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At least 559 records · Page 31Linked to original sources
PubMed2002

Microcirculatory changes in travelers to a tropical country.

BACKGROUND: Travelers to tropical areas seem to be affected by nonhealing leg ulcers more frequently. One of the factors that can affect wound healing in a negative manner is leg edema. This study was performed to determine whether there is increased leg edema in travelers to tropical areas. METHOD: In this study, we measured the capillary filtration rate (CFR) of the lower leg by strain gauge plethysmography, as a measure of leg edema, on location in Surinam. Three groups were included: A, travelers in the first few weeks after arrival; B, travelers who had stayed in the tropics for a minimum of 2 months; C, native inhabitants. RESULTS: The mean CFR (mL/100 mL tissue/min) was significantly higher in group A than in groups B and C; the difference between groups B and C was not significant (group A 0.05 mL/100 mL tissue/min (standard deviation (SD), 0.03) vs. group B 0.02 mL/100 mL tissue/min (SD, 0.02), P = 0.01, and vs. group C 0.02 mL/100 mL tissue/min (SD, 0.02), P = 0.01). CONCLUSIONS: Travelers to tropical areas are affected by increased CFR in the first few weeks after arrival. A prolonged stay leads to the normalization of the CFR. Compression therapy is recommended for travelers to the tropics.

Adult↗
PubMed2003

Problems in prescribing malaria chemoprophylaxis for travelers.

To offer effective malaria chemoprophylaxis for travelers in a country, the physician must know the precise status of malaria there (frequency, resistance), determine the degree of exposure to mosquito bites, evaluate the precise clinical condition of the traveler, and improve the traveler's compliance with treatment by providing good information on potential side-effects. These side-effects, sometimes overemphasized in the media, lead to poor compliance, particularly after returning home, and, consequently, increase the risk of acquiring malaria. The recently approved Malarone could overcome these drawbacks. But its cost is high and its wide use could also lead to the emergence of resistant strains. Therefore, training professionals in travel medicine is important in malaria prevention and decrease the prescription of abusive or inaccurate prophylaxis (e.g., most tourists traveling in organized tours in Asia, with no stay in remote malaria endemic areas, do not need any prophylaxis). In addition, prevention of mosquito bites with repellents, impregnated bed nets, and indoor insecticide-dispensing devices is still an important tool for controlling malaria in travelers.

Animals↗
PubMed1990

[Malaria prophylaxis of West German travelers to Africa].

From May 1985 to July 1988, 11,445 German residents who had travelled to Africa filled in a questionnaire during the return flight and a second questionnaire sent to them 3 months later. 92.6% of the travellers had been on holiday and 99.3% of these holiday-makers were aware of the risk of malaria. Before and during their stay in the tropics 10,955 travellers (95.7%) had taken the chemoprophylaxis correctly, though in some instances the drugs prescribed were not in accordance with the guidelines existing at the time. However, 3227 of them (35.5%) discontinued the drugs too early, i.e. less than four weeks after their return. Only 4.3% of the travellers had taken proper precautions against mosquito bites. In view of the ever increasing numbers of people travelling to countries where malaria is endemic, doctors and travelers should be provided with more information and should be given more consistent advice on malaria prophylaxis.

Africa, Western↗
PubMed2003

Social networks, travel and talk.

This paper considers the role that physical, corporeal travel plays in social life. There is a large and increasing scale of such travel. This increase has occurred simultaneously with the proliferation of communication devices that in some ways substitute for physical travel. I hypothesize that the bases of such travel are new ways in which social life is 'networked'. Such increasingly extensive networks, hugely extended through the informational revolution, depend for their functioning upon intermittent occasioned meetings. These moments of physical co-presence and face-to-face conversation, are crucial to patterns of social life that occur 'at-a-distance', whether for business, leisure, family life, politics, pleasure or friendship. So life is networked but it also involves specific co-present encounters within specific times and places. 'Meetingness', and thus different forms and modes of travel, are central to much social life, a life involving strange combinations of increasing distance and intermittent co-presence. The paper seeks to examine the place of travel within the emergent pattern of a 'networked sociality'. It seeks to contribute to the emerging 'mobility turn' within the social sciences.

Automobile Driving↗
PubMed1985

Travelers' diarrhea. Controversy and consensus.

In view of all the controversy surrounding travelers' diarrhea, how should patients be counseled regarding its prevention and treatment? First, all patients should be instructed on the importance of eating and drinking only safe food and water and on methods of dietary manipulation and oral rehydration therapy. The travelers listed in table 4, as well as short-term visitors to Mexico, may be candidates for prophylactic medication unless such treatment is contraindicated. All patients can be offered an antimotility agent for discriminant use as discussed, and a prescription for trimethoprim-sulfamethoxazole is generally a good idea in the event of a severe bout of illness during travel. A traveler can go overboard in an attempt to avoid diarrheal illness. Such overconcern can detract from the enjoyment of travel and limit the spectrum of activities and cuisine. One report noted that diarrhea seemed to occur more frequently the more a traveler tried to elude it! This could well set the stage for the biggest controversy of all.

Antidiarrheals↗
PubMed1987

Travel medicine resources for the primary care physician.

Emporiatrics, or travel medicine, is not a part of everyday medical practice for most physicians, but with the growth in both domestic and international travel it makes sense to be prepared when the need arises. A number of useful resources are available to help in providing travel medicine services for both occasional and frequent travelers in need of accurate information about travel and health. A most useful aspect of the resources reviewed here is that they can be ordered or used according to the travel medicine needs of particular patients.

Education, Medical, Continuing↗
PubMed2001

Internet and computer-based resources for travel medicine practitioners.

The field of travel medicine is concerned primarily with ways to maintain the health of international travelers. Remaining current in this area requires up-to-date knowledge of global infectious diseases, patterns of drug resistance, advances in preventive measures, and public health regulations pertaining to the crossing of international borders. This review of off-line commercial databases and Internet sources will assist infectious disease consultants in accessing current reliable travel health information. Of the North American pretravel off-line databases, TRAVAX (United States) and The Medical Letter are the most comprehensive, whereas the Global Infectious Disease and Epidemiology Network is extraordinary in its provision of global infectious disease epidemiology for posttravel assessment. A total of 65 Web sites are listed within 9 categories, covering such areas as authoritative government travel health recommendations, commercially-oriented sites, and travel medicine listserv discussion groups. Even among reputable Web sites, contradictory information may be found that demands careful consideration by the clinician and by the traveling public.

Communicable Disease Control↗
PubMed2001

Association of tuberculin sensitivity in Dutch adults with history of travel to areas of with a high incidence of tuberculosis.

International travel may be a source of introduction of tuberculosis into low-incidence countries. We assessed whether, in The Netherlands, sensitivity to tuberculin was associated with a history of travel to countries with a high incidence of tuberculosis. Immunocompetent adults with no history of Bacille Calmette-Guérin vaccination or sensitivity to tuberculin were skin-tested simultaneously with 1-tuberculin unit (TU) purified protein derivative (PPD) of Mycobacterium tuberculosis and 1-TU sensitin of Mycobacterium scrofulaceum. Tuberculin sensitivity was defined as a reaction to PPD of > or =10 mm that was > or =3 mm larger than the reaction to M. scrofulaceum sensitin. Tuberculin sensitivity was found in 7 (0.7%) of 1014 participants (95% confidence interval [CI], 0.3%-1.4%); it was independently associated with a cumulative history of >3-months' travel to high-incidence areas (odds ratio, 6.0; 95% CI, 1.2-31.2; P=.016) and increased in association with total duration of travel (P=.02). Travel to high-incidence areas increases the risk of tuberculin sensitivity and, consequently, of latent tuberculous infection. In countries with a low incidence of tuberculosis, cases of infection acquired during travel may account for a substantial proportion of new infections in the resident population.

Adult↗
PubMed2003

Respiratory tract infections in travelers: a review of the GeoSentinel surveillance network.

Respiratory tract infections are common in travelers, and improving our knowledge of risk factors associated with specific types of respiratory infections should enable implementation of better preventive strategies. Data collected by the GeoSentinel surveillance network were analyzed, and the most significant predictors for developing specific categories of respiratory infections while abroad were age, sex, season of travel, trip duration, and reason for travel. In particular, influenza was associated with travel to the Northern Hemisphere during the period of December through February, travel involving visits to friends or relatives, and trip duration of >30 days. Lower respiratory tract infections were associated with male sex and increasing age. Knowledge of the respiratory tract infections that occur in specific groups of travelers allows for the development of targeted pretravel preventive strategies to high-risk groups.

Adolescent↗
PubMed1999

Seroconversion to circumsporozoite antigen of Plasmodium falciparum demonstrates a high risk of malaria transmission in travelers to East Africa.

Circumsporozoite (CS) antibodies have been shown to be reliable indicators of malaria transmission in endemic areas. Their prevalence in travelers can indicate the degree of exposure to plasmodial infection. Two hundred sixty-two short-term travelers to Kenya were recruited to a prospective study to determine the incidence of CS antibody conversion. All travelers were receiving malaria chemoprophylaxis. Serum samples were drawn before departure and 4-6 weeks after their return to Germany. Sera from 310 volunteers who did not leave Germany served as controls. Serum specimens from 13 (4.96%) of the 262 travelers were found to be positive after return. None of the travelers developed symptoms of clinical malaria or antibodies against the blood stages of Plasmodium falciparum. All 310 control samples tested negative. These data demonstrate a considerable risk of malaria transmission for short-term travelers to East Africa.

Adolescent↗
PubMed1995

Outbreak of schistosomiasis among travelers returning from Mali, West Africa.

Schistosomiasis in travelers often remains unrecognized because doctors are unfamiliar with the clinical presentation and diagnosis of this imported disease. We describe the epidemiological, clinical, and laboratory characteristics associated with an outbreak of schistosomiasis among nonimmune travelers. Of 30 travelers in two consecutive groups, 29 who had swum in freshwater pools in the Dogon area of Mali, West Africa, were followed for 12 months. Twenty-eight (97%) of those 29 became infected; 10 (36%) of the 28 had cercarial dermatitis, and in 15 (54%), Katayama fever developed. Eggs were found in 22 (79%) of the infected travelers: eggs of Schistosoma mansoni or terminally spined eggs (probably of Schistosoma intercalatum) were in the stools of 19 and 10 patients, respectively, and eggs of Schistosoma haematobium were in the urine of 7 patients. The eggs of 2 of these Schistosoma species were present in 6 cases, and in 4 cases eggs of all 3 species were found. The limited exposure of this group of travelers resulted in a high rate of infection with all three of the Schistosoma species that are prevalent in Africa. A diagnosis of schistosomiasis should be considered for any traveler with a history of exposure to fresh water in an area of endemicity. The only effective method of prevention is avoiding all contact with fresh water in these areas.

Adult↗
PubMedDate not supplied

Etiology and epidemiology of travelers' diarrhea in Asia.

Travelers' diarrhea in Asia has been studied among Peace Corps volunteers in Thailand, Japanese travelers, foreign residents in Bangladesh, guests in hotels, and members of various tour groups. Rates of diarrheal attack of greater than 50% during four- to six-week sojourns were reported for these groups. Among travelers with diarrhea, the most commonly isolated pathogen was enterotoxigenic Escherichia coli (20%-34%), followed by Salmonella (11%-15%), Shigella (4%-7%), Campylobacter (2%-5%), and Vibrio parahaemolyticus (1%-13%). In 9%-22% of diarrheal episodes, multiple pathogens were recovered. Among Japanese travelers, Salmonella was more commonly acquired in the Far East; Shigella and Campylobacter, in the Indian subcontinent; and V. parahaemolyticus, in Southeast Asia. Aeromonas hydrophila and Plesiomonas shigelloides were commonly isolated from ill travelers in Thailand but less frequently from other travelers. Protozoa and Vibrio species other than V. parahaemolyticus were isolated in less than 5% of episodes.

Asia↗
PubMedDate not supplied

Environmental interventions for the prevention of travelers' diarrhea.

The diarrheal illnesses affecting travelers to areas with low standards of hygiene are due to exposure to microbial agents not in wide circulation in the travelers' home area. A major objective for the prevention of travelers' diarrhea should be to minimize exposure to these infectious agents. Studies of sporadic and epidemic travelers' diarrhea have shown that contaminated food and water are usually the most important vehicles for transmission of these agents. Travelers must know which foods and water sources to avoid and which they may reasonably be assured are safe. Also, methods for disinfecting potentially contaminated sources must be simple and practical. Acceptable methods for ensuring the safety of food and drink are amply documented in the literature. However, although the consumption of certain foods and beverages is clearly associated with an increased risk of developing travelers' diarrhea, in some retrospective studies adherence to strict dietary rules generally did not appear to diminish the incidence. Despite these findings, whose validity may have been weakened by study design flaws, careful attention to the preparation and choice of food and beverage is recommended for prevention of both diarrheal and nondiarrheal illnesses.

Diarrhea↗
PubMed2005

Relationship between travel time to the nearest hospital and survival from ruptured abdominal aortic aneurysms: record linkage study.

BACKGROUND: There is currently a trend in Britain to concentrate specialist services in a smaller number of hospitals in order to improve outcomes. However, for rapidly life-threatening conditions such as ruptured abdominal aortic aneurysms (RAAAs), the resulting increased travel time to hospital might adversely affect survival. This study aimed to evaluate the relationship between travel time to the nearest hospital and survival from RAAAs in West Sussex. METHODS: Information was collected regarding outcome, postcode, age, sex and diagnoses for all West Sussex residents who had a RAAA between January 1996 and September 1999, including admissions and deaths, wherever they occurred. Deprivation scores were calculated based on postcode. Potential travel time to the nearest hospital was calculated using "Microsoft AutoRoute Express" and its effect on outcome was analysed using multiple logistic regression. RESULTS: After adjusting for age, sex, Townsend deprivation score and nearest hospital, the odds ratio for survival associated with a 10 min increase in potential travel time to the nearest hospital was 0.97 (0.88 unadjusted) (95 percent confidence interval for adjusted odds ratio: 0.70 to 1.34; p = 0.86). CONCLUSION: Several previous studies suggested better survival with longer distances travelled. They are likely to be biased by omission of community deaths. This methodologically better study found no such relationship between RAAA survival and travelling time to hospital in West Sussex, although confidence intervals were wide. This is particularly pertinent while there is a push to centralize vascular and other services in the United Kingdom.

Aged↗
PubMed2004

New world mucosal and cutaneous leishmaniasis: an emerging health problem among British travellers.

BACKGROUND: Mucosal leishmaniasis (ML) is an important complication of new world cutaneous leishmaniasis (CL) caused by species of the Leishmania Viannia subgenus. Previous reports of ML among travellers to Latin America are few. AIMS: To determine the annual number of cases of CL due to L. Viannia species diagnosed at this institution and to correlate this with changing patterns of travel. Secondly, to document the clinical presentation, diagnosis, treatment and outcome of ML at this institution. DESIGN: Retrospective observational study. METHODS: Data were collected from a clinical database, laboratory records, patient case notes and an international passenger survey. RESULTS: Between 1995 and 2003, the annual number of cases of CL (total 79) steadily increased from 4 per year to 18 per year; the estimated number of travellers from the UK to Latin America increased 3.5-fold. Six cases of ML were diagnosed among British travellers in 1995 (1), 1997 (1) and 2002 (4). These infections were acquired in Bolivia (3), Colombia (2) and Belize (1). Nasopharyngeal symptoms developed 0-15 months after returning to the UK. Four patients had concurrent CL at diagnosis. Diagnosis of ML was delayed up to 6 months from the onset of symptoms. Mucosal biopsies from all 6 patients were PCR-positive for L. (Viannia) DNA; microscopy and culture were less sensitive. ML relapsed in one patient following treatment. DISCUSSION: Increasing travel to Latin America from the UK was associated with an increasing number of diagnoses of L. Viannia CL. ML is likely to emerge as a more frequently imported infection among such travellers. Familiarity with these diseases is important for prompt diagnosis and optimal management.

Adolescent↗
PubMed2003

Current immunizations for travel.

PURPOSE OF REVIEW: International travelers may be at risk from a variety of potentially severe and life-threatening infections. Some of these diseases are preventable, and vaccination remains a cornerstone of travel medicine. Vaccines that are important for international travel are reviewed, in a succinct update based on the most recent literature. RECENT FINDINGS: Discussed are vaccines for enteric infections (polio, cholera, hepatitis A, and typhoid), as well as those for hepatitis B, Japanese encephalitis, yellow fever, and meningococcal vaccines. The controversial end to the polio eradication campaign and the recognition of vaccine-derived polioviruses are discussed. New monovalent cholera vaccines, including the live attenuated Peru-15 and CVD 103-HgR and the oral killed whole cell B subunit vaccine are reviewed, as well as a new oral bivalent vaccine that may offer protection against Vibrio cholerae 0139. Advances in typhoid vaccination include promising preclinical and clinical trial results of recombinant ZH9 and CVD 908-htrA vaccines, which, in addition to providing protection against typhoid fever, may be useful vectors for heterologous antigens. A growing recognition of rare adverse reactions to the 17D yellow fever vaccine, especially postvaccinal encephalitis, has led to a reassessment of its risks and benefits. Development of a novel chimeric vaccine may improve the safety and efficacy of the current Japanese encephalitis vaccine. Vaccination for meningococcal disease is characterized by the need for polyvalent, conjugate vaccines as well as a product that affords protection against serotype B. SUMMARY: This travel vaccination review highlights progress in new travel-related vaccine development and updates the reader on issues surrounding licensed products. It will be useful for generalists, infectious disease physicians, and travel medicine specialists.

Bacterial Infections↗
PubMed2006

Accessibility to air travel correlates strongly with increasing melanoma incidence.

As the cost of air travel has decreased substantially in the USA and Europe over the past few decades, leisure travel to vacation destinations during the winter months has expanded significantly. This trend has probably increased the incidence of significant ultraviolet radiation exposure and sunburn in a broader population who could not previously afford this kind of travel. The purpose of this study was to analyse the correlation between increasing accessibility to air travel and melanoma incidence. This ecological study surveyed air travel patterns and melanoma incidence over the past three decades. Melanoma age-adjusted incidence was obtained from the United States Surveillance, Epidemiology, and End Results 9 Registry Database, 1975-2000, and the Cancer Registry of Norway, 1965-2000. United States mean inflation-adjusted airfare prices for four airports linked to leisure destinations (Miami, Los Angeles, San Diego, Phoenix) were compared with melanoma incidence. Parallel analyses were performed using annual domestic passenger-kilometres and melanoma incidence in Norway. Declining United States leisure-specific airfares corresponded strongly with increasing melanoma incidence (r = 0.96, r = 0.92, P < 0.001). Modelling a 5-year time lag between airfare and melanoma diagnosis strengthened the association (r = 0.98, r = 0.96, P < 0.001). Longer time lags could not be modelled due to data limitations. Data from Norway similarly showed that increasing air passenger mileage corresponded strongly with increasing melanoma incidence. Although correlation does not equate to causality, the very strong relationship between increasing access to air travel and melanoma incidence suggests that changes in recreational patterns may be contributing significantly to the public health problem of melanoma.

Aircraft↗
PubMed2006

Travel undertaken by women accessing private Victorian pregnancy termination services.

OBJECTIVE: To investigate the extent and cost of travel undertaken by women accessing Victorian termination of pregnancy services. DESIGN, SETTING AND PARTICIPANTS: This was a multi-centre, cross-sectional observational study of women receiving privately funded pregnancy termination services, conducted between November 2002 and June 2003 at eight major pregnancy termination service providers in Victoria. MAIN OUTCOME MEASURES: Distance travelled, money and time expended undertaking travel, and reasons women chose particular clinics. RESULTS: Of the 1,244 Australian resident respondents who resided in Victoria, 9.3% travelled more than 100 km to access services. Teenagers were 2.5 times more likely than other respondents to travel further than 100 kilometres (km) (18.2% compared with 7.8%, OR = 2.5, 95% CI 1.5-4.2, p < 0.001). Women originated from all Australian States and Territories except South Australia and 13.7% were from Statistical Divisions other than Melbourne. More than one-third of respondents (41.3%) chose their clinic because they were referred by a doctor or general practitioner. CONCLUSION: Many pregnancy termination patients face substantial and immediate costs beyond the service fee, as well as the difficulties associated with poor continuity of care and significant time away from home. Patients and service providers should be consulted further to determine appropriate clinical services, support services and subsidy schemes for the sizeable proportion of patients who undertake long-distance travel to access pregnancy termination services.

Abortion Applicants↗