Expatriate Business Travelers
Expatriate business travelers who stay and work for long durations in developing countries have increased exposure time, and their disease risks for some infections approach those of the local residents. Some studies have found worsening food safety practices, higher rates of animal exposure and hepatitis B positivity with longer duration of travel. In the GeoSentinel analysis of long-term travelers, assessment of vaccine-preventable diseases found more frequent presentations of enteric fever than shorter-term travelers whereas the proportionate morbidities for hepatitis B and rabies were lower, presumably because of higher immunization rates among long-term travelers.
For expatriate business travelers, the concept of cumulative risk strongly supports vaccinating against all vaccine-preventable diseases that may arise at the destination country as well as other countries that the traveler may need to visit.