Antibiotics for the presumptive treatment of respiratory and urinary tract infections may be considered, as well as antacid medications. At-risk patients should be referred to a specialist for medical evaluation before departing, and optimal control of co-morbidities such as cardiovascular and chronic obstructive pulmonary diseases

should be achieved, particularly for high-altitude travel. Older individuals represent a substantial proportion of international travelers, with an estimated 15–30% of travelers being aged 60 years or older;1–3 this proportion is increasing over time.4 In a study of 1,416 US travelers attending a pre-travel clinic, 48% were >50 years of age, one third were >60 years, and almost 1.5% were

>80 years of age.2 Because of their greater difficulty in acclimatizing during travel, adjusting to extreme climatic conditions (temperature, humidity, and altitude), their C59 wnt ic50 greater predisposition for contracting certain diseases, their increased probability of underlying medical conditions, waning immunity from vaccines previously received, and reduced responses to vaccines provided at pre-travel consultations, including those against hepatitis A, hepatitis B, and rabies,5 as well as “routine” vaccines such as influenza6 and pneumococcal infections,7 selleck compound older travelers might be at a higher risk for at least PRKD3 some travel-associated diseases.8,9 The premiums of travel health insurance for people over 60 years of age are often a lot higher than those for younger people because of an increased proportion of claims, costly air medical evacuations,10 and death abroad in the older group.11 However, the epidemiology of travel-associated diseases in older adults, including chronic disease exacerbation, is not well described with the exception

of traveler’s diarrhea and considerable health advice written for older travelers is based on data taken from the entire older (non-traveling) population.9 There are wide physiological differences between younger and older people,12 although the population of older travelers may be somewhat distinct from the general older population, as the truly frail elderly probably do not frequently undertake international travel. No study has been published that addresses the spectrum of illnesses among older individuals traveling to a broad range of destinations. In this context, we analyzed diagnoses with demographic, clinical, and travel-related predictors of disease among older ill travelers who presented to GeoSentinel clinics between 1997 and 2009, including a large proportion of individuals returning from tropical countries. Data were prospectively collected on patients presenting to GeoSentinel sites from March 1997 to August 2009.