Underlying diseases associated with increased risk include:
(1) transplant recipient
(2) pregnant woman
(3) immunosuppression or immunocompromised state
(4) cancer, including CLL or lymphoma
(5) HIV disease
(6) chronic renal failure
(7) chronic heart disease
(8) chronic lung disease
(9) multiple sclerosis or other neurodegenerative disease
Infections that can pose a problem may include:
(1) enteric bacteria (Salmonella, other)
(2) Vibrio species
(3) tuberculosis and other mycobacteria
(4) deep fungal
(5) intestinal protozoa (Entamoeba, Isospora, other)
(6) Leishmania
Checklist:
(1) travel plan with detailed itinerary.
(2) identification of potential hazards, including environmental exposures
(3) knowledge about how to avoid hazards.
(4) adequate supply of medications, with critical medications always at hand
(5) emergency plan, including medical evacuation insurance.
(6) access to healthcare during the trip
(7) reliable travel companion(s) who can assist the patient or dependents when necessary
(8) reliable means of communication.
(9) willingness to adhere to a healthy lifestyle
(10) mental health
(11) ability to adapt to the unexpected
(12) medical alert bracelet or other means of hazard notification
(13) undergone an assessment prior to departure with all necessary vaccinations
(14) a followup exam afterwards
where:
• Storage requirements of medications should be reviewed. Medications should be protected from conditions that may affect drug potency such as moisture and temperature extremes.
• Local regulations about medications and administration equipment should be reviewed.
