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. 1992 Jul-Aug;65(4):317–327.

The pre-travel medical evaluation: the traveler with chronic illness and the geriatric traveler.

J E Patterson 1
PMCID: PMC2589584  PMID: 1290273

Abstract

The pre-travel medical evaluation of elderly patients and patients with chronic illness requires special assessment and advice. Screening and special precautions are reviewed for traveling patients with respiratory disease, cardiac disease, sinusitis, diabetes mellitus, HIV infection, and other chronic medical conditions. Current guidelines for empiric therapy and prophylaxis of travelers' diarrhea are reviewed, with emphasis on concerns in geriatric or chronically ill travelers. Special considerations such as potential drug-drug interactions and insurance coverage are also discussed.

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Selected References

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  1. Baciewicz A. M., Swafford W. B., Jr Hypoglycemia induced by the interaction of chlorpropamide and co-trimoxazole. Drug Intell Clin Pharm. 1984 Apr;18(4):309–310. doi: 10.1177/106002808401800407. [DOI] [PubMed] [Google Scholar]
  2. Baskin D. H., Lax J. D., Barenberg D. Shigella bacteremia in patients with the acquired immune deficiency syndrome. Am J Gastroenterol. 1987 Apr;82(4):338–341. [PubMed] [Google Scholar]
  3. Bernard E., Roger P. M., Carles D., Bonaldi V., Fournier J. P., Dellamonica P. Diarrhea and Campylobacter infections in patients infected with the human immunodeficiency virus. J Infect Dis. 1989 Jan;159(1):143–144. doi: 10.1093/infdis/159.1.143. [DOI] [PubMed] [Google Scholar]
  4. Black R. E. Epidemiology of travelers' diarrhea and relative importance of various pathogens. Rev Infect Dis. 1990 Jan-Feb;12 (Suppl 1):S73–S79. doi: 10.1093/clinids/12.supplement_1.s73. [DOI] [PubMed] [Google Scholar]
  5. Costel E. E., Wheeler A. P., Gregg C. R. Campylobacter fetus ssp fetus cholecystitis and relapsing bacteremia in a patient with acquired immunodeficiency syndrome. South Med J. 1984 Jul;77(7):927–928. doi: 10.1097/00007611-198407000-00035. [DOI] [PubMed] [Google Scholar]
  6. Cottrell J. J. Altitude exposures during aircraft flight. Flying higher. Chest. 1988 Jan;93(1):81–84. doi: 10.1378/chest.93.1.81. [DOI] [PubMed] [Google Scholar]
  7. Cruickshank J. M., Gorlin R., Jennett B. Air travel and thrombotic episodes: the economy class syndrome. Lancet. 1988 Aug 27;2(8609):497–498. doi: 10.1016/s0140-6736(88)90134-1. [DOI] [PubMed] [Google Scholar]
  8. Cummins R. O., Chapman P. J., Chamberlain D. A., Schubach J. A., Litwin P. E. In-flight deaths during commercial air travel. How big is the problem? JAMA. 1988 Apr 1;259(13):1983–1988. [PubMed] [Google Scholar]
  9. Dillard T. A., Berg B. W., Rajagopal K. R., Dooley J. W., Mehm W. J. Hypoxemia during air travel in patients with chronic obstructive pulmonary disease. Ann Intern Med. 1989 Sep 1;111(5):362–367. doi: 10.7326/0003-4819-111-5-362. [DOI] [PubMed] [Google Scholar]
  10. DuPont H. L. Chemoprophylaxis remains an option in travelers' diarrhea. Am J Gastroenterol. 1991 Apr;86(4):403–404. [PubMed] [Google Scholar]
  11. DuPont H. L., Galindo E., Evans D. G., Cabada F. J., Sullivan P., Evans D. J., Jr Prevention of travelers' diarrhea with trimethoprim-sulfamethoxazole and trimethoprim alone. Gastroenterology. 1983 Jan;84(1):75–80. [PubMed] [Google Scholar]
  12. DuPont H. L., Hornick R. B. Adverse effect of lomotil therapy in shigellosis. JAMA. 1973 Dec 24;226(13):1525–1528. [PubMed] [Google Scholar]
  13. Duckett Margaret, Orkin Andrew J. AIDS-related migration and travel policies and restrictions: a global survey. AIDS. 1989;3(Suppl 1):S231–S252. doi: 10.1097/00002030-198901001-00034. [DOI] [PubMed] [Google Scholar]
  14. Dworkin B., Wormser G. P., Abdoo R. A., Cabello F., Aguero M. E., Sivak S. L. Persistence of multiply antibiotic-resistant Campylobacter jejuni in a patient with the acquired immune deficiency syndrome. Am J Med. 1986 May;80(5):965–970. doi: 10.1016/0002-9343(86)90646-7. [DOI] [PubMed] [Google Scholar]
  15. Ericsson C. D., DuPont H. L., Mathewson J. J., West M. S., Johnson P. C., Bitsura J. A. Treatment of traveler's diarrhea with sulfamethoxazole and trimethoprim and loperamide. JAMA. 1990 Jan 12;263(2):257–261. [PubMed] [Google Scholar]
  16. Fairhurst R. J. The invalid passenger and air transport. Practitioner. 1976 Aug;217(1298):229–234. [PubMed] [Google Scholar]
  17. Fischl M. A., Dickinson G. M., Sinave C., Pitchenik A. E., Cleary T. J. Salmonella bacteremia as manifestation of acquired immunodeficiency syndrome. Arch Intern Med. 1986 Jan;146(1):113–115. [PubMed] [Google Scholar]
  18. Giannella R. A., Broitman S. A., Zamcheck N. Influence of gastric acidity on bacterial and parasitic enteric infections. A perspective. Ann Intern Med. 1973 Feb;78(2):271–276. doi: 10.7326/0003-4819-78-2-271. [DOI] [PubMed] [Google Scholar]
  19. Glaser J. B., Morton-Kute L., Berger S. R., Weber J., Siegal F. P., Lopez C., Robbins W., Landesman S. H. Recurrent Salmonella typhimurium bacteremia associated with the acquired immunodeficiency syndrome. Ann Intern Med. 1985 Feb;102(2):189–193. doi: 10.7326/0003-4819-102-2-189. [DOI] [PubMed] [Google Scholar]
  20. Gong H., Jr Advising patients with pulmonary diseases on air travel. Ann Intern Med. 1989 Sep 1;111(5):349–351. doi: 10.7326/0003-4819-111-5-349. [DOI] [PubMed] [Google Scholar]
  21. Gong H., Jr Air travel and patients with chronic obstructive pulmonary disease. Ann Intern Med. 1984 Apr;100(4):595–597. doi: 10.7326/0003-4819-100-4-595. [DOI] [PubMed] [Google Scholar]
  22. Gong H., Jr, Tashkin D. P., Lee E. Y., Simmons M. S. Hypoxia-altitude simulation test. Evaluation of patients with chronic airway obstruction. Am Rev Respir Dis. 1984 Dec;130(6):980–986. doi: 10.1164/arrd.1984.130.6.980. [DOI] [PubMed] [Google Scholar]
  23. Henry J. N., Krenis L. J., Cutting R. T. Hypoxemia during aeromedical evacuation. Surg Gynecol Obstet. 1973 Jan;136(1):49–53. [PubMed] [Google Scholar]
  24. Johnson J. F., Dobmeier M. E. Symptomatic hypoglycemia secondary to a glipizide-trimethoprim/sulfamethoxazole drug interaction. DICP. 1990 Mar;24(3):250–251. doi: 10.1177/106002809002400307. [DOI] [PubMed] [Google Scholar]
  25. Johnson P. C., Ericsson C. D., Morgan D. R., Dupont H. L., Cabada F. J. Lack of emergence of resistant fecal flora during successful prophylaxis of traveler's diarrhea with norfloxacin. Antimicrob Agents Chemother. 1986 Nov;30(5):671–674. doi: 10.1128/aac.30.5.671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Kozicki M., Steffen R., Schär M. 'Boil it, cook it, peel it or forget it': does this rule prevent travellers' diarrhoea? Int J Epidemiol. 1985 Mar;14(1):169–172. doi: 10.1093/ije/14.1.169. [DOI] [PubMed] [Google Scholar]
  27. Lake-Bakaar G., Quadros E., Beidas S., Elsakr M., Tom W., Wilson D. E., Dincsoy H. P., Cohen P., Straus E. W. Gastric secretory failure in patients with the acquired immunodeficiency syndrome (AIDS). Ann Intern Med. 1988 Sep 15;109(6):502–504. doi: 10.7326/0003-4819-109-6-502. [DOI] [PubMed] [Google Scholar]
  28. Love J. T., Jr, Caruso V. G. Civilian air travel and the otolaryngologist. Laryngoscope. 1978 Nov;88(11):1732–1742. doi: 10.1288/00005537-197811000-00002. [DOI] [PubMed] [Google Scholar]
  29. Murray B. E., Rensimer E. R., DuPont H. L. Emergence of high-level trimethoprim resistance in fecal Escherichia coli during oral administration of trimethoprim or trimethoprim--sulfamethoxazole. N Engl J Med. 1982 Jan 21;306(3):130–135. doi: 10.1056/NEJM198201213060302. [DOI] [PubMed] [Google Scholar]
  30. Ongerth J. E., Johnson R. L., Macdonald S. C., Frost F., Stibbs H. H. Back-country water treatment to prevent giardiasis. Am J Public Health. 1989 Dec;79(12):1633–1637. doi: 10.2105/ajph.79.12.1633. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Patterson J. E., Patterson T. F., Bia F. J., Barry M. Assuring safe travel for today's elderly. Geriatrics. 1989 Oct;44(10):44-6, 49-53, 57. [PubMed] [Google Scholar]
  32. Reves R. R., Johnson P. C., Ericsson C. D., DuPont H. L. A cost-effectiveness comparison of the use of antimicrobial agents for treatment or prophylaxis of travelers' diarrhea. Arch Intern Med. 1988 Nov;148(11):2421–2427. [PubMed] [Google Scholar]
  33. Richards P. R. The effects of air travel on passengers with cardiovascular and respiratory diseases. Practitioner. 1973 Feb;210(256):232–241. [PubMed] [Google Scholar]
  34. Ryan C. A., Hargrett-Bean N. T., Blake P. A. Salmonella typhi infections in the United States, 1975-1984: increasing role of foreign travel. Rev Infect Dis. 1989 Jan-Feb;11(1):1–8. doi: 10.1093/clinids/11.1.1. [DOI] [PubMed] [Google Scholar]
  35. Sack R. B., Froehlich J. L., Zulich A. W., Hidi D. S., Kapikian A. Z., Orskov F., Orskov I., Greenberg H. B. Prophylactic doxycycline for travelers' diarrhea: results of a prospective double-blind study of Peace Corps volunteers in Morocco. Gastroenterology. 1979 Jun;76(6):1368–1373. [PubMed] [Google Scholar]
  36. Sarvesvaran R. Sudden natural deaths associated with commercial air travel. Med Sci Law. 1986 Jan;26(1):35–38. doi: 10.1177/002580248602600108. [DOI] [PubMed] [Google Scholar]
  37. Schwartz J. S., Bencowitz H. Z., Moser K. M. Air travel hypoxemia with chronic obstructive pulmonary disease. Ann Intern Med. 1984 Apr;100(4):473–477. doi: 10.7326/0003-4819-100-4-473. [DOI] [PubMed] [Google Scholar]
  38. Sperber S. J., Schleupner C. J. Salmonellosis during infection with human immunodeficiency virus. Rev Infect Dis. 1987 Sep-Oct;9(5):925–934. doi: 10.1093/clinids/9.5.925. [DOI] [PubMed] [Google Scholar]
  39. Steffen R. Worldwide efficacy of bismuth subsalicylate in the treatment of travelers' diarrhea. Rev Infect Dis. 1990 Jan-Feb;12 (Suppl 1):S80–S86. doi: 10.1093/clinids/12.supplement_1.s80. [DOI] [PubMed] [Google Scholar]
  40. Taylor D. N., Sanchez J. L., Candler W., Thornton S., McQueen C., Echeverria P. Treatment of travelers' diarrhea: ciprofloxacin plus loperamide compared with ciprofloxacin alone. A placebo-controlled, randomized trial. Ann Intern Med. 1991 May 1;114(9):731–734. doi: 10.7326/0003-4819-114-9-731. [DOI] [PubMed] [Google Scholar]
  41. Ullrich R., Zeitz M., Heise W., L'age M., Höffken G., Riecken E. O. Small intestinal structure and function in patients infected with human immunodeficiency virus (HIV): evidence for HIV-induced enteropathy. Ann Intern Med. 1989 Jul 1;111(1):15–21. doi: 10.7326/0003-4819-111-1-15. [DOI] [PubMed] [Google Scholar]
  42. Whimbey E., Gold J. W., Polsky B., Dryjanski J., Hawkins C., Blevins A., Brannon P., Kiehn T. E., Brown A. E., Armstrong D. Bacteremia and fungemia in patients with the acquired immunodeficiency syndrome. Ann Intern Med. 1986 Apr;104(4):511–514. doi: 10.7326/0003-4819-104-4-511. [DOI] [PubMed] [Google Scholar]
  43. Wilson M. E., von Reyn C. F., Fineberg H. V. Infections in HIV-infected travelers: risks and prevention. Ann Intern Med. 1991 Apr 1;114(7):582–592. doi: 10.7326/0003-4819-114-7-582. [DOI] [PubMed] [Google Scholar]

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