About 1 in 30 travelers need when traveling abroad emergency assistance. An illness abroad may involve significant difficulties. Many health insurance plans do not apply abroad. Hospitals in other countries require foreigners often a substantial down payment in cash, regardless of insurance. Travel insurance incl. Medical transport mediated by travel agents and some credit card companies. There are lists of English or German doctors abroad. The messages can help in medical emergencies and also have information about the travel risks in the countries concerned (s. Useful contacts for people traveling abroad). Patients with severe disease should make arrangements with the tour operator before traveling so that in an emergency a medically supervised evacuation from abroad is guaranteed. Certain infections are common when traveling in certain areas. Useful contacts for people traveling abroad business phone numbers Website International Association for Medical Assistance to Travelers (IAMAT) USA: (716) 754-4883 (Niagara Falls, NY) Canada: (519) 836-0102 (Guelph, Ontario), ( 416) 652-0137 (Toronto, Ontario) http://www.iamat.org Centers for Disease Control and Prevention (CDC) US: toll-free (800) CDC-INFO (800-232-4636) TTY: (888) 232 -6348 (Atlanta, GA) http://www.cdc.gov/travel CDC Malaria Hotline USA: (770) 488-7788 or (855) 856-4713; after hours, (770) 488-7100 (Atlanta, GA) http://www.cdc.gov/MALARIA/ US Department of State, Overseas Citizens Services USA: (888) 407-4747 (Washington, DC) http: / /www.travel.state.gov World Health Organization (WHO) International: (+41 22) -791-2111 (Geneva, Switzerland) http://www.who.int/en/ vaccines Some countries require specific vaccinations (s . vaccines for international travel *, , ). General travel and current information about vaccinations, immunization and malaria prophylaxis can be obtained from the Centers for Disease Control and Prevention (CDC), malaria hotline and Web site (see also the recommendations of the CDC Travelers’ Health: Vaccinations and Malaria and Travelers ). Vaccines for international travel *, , infection regions for which vaccination is recommended is hepatitis comments all low-income countries 2 doses ? 6 months apart, complete protection for 6-12 months after the first dose and for life after 2nd dose hepatitis B low-income countries, particularly China recommended for a longer stay and all health care workers Influenza all year in the tropics from April to September in the southern hemisphere; to April separated 2 doses at least 28 days of October in the Northern Hemisphere Recommended for all travelers> 6 months Japanese encephalitis Rural areas in most Asian countries, especially in areas where rice farming and pig farming Not recommended for pregnant women meningococcal infections Northern Africa below the Sahara to Ethiopia Mali (the meningitis belt) required for entry into Saudi Arabia during Hajj or Umrah all over the world, particularly in overcrowded living situations (eg. as residences) High risk during the dry season (December to June) Rabies All countries, including the United States Recommended for travelers (eg in danger of animal bites. B. Rural campers, veterinarians, farm workers, people in remote areas) Eliminates not the need for additional vaccinations after animal bite for added protection recommended during pregnancy only if the risk of infection is high fever all low-income countries, especially South Asia (including India) Tabelettenform: 1 tablet every other day for a total of 4 tablets; Vaccination: 5 years Not safe for pregnant women single injection protects for two years and is safer for pregnant women than the tablet form of the vaccine. Yellow Fever Tropical America Tropical Africa Although this infection is rare, is a vaccination for entry into many countries required Not safe for pregnant women increased risk of adverse events in elderly Menschen§. * In addition to the listed vaccinations vaccinations against measles, mumps, rubella, tetanus, diphtheria, polio, pneumococcal and varicella to date should be. All recommendations are subject to change. For the latest recommendations, s. Centers for Disease Control and Prevention (www.cdc.gov or 800-CDC-INFO [800-232-4636]). Overview of immunization. §Ärzte should consider freeing older travelers by a written statement from the vaccination, unless there is a high risk of exposure. Injury and death Traffic accidents are the leading cause of death when traveling abroad by young people and middle-aged persons. Travelers should, if possible, always wear a seat belt and wear a helmet when cycling. Motorcycle and moped trips should be avoided as well as riding on a bus roof or an open truck bed. To protect against drowning as another important cause of death when traveling abroad beaches should be avoided with turbulent breakers. Also, do not want to swim after drinking alcohol. The travelers ‘diarrhea Travelers’ diarrhea (traveler’s diarrhea) is the most common illness when traveling abroad. Although it is a self-limiting disease, which typically subsides after 5 days, 3-10% of travelers have 2 weeks symptoms and up to 3% even for a month. For a traveler’s diarrhea, lasting less than 1 week, no further investigation is required. In persistent diarrhea Laboratory tests are displayed (diarrhea: Test Procedure). A self-treatment is indicated for moderate to severe symptoms (? 3 unformed stools over 8 h), especially if vomiting, fever, abdominal cramps or blood present in the stool. The treatment is carried out with an appropriate antibiotic (in most regions z. B. fluoroquinolone, a macrolide in Southeast Asia such as azithromycin). Other measures include loperamide (except in patients with fever, blood in the stool or abdominal pain and in children <2 years); Replacement of liquid, and in the elderly and infants, electrolytes (eg. As an oral rehydration solution). Measures that can reduce the risk One of travelers' diarrhea are: drinking and brushing teeth with bottled water, filtered, boiled or chlorinated water Avoid ice cubes or ice in drinks fresh prepared foods should only be eaten if they have been very hot, it should only fruits and vegetables are eaten with shells that were peeled by the traveler himself avoiding foods from street vendors Frequent hand washing Avoid all foods that fly may have been exposed Prophylactic antibiotics are effective in preventing diarrhea, but should take into account possible side effects and the development of resistances are reserved mainly immunocompromised patients. Schistosomiasis (bilharzia) Schistosomiasis is widespread and is caused by contact with standing water in Africa, Southeast Asia, China, South America and Eastern Europe. The risk of schistosomiasis, by wearing shoes and socks when walking through water can be reduced and by avoiding swimming in areas where schistosomiasis is widespread (schistosomiasis). Problems after returning the most common medical problems after returning from trips is Persistent Travelers' Diarrhea The most potentially serious diseases are malaria (malaria) Hepatitis B and B (hepatitis) fever (typhoid) Sexually transmitted diseases (reviewed by STDs), including HIV (human immunodeficiency virus (HIV)) amebiasis (amebiasis) meningitis (meningitis) one can also lice (lice) and scabies (scabies) take home if you were in cramped living conditions or in places where hygiene conditions were bad , Some diseases show up until months after returning from the trip. The International Society of Travel Medicine (www.istm.org) and the American Society of Tropical Medicine and Hygiene (www.astmh.org) have lists of clinics that specialize in travel medicine, on their websites. Many of these clinics are specialized in supporting travelers who are ill after their return home.