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Crowded airplanes and rest stops, busy hotels and mobbed tourist spots, and germs, germs everywhere. If you're traveling with children, the last thing you want is for them to spend their vacation sick in bed. But how cautious should you be about germs and illness when traveling with kids in the U.S.?

Experts agree that a few major precautions, like washing hands frequently, are critical to keeping nasty germs from making children ill while traveling. But beyond those, how careful you are about germs on the road may depend on how careful you are about germs at home.

"If you let your kids crawl around in other people's homes, it's probably not a big deal for them to crawl around in a hotel as long as you check first for safety hazards and wash their hands afterward," says James Conway, MD, associate professor of pediatrics and a pediatric infectious-disease specialist at the University of Wisconsin School of Medicine and Public Health in Madison.

But what if the thought of your child touching a hotel room floor or snuggling up in an airplane blanket makes you feel ill? "Some parents may be more comfortable taking more measures," says Athena P. Kourtis, MD, PhD, MPH, a pediatrician specializing in infectious diseases and author of Keeping Your Child Healthy in a Germ-Filled World. And some children are just more prone to illness when traveling than others, Kourtis says. In those cases, parents often choose to take extra care.

Here are some strategies for keeping illness at bay when traveling with healthy children. If you are planning to travel with a newborn infant or a child with a compromised immune system, you should talk to your child's doctor about special precautions.

Top 3 Tips for Keeping Kids Well During Travel

Are children more vulnerable to illness when traveling? Yes, Conway says, and for two main reasons: "They are not particularly good at keeping things out of their mouths and not as careful with hand hygiene."

Children's immune systems are also less developed than those of adults. This makes them more vulnerable to illness, Kourtis says.

These three strategies can help you protect them:

Make sure your child is up to date on immunizations. Even when traveling in the U.S., be sure your child has had routine vaccinations for measles, whooping cough, and other serious illnesses on the normal schedule. And anyone in your travel party who hasn't gotten a yearly flu shot should consider getting one before heading out. The CDC recommends annual flu vaccine for everyone six months old and older.

A flu shot provides double benefits: "It protects your child individually and cuts down on the general level of flu being transmitted," says David Shlim, MD, a travel-medicine specialist and president-elect of the International Society of Travel Medicine.

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