Immunizations.

Vaccinations are a cornerstone of the pretravel consultation. The pretravel provider should assess a traveler's past medical history, planned itinerary, activities, mode of travel, and duration of stay and make appropriate vaccine recommendations. Given that domestic vaccine-preventable illnesses are more common in international travelers than are exotic or low-income nation-associated vaccine-preventable illnesses, clinicians should first ensure that travelers are current regarding routine immunizations.

United States epidemiology of hepatitis A: influenced by immigrants visiting friends and relatives in Mexico?

Among the industrialized nations, the United States annually receives the greatest number of immigrants as permanent residents. Immigrants from Mexico have represented the largest segment of the foreign-born population in recent decades, and continued growth of Mexican immigration is predicted for the decades ahead. The changing demographics of this population, including the emergence of new immigrant growth centers, will influence the future epidemiology of hepatitis A virus transmission in the United States.

Intestinal parasites.

Although safe and efficacious broad-spectrum antiparasitic drugs have been developed, their availability for use in mass-treatment programs and for individual treatment worldwide can be limited by economic resources, existing manufacturing and distribution networks, and national regulations. Increasing population density, environmental pollution with human waste products, and global migration patterns will continue to promote transmission of human intestinal parasites in the foreseeable future because untreated or incompletely treated infected individuals can serve as roving reservoirs of infection for long-lived parasites. Asking primary care patients about possible geographic exposures and activities associated with an increased likelihood of intestinal parasite infection is an important part of the medical history.

An open randomized study of inactivated hepatitis A vaccine administered concomitantly with typhoid fever and yellow fever vaccines.

Background: Concomitant administration of several vaccines is a common practice when travel clinics prepare persons for international travel. The purpose of the study was to compare the immunogenicity and safety of hepatitis A, typhoid fever, and yellow fever vaccines administered concomitantly with hepatitis A vaccine administered alone and typhoid fever and yellow fever vaccines administered alone.

Methods: Healthy adults 18 to 55 years of age were randomized to receive either VAQTA, TyphimVi, and YF-VAX on day 0 and VAQTA at week 24 (Group 1); TyphimVi and YF-VAX on day 0 and an optional dose of VAQTA 1 month later (Group 2); or VAQTA at day 0 and week 24 (Group 3).