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Venous Thromboembolism
Prolonged immobilization (>8 hours) increases the risk of lower extremity deep vein thrombosis (DVT), particularly in travelers with risk factors for thrombosis. Nevertheless, flight-related symptomatic pulmonary embolism is rare.To minimize the risk, travelers should be advised to walk around or exercise while sitting by flexing/extending ankles and knees, to drink plenty of fluids and to avoid alcohol. Compression stockings can decrease the risk of asympto- matic DVT. One study found that giving a single dose of a low-molecular-weight heparin or aspirin as pro- phylaxis to travelers at high risk (past history of thrombosis, obesity, malignancy, increased platelets) reduced the incidence of DVT, but there is little evidence supporting this approach.
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Hepatitis A Hepatitis A vaccine (Havrix - GlaxoSmithKline; Vaqta Merck) is recommended for all susceptible travelers going anywhere other than Canada, Australia, New Zealand,
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