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At least 505 records · Page 28Linked to original sources
PubMed1998

The prevalence of asthma in schoolboys of travellers' families.

This study compared the prevalence of asthma in travelling schoolboys and settled controls to determine whether the travelling lifestyle may be a protective factor in the development of asthma. Information was collected by parental responses to the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire. The design was a cross-sectional study with descriptive and analytical components. The subjects were six to twelve year old schoolboys from all male travelling children in Cork and from a selection of settled schoolboys. In addition the study collected information on the predictor variables--age, passive smoking and number of siblings. The questionnaire was administered to 54 travelling boys and 129 controls. The parent reported prevalence of wheeze and related symptoms were all more common in controls compared with the travelling boys. The values were significant for wheeze in the last year (31.3% v 14.8%; OR-5.6, p = 0.025), and for doctor diagnosed asthma (25.6% v 11.1%; OR = 5.1, p = 0.04). Schoolboys from travelling families have less wheeze and doctor diagnosed asthma than controls. The experience of the travelling lifestyle maybe a protective factor in the development of asthma.

Analysis of Variance↗
PubMed1999

The use of the sonic pathfinder as a secondary mobility aid for travel in business environments: a single-subject design.

Two studies were conducted using a single subject research design in different business environments to evaluate the efficacy of the Sonic Pathfinder for increasing efficiency in travel with an experienced and accomplished blind traveller. The Sonic Pathfinder is one of eight or nine commercially available electronic travel aids (ETAs) designed for use by blind or visually impaired persons. The use of ETAs are thought to result in more rapid travel and a greater ability to detect and avoid obstacles in one's path. Elapsed time for travel and the number of unintentional contacts made while travelling were used as the dependent variables in both studies. No marked effect was observed for either variable in either study. An additional traveller who was slower and more tenuous in his movements was recruited to participate in the second study to investigate the possibility that a floor effect may have masked the results of the use of the ETA with the first subject. However, no marked effects were observed with this subject either. Yet, both subjects stated that the use of the aid increased their distance for environmental preview over and above that provided by the long cane alone, while providing them with the opportunity to judge the distance of objects approached beyond cane length. Discussion centers on the need to identify other means to evaluate the utility of this aid in light of the positive statements made by the participants of these studies.

Adult↗
PubMed2000

Preparing patients to travel abroad safely. Part 2: Updating vaccinations.

OBJECTIVE: To provide, for family physicians without access to a travel clinic, evidence-based recommendations on vaccinating infants and children, adults, pregnant women, and immunocompromised patients traveling to non-Western countries. QUALITY OF EVIDENCE: Searches were undertaken of MEDLINE from 1990 to November 1998 (372 articles); the Cochrane Collaboration Library; publications of the National Action Committee on Immunization and the Committee to Advise on Tropical Medicine and Travel in Canada Communicable Disease Reports; the Canadian Immunization Guide; and Laboratory Centre for Disease Control, United States Centres for Disease Control, and World Health Organization websites. Evidence-based statements, randomized controlled trials, systematic reviews, and meta-analyses were selected. Vaccination recommendations are based on this evidence. MAIN MESSAGE: Physicians should complete vaccination schedules for children whose primary series is incomplete and vaccinate unvaccinated adults. Hepatitis A is widespread, and travelers to areas where it is endemic should be vaccinated. The elderly should be vaccinated against influenza and pneumococcal disease. Pregnant women should receive vaccines appropriate to their trimester. Immunocompromised patients should be vaccinated, but BCG and live vaccines are contraindicated. Travelers to areas where meningitis, typhoid, cholera, Japanese encephalitis, and rabies are endemic should be vaccinated if they are likely to be exposed. Those traveling to areas where tuberculosis is endemic should take precautions and should have skin tests before traveling and 2 to 4 months after return. CONCLUSIONS: Family physicians can administer all necessary vaccinations. They can advise pregnant women and immunocompromised people about the balance of risk of disease and benefits of vaccination.

Adult↗
PubMed2000

Preparing patients to travel abroad safely. Part 4: Reducing risk of accidents, diarrhea, and sexually transmitted diseases.

OBJECTIVE: To present evidence-based recommendations on traveling abroad safely so family physicians can advise travelers on how to reduce risk of accidents, diarrhea, and sexually transmitted diseases (STDs) and how to treat diarrhea themselves if medical care is unavailable. QUALITY OF EVIDENCE: A MEDLINE search from 1990 to November 1998 found 163 articles on travel and accidents, 504 on travel and diarrhea, and 42 on travel and STDs. Titles and abstracts were reviewed, and randomized controlled trials (RCTs) and systematic reviews were sought. The Cochrane Collaboration database of systematic reviews and meta-analyses was searched for studies relevant to family physicians. MAIN MESSAGE: For preventing diarrhea, RCTs demonstrate that bismuth subsalicylate, doxycycline, ciprofloxacin, and trimethoprim-sulfamethoxazole are useful prophylactics. Once travelers have diarrhea, RCTs show that loperamide and zaldaride reduce symptoms and duration; quinolones, ciprofloxacin, norfloxacin, and oral aztreonam reduce abdominal symptoms and time to last liquid stool by several days; azithromycin is effective in treatment of ciprofloxacin-resistant Campylobacter, and trimethoprim-sulfamethoxazole is effective in treating cyclospora. There are no RCTs of preventing accidents and STDs abroad. Health Canada has issued a statement summarizing the risks of acquiring STDs abroad. CONCLUSION: Family physicians can advise their patients on how to reduce risk of travelers' diarrhea and how to treat it themselves on holiday. There is expert advice on how to reduce risk of STDs.

Accident Prevention↗
PubMed2001

[Thromboembolism in travelers].

The association between long haul travel and the risk of venous thromboembolism are suspected for long time. Mostly air travel related thrombosis series have been reported in the literature. Risk factors can be classified as: 1. travel related factors (coach position, immobilization, prolonged air travel, narrow seat and room, diuretic effect of alcohol, insufficient fluid intake, dehydration, direct pressure on leg veins, rare inspiration). 2. air plane related risk factors (low humidity, relative hypoxia, stress). 3. patient related factors (hereditary and acquired thrombophylia, previous deep venous thrombosis, age over 40, recent surgery or trauma, gravidity, puerperium, oestrogen containing pills, varicosity, chronic heart disease, obesity, fever, diarrhoea, vomiting, smoking). No patient related factors were found in some cases. To reduce the hazards air travellers are rightly concerned to know the level of the risk and the airlines should be responsible for this information. People should discuss with their physician what prophlylactic measures should be taken, such as compression stockings or low molecular weight heparin. Not only flight but car, bus and train travellers are also at risk of developing venous thromboembolism. Long haul travel alone is a separate risk factor for venous thromboembolism.

Humans↗
PubMed2003

Screening international travellers in China for SARS.

Faced with the spread of SARS through international travel, the World Health Organisation (WHO) advised against inessential travel to certain areas with local SARS transmission, and also the screening of travellers from such areas. This report looks at the steps taken in China for the screening of travellers. Travellers were asked about contact with SARS and possible symptoms, were screened for high fever, provided with health information and observed for any clinical signs. Arrangements were in place for dealing with ill travellers and for contact tracing of fellow travellers. There were also extra measures that could only be justified by the reassurance they provided. The overall impact of these measures in preventing international spread of SARS is unknown, but the experience could contribute to the control of future epidemics.

China↗
PubMed1992

Knowledge and beliefs of international travellers about the transmission and prevention of HIV infection.

OBJECTIVES: To measure the perceived risk of acquired immunodeficiency syndrome (AIDS) among international travellers, to measure their knowledge of the transmission and prevention of HIV infection abroad and to identify some of the determinants of this knowledge. DESIGN: Survey. SETTING: Travellers' immunization clinic providing mostly primary preventive care to international travellers. PARTICIPANTS: All clients aged 18 to 50 years seen at the clinic between Oct. 2 and Dec. 21, 1989, before their departure. MAIN OUTCOME MEASURES: Sixteen statements measured knowledge of transmission and prevention of HIV infection. Standardized scales measured health beliefs. RESULTS: The response rate was 81% (331/409). Compared with other diseases AIDS was perceived to be associated with a low risk except by those travelling to countries with a high prevalence of AIDS. Most of the clients were found to have a good knowledge of HIV transmission to travellers, although some myths remained popular and some real routes of transmission, especially blood, remained underrated. In all, 70% of the subjects believed in the efficacy of condoms when used with local people, as compared with 79% when used with other tourists; this difference was greatest among travellers who perceived AIDS as being particularly severe but difficult to prevent. The determinants of the knowledge of HIV transmission and prevention were a high level of education, a mother tongue other than French, unmarried status, a high prevalence of AIDS at the destination, the duration of the trip and a high perceived risk of HIV infection. CONCLUSIONS: Counselling should teach travellers (a) not to underestimate their risk of HIV infection during their trip, (b) to decrease the risk of requiring health care in developing countries and (c) to rely on their own prudent sexual behaviour rather than on their assessment of the level of risk posed by the environment.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Improving health sector travel.

Preventing ill health and obesity and building more physical activity into our daily lives have never been so high on the agenda, and the way we travel can help. Many workplaces and schools are drawing up travel plans, with the aims usually to minimise car use and encourage healthier and more environmentally friendly travel. The Transport White Paper of 1998 advocated travel plans and singled out hospitals for action. Travel plans continue to be a focus within the latest Transport White Paper, launched in July 2004. This article covers various prompts to the health sector to implement travel plans. It addresses issues and concerns facing NHS Trusts, the practical things Trusts can do, and the increasing amount of good practice available. Finally, it demonstrates that travel plans can work, and are working, in the health sector.

Health Care Sector↗
PubMed1992

General advice for the international traveler.

Medical concerns of the traveling patient may be organized into pre-travel medical advice and preparation, maintenance of health and behavioral modification during travel, and post-travel diagnosis and treatment for travelers returning with illness or a significant change in their general health. Pre-travel medical advice and preparation may be done in large part by well-informed primary-care providers, although patients with special health conditions or unusually complicated or high-risk itineraries may be best referred to a travel medicine specialist. Although diagnosis and treatment of exotic and tropical diseases usually falls within the area of expertise of the infectious diseases specialist, primary physicians should be familiar with the geographic distribution and presentation of the more common of these diseases, so that appropriate referrals will be made.

Altitude Sickness↗
PubMed2006

Hepatitis A vaccination policy for travellers to Egypt in eight European countries, 2004.

In 2004, an outbreak of hepatitis A occurred in European tourists returning from Egypt. The reported hepatitis A attack rates varied considerably between tourists from different European countries. To determine the reason for this divergence in attack rates, a survey was undertaken with the following objectives: (a) documentation of national hepatitis A prevention policies for people travelling to Egypt and (b) documentation of hepatitis A reporting practices in these countries. A questionnaire was compiled and distributed to 13 European countries. All eight of the countries that responded had produced guidelines for the prevention of travel-associated hepatitis A. Between 2001-2003, 40% (range 4-51) of hepatitis A cases reported annually were associated with travel abroad. This occurred despite the fact that all countries recommended active vaccination with hepatitis A vaccine for people travelling to Egypt for holidays. There was no standard case definition for reporting confirmed cases in the countries that reported hepatitis A cases. As it is likely that travel-associated infections will increase as more people take overseas holidays, innovative ways to increase the number of travellers who seek and adhere to appropriate medical advice prior to travel must be explored. In addition, we recommend the use of the European Commission case definition for notification of confirmed cases of hepatitis A.

Egypt↗
PubMed2006

Air travel and fatal pulmonary embolism.

Although long-distance air travel is commonly regarded as a risk factor for venous thromboembolism, the risk of clinically important events has not been well defined. We estimated the absolute risk of dying from pulmonary embolism following long-distance air travel in a national population-based descriptive study of 121 men and women who were aged 15-59 years (the age range in which the majority of international arrivals are found) and whose underlying cause of death was certified as codes 415.1, 451, or 453 of the International Classification of Diseases (ninth revision). Eleven cases had undertaken long-distance air travel in the four weeks before the onset of the fatal episode. The estimated risks of fatal pulmonary embolism following a flight of at least three hours' duration were 0.5 (95% CI 0.2-1.2) and 0.6 (95% CI 0.2-1.4) per million arrivals for overseas visitors and New Zealand residents, respectively. For air travel of more than eight hours' duration, the risk in New Zealand residents was 1.3 (95% CI 0.4-3.0) per million arrivals. We also conducted a case-control study based on those cases who were normally resident in New Zealand and registered on the electoral roll (n = 99). For each case, four controls matched for sex, age, and electorate, were randomly selected from the electoral roll. In the key analysis (based on 88 cases and 334 controls), the adjusted odds ratio for travellers who had flown for more than eight hours was 7.9 (95% CI 1.1-55.1) compared with those who did not undertake a long-distance flight. Long-distance air travellers have a higher risk of dying from pulmonary embolism than non-travellers, but the absolute risk in people aged 15-59 years appears to be very small.

Adolescent↗
PubMed2006

Travel-associated dengue--United States, 2005.

Dengue is a mosquito-transmitted, acute viral disease caused by any of four dengue virus serotypes (DEN-1, DEN-2, DEN-3, or DEN-4). Dengue is endemic in most tropical and subtropical areas of the world and has occurred among U.S. residents returning from travel to such areas. In collaboration with state health departments, CDC maintains a passive surveillance system for travel-associated dengue among U.S. residents. Suspected dengue in travelers is reported to state health departments, which forward specimens to CDC for diagnostic testing. A case of travel-associated dengue is defined as laboratory-diagnosed dengue in a resident of one of the 50 states or the District of Columbia (DC) who traveled to a dengue-endemic area outside the United States or DC any time during the 14 days before symptom onset. This report summarizes information regarding 96 travel-associated dengue cases, including one fatality, among U.S. residents during 2005. Travelers to tropical areas can reduce their risk for dengue by using mosquito repellent and avoiding exposure to mosquitoes. Health-care providers should consider dengue in the differential diagnosis of febrile illness in patients who have returned recently from dengue-endemic areas.

Adolescent↗
PubMed1990

Travel to developing countries: pre-departure medical advice.

Travelers to developing countries are at risk of contracting tropical infectious diseases that they or their physicians may be unfamiliar with. Proper pre-travel counsel should be given concerning general health risks that may be encountered abroad, immunizations, malaria prophylaxis and prevention and treatment of traveler's diarrhea. In Rhode Island, expert advice may be obtained at the Traveler's Clinics at the Miriam Hospital in Providence (401-274-3700 or 331-8500, ext. 4075) and the Memorial Hospital in Pawtucket (401-722-6000, ext. 2545). The Miriam Traveler's Clinic is open Wednesday (9-1) and all day Friday while the Memorial Traveler's Clinic is open Tuesday afternoon. These Traveler's Clinics are headed by Drs G.R. Olds and S.M. Opal, respectively.

Altitude Sickness↗
PubMed1989

International travel and sexually transmitted diseases.

Sexually transmitted diseases (STDs) are a group of communicable diseases transferred mainly by sexual contact. Population movements are undoubtedly a major contributing factor in the spread of STDs. Owing to the ease of modern travel, larger numbers of people are moving around than ever before in peacetime. Travellers may both import and export infection, and the importance of their role in the transmission of STDs is demonstrated by the rapid worldwide spread of penicillinase-producing strains of N. gonorrhoeae (PPNG) and AIDS. While in most industrialized countries the incidence of the classic STDs (syphilis, gonorrhoea, chancroid) has decreased during the last decade, they remain hyperendemic in many developing countries due to poorly developed STD services. In many industrialized countries, the incidence of genital C. trachomatis infection now exceeds that of gonococcal infection. Chlamydial infections were previously thought to be infrequent in developing countries, but recent research has made it clear that this infection is at least as frequent as gonorrhoea. Incidence of genital herpes and genital human papilloma-virus infections (HPV) has increased dramatically during the last 20 years. Now that international travel takes place increasingly by air, it is more likely than previously for a traveller to return home within the incubation period of many STDs. Moreover, people behave differently when they travel. Tourists travel to seek adventure and new experiences, including sex. In countries where a good notification system exists, up to 30% of new cases of syphilis were found to be acquired abroad. Since PPNG appeared in 1976, these strains have spread to almost all areas of the world. During the first five years of the epidemic, most cases in Europe and the United States of America were imported. Measures for preventing STDs are the same whether the individual is travelling or not. Abstinence or sexual intercourse between two mutually-faithful uninfected partners exclusively are the only totally effective prevention strategies. The risk of infection can also be significantly reduced by adopting safe sexual practices such as the use of condoms. Prophylactic use of an antibiotic is not recommended, however.

Female↗
PubMed1989

Counseling the international traveler.

The itinerary of international travelers will largely determine the amount of pretravel counseling number of immunizations and type of malaria prophylaxis they will need. The countries visited are also the best predictor of traveler's diarrhea. Only yellow fever and cholera vaccines are required for entry into certain countries; the latter generally given only to satisfy entry requirements. Polio vaccine is important for some areas and is frequently neglected. For most malarious areas, chloroquine once per week is recommended. Fansidar should be prescribed weekly for very few travelers. Traveler's diarrhea is best prevented by avoiding high risk foods and beverages. Antibiotics, generally not recommended for prophylaxis, are very effective in treatment. Travelers should be reminded to advise physicians of their travel history during future medical encounters so that diseases, possibly contracted during travel, may be considered in diagnoses.

Antimalarials↗
PubMed1989

[Vaccination protection and advice to travellers. Statistical data on the activity of the International Vaccination Center of Bordeaux (France) in 1988].

Most travellers to tropical countries are young adults aged between 25 and 44; they tend to be of average or high socioeconomic status, to have a university education and to live in urban areas. The number of countries visited is high (111). Half the travellers go to Senegal, Ivory Coast and French Guiana. Asian countries are underrepresented among the clients of the Bordeaux centre because they do not require yellow-fever vaccination. The main reasons for travel are pleasure (73%) and business (23%). The length of stay is closely correlated with the reason for travel. Considerably more people travel in the winter period. The most frequently performed vaccinations are yellow fever, tetanus and poliomyelitis, in roughly equal numbers. A major role of a vaccination centre in the eyes of the public is to provide travellers with information and advice. A specialist centre of this kind, kept regularly informed about epidemiological developments around the world, is best equipped to advise on effective malaria prophylaxis. The centre's health-education role extends to all risks associated with travelling, in particular the sexually transmitted diseases and specifically tropical diseases, and also the consequences of changes in climate or altitude and failure to take general hygiene precautions. Computerized data banks accessible to the general public are certainly an information medium for the future, but at present are still underused.

Adolescent↗
PubMed1989

Frequency and types of medical emergencies among commercial air travelers.

We performed a one-year prospective survey of emergency medical responses to travelers at an international airport to observe the frequency and type of emergencies experienced in flight and before and after travel. Emergency personnel evaluated a total of 1107 people; 754 (68%) were travelers, 232 (21%) were employees of the airport or airlines, and 118 (11%) were area residents. Of the 754 travelers, 190 (25%) experienced their problem during flight; the aircraft made an unscheduled landing for seven of these travelers. The frequency of in-flight emergencies was 1 per 753 inbound flights, or 1 per 39,600 inbound passengers. The most common emergency problems among all travelers were abdominal pain, chest pain, shortness of breath, syncope, and seizures; 25% of the emergencies were caused by minor trauma. The majority of emergencies among air travelers (75% [564/754]) happened on the ground within the air terminal. Most problems (84% [633/754]) were effectively handled by personnel trained as emergency medical technicians. The types of problems encountered suggest that the "doctors only" medical kit now required aboard US air carriers contains clinically useful items and should continue to be required on board.

Aircraft↗
PubMed1986

Comprehensive care of travelers.

Travel, especially if it is international, often means major changes for the family. Family physicians should assess the epidemiologic risk and psychosocial significance of travel or relocation in light of the family's life-cycle stage and antecedent health. Using core references, which are kept current in partnership with public health agencies, family physicians are able to provide comprehensive immunization, medications, and patient education for all travel risks. Families are given medical record summaries and recommended sources of care at their destination. Eight weeks after their return patients are reassessed for newly acquired illness and helped to integrate the perspectives gained during the travel into the family's future dynamics. Taking advantage of growing travel medicine opportunities, family medicine educators should base the care of travelers and teaching of residents on defined competence priorities. Travelers' health provides a mutually rewarding model of shared care with public health consultants in the community medicine curriculum.

Bibliographies as Topic↗