Travel Medicine

Cover......Page 1
Dedication......Page 2
Travel Medicine......Page 3
Copyright Page......Page 4
Preface......Page 5
List of Contributors......Page 6
Acknowledgments......Page 11
1 Introduction to Travel Medicine......Page 12
Reference......Page 13
Cornerstones of Travel Health Epidemiology......Page 14
Keywords......Page 15
Accidents......Page 18
Travelers’ Diarrhea......Page 20
Vaccine-Preventable Infections......Page 21
Routine Immunizations.......Page 22
Other Arboviral Infections: Dengue, Chikungunya, Zika.......Page 23
References......Page 24
The Practice of Travel Medicine......Page 27
Keywords......Page 28
Are There Different Models of Care Delivery?......Page 29
What Vaccines Should Be Provided? Should the Clinic Offer Yellow Fever Vaccine?......Page 30
Documentation......Page 31
Legal Issues......Page 32
Offsite Services......Page 33
Direct Marketing Methods: Internet, Print, and Media......Page 34
Professional Development......Page 35
References......Page 36
Logistics and Mechanics of the Pretravel Consultation......Page 38
Keywords......Page 39
General Considerations......Page 40
General Topics to Be Covered......Page 41
Challenges Regarding Travel Advice......Page 42
Acknowledgments......Page 43
References......Page 44
Etiology and Risk of Waterborne Infection......Page 45
Keywords......Page 46
Clarification......Page 47
Coagulation–Flocculation.......Page 48
Filtration......Page 49
Improving Halogen Taste.......Page 50
Preferred Technique......Page 51
References......Page 54
Habitat Avoidance......Page 57
Keywords......Page 58
Physical Protection......Page 60
DEET Safety and Toxicity.......Page 61
Citronella.......Page 62
BiteBlocker.......Page 63
Alternative Repellents.......Page 64
Reducing Local Mosquito Populations......Page 65
References......Page 66
Dengue......Page 68
Keywords......Page 69
Zika......Page 71
Severe Respiratory Infections With Regional Endemicity......Page 72
Other Regionally Important Infections in Travelers......Page 73
References......Page 75
Summary of Factors Determining Medical and First-Aid Kit Construction......Page 77
Keywords......Page 78
Contents of Medical and First-Aid Kits......Page 79
More Comprehensive Kits......Page 80
References......Page 81
Active Immunization......Page 82
Keywords......Page 83
Immune Memory and Booster Doses.......Page 84
Route of Immunization.......Page 86
Intramuscular route.......Page 87
Serologic Testing Before and After Immunizations.......Page 88
Special Conditions/Contraindications......Page 89
References......Page 90
Contraindications......Page 92
Keywords......Page 93
Dosing Schedules......Page 96
Measles, Mumps, and Rubella Vaccine......Page 97
Precautions......Page 98
Dosing Schedule......Page 99
Varicella and Herpes Zoster Vaccines......Page 100
Pneumococcal Vaccine......Page 101
Human PapillomaVirus Vaccine......Page 102
Indications......Page 103
References......Page 104
Precautions......Page 106
Keywords......Page 107
Dosing Schedules......Page 108
Indications......Page 109
Dosing Schedules......Page 110
Measures of Immune Response and Duration of Immunity/Protection......Page 111
Measures of Immune Response and Duration of Immunity/Protection......Page 114
Indications......Page 115
Drug and Vaccine Interactions......Page 116
References......Page 117
Adverse Events......Page 119
Keywords......Page 120
Recommendations.......Page 121
Indications.......Page 127
Adverse Events.......Page 128
Dosing Schedules.......Page 129
Japanese Encephalitis Vaccine......Page 130
Chimeric JE Vaccine (JE-CV)......Page 131
Drug and Vaccine Interactions.......Page 132
Indications.......Page 133
Polio Vaccine......Page 134
Accelerated Schedules for Primary IPV Immunization.......Page 135
Rabies Vaccine......Page 136
Postexposure Vaccination.......Page 137
Tickborne Encephalitis Vaccine......Page 138
Measures of Immune Response and Duration of Immunity/Protection.......Page 139
References......Page 140
Intercurrent Illness and Vaccination......Page 144
Keywords......Page 145
Routine Pediatric Vaccines......Page 146
Measles–Mumps–Rubella Vaccine......Page 150
Varicella Vaccine......Page 151
Yellow Fever Vaccine.......Page 152
Typhoid Vaccine......Page 153
Rabies Vaccine......Page 154
References......Page 155
Who Is at Risk?......Page 157
Keywords......Page 158
Where Are Travelers at Risk of Acquiring Malaria?......Page 161
Primaquine......Page 163
References......Page 164
Assessing Individual Risk—Parasite, Place, and Person......Page 166
Keywords......Page 167
Description, Pharmacology, and Mode of Action.......Page 168
Efficacy and Drug Resistance.......Page 169
Contraindications, Precautions, and Drug Interactions.......Page 171
Efficacy and Drug Resistance.......Page 172
Tolerability.......Page 173
Contraindications, Precautions, and Drug Interactions.......Page 174
Efficacy and Drug Resistance.......Page 175
Contraindications, Precautions, and Drug Interactions.......Page 176
Efficacy and Drug Resistance.......Page 177
Indications and Administration.......Page 178
Indications and Administration.......Page 179
New Pipeline Drugs for Malaria Chemoprophylaxis......Page 180
Business Travelers......Page 181
Migrant and VFR Travelers......Page 182
Differences in Guidelines and Recommendations on Malaria Chemoprophylaxis......Page 183
References......Page 184
Introduction......Page 190
Keywords......Page 191
Performance of RDTs for Laboratory Diagnosis of Malaria......Page 192
Performance of RDTs for Self-Use by Travelers......Page 193
Principle and Rationale for Use.......Page 194
SBET Recommendations for Pregnant Women, Children, and Chronically Ill Patients......Page 196
Balancing of Recommendations......Page 197
References......Page 198
The Malarias......Page 201
Keywords......Page 202
Clinical Presentation of Uncomplicated Malaria......Page 203
Clinical Diagnosis......Page 204
Treatment of Uncomplicated Malaria......Page 205
Treatment of Severe Malaria......Page 206
Antirelapse Therapy With Primaquine......Page 207
References......Page 208
Clinical Characteristics......Page 210
Keywords......Page 211
Diarrhea Producing E. coli......Page 212
Giardia......Page 213
Travelers’ Diarrhea in Children......Page 214
Specific Host Factors......Page 215
Travel Packages and Meals......Page 216
Risk by Geographic Region......Page 217
Conclusion......Page 218
References......Page 219
The Impact of Prevention......Page 223
Keywords......Page 224
Education and Behavior Modification......Page 225
Probiotics and Other Nonantibiotic Forms of Prophylaxis......Page 226
Antimicrobial Agents......Page 227
References......Page 228
Syndromic Presentations and Etiology......Page 230
Keywords......Page 231
Management of Travelers’ Diarrhea......Page 232
Fluids......Page 233
Other Nonantibiotic Alternatives......Page 234
Antibiotic Resistance as Both Cause and Consequence of Travelers’ Diarrhea......Page 235
References......Page 236
Persistent Gastrointestinal Symptoms Incidence......Page 238
Keywords......Page 239
Entamoeba histolytica.......Page 240
Enterobacteriaceae.......Page 241
Postinfectious Functional Gastrointestinal Disorders Epidemiology and Pathogenesis.......Page 242
Colorectal Cancer.......Page 244
Blood Testing.......Page 245
Therapy......Page 246
References......Page 248
Access to Medical Care Abroad......Page 251
Keywords......Page 252
Water Sports and Travel by Boat.......Page 253
Travel by Automobile.......Page 255
Zika Virus and Pregnancy......Page 256
Treatment.......Page 258
Travelers’ Diarrhea......Page 259
Altitude and Pregnancy......Page 260
Medical Kit......Page 261
References......Page 262
Should Children Be Subjected to the Discomforts of International Travel? Is It Safe for Children to Travel Internationally?......Page 264
Keywords......Page 265
Does Jet Lag Occur in Children?......Page 266
Altitude.......Page 267
Immunization......Page 268
Insect-Borne Diseases......Page 269
Tickborne Diseases.......Page 270
Treatment......Page 271
Conclusion......Page 272
References......Page 273
Fitness to Travel......Page 275
Keywords......Page 276
Medications and Medical Supplies......Page 277
Jet Lag......Page 278
Travelers’ Diarrhea......Page 279
Typhoid Fever.......Page 280
References......Page 281
Choosing a Trip and Making Travel Arrangements......Page 283
Keywords......Page 284
Traveling With an Attendant......Page 286
Air Travel With a Wheelchair or Scooter......Page 287
Service Animals......Page 288
References......Page 289
Before You Go......Page 290
Keywords......Page 291
The Voyage......Page 292
Cardiac Disease......Page 293
Diabetes Mellitus......Page 294
Gastrointestinal Disease......Page 295
References......Page 296
Corticosteroids, Disease-Modifying Antirheumatic Drugs, and Biologic Therapies......Page 298
Keywords......Page 299
Asplenic Travelers......Page 301
Transplant Recipients......Page 302
Yellow Fever......Page 303
Vaccination of Family Members and Household Contacts......Page 304
Strongyloides......Page 305
References......Page 306
Introduction......Page 308
Keywords......Page 309
Pretravel Advice......Page 310
Inactivated vaccines.......Page 311
Risk and Severity of Vaccine Preventable Disease in the HIV-Infected Traveler.......Page 312
Conclusion......Page 314
References......Page 315
Health Risks of International Business Travelers......Page 317
Keywords......Page 318
Air Pollution......Page 319
Pretravel Considerations for Health Risks Before International Travel......Page 320
Travel Kits......Page 322
Conclusion......Page 323
References......Page 324
Mission-oriented Medicine and VIP Travel Medicine......Page 325
Keywords......Page 326
Operationalizing VIP Travel Support......Page 327
Medical Threat Assessment and Countermeasures......Page 328
Nothing More, Nothing Less......Page 329
Right Equipment.......Page 330
Common pitfalls.......Page 331
Knowing Where to Get Help: Host Country Solutions......Page 332
References......Page 333
The Children......Page 334
Keywords......Page 335
Skin and Intestinal Infections.......Page 336
Tuberculosis (TB).......Page 338
References......Page 339
Epidemiology of Travel by Visiting Friends and Relatives......Page 342
Keywords......Page 343
Enteric Fever......Page 344
Malaria......Page 345
Sexually Transmitted Infections and Bloodborne Viruses......Page 346
Improving Access to Pretravel Services......Page 347
Travel-Specific Immunizations......Page 348
Conclusion......Page 349
References......Page 350
Hidden Costs of Expatriation......Page 352
Keywords......Page 353
Predeparture Psychologic Assessment......Page 354
Rabies.......Page 355
Culture Shock and the U-Curve Hypothesis......Page 356
“Normal” Adjustment Difficulties......Page 357
Returning Home......Page 358
Easing Return......Page 359
References......Page 360
Tuberculosis.......Page 362
Keywords......Page 363
Chronic Viral Hepatitis.......Page 364
Noncommunicable Diseases.......Page 365
References......Page 366
Mortality in Humanitarian Workers......Page 367
Keywords......Page 368
Malaria......Page 369
Dental Care......Page 370
Health Recommendations for the Relief Worker Traveling to Challenging Work Zones......Page 371
References......Page 372
Introduction......Page 374
Keywords......Page 375
Malaria and Other Vectorborne Diseases......Page 377
Dermatologic Diseases......Page 378
References......Page 379
Questions to Ask......Page 381
Keywords......Page 382
Risk Assessment and Preparation......Page 383
Personal Preparation......Page 384
Supplies......Page 386
Field Data......Page 388
Psychiatric Problems......Page 389
Mountaineering......Page 390
Jungle/Tropical Environments......Page 391
Scuba Diving Expeditions......Page 392
Medical Care of Others......Page 393
Death Overseas......Page 394
References......Page 395
Ecotourists......Page 397
Keywords......Page 398
Infectious Disease Risks......Page 399
Risks to Other Species.......Page 400
References......Page 401
Medical Tourism Defined......Page 405
Keywords......Page 406
Cosmetic Surgery Tourism Recommendations......Page 407
Adverse Effects and Complications......Page 408
References......Page 409
International Regulations......Page 411
Keywords......Page 412
Influenza.......Page 413
Seasickness......Page 414
During Travel......Page 415
References......Page 416
Noncommunicable Diseases and Trauma......Page 418
Keywords......Page 419
Planning for Mass Gatherings......Page 420
References......Page 421
Section 8: Environmental Aspects of Travel Medicine
......Page 423
Keywords......Page 424
Epidemiology......Page 426
Clinical Presentation and Diagnosis......Page 427
Preacclimatization......Page 428
Prevention......Page 431
Travel Advice for Parents......Page 432
Pulmonary and Cardiac Problems......Page 433
Hematologic Disorders......Page 434
References......Page 435
The Ears, Nose, and Throat System and Diving......Page 438
Keywords......Page 439
Diabetes and Diving......Page 440
Medication and Diving......Page 441
Further Information and Advice......Page 442
References......Page 443
Heat Balance......Page 445
Keywords......Page 446
Heat Adaptation......Page 447
Diagnosis.......Page 448
Heat Exhaustion.......Page 449
Cold Injuries......Page 450
Treatment.......Page 451
Preventing Cold Injuries......Page 452
Rehydration......Page 453
References......Page 454
Treatments......Page 455
Keywords......Page 456
Light Therapy.......Page 457
MMAs.......Page 458
Conclusion......Page 459
References......Page 460
Triggers of Motion Sickness......Page 462
Keywords......Page 463
Nonmedicinal Prevention and Treatment Options......Page 464
Medications for Prevention and Treatment of Motion Sickness......Page 465
Treatment of Established Motion Sickness......Page 466
References......Page 467
The Pressurized Cabin......Page 469
Keywords......Page 470
Cosmic Radiation......Page 472
Measles......Page 473
Assessment Criteria......Page 474
In-Flight Medical Emergencies......Page 475
Conclusions......Page 476
References......Page 477
Treatment of Arthropod Bites.......Page 478
Keywords......Page 479
Prevention of Animal Attack.......Page 481
Venomous Bites and Stings......Page 482
Venomous Arthropods......Page 483
Hymenoptera.......Page 484
Venomous Reptiles......Page 485
Prevention of Marine Animal Stings and Attacks......Page 487
Marine Infections......Page 488
References......Page 489
Ciguatera......Page 490
Keywords......Page 491
Scombroid (Histamine Fish Poisoning)......Page 494
Pufferfish (Fugu) Poisoning......Page 495
Neurotoxic Shellfish Poisoning......Page 496
References......Page 497
Fatal Injury......Page 499
Keywords......Page 500
A Global Public Health Approach for Travel Medicine......Page 501
Water-Related Injuries......Page 502
Alcohol as a Risk Factor......Page 503
References......Page 504
Sources of Stress in International Travel......Page 505
Keywords......Page 506
Clinical Operating Environments Overseas and Their Vicissitudes......Page 507
Psychosis: Some Specifics and Relation to International Travel......Page 508
Posttravel Consultations......Page 509
References......Page 510
Size of the Risk After Travel......Page 511
Keywords......Page 512
Passenger-Related Risk Factors......Page 513
Mechanism......Page 514
Conclusions and Recommendations......Page 515
References......Page 516
Continued Globalism of Quality......Page 517
Keywords......Page 518
Health Care Resources.......Page 519
Medical assistance plans.......Page 520
Other resources for locating care.......Page 521
Paying for Care......Page 522
Pharmacy and Medication Issues......Page 523
References......Page 524
Before Departure......Page 525
Keywords......Page 526
Out and About......Page 527
Getting Sick......Page 528
References......Page 529
Who and When to Screen?......Page 530
Keywords......Page 531
Physical Examination......Page 532
Sexually Transmitted Infections......Page 533
Introduction.......Page 535
Invasive Amebiasis.......Page 536
References......Page 537
Causes of Fever in Travelers......Page 539
Keywords......Page 540
Incubation Period......Page 542
Clinical Presentations......Page 543
Rickettsial Infections.......Page 544
Acute Schistosomiasis.......Page 545
Elevated Liver Enzymes......Page 546
Conclusion......Page 547
References......Page 548
Hookworm-Related Cutaneous Larva Migrans......Page 550
Keywords......Page 551
Localized Cutaneous Leishmaniasis......Page 553
Myiasis......Page 554
Tungiasis......Page 555
Pyodermas......Page 556
Scabies......Page 557
Photosensitivity and Photo-Induced Disorders......Page 558
Urticaria......Page 559
Febrile Rash......Page 560
Sexually Transmitted Infections......Page 561
References......Page 562
Drug Hypersensitivity......Page 564
Keywords......Page 565
Helminths.......Page 566
Skin/Soft Tissue Involvement......Page 567
Gastrointestinal Symptoms......Page 568
Schistosomiasis.......Page 569
Evaluation of Patients With Eosinophilia......Page 570
References......Page 571
Epidemiology......Page 573
Keywords......Page 574
Management of Respiratory Tract Infections......Page 576
Prevention in Travelers......Page 578
Influenza......Page 579
Melioidosis......Page 580
Paragonimiasis......Page 581
Conclusion......Page 582
References......Page 583
Point-of-Care Travel Clinic Destination Resources......Page 585
Keywords......Page 586
Electronic Notifications and Feeds......Page 591
A......Page 592
B......Page 593
C......Page 594
D......Page 595
E......Page 596
G......Page 597
H......Page 598
I......Page 599
L......Page 600
M......Page 601
N......Page 602
P......Page 603
R......Page 605
S......Page 606
T......Page 607
V......Page 608
Z......Page 609