Motor Vehicle Travel

systemic febrile illnesses. Travelers most commonly contracted Falciparum malaria in West Africa, enteric fever on the Indian subcontinent, and leptospirosis, scrub typhus and murine (flea-borne) typhus in Southeast Asia.2 Respiratory illnesses include common cold, flu, upper respiratory infections and pneumonia. Common skin and soft tissue infections, mosquito bites (often infected) and allergic dermatitis were the most common skin conditions affecting travelers.3 U.S. citizens who seek medical help after returning from a trip abroad suffered most from Illnesses of the gastrointestinal tract (58 percent) followed by systemic febrile illnesses (18 percent) and dermatologic disorders (17 percent).4

A study of travelers returning to China from 2014 to 2018 reported an overall sickness rate of 41.64 per million travelers, with 27.44 per million becoming sick during travel and 14.2 per million developing illnesses within 14 days of return. Those who returned sick suffered mainly from respiratory infections such as influenza and rhinovirus and had returned from Asian countries. Travelers who got sick after return primarily had vector-borne diseases such as malaria and dengue and had returned from Africa.5

Risks during travel appear to be similar among Europeans of various nationalities. A study showed that 42.9 percent of German travelers reported illness, with 10 percent reporting more than one adverse health event. Gastrointestinal symptoms were 80 percent of reported illnesses, respiratory symptoms 13.7 percent and accidents 5 percent. The risk of getting ill significantly increased when visiting the Indian subcontinent or when traveling in areas with limited availability of modern medical care.6

Statistics for travelers from other countries and travelers to South America and the Caribbean are similar in the prevalence of disease categories, but specific diseases may vary due to the regional spread of diseases such as Zika or yellow fever.

COMMON CAUSES OF DEATH AMONG TRAVELERS

Cardiovascular disease is the leading cause of death among travelers abroad, accounting for nearly 50 percent of all deaths and the most deaths in travelers older than 55 years of age.7 This percentage is similar within the same age group at home and does not necessarily reflect travel-related risks.

Injuries are the cause of approximately 13 percent of travel-related deaths. Motor vehicle accidents are the most common cause of injury-related death in travelers younger than age 55, followed by drowning.8,9 Compared with the incidence of injury-related death in the United States, the incidence doubles in Southeast Asia and nearly triples in Africa.10

Infectious diseases cause relatively few travel-related deaths. Travelers’ risk of acquiring life-threatening infections is generally low because prophylactic medications or vaccinations can prevent many infectious diseases. New diseases such as COVID-19, however, can increase the risk.

HAZARDS OF SPECIFIC MODES OF TRAVEL

Plane crashes and shipwrecks make headlines, but the chances of experiencing such events are minuscule. Travelers can, however, plan for the more common hazards associated with various modes of travel.

PLANE TRAVEL

Flying exposes travelers to high altitudes, a decreased level of oxygen, relatively quick atmospheric pressure changes during ascent and descent, very dry air, and proximity to other travelers who may have transmissible diseases. While you should always be on guard against respiratory infections, it is especially important to follow public health recommendations at times of outbreaks and take care of personal protection. When planning travel by airplane, check with your air carriers and the U.S. Centers for Disease Control and Prevention (CDC) for current guidelines.

Major passenger airliners typically cruise at an altitude of 36,000 feet while maintaining cabin pressure at a level equivalent to 5,000 to 8,000 feet, which is roughly 15 percent to 25 percent less than sea-level atmospheric pressure. The oxygen in cabin air is proportionally reduced, affecting people with severe lung, heart or circulatory diseases. People with such conditions should consult their physicians before traveling by air.