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At least 883 records · Page 49Linked to original sources
PubMed2001

A study of fructo oligosaccharides in the prevention of travellers' diarrhoea.

BACKGROUND: Prebiotic carbohydrates selectively stimulate the growth of bifidobacteria and lactobacilli in the human colon. These bacteria form part of the gut's inherent defence against invading pathogens. AIM: To test the effectiveness of fructo oligosaccharides in preventing travellers' diarrhoea. METHODS: A total of 244 healthy subjects, travelling to high and medium risk destinations for travellers' diarrhoea, took part in a randomized, double-blind, placebo-controlled study. The protocol comprised a preliminary week for recording bowel habit by diary, a 2-week pre-holiday period with the diary and consumption of 10 g of fructo oligosaccharides or placebo daily, followed by a 2-week holiday with continuation of treatment and diary. A post-study questionnaire was completed by all subjects on their return to the UK. RESULTS: The consumption of fructo oligosaccharides led to a small (6%; P < 0.02) increase in stool frequency in the pre-holiday period and gave a significantly better sense of 'well-being' during the holiday, although subjects reported more flatulence. There were non-significant decreases in episodes of diarrhoea with 20% on placebo and 11% on fructo oligosaccharides recording episodes in the post-study questionnaire (P=0.08) and 46% placebo, 38% fructo oligosaccharides recording episodes in the diary (P > 0.1). No change in bowel frequency, consistency or stool size was recorded. CONCLUSION: Travel to high risk areas increases diarrhoea. Fructo oligosaccharides alone are not sufficient to prevent this, although do have some benefits for the subjects.

Bifidobacterium↗
PubMed1998

Effectiveness of chemoprophylaxis and other determinants of malaria in travellers to Kenya.

OBJECTIVE: To investigate the effectiveness of chemoprophylaxis and the determinants of malaria importation from Kenya. METHOD: In a population-based case-control study, 51 travellers from Bavaria diagnosed with falciparum malaria imported from Kenya (cases) and a sample of 383 healthy Bavarian travellers returning from Kenya (controls) were interviewed. Data were analysed by multiple logistic regression. RESULTS: Mefloquine (OR = 0.055; 95% CI 0.019-0.16) and chloroquine combined with proguanil (OR = 0.128; 95% CI 0.039-0.419) were highly protective against P. falciparum malaria, whereas other drugs were ineffective (OR = 1.225; 95% CI 0.536-2.803). Ineffective prophylaxis (10.4%) and non-prophylaxis (11.2%) were the main reasons for malaria importation. Travelling alone or with friends, male sex, and travel duration over 4 weeks could be identified as additional risk factors. The main reason for inadequate chemoprophylaxis was inappropriate medical advice (87.5%). Prophylaxis refusal occurred frequently despite correct advice (58.1%). Diagnosis was often delayed unnecessarily (27.5%). CONCLUSION: Malaria importation from Kenya could be reduced substantially (34%) by eliminating inappropriate medical advice.

Adult↗
PubMed2002

Plasmodium falciparum: use of a NANP19 antibody-test for the detection of infection in non-immune travellers.

Circumsporozoite (CS) antibodies are a reliable serological marker for the infection of Plasmodium falciparum. The purpose of this investigation was to construct and evaluate an enzyme-linked immunosorbent assay test for the detection of CS antibodies. While the sensitivity of the newly developed test reached 78%, the specificity was 99%. In addition, the optimized kit was used to test for infection with P. falciparum in 1903 travellers that were recruited from a prospective study for malaria chemoprophylaxis. Sixty-six of the 1903 patients (3.5%) showed elevated CS antigen antibody titres. However, seroconversion could only be demonstrated in 18 (0.95%) patients. Among those seroconverting, there was a significantly higher percentage of male travellers (1.28%) than female travellers (0.56%). Positive reactions were more frequent among returnees from West and East Africa (1.49 and 1.14%, respectively) than among those from other endemic areas, e.g. South America (n=0). Despite its limited sensitivity, this newly developed kit for CS antibody testing may be a valuable tool for the estimation of the risk for travellers in malarious regions to acquire an infection with P. falciparum. It may also be useful for the determination of the efficacy of malaria chemoprophylaxis for inhibiting outbreak of disease.

Adolescent↗
PubMed2003

Clinical presentation and diagnostic sensitivity of laboratory tests for Strongyloides stercoralis in travellers compared with immigrants in a non-endemic country.

OBJECTIVES: To assess whether the clinical and laboratory methods for diagnosing Strongyloides stercoralis infection in non-endemic countries is different between those who are chronically exposed and those who travel. METHODS: Analysis of laboratory and clinical data from 204 patients having S. stercoralis infection at the Hospital for Tropical Diseases, London. RESULTS: Sixty-four travellers and 128 immigrants from endemic countries had laboratory-proven strongyloides. In those with microscopically proven disease, serology was 73% sensitive in travellers and 98% sensitive in immigrants (P < 0.001). There was no difference in the eosinophil count between the two groups with 19% having a normal count. Patterns of symptoms varied between the groups, and around one-third were asymptomatic in both groups. Serology was of limited use in follow-up. CONCLUSIONS: Eosinophil count and stool microscopy are insufficiently sensitive to be used alone for screening strongyloides. The sensitivity of serology is good in immigrants with chronic infection, but lower in travellers.

Adolescent↗
PubMed2004

Prevention of infectious diseases among international pediatric travelers: considerations for clinicians.

An estimated 1.9 million children travel overseas annually. Infectious disease risks associated with international travel are diverse and depend on the destination, planned activities, and baseline medical history. Children have special needs and vulnerabilities that should be addressed when preparing for travel abroad. Children should have a pretravel health assessment that includes recommendations for both routine and special travel-related vaccination; malaria chemoprophylaxis, if indicated; and prevention counseling regarding insect and animal exposures, food and water safety, and avoiding injuries. Special consideration should be given to children with chronic diseases. Families should be given anticipatory guidance for management of potential illnesses and information about the location of medical resources overseas.

Adolescent↗
PubMed2002

An outbreak of eosinophilic meningitis caused by Angiostrongylus cantonensis in travelers returning from the Caribbean.

BACKGROUND: Outbreaks of eosinophilic meningitis caused by the roundworm Angiostrongylus cantonensis are rarely reported, even in regions of endemic infection such as Southeast Asia and the Pacific Basin. We report an outbreak of A. cantonensis meningitis among travelers returning from the Caribbean. METHODS: We conducted a retrospective cohort study among 23 young adults who had traveled to Jamaica. We used a clinical definition of eosinophilic meningitis that included headache that began within 35 days after the trip plus at least one of the following: neck pain, nuchal rigidity, altered cutaneous sensations, photophobia, or visual disturbances. RESULTS: Twelve travelers met the case definition for eosinophilic meningitis. The symptoms began a median of 11 days (range, 6 to 31) after their return to the United States. Eosinophilia was eventually documented in all nine patients who were hospitalized, although on initial evaluation, it was present in the peripheral blood of only four of the nine (44 percent) and in the cerebrospinal fluid of five (56 percent). Repeated lumbar punctures and corticosteroid therapy led to improvement in symptoms in two of three patients with severe headache, and intracranial pressure decreased during corticosteroid therapy in all three. Consumption of one meal (P=0.001) and of a Caesar salad at that meal (P=0.007) were strongly associated with eosinophilic meningitis. Antibodies against an A. cantonensis--specific 31-kD antigen were detected in convalescent-phase serum samples from 11 patients. CONCLUSIONS: Among travelers at risk, the presence of headache, elevated intracranial pressure, and pleocytosis, with or without eosinophilia, particularly in association with paresthesias or hyperesthesias, should alert clinicians to the possibility of A. cantonensis infection.

Adrenal Cortex Hormones↗
PubMed2003

Travel: a long-range goal of retired women.

The authors surveyed retired persons (predominately women) with regard to their immediate, intermediate, and long-range activities following retirement. As predicted, leisure travel emerged as a frequent long-range goal for persons retired more than 5 years. The travel activity preferences of long-retired older women present challenges and opportunities to both researchers and marketers. Length of trips and frequency of trips have been predicted from regression models, with trip length in particular being well predicted by the problem of daily life hassles. A theoretical model of continued post-retirement travel is presented as a variant of Solomon's opponent process theory of affect (R. L. Solomon, 1980). The authors suggest that to the degree that places traveled to are varied and different, older people may remain stimulated and continue to enjoy retirement.

Aged↗
PubMed1990

Medical complications of air travel. Who is at risk?

After a long flight, most travelers experience fatigue and/or other symptoms of jet lag. In addition, air travel may pose medical complications for patients with certain conditions, such as cardiovascular or pulmonary disease. If the effects of air travel on these patients is recognized, risks during flight and while traveling in foreign countries can be minimized.

Aerospace Medicine↗
PubMed2005

Persistent diarrhea in the returning traveler: think beyond persistent infection.

The report describes a young female United Nations worker, stationed in East Timor for an extended duration, who presented with persistent travelers' diarrhea and who was convinced that she was harboring a persistent infestation. In fact, careful history, laboratory evaluation and endoscopy with duodenal biopsies found all the classical hallmarks of unmasked celiac sprue. The patient then had a dramatic response to a gluten-free diet, with complete resolution of symptoms. Persistent travelers' diarrhea is an entity which carries an interesting and extensive differential diagnosis beyond persistent enteric infections or infestations. Rather, many sufferers have long been cleared of the initial offending pathogen and are left with either a post-infectious disorder of absorption, digestion, motility or visceral sensation or carry a chronic gastrointestinal disorder which has been unmasked by an enteric infection, such as idiopathic inflammatory bowel disease, gastrointestinal malignancy or celiac sprue. Other key issues raised by the case include the vanishing incidence of tropical sprue, an entity to which most clinicians would have mistakenly attributed this malabsorptive syndrome arising in a traveler, and the under-recognition of the protean manifestations of celiac sprue, to which we would add persistent travelers' diarrhea.

Adult↗
PubMed2004

The stress of travel.

International travel is an essential part of the life of elite athletes, both for competition and training. It is also becoming increasingly common among recreational sportspersons. Long-distance travel is associated with a group of transient negative effects, collectively referred to as 'travel fatigue', which result from anxiety about the journey, the change to an individual's daily routine, and dehydration due to time spent in the dry air of the aircraft cabin. Travel fatigue lasts for only a day or so, but for those who fly across several time zones, there are also the longer-lasting difficulties associated with 'jet lag'. The problems of jet lag can last for over a week if the flight crosses 10 time zones or more, and they can reduce performance and the motivation to train effectively. Knowledge of the properties of the body clock enables the cause of the difficulties to be understood (an unadjusted body clock), and forms the basis of using light in the new time zone to promote adjustment of the body clock. Sleep loss and its effects are important components of jet lag, and attempts to promote sleep by the use of melatonin and other hypnotics are also relevant. Sleep loss is also found in those who undertake challenges that involve long periods where the normal consolidated sleep of 8 h length is not possible. Advice on sleep regimens in such circumstances is given.

Adaptation, Physiological↗
PubMed1988

Travellers' diarrhoea among children returning to the United Kingdom from visits abroad.

Between January 1984 and March 1986, 10 children aged between 7 and 56 months were admitted to Queen Elizabeth Hospital for Children in London with chronic travellers' diarrhoea, after visiting the Indian subcontinent, France or Morocco. All the children were born in the United Kingdom and had been in good health before their journey abroad. On return to England most of these children were malnourished and two of them (twins) had a post-infective, tropical malabsorption-like syndrome. There was a high incidence of positive stool cultures and, on small intestinal biopsy, histological abnormalities were present in six. Children from the United Kingdom travelling abroad are at risk of developing severe travellers' diarrhoea, with serious consequences to their health and nutrition. There is a need for intensive parental education before travelling and this could be achieved through community health workers.

Bacterial Infections↗
PubMedDate not supplied

The origins of the Irish travellers and the genetic structure of Ireland.

Ireland's unique and well-documented history provides insight into the formation and origins of population subdivisions. Of particular interest, is the controversial ethnogenesis of an itinerant population of Ireland: the Travellers. The objectives of this study were: (1) to determine the genetic affinity of the Travellers to the general Irish population based on gene frequency data, subdivided by county, and (2) to explore the relationship between subpopulations of Ireland, given its turbulent history. The gene frequencies of standard genetic markers collected from populations residing in counties of Ireland and the Travellers were calculated and analysed using several multivariate methods. First, a relationship (R) matrix was used to ascertain the scaled variance covariance matrix of population similarity. Second, mean per locus heterozygosity (H) was regressed on distance of the region from the gene frequency centroid (r(ii)). The results of this study include: (1) the confirmation of Crawford's (1975, in Biosocial Interrelations in Population Adaptations, E. S. Watts et al. (eds), pp. 93-103) conclusions concerning the origins and genetic affinity of the Travellers; (2) based on several multivariate analyses, the major influence on population structure was unique historical events; and (3) Relethford and Crawford's (1995, American Journal of Physical Anthropology, 96, 25-38) hypothesis concerning the distinctiveness of the midland counties was verified by this study.

Emigration and Immigration↗
PubMed2006

Foreign travel and the risk of harm.

Systematic data on the risk of fatal and non-fatal injury from external causes to those who travel abroad for purposes of business or pleasure are seldom recorded and are consequently hard to come by. In this paper, the risk of fatal injuries to foreign travellers using historical and newly acquired data from national databases is estimated. Overall, it appears from these data that the risk of fatal injury to foreign travellers lies in the range of 20 to 90 per 100 000 person-years of exposure for many destinations worldwide, although different rates may pertain in selected situations where special conditions apply, for example, where there is heavy participation in risky sports or increased driving. This level of fatal injury risk is not noticeably different from that of staying in one's home country if one lives in a Western-style industrial country, although the types of hazards responsible may vary in type and proportion. With increasing levels of travel, and the growing popularity of more adventurous pursuits, it is possible that risks could be increasing in this sector.

Accidents↗
PubMed1999

Hepatitis E virus infection in travelers.

Hepatitis E virus (HEV) is a major cause of clinical hepatitis in regions of endemicity, affecting primarily young adults and travelers to these areas. We present 5 cases of acute HEV infection in travelers and review 143 cases of HEV infection found by a literature search that were contracted in areas of endemicity. Fulminant hepatitis occurred in 2.7% of the reported cases; 2 of these were fatal. The destination of most of the travelers with acute HEV infection was the Indian subcontinent. The overall risk of contracting HEV infection for travelers appears to be lower than the risk for hepatitis A virus infection. Pregnant women and individuals with underlying liver disease may be a risk for severe infection.

Acute Disease↗
PubMed1999

Primaquine as prophylaxis for malaria for nonimmune travelers: A comparison with mefloquine and doxycycline.

Malaria prophylaxis for travelers is a controversial issue. The commonly used regimens are associated with side effects, low compliance, or low efficacy, which have raised concern regarding their use. In addition, they are inefficient against the tissue stage of the parasite and thus do not prevent relapses of Plasmodium vivax infection. Primaquine is aimed at the pre-erythrocytic stage and thus may be a potential causal-prophylactic treatment that can abolish the need for long postexposure therapy. During 1995-1998, we followed retrospectively travelers who joined rafting trips to an area in Ethiopia where both P. vivax and Plasmodium falciparum are hyperendemic. Of the 106 travelers who received primaquine, 5.7% developed malaria; of the 19 doxycycline recipients, 53% developed malaria; and of the 25 mefloquine recipients, 52% developed P. vivax malaria (>/=3 months after return from the area of endemicity). Primaquine was well tolerated, and only 1 withdrawal from therapy (due to gastrointestinal symptoms) was reported. Primaquine was shown to be a safe and effective prophylactic drug against both P. falciparum malaria and P. vivax malaria in travelers.

Adult↗
PubMed2000

Dengue fever in international travelers.

Dengue virus infection is becoming increasingly recognized as one of the world's major emerging infectious diseases. Although only a few systematic studies have been conducted to assess the incidence and clinical course of dengue fever in travelers, it is now possible to estimate risk factors for travelers to areas of endemicity. Dengue virus and its vector, Aedes mosquitoes, benefit from human habitation and travel-related aspects of human behavior. Thus, travelers serve an important double role as potential victims of the disease and as vehicles for further spread of dengue.

Animals↗
PubMed2001

Viral hemorrhagic fever hazards for travelers in Africa.

This short review covers 6 viral hemorrhagic fevers (VHFs) that are known to occur in Africa: yellow fever, Rift Valley fever, Crimean-Congo hemorrhagic fever, Lassa fever, Marburg virus disease, and Ebola hemorrhagic fever. All of these have at one time or another affected travelers, often the adventurous kind who are "roughing it" in rural areas, who should therefore be made aware by their physicians or travel health clinics about their potential risk of exposure to any VHF along their travel route and how to minimize the risk. A significant proportion of VHF cases involving travelers have affected expatriate health care workers who were nosocomially exposed in African hospitals or clinics. The VHFs are associated with a high case-fatality rate but are readily prevented by well-known basic precautions.

Africa↗
PubMed2001

Risk of travel-associated tuberculosis.

Infection with Mycobacterium tuberculosis might be acquired at home or during travel. The risk is determined by exposure frequency to a source case and the duration of the exposure. Thus, whether travel increases the background risk depends on origin, destination, and duration of travel. Infection might be acquired indoors or outdoors, but the overall risk seems small, whatever the setting. Bacille Calmette-Guérin vaccination and preventive therapy have both been discussed as possible preventive interventions, but the disadvantages associated with both approaches appear to outweigh any benefits. Because the risk of acquisition of infection with M. tuberculosis is small, the most rational approach is likely to delay intervention until a traveler presents with clinically active tuberculosis, as is done with any other patient.

Humans↗