Disease Risk Assessment

Disease risk assessment and recommendations are found on multiple governmental sites.

In addition to the sites listed earlier, the primary US source is the Centers for Disease Control at http://www.cdc.gov/travel/

The World Health site is: http://www.who.int/ith/

Many private travel medicine sites reproduce material from the above sites. An informative pharmaceutical industry portal site is: http://www.surf-for-safe-travel.com, which is financed by GalaxoSmithKline. It in turn will link you to http://www.fitfortravel.com/en/, the website of the University of Munich Tropical Institute; and http://www.travelmedicineweb.org/, which is also funded by GSK containing articles especially written for this site and links to many outside sites such as commercial CME offerings, etc. Another portal site is http://www.us.aventispasteur.com recently renamed http://www.sanofipasteur.us  with multiple resource areas for both professional and public access.

IAMAT is a non-profit membership that maintains a network of physicians - general practitioners and specialists, hospitals and clinics around the world - who have agreed to treat IAMAT members in need of medical care during their journey. Their aim is also to advise travelers about health risks, the geographical distribution of diseases, immunization requirements, sanitary conditions of water, milk and food, and environmental and climatic conditions around the world. Its website, http://www.iamat.org, contains unique, non-government filtered disease risk information and specific recommendations for international immunization compiled by its international scientific advisory board. Membership in IAMAT is free and access to the website is immediate even without membership.

The International Society for Travel Medicine (ISTM) website at http://www.istm.org has a particularly useful link to non-ISTM information resources on its web site, which is hosted at http://info.dom.uab.edu/gorgas/geomed/links2.html.

Assigning countries to one of three zones can roughly calculate disease risk.

ZONE I

Health risk in these countries is the same as expected here at home.  In fact Zone I includes the United States and Canada, the nations of northern Europe (to include France), and New Zealand and Australia. Advise persons visiting these countries to obtain routine age specific and special risk immunizations.

ZONE II

There is an increased health risk in these countries which include European countries bordering the Mediterranean (except France), all islands of the Caribbean (except Haiti and the Dominican Republic), Israel, South Africa, Japan, Eastern Europe, and the Soviet Union.  Besides the expected illnesses of Zone I, there is increased exposure to the food‑ and water‑borne diseases. Immunization with typhoid and hepatitis A is appropriate.

ZONE III

Countries in this highest risk area include all nations in Central and South America, Mexico, the Dominican Republic, Haiti, and all nations in Asia and Africa, except Japan, Israel, and South Africa.  In addition to the exposure risks of Zones I and II, the traveler will encounter significant exposure to insect‑borne illness, as well as increased risk to the food‑ and water‑borne diseases. Immunize with typhoid and hepatitis A as in Zone II and additionally Japanese encephalitis or yellow fever if appropriate and advise the traveler to take additional insect protection precautions.