Arboviral Infections

Children traveling to regions where arboviruses are endemic or epidemic—such as chikungunya, dengue, Japanese encephalitis, yellow fever, and Zika—are at increased risk of infection. Pediatric travelers should follow the same mosquito protection strategies outlined later in this chapter (see also the Mosquitoes, Ticks, and Other Arthropods section). Vaccinations for Japanese encephalitis, tick-borne encephalitis, and yellow fever may be recommended for some children, especially those undertaking prolonged or repeated travel to affected areas.

Diarrhea and Vomiting

Gastrointestinal illnesses, particularly diarrhea, are among the most frequent travel-related health issues in children. Due to their smaller fluid reserves, infants and young children are more vulnerable to dehydration than adults. The causes of travelers’ diarrhea (TD) in children mirror those in adults. However, the evidence supporting the use of standby treatment—such as antibiotics, antimotility agents, and antiemetics—in pediatric populations is limited and largely based on adult data. More pediatric-focused research is needed to better inform pre-travel counseling and treatment decisions.

Preventive Measures

• Safe Food and Water:
  Adults should ensure children adhere to safe food and water practices and wash hands frequently to prevent foodborne and waterborne infections.
  
  

• Infant Feeding:
  Breastfeeding offers the best protection against gastrointestinal illnesses in infants. Parents using formula should be cautious, as products available abroad may differ in nutritional content and safety standards. Bringing formula from home is advisable, especially sterile liquid formula. Water used for preparing formula should be properly disinfected, as even bottled water can be contaminated in some regions.
  
  

• Snacks and Hydration:
  Parents are encouraged to pack familiar, safe snacks from home in case local food options are unappealing or unsafe. Potable water should be used for cleaning bottles, pacifiers, teething rings, and toys, particularly those that fall on the ground or are handled by others.
  
  

Hygiene:
Hand hygiene is critical, especially after diaper changes. Parents should take care to wash hands thoroughly to prevent the spread of infection, especially if a child has diarrhea.