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To the Editor-in-Chief:

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Individuals' travel-related risk during pre-planned visits to friends and relatives (VFRs) to India1 could differ significantly among family members or participants on a group travel. Persisting cellular or humoral immunity, postinfection or postvaccination, in the elderly and adults acquired before immigration, would protect against hepatitis A and typhoid. First VFRs visit by children or young adults with no pre-travel exposure to circulating entero-pathogens would imply some probability of typhoid and hepatitis A infection. Pretravel health advice or preventive measures1 should be targeted to children and young adults: the elderly in family VFRs or group leaders should exhort younger co-travelers to accept malaria chemoprophylaxis and avoid indiscriminate consumption of otherwise tasty edibles from unhygienic establishments.

There are several sudden, unscheduled trips by US residents while VFRs in India or adjoining countries1 with no pretravel health preparations. They might have to participate actively in multi-tier functions including marriage or mourning. They are obliged to consume edibles in unsanitary environments. They get exposed to exorbitant doses of enteric pathogens including hepatitis A virus and typhoid/paratyphoid. They might participate in religious activities including pilgrimages with inadvertent exposure to bites by several disease vectors. Rather than a comprehensive pretravel guide, basic preventive Dos and Don’ts could be distributed during travel upon departure in the outgoing flights.

Subhash C. Arya 1 and Nirmala Agarwal 1

References

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