[14] Other epidemiologic approaches in travel medicine research, such as large surveillance network studies, offer the potential for more specific disease diagnoses. In addition, larger surveillance studies allow for other types of data analysis such

as proportionate morbidities and assessment of disease trends over time.[14] A drawback of these surveillance studies, however, is the inability to calculate specific disease rates for a defined geographic region. Limitations of our study include the retrospective aspect of this survey tool, potentially leading to recall bias. As a counteractive measure, we mailed surveys during the month of our patients’ travel; screening assay in many cases the surveys had already been delivered by the time the travelers returned home. Another limitation was the subjective nature of the survey tool, which made it difficult to categorize illness into the discrete Akt inhibitor disease entities. In addition, the low overall survey response may preclude one from generalizing our results to a larger travel population. In the cohort study of American travelers by Hill, follow-up phone interviews were conducted with those who reported illness as well as with survey nonresponders.[7] This strategy might be helpful to maximize survey response rates and also to potentially minimize the effects of recall bias. As our initial focus was on the most common travel ailments

for which our patients were precounseled, the original survey did not include questions regarding type of travel (eg, business or tourism), nor did we ask about pre-existing conditions. On the basis of the limitations of our cohort study, implementation of a modified survey (Appendix 2) should

better capture post-travel illness data. Our survey tool has demonstrated value as a novel method for quality improvement in this travel medicine clinic, and has captured travel-related variables useful for defining predictors of acquiring mafosfamide illness while traveling abroad. Future directions for our clinic will incorporate the development of additional survey modalities, including a web-based survey to improve response rates and adoption of the method used by Hill in delivering surveys prior to departure[7] so that participants can log their illnesses in “real time” while traveling. We recommend that other clinics use a similar survey process to promote improved patient-centered counseling during the pre-travel encounter. The authors wish to acknowledge the very generous contributions made by Jacqueline Grove in the preparation and review of this manuscript. The authors state they have no conflicts of interest to declare. “
“Primary care physicians (PCP) are first in line to provide adequate pre-travel medical advice. Little data are available on the content of pre-travel PCP consultations in France. We undertook an observational survey to assess the level of specific knowledge among PCPs on health advice, vaccinations, and malaria prophylaxis.