- Travel medicine
Travel medicine or emporiatrics is the branch of
medicinethat deals with the prevention and management of health problems of internationaltravelers.
Globalization and travel
Globalization facilitates the spread of disease and increases the number of travelers who will be exposed to a different health environment. Major content areas of travel medicine include the global epidemiology of health risks to the traveler, vaccinology,
malariaprevention, and pre-travel counseling designed to maintain the health of the approximately 600 million international travelers. It has been estimated that about 80 million travelers go annually from developed to developing countries. [ [http://www.pitt.edu/~super1/lecture/lec19341/index.htm Supercourse on Travel Medicine] ]
Mortality and morbidity
Mortality studies indicate that the
cardiovascular diseaseaccounts for most deaths during travel (50-70%), while injuryand accidentfollow (~25%). Infectious diseaseaccounts for about 2.8-4% of deaths during/from travel. Morbiditystudies suggest that about half of the people from a developed country that stay one month in a developing country will get sick. [ [http://www.pitt.edu/~super1/lecture/lec19341/index.htm Supercourse on Travel Medicine] ] Traveler's diarrheais the most common problem encountered.
The field of travel medicine encompasses a wide variety of disciplines including
epidemiology, infectious disease, public health, tropical medicine, high altitude physiology, travel related obstetrics, psychiatry, occupational medicine, military and migration medicine, and environmental health.
Special itineraries and activities include
cruise shiptravel, diving, mass gatherings (e.g. the Hajj), and wilderness/remote regions travel.
Basically, the travel medicine can divide into 4 main topics: the
prevention(vaccination and travel advice), the assistance medicine(dealing with repatriation and medical treatment of travelers), the wilderness medicine(e.g. high-altitude medicine, cruise ship medicine, expedition medicine, etc.) and the insurance medicine.
Travel medicine includes pre-travel consultation and evaluation, contingency planning during travel, and post-travel follow-up and care. Information is provided by the WHO that addresses health issues for travelers for each country as well as the specific health risks of air travel itself. [ [http://www.who.int/ith/en/ WHO Travel Information] ] Also, the CDC publishes valuable and up-to-date information. (see external links). Key areas to consider are vaccination and the six I’s:
# Insects: repellents, nets, medication
# Ingestions: safety of water, food
HIV, sexually transmitted disease
# Injuries: accident avoidance, personal safety
# Insurance: coverage and services during travel, access to care
pecific disease problems
Yellow feveris endemic to certain areas in Africa and South America. The CDC site delineates the risk areas and provides information about vaccination and preventive steps. [ [http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=yellowfever.htm CDC re: Yellow Fever] ] Meningococcal meningitisis endemic in the tropical meningococcal belt of Africa. Vaccination is required for pilgrims going to Mecca. Detailed information is available on the CDC site. [ [http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=menin.htm&cssNav=browsecyb CDC re: Meningococcal Meningitis] ] Malariaprevention is done by preventing or reducing exposure to mosquitos (screened rooms, air-conditioning, nets) use of repellents (usually DEET). In addition chemoprophylaxis is started before the travel, during the time of potential exposure, and for 4 weeks (chloroquine, doxycycline, or mefloquine) or 7 days (atovaquone/proguanil or primaquine) after leaving the risk area. See detailed CDC site. [ [http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=index.htm&cssNav=browsecyb CDC re:Malaria] ]
The traveler should have a medication kit to provide for necessary and useful medication. Based on circumstances it should include also malaria prophylaxis,
condoms, and medication to combat traveler's diarrhea. In addition, a basic first aid kitcan be of use.
Studies have shown there are four main medical problems that travellers develop - diarrhoea or gut problems, respiratory problems, wounds and pain. The medical kit should at least address these common things.
Research has also shown that the best treatment for travellers diarrhoea is to take an antibiotic (e.g. ciprofloxacin) plus a stopper ( e.g. loperamide). Due to bacterial resistance, different parts of the world require different antibiotics. It is best to consult a travel doctor to sort out the best medical kit for the exact destination and medical history of the person travelling.
Prince Leopold Institute of Tropical Medicine
Royal Society of Tropical Medicine and Hygiene
* [http://www.who.int/countries/en/ Countries] -
World Health Organization- includes information on outbreaks and health information
* [http://www.Tropeninstitut.de/ Institute for tropical medicine Dr. Gontard] - provides information about health risks which might arise during stays in foreign countries and points out preventive measures
* [http://www.cdc.gov/travel/ Travelers' Health] -
Centers for Disease Control and Prevention- includes information on outbreaks, specific diseases, recommended vaccinations
* [http://medlineplus.nlm.nih.gov/medlineplus/travelershealth.html Traveler's Health] -
* [http://www.safewateronline.com/ Safe Water for International Travelers] includes a Worldwide Rating of Drinking Water Safety and waterborne diseases prevention.
*Global Infectious Diseases and Epidemiology Network - a travel medicine resource known as GIDEON.
* [http://www.travelvaccinelongisland.com/ Long Island Travel Medicine] includes a vaccine preparedness list for travel to areas in the Middle East and Africa.
* [http://www.passporthealthusa.com/ Passport Health] is the largest provider of travel medical services in the United States with 165 convenient locations nationwide.
* [https://www.istm.org/ The International Society of Travel Medicine]
** [https://www.istm.org/trav_med_exam/body.aspx Travel Medicine Body of Knowledge]
* [http://www.astmh.org/ The American Society of Tropical Medicine and Hygiene]
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