Hazard	Examples	Precautions
Insect-borne disease	Malaria, Japanese encephalitis, filariasis, trypanosomiasis, leishmaniasis, dengue, yellow fever	Insect repellents with 30% DEET or 20% picaridin are effective for the prevention of many vector-borne diseases (e.g., malaria)1
		Wear proper clothing (i.e., loose-fitting, covering as much skin as possible) when traveling to high-risk areas
		Consider permethrin-impregnated bednets when traveling to high-risk areas
		Minimize outdoor exposure during times of peak vector activity in high-risk areas
		Appropriate chemoprophylaxis is effective for preventing malaria1–6 (see Table 5)
Foodborne disease	Acute diarrheal disease, hepatitis A, various parasitic diseases	Cook all food thoroughly; avoid foods that cannot be boiled or peeled
		Consider self-directed therapy for traveler's diarrhea (first-line treatment: ciprofloxacin [Cipro], 500 mg twice daily for one to three days; azithromycin [Zithromax], 500 mg daily for one to three days in southeast Asia; rifaximin [Xifaxan], 200 mg three times daily for three days is an alternative)*
		Antimotility agents such as loperamide (Imodium) may be used in the absence of fever or bloody diarrhea
		Although discouraged for most travelers, chemoprophylaxis for traveler's diarrhea can be considered for select travelers with brief itineraries (e.g., bismuth subsalicylate [Pepto-Bismol], 524 mg four times daily; ciprofloxacin, 500 mg daily; rifaximin, 200 mg twice daily)7,8
Waterborne disease	Acute diarrheal disease (including cholera), gastrointestinal parasites, typhoid fever, schistosomiasis	Drink only bottled, boiled, iodinated, microfiltered, or carbonated beverages
		Avoid ice in beverages, and do not brush teeth with tap water9
		Antibiotic chemoprophylaxis as described above for foodborne disease
		Consider offering self-directed therapy for traveler's diarrhea as described above for foodborne disease*
		Avoid swimming in unchlorinated freshwater9
Solar injury	Sunburn, skin neoplasia	Wear proper clothing (including broad-brimmed hat)
		Use sunscreen (SPF of at least 30)
		Avoid sun during peak hours, especially at higher altitudes and lower latitudes
Altitude sickness	Acute mountain sickness, high-altitude pulmonary edema, high-altitude cerebral edema	Ascend slowly (1,000 ft per day above 8,000 ft), with time to acclimatize10
		Rapid descent is advisable if significant illness develops10
		Consider prophylactic acetazolamide (formerly Diamox; 125 to 250 mg twice daily)11
Transportation-related illness	DVT, motion sickness, barotrauma, jet lag, ionizing radiation	Avoidance of ionizing radiation is particularly important in pregnant and frequent travelers
		Staying hydrated, moving around the cabin, and wearing compression stockings may decrease risk of DVT during air travel
		Wait 24 to 48 hours to fly after scuba diving with decompression stops
		Scopolamine (1.5-mg patch every three days) or dimenhydrinate (Dramamine; 50 mg every six hours) diminishes motion sickness
		Pseudoephedrine (60 mg every six hours) may decrease risk of barotrauma
		Staying hydrated and avoiding caffeine during air travel may decrease jet lag; consuming caffeinated beverages in the mornings after arrival may aid in alertness, and melatonin may promote sleep; exposure to bright light during the day and dim lights during the evenings may speed acclimatization
Accidental injury	Motor vehicle crashes, falls, electrocution, drowning	Practice situational awareness
		Use seat belts (if available) and other personal protective measures
		Avoid driving at night
		Obtain medical evacuation insurance
Political hazards	Harassment, arrest, abduction, assault	Avoid large crowds and demonstrations
		Travel in pairs or small groups
		Be familiar with local laws
		Be aware that persons with dual citizenship may be subject to local requirements, including conscription