Patients planning to travel to other countries often ask for information about appropriate vaccines and prevention of diarrhea and malaria. More detailed advice for travelers is available from the Centers for Disease Control and Prevention (CDC) at www.cdc.gov/travel. Guidelines are also available from the Infectious Diseases Society of America (IDSA).

Patients planning to travel to other countries often ask physicians for information about appropriate vaccines and prevention of diarrhea and malaria. Guidelines are also available from the Infectious Diseases Society of America (IDSA).

Patients planning to travel to other countries often ask physicians for information about immunizations and prevention of diarrhea and malaria. More detailed advice for travelers is available from the Centers for Disease Control and Prevention at 877-FYI-TRIP (877-394-8747) or www.cdc.gov/travel.

Many patients planning to travel seek advice about prevention of malaria. No drug is 100% effective for this indication; travelers should be told to take other protective measures as well. Malaria in pregnancy is particularly serious for both mother and fetus; prophylaxis is indicated if travel cannot be avoided. Countries with a risk of malaria are listed in the table on page 102. Some countries with endemic malaria transmission may not have malaria in the most frequently visited major cities and rural tourist resorts.

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Picaridin (KBR 3023), which has been used as an insect repellent for years in Europe and Australia (Autan Repel, and others), is now available in the US in 7% solution as Cutter Advanced (Spectrum Brands). The US Centers for Disease Control and Prevention (CDC) is recommending it as an alternative to DEET.

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Insect repellents have been used on the skin for many years, primarily to prevent mosquito bites, which transmit malaria, West Nile virus infection, and various types of encephalitis. With increased concern about Lyme disease in recent years, skin and clothing repellents are now also recommended for protection against ticks. This review describes the effectiveness of the most widely used repellents DEET and permethrin , as well as some alternatives, and a new product called picaridin that may be available soon. The safety of these products is also discussed. The review concludes with an overall assessment of safety and efficacy and a recommendation on how to achieve the best protection.

Patients planning to travel to other countries often ask physicians for advice about immunizations and prevention of diarrhea and malaria. More detailed advice for travelers is available from the CDC at 877-FYI-TRIP (877-394-8747) or www.cdc.gov/travel.