Current Infectious Disease Reports

, Volume 15, Issue 4, pp 299–306 | Cite as

Expatriates: Special Considerations in Pretravel Preparation

  • Cassandra M. Pierre
  • Poh-Lian Lim
  • Davidson H. Hamer
Invited Commentary


Expatriates comprise a diverse set of travelers who face unique medical, psychiatric, and non-health-related risks as a result of increased exposure to host country environment and associated lifestyle. Expatriates have an increased risk of developing malaria, gastrointestinal disorders, latent tuberculosis, vaccine-preventable infections, and psychological disorders, when compared with other travelers, yet the majority of existing pretravel guidelines have been designed to suit the needs of nonexpatriates. Although greater interest in expatriate health issues has led to improved characterization of illness in this population, expatriate-specific risk mitigation strategies—including modifications to chemoprophylaxis recommendations, limiting tuberculosis exposure, and prevention of occupational or sexual blood-borne virus transmission—are poorly described. Occupations and destinations affect travel-related disease risk and should inform the pretravel consultation.


Expatriates Rabies vaccine Japanese encephalitis vaccine Chemoprophylaxis Malaria International travel 


Compliance with Ethics Guidelines

Conflict of Interest

Cassandra M. Pierre, Poh-Lian Lim, and Davidson H. Hamer declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Cassandra M. Pierre
    • 1
  • Poh-Lian Lim
    • 2
  • Davidson H. Hamer
    • 1
    • 3
    • 4
  1. 1.Section of Infectious Diseases, Department of MedicineBoston University School of MedicineBostonUSA
  2. 2.Department of Infectious DiseasesInstitute of Infectious Disease & Epidemiology, Tan Tock Seng HospitalSingaporeSingapore
  3. 3.Center for Global Health and DevelopmentBoston UniversityBostonUSA
  4. 4.Department of International HealthBoston University School of Public HealthBostonUSA

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