However, pre-travel preparation of tourists to a moderate altitude destination like Cusco is inadequate

with underutilization of health services, inadequate counseling, and limited use of acetazolamide. AMS was common among study participants and had a big impact on travel plans. Few of those even with severe symptoms sought professional health care. Further research on determinants of pre-travel and local health care services use is needed. Also, it is paramount to raise awareness about the potentially fatal consequences of traveling to moderate and high altitudes without adequate preparation. This should be raised among counseling physicians and among travelers at risk. The authors state they have no conflicts of interest to declare. “
“In our recent editorial we discussed the difficulties related

to the prevention of malaria in international pediatric travelers, MDV3100 in general, and in pediatric PCI-32765 in vitro travelers visiting friends and relatives specifically.1 We highlighted many travel medicine logistical obstacles that result in significant risk for children who travel to malaria-endemic regions. A pivotal need when traveling to a high risk malaria-endemic area is to have a safe, efficacious, and acceptable prophylactic antimalarial drug. If parents are required to sign a special consent form before the prescription for an antimalarial can be issued, this will complicate procedures and will hinder the acceptance and adherence to the drug regimen. We would like to thank Drs Takeshita and Kanagawa for sharing, with us, this important reality of pretravel

care for children in Japan.2 It is noteworthy that the Pediatrics Interest Group within the International Society of Travel Medicine was just constituted and met at the recent CISTM meeting in Boston for the first time.3 It is our hope that this renewed focus on pediatric travel medicine will help advocate for an improved and easy access of children to competent pretravel care and efficacious antimalarial drugs for prophylaxis. Stefan Hagmann *† and Patricia Schlagenhauf “
“An estimated 1 billion people will travel internationally in 2012,[1] some of whom are immunocompromised hosts through and who are more vulnerable to infection and subsequent complications, including those with cancer, human immunodeficiency virus/acquired immune deficiency syndrome, organ transplant recipients, or those on immunosuppressive drugs for autoimmune disorders. Little is known about the risks of travel in immunocompromised hosts. There are a handful of descriptive studies on travel medicine in organ transplant[2-4] and splenectomized[5] patients, although larger studies are yet to be done. Mikati and colleagues[6] describe the first retrospective cohort study of cancer patients who presented for pre-travel health advice at a single center over an 8-year span.