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At least 649 records · Page 36Linked to original sources
PubMed1989

Traveller's diarrhea among Austrian tourists in warm climate countries: I. Epidemiology.

Travellers from temperate climates to the tropics of the Third World face a high risk of acquiring traveller's diarrhea. Epidemiology plays a major role in the exact description of this syndrome. This paper describes the epidemiology of traveller's diarrhea in 3696 Austrian tourists and the influence of various epidemiologic parameters on incidence is evaluated. Destination and season of travel influences attack rates, in particular in the sub-tropics. High (up to app. 60% incidence) and low risk (below 35% incidence) regions can be described, exhibiting risk differences of nearly 100%. Individual parameters, like age and body weight, can influence the risk in an evident manner and, or course, the duration of stay plays a major role. It is pointed out that accommodation and travel characteristics are important factors for risk evaluation, as well as dietary hygiene.

Adult↗
PubMed1993

Prevalence of hepatitis A antibodies in Swiss travellers.

To assess the prevalence of antibodies to hepatitis A virus (anti-HAV) in future travellers, all visitors to the Zurich University Vaccination Center in July/August 1990 were invited to participate in a cross-sectional study. A total of 1126 future travellers were recruited to have a blood sample drawn and to complete a brief questionnaire. Among these, 35 refused or were excluded, thus 1091 were evaluated. The overall prevalence of anti-HAV was 16.5%. This rate was 5.9% in future travellers born in or after 1961, 11.8% in those born 1951-60, 21.4% in those born 1941-50 and exceeded 49% in all decades born in or before 1940. Risk factors for significantly elevated anti-HAV rates were place of birth or a stay exceeding one year in tropical, subtropical or Southern European countries and travel for occupational reasons. Compared with findings from earlier surveys conducted mainly among blood donors in Switzerland and elsewhere in Europe, the results of the present study show lower anti-HAV prevalence rates. In conclusion, it seems unnecessary to test future travellers for anti-HAV except if they are born before 1944, or have a history of jaundice or of prolonged stay in the tropics, subtropics or in Southern Europe.

Adolescent↗
PubMed1990

Malaria prophylaxis in travellers to tropical Africa.

This study investigated travellers to tropical Africa with regard to prophylactic treatment of malaria. A total of 5703 travellers completed a questionnaire on their flights back to the Federal Republic of Germany; 4116 passengers (73.7%) had visited East Africa, while 808 (14.5%) had been to West Africa. The results indicate that 90.2% took a regular chemoprophylaxis against malaria. Nevertheless, 8.1% of the travellers used no antimalarials and in 9.3% chemoprophylaxis was inadequate due to inappropriate advice; for example, 7.5% still took pyrimethamine-sulfadoxine as prophylactic. Mefloquine was correctly taken by 38.9% of the travellers in East Africa; 12.6% used it in West Africa where it is not necessary. Antimosquito measures have a high priority for travellers to tropical Africa and dissemination of this fact must be improved since only 72.6% followed through on such advice.

Africa↗
PubMed2004

[Fever after travel return].

Between 20 and 70 percent of the 50 million people who travel from the industrialized world to the developing world each year report some illness associated with their travel. Approximately 3 percent of people traveling internationally for short periods (<2 weeks) report fever even after travel. Careful assessment of the travel history, likely incubation period, exposure history, associated signs and symptoms, duration of fever, immunization status use or nonuse of antimalarial chemoprophylaxis, and degree of compliance with a chemoprophylactic regimen, if used, helps to establish the diagnosis. Determining an approximate incubation period can be particular helpful in ruling out possible causes of fever. Specific examinations targeting the individual infection, assumed to be responsible for the development of febrile disease may ascertain diagnosis and lead to effective treatment.

Communicable Diseases↗
PubMed2005

Histoplasmosis infection in Spanish travelers to Latin America.

The aim of the study presented here was to assess the incidence of histoplasma infection in a cohort of 342 individuals in Spain who had traveled to Latin America for the first time. The histoplasmin skin test was positive in 20% of the travelers, and Central America posed a higher risk for infection than South America (p=0.013). Sleeping outdoors (p=0.031) and the duration of travel (p=0.016) were also identified as significant risk factors. Serological testing demonstrated poor overall sensitivity for detecting infection in the travelers, but for the symptomatic acute cases the results were improved. Histoplasmosis must be considered in patients presenting with fever (odds ratio=3.51 [1.52-8.12]) or cough (odds ratio=4.24 [1.32-13.58]) after visiting Latin America. The results of this study have public health implications and indicate the risks of acquiring histoplasmosis should be included in pre-travel counseling.

Adult↗
PubMed1996

Effects of long travels in sitting position in elderly volunteers on biological markers of coagulation activation and fibrinolysis.

OBJECTIVE: To evaluate whether long travel in sitting position is associated with an increase of coagulation activation and/or a decrease of fibrinolytic activity. DESIGN: Comparison of blood coagulation and fibrinolysis parameters before and after two pleasure trips by bus organized in winter period (600 km in 8 hours) and in summer period (1200 km in 16 hours). SUBJECTS: 31 and 23 healthy elder volunteers for the winter and the summer trip respectively. Nine other elder volunteers were selected as a control group for the winter study. MAIN OUTCOME MEASURES: prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin III (TAT), D-dimers (D-D), factor VII activated, plasminogen activator inhibitor (PAI), tissue-type plasminogen activator (t-PA), plasma albumin. RESULTS: A significant difference before and after the travel was only observed for TAT in the summer period. However all values of TAT were in the normal range. No volunteer presented with thromboembolic disease during the month following the travel. CONCLUSION: In the condition of our study, long travel in sitting position does not lead to an enhanced procoagulant state for elderly with varicose veins. These results suggest that there is no biological support to propose heparin prophylactic therapy for the elderly with varicose veins wishing to travel by bus.

Aged↗
PubMed2005

Travel and thrombosis.

The available evidence suggests an association between long distance travel and the development of venous thromboembolism. The main problem for travellers and physicians is the interpretation of the evidence and its translation into appropriate advice on the risk and the prevention of thrombosis. Most available data relate to air travel. Thrombosis risk is greater following journeys of more than 8 h and those at greatest risk are travellers with a history of venous thromboembolism or risk factors. Based on the best evidence available the risk of symptomatic venous thromboembolism after flights of more than 12 h is 0.5%. It is likely that stasis plays a major role in the aetiology of travel related thrombosis. The evidence for hypobaric hypoxia induced coagulation activation requires confirmation. There is evidence that compression stockings and low molecular weight heparin prevent asymptomatic deep vein thrombosis (DVT) but clinical DVT has been observed in long distance flyers in spite of prophylaxis with aspirin and stockings.

Humans↗
PubMed2005

Venous thromboembolic complications following air travel: what's the quantitative risk? A literature review.

OBJECTIVES: To quantify the risk of venous thromboembolism (VTE) following air travel and assess methods of prevention. DESIGN: Review of literature. METHODS: We reviewed Pubmed, Medline, Embase and Cochrane Databases for studies that have assessed the risk of VTE associated with air travel. RESULTS: There is an association of VTE with air travel with pooled odds ratio of 1.59 (confidence interval 1.04-2.43) from three case control studies and relative risk of 2.93 (confidence interval 1.5-5.58) from two controlled cohort studies. The incidence of symptomatic pulmonary embolism (PE) is extremely low but there is substantial increase when the distance travelled is more than 5,000 miles (1.5 PE per million passengers) or time of flight is more than 8h duration (2.57 PE per million passengers). The quantitative risk of lower limb venous thrombosis in high-risk subjects is 5% per flight and 1.6% per flight for low risk subjects following long haul flights. All six randomised trials to test the below knee compression stockings with ankle pressures of 14-30 mmHg have shown reduction in lower limb venous thrombosis. CONCLUSION: VTE is more common in those with additional risk factors when the risk is about 5% per air travel for long haul flights. Class I or II below knee compression stockings are effective in the prevention of lower limb venous thrombosis.

Aerospace Medicine↗
PubMed2006

Illness severity and propensity to travel along the urban-rural continuum.

In this paper, we examine whether the relationship between severity of illness and the propensity to travel greater distance relative to the norm (defined by peers in one's county of residence) is uniform across the urban-rural continuum of geography or over time. We focus on the elderly in New York State who have been admitted to hospital for ambulatory care sensitive conditions (ACSCs), admissions which are presumed to be representative of usual travel patterns. The two periods of time examined span the implementation of the Balanced Budget Act (BBA) of 1997, which established the Medicare Rural Hospital Flexibility Program, a major national initiative to strengthen rural health care with the development of rural Critical Access Hospitals (CAHs). As the number of NY rural hospitals certified as CAH increased with the expanded funding from the BBA, one might expect to see increased distance traveled by more severely ill rural elderly, as their CAHs referred them to their affiliated support hospitals. The logistic regression estimates support this expectation, highlighting an asymmetrical relationship between relative distance and severity across patients in rural and urban areas. Despite a general decline in average propensity to travel further than the norm across the landscape, severity had a larger impact on travel propensity in rural areas, which increased over time.

Aged↗
PubMed2005

A travel medicine guide to arthropods of medical importance.

Guidance has been offered to clinicians so they might better educate and advise travelers how to protect themselves, and evaluate complaints by travelers once they have returned. Any biting arthropod may cause direct injury, and the bite of just one infectious vector can be enough to prove fatal to the unprotected. Travelers and travel medicine practitioners should familiarize themselves with the vectors and vector-borne agents likely to been countered corresponding to the traveler's specific itinerary, accommodations, and planned activities, and devise a rational strategy to reduce risk.

Animals↗
PubMed2005

Surveillance of imported diseases as a window to travel health risks.

When using all its advantages of clinical vigilance, direct communication,and fast feedback, a clinical surveillance network can be remarkably effective in detecting sentinel events and in translating the new information into modifications of clinical practice. Travelers have great advantage when serving as surveillance tools for imported diseases. They travel widely and potentially expose themselves to all types of infectious diseases, they are very mobile, and they return during the incubation period of most diseases to a medical system that is capable of achieving fast and definitive diagnosis. Clustering of infections in returnees can be used immediately to warn outbound travelers of a particular risk and to increase their protection. In addition, travelers can also serve as "canary birds" for disease outbreaks in developing countries that might not be able to provide facilities for fast diagnosis. Information derived from returning travelers can be invaluable for the host country if channeled back to the medical authorities. TropNetEurop screening for increases in unexpected notifications has proved to be a sensitive early warning tool for the detection of increased transmission rates in endemic countries. For the future, it is hoped that traditional surveillance systems and recently introduced networks will be able to cooperate more fully. All systems have strengths and weaknesses and can gain from information provided by each other. Linkage of existing networks, which avoids duplication of work and fully exploits the information potential of all combined systems, should be targeted.

Africa↗
PubMed2005

Hypoxia-reoxygenation contributes to increased frequency of venous thromboembolism in air travellers.

Commercial air travel is widespread, with close to 2 billion people traveling each year. The association between venous thromboembolism (VTE) and confined sitting has been established and a correlation between the distance traveled and its incidence had been documented. Most studies underscore stasis caused by immobility as the cause of VTE and ignore the possible contribution of additional factors including coagulation and the blood vessel wall. Recent studies indicate that hypobaric hypoxia may contribute to blood vessel wall alteration and activation of coagulation. We suggest that air travel associated hypobaric hypoxia may lead to endothelial injury and initiation of a pro-coagulatory response, effects which are augmented by the reoxygenation upon landing, thus culminating in thrombosis. Prevention of air travel associated hypoxia and reoxygenation injury may decrease the incidence of flight associated VTE.

Air Pressure↗
PubMed2005

Prevention of travel-related infectious diseases in families of internationally adopted children.

Pretravel consultation before international adoption must encompass standard advice for those who travel, advice for those who are exposed to the newly adopted child, and information about caring for a new child during travel. Children who travel to meet siblings may need special accommodations before and during travel. Data on the health of internationally adopted children illustrate the risk of exposing family members and close contacts to some infectious diseases during or after international adoption. Parents, family members, and close contacts of the newly adopted child should be given advice to reduce their own and their child's risk. Targeted preadoption counseling, close attention to hygiene and safety advice, and prompt identification and treatment of infections lead to the safest and most trouble-free adoption travel experience.

Adoption↗
PubMed2004

Threats to international travellers posed by tick-borne diseases.

To date, 14 tick-borne diseases have been reported in international travellers, the majority of cases being Lyme borreliosis caused by Borrelia burgdorferi sensu lato in North America and Eurasia, African tick bite fever caused by Rickettsia africae in sub-Saharan Africa and eastern Caribbean, and Central European encephalitis caused by tick-borne encephalitis virus in Europe. The clinical presentation is frequently non-specific, and tick-borne diseases should always, in the absence of other likely diagnoses, be suspected in travellers with flu-like symptoms following a recent visit to tick-infested areas. Feasible microbiological diagnostic tests are widely unavailable, at least outside areas of endemicity where many infected travellers present. Empiric treatment with doxycycline should be considered in suspected cases of tick-borne bacterial diseases. Since ecotourism and adventure travel are increasingly popular worldwide, the incidence of travel-associated tick-borne diseases is likely to increase in the future.

Animals↗
PubMed2005

Travel as a risk factor for uncomplicated Plasmodium falciparum malaria in the highlands of western Kenya.

In the 1980s, highland malaria returned to the tea estates of western Kenya after an absence of nearly a generation. In order to determine the importance of travel for the spread of malaria in this region, we prospectively collected blood films and travel, demographic and geographic information on well persons and outpatients on tea estates near the western rim of the Rift Valley. Risk factors for malaria asexual parasitaemia included: tribal/ethnic group, home province and home district malaria endemicity. Travel away from the Kericho tea estates within the previous two months showed an odds ratio (OR) for parasitaemia of 1.59 for well persons and 2.38 for outpatients. Sexual stages of malaria parasites (gametocytes) had an OR of 3.14 (well persons) and 2.22 (outpatients) for those who had travelled. Increased risk of malaria parasitaemia with travel was concentrated in children aged <5 years. An increase in population gametocytaemia is possibly due to increased chloroquine resistance and suppressed infections contracted outside of the tea estates.

Animals↗
PubMed2001

Medical advice for international travelers.

Each year, approximately 30 to 40 million Americans travel outside the United States. Although the most popular destinations are Europe, Central America, and the Caribbean, travel to Africa and Asia is increasing substantially. International travel, particularly to developing countries, can be associated with the risk of infectious and noninfectious diseases. These risks can be decreased, eliminated, or modified with vaccinations, prophylactic medications, and education. Optimally, pretravel advice must be individualized to a person's medical history, itinerary, and risk behavior. In addition to risk assessment-based immunizations, issues such as traveler's diarrhea, malaria prophylaxis, sexually transmitted diseases, and management of underlying medical problems must form a part of pretravel management. Adventure or prolonged travel or persons with underlying medical diseases such as insulin-dependent diabetes mellitus, transplantation, immunodeficiencies, and dialysis warrant additional preventive measures. This review primarily updates pretravel management of adults.

Bacterial Vaccines↗
PubMed1992

Immunizations for international travelers.

Immunizations for international travel are an important component of pretravel medical care. Travelers should receive protection against vaccine-preventable exotic diseases, and their immunity against common infectious diseases should be reviewed and updated. There are no immunizations for some important infectious hazards of travel. In the course of considering a traveler's risk for exposure to infectious disease on the basis of geographic destination, style of travel, and anticipated activities, the health care provider should discuss preventive measures and personal behavior with regard to food and water, avoidance of insect bites, personal safety, and sexual activity.

Humans↗
PubMedDate not supplied

Increased risk of wasting syndrome in HIV-infected travellers: prospective multicentre study.

HIV-infected patients from moderate regions who travel in tropical countries may experience clinical disease progression due to exposure to bacteria (including mycobacteria), fungi and parasites. In the Swiss HIV Cohort Study we examined the hypothesis that travelling increases the risk of tuberculosis, wasting syndrome, cryptosporidiosis, isosporiasis, cryptococcosis, coccidiomycosis, histoplasmosis and Salmonella septicaemia. A total of 4549 participants were included (in 1988-98) of whom 596 (13.1%) travelled at least once. During 16,800 person-years of follow-up 231 patients developed at least 1 of the diseases of interest. Wasting syndrome was the only diagnosis significantly associated with travelling (hazard ratio 2.16, 95% confidence interval 1.09 to 4.30). The risk of wasting syndrome ('slim disease') should be taken into account when counselling HIV-infected patients intending to travel in tropical regions.

AIDS-Related Opportunistic Infections↗