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The increasingly exotic and affordable nature of international travel has spawned myriad travel medicine resources and reference tools for the health care practitioner. This atlas is one such tool, borne from a movement toward sage pre-travel intervention and the prevention of travel-related illnesses.
The atlas is designed for use in concert with other definitive sources on travel medicine, such as the HMSO "green book." It provides a framework for health care practitioners when discussing travel health with patients, and identifies destination-specific risks of disease. The atlas is divided into three sections. The first section provides the health care practitioner with very general travel-related information on topics such as food and water safety, biting insects and animals, sun and heat, and blood and body substance precautions. This section is comprised of a series of travel medicine fundamentals such as "peel all fruit" and "do not go swimming alone." These maxims are handily organized in point form to facilitate easy translation to the traveler.
The next section consists of "disease" pages, and provides the reader with short synopses of what are considered to be the 13 most important travel-related diseases. These include the hepatitides, malaria, typhoid, yellow fever, meningitis, schistosomiasis, dengue, rabies, and traveler’s diarrhea. This section provides a general description of disease epidemiology, pathogenesis, and prevention, as well as global distribution maps, usually adapted from the WHO. The distribution maps are fairly recent (2002), and grade incidence rate where applicable. In addition, key references for topical reviews are listed at the close of each disease chapter.
The third and final section consists of country-specific information for the top travel destinations. For each country, the authors provide a country map indicating malaria endemicity, immunization advice, weather graphs, and a list of "other" health considerations. Although general information on the presence or absence of malaria transmission is noted for each country, information on drug resistance patterns is not provided, nor is it mentioned. The immunization advice is helpful, particularly because requirements for yellow fever certification are indicated. The "other health considerations" consist of the standard list of common-sense travel precautions such as insect-bite avoidance, and the risks associated with casual sex. Not surprisingly, this list varies little from country to country. The weather histograms, which provide mean daily sunshine, rainfall, and temperatures, are a useful adjunct if the traveler is visiting a country’s capital city. These weather graphs were included not to provide comprehensive climatologic data, but rather to serve as a guide for determining what weather-related precautions might be necessary for the traveler. The mean rainfall data are helpful in surmising when malaria transmission may be at its peak. The authors prudently advise travelers and health care providers to consult other sources of climatologic data prior to travel.
While this atlas was written with exceptional brevity and clarity, the limited scope and content render it best suited for students and nurses early on in their training who would like to acquire a basic understanding of the principles of travel medicine. Indeed, all of the topics to be considered in pre-travel counseling are represented within. Alternatively, it is a very succinct, comprehensible reference for the traveler, though clearly, this is no substitute for pre-travel intervention. The atlas has the advantage of a parallel CD version, which makes it portable for its readership. In addition, the authors have done a commendable job of directing readers to more comprehensive travel-medicine references.
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