Patients planning to travel to other countries often ask physicians for information about appropriate vaccines and prevention of diarrhea and malaria. Guidelines are also available from the Infectious Diseases Society of America (IDSA).

Patients planning to travel to other countries often ask pysicians for advice about immunizations and prevention of diarrhea and malaria. Legal requirements for entry and epidemiological conditions in different countries vary from time to time, often unpredictably, but some reasonable recommendations can be made.

RabAvert (Chiron), a new human rabies vaccine prepared in purified chick embryo cell culture (PCEC), has been marketed in the USA for pre- and post-exposure prophylaxis. It is available in other countries as Rabipur. Human rabies is rare in the United States, but thousands of people receive post-exposure prophylaxis every year (DL Noah et al, Ann Intern Med, 128:922, June 1, 1998).

Human rabies continues to be rare in the USA, but animal rabies is becoming more common. An animal epizootic in the mid-Atlantic states, involving especially raccoons, has recently spread into the northeastern states.