provided.

The manual focuses on pre-travel health advice and does not cover assessment and treatment of the unwell returned traveller. Although this is a substantial omission, it is not a major drawback for a GP readership who are mainly providing pre-travel health advice. As might be expected with an author list entirely made up of infectious diseases specialists, there is a focus on vaccine preventable diseases plus substantial chapters on malaria prevention, and prevention and management of travellers’ diarrhoea. Non-vaccine preventable diseases including severe acute respiratory syndrome (SARS) are covered, and there are sections on non-infectious problems such as venous thrombosis, altitude sickness and jet lag.

Though not as inexpensive as the first, this edition of the Manual of travel medicine is still reasonably priced, and has the advantages of a more professional look and the welcome addition of an index.

Nicholas A ZwarProfessor, General Practice Unit, Fairfield Hospital, NSW