Travel Flashcards by Romana J

What is another name for travel health?

Emporiatrics

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List some health-related risks for travellers

Medical related:
• malaria
• influenza
• traveler’s diarrhoea
• hep A

• drowning
• driving on opposite side
• taking risks
• alcohol/drugs use
• STIs
• heart disease

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What are the 3 main trends - in international travel

• change is the amount of people travelling - more people are travelling
• change in destination of travel
• change in the type of travellers

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Change in the amount of people travelling?

More people are travelling to developing countries

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Change in destination of travel

• More people are travelling to hight risk places
• travelling on shorter notices
• little to no planning
• require greater healthcare needs during and after the trip

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Change in the type of travellers

Reasons for travels (order of most to least)
1. Leisure
2. Religious (VFR)
3. Business
*all there purposes are increasing to developing countries)

Types of traveler’s -
• older people
• those with pre existing, co-morbidities
• those using chronic medications

More people are travelling who aren’t always young and healthy

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Religious travellers - VRF

• there people are in close proximity with local people
• don’t really comply with professional advise
• believe to have immunity again country specific diseases

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Travel health - what do they want to cover?

• pre-assessment risks
• medication/prescriptions for managing/prophylaxis treatment of disease
• vaccinations.
• managing health issues over retiring travellers

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A pre-travel assessment consists of?

• assessment of general heath
• discussion of the possible risks in that destination
• vaccinations
• education and disease prevention

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Educational interventions?

Inset precautions
Malaria prophylaxis
Food and water precautions
Diarrhea and self-management
Current disease breakouts at destination
Vector-bone disease
Climate and jetlag
Routine meds
Sextual activity
First aid kits
Local medical care destinations
Crime and safety at destination

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Define travellers diarrhoea

3+ loose stools within 24 hours

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Sign and symptoms of TD

• n+v
• abdominal pain
• blood or mucus in stool
• fever

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Pathogens which can cause TD?

Bacteria - E.coli
Virus - norovirus
Parasite

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Risk factoids of TD

• consuming unclean water and food
• season
• length of stay
• medication: PPIs & H2 antagonist

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Prevention of TD

Food hygiene
Water hygiene
• boil water (2-3mins) boil for longer at higher altitudes
• use chlorine or iodine (iodine-not in women)
• vaccination
• chemoporphylaxis - pepto-bismol

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Treatment of TD

•hydration & diet
• Oral rehydration
• loperamide - not in young people, fever or blood/mucus in stool
• antibiotic - 3days
+ fluroquinolones
+ azithromycin or nor

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Reasons for Malaria worldwide spread?

• global warming
• resistance to plasmodium
• insecticide resistance to vector

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Types of malaria? 4 (5)

• p. Falciparum
• p. Ovale
• p. Vivax
• p. Malaria
• p. Knowlessi

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Which agents is P.falciparum resistant to?

Chloroquine

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Do people who live in endemic areas have semi-immunity to p.falciparum?

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Yes
- life-threatening cases of malaria to these healthy people is rare

Risk of malaria is lower in which areas?

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• Urban
• coastal
• above 2000m

Malaria - life cycle

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Bite of mosquito injects sporozoite into blood stream, enters liver an multiplies
Merozoites enter blood steam and invade red blood cells (erythrocytes)

Early signs of p.falciparum

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Fever:
• cold
• hot and flushed
• intense sweating

What can happen if p.falciparum is left untreated

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Coma and death within 24 hours

P.falciparum symptoms

• fever • n+v • headache • diarrhoea

High risk issue with p.falciparum in non-immune traveler’s

• carebral malaria - due to change in RBC • renal issues • thrombopenia

First line for plasmodium falciparum

Artemeter & Lumefantrine

3 chemoprophylaxis/treatment antimalarial agents

• chloroquine • doxycycline • mefloquine MOA: suppressors blood parasite

Chloroquine?

• safe in pregnancy + breastfeeding

Doxycycline

Not safe in: • pregnancy • oral contraceptives • <8 • virginal thrush • oesophagitis Start: 2 days before trip

Mefloquine

Not safe in those with neurological issues Avoid in pregnancy Start: 2-3 weeks before trip

Best agent for stand by treatment?

Artemether & Lumefeantrine

Non-pharmacological management of malaria- Bite avoidance

• cover arms and sleeves. • wear light colour clothes and thicker material • apply inset repelant • apply insecticide to clothing • avoid perfume • avoid daytime exposure to Anopheles mosquitoes • avoid nighttime exposure to Aedes mosquitoes • cautious in wet weather

What causes Rabies?

rhabdovirus of the genus Lyssavirus

How is Rabia transmitted?

Virus is in the saliva of the infected animal and is transmitted to humans through bites and scratches

If rabies is untreated is it fatal?

Yes

Which countries is their a higher risk of Rabies

In the Rural areas of: • Asia • Africa • south and North Africa

Which types of travellers are at a risk risk of developing rabies?

• small children • travelling on bicycles • adventures behaviour • working with animals

Clincal features of rabies?

• fever • hallucinations • sensory changes around animals • aerophobia • hydrophobia

Whats is Economy Class syndrome - DVT/VTE caused by

Lack of mobility and cramp conditions DVT = blood clots in the deep veins

What beverages contribute to dehydration and sluggish circulation?

Caffeine & Alcohol

What is jet lag?

A psychological + physiological desynchronising of sever different time zones

Which factories can aggregate jet lag?

• age • dehydration • poor diet • snaps • lack of sleep • coffee + alcohol • direction of travel

Melatonin can be used to reduce effects of get lag, but who should not take it?

Epileptics and those taking warfarin

Measures to take BEFORE flight

• adequate sleep • don’t book tasks which need to be done immediately after landing

Measures to take During flight

• drink plenty of fluids • avoid alcohol + caffeine • avoids sleep deprivation *hypnotics - temazepam (but can increase DVT)

Measures to take AFTER flight

• adapt to the counties sleeping and eating times • But avoid sleep deprivation

Which health risks are associated with cruise ships?

• being in close proximity with diverse people • risk of foodbourn + waterbourn diseases

Illnesses on board include:

• GI - norovirus • respiratory - influenza • slips and falls • death - CV disease

Travel Flashcards

(49 cards)