Emporiatrics by dhanush anand
Click here to load reader
-
Upload
dhanush-anand -
Category
Health & Medicine
-
view
573 -
download
16
description
Transcript of Emporiatrics by dhanush anand
BYDHANUSH ANAND NO.21
OBJECTIVES
Define emporiatricsEpidemology & risk factorsFood/water borne diseasesAir-borne diseasesDroplet infectionsHealth counselling&travel noticesMedical travel kitsTravel notices
What is Emporiatrics ?
“Emporiatrics or travel medicine is the branch of medicine that deals with the prevention & management of health problems of international travellers”
Basically, travel medicine can divide into 4 main topics:
GLOBAL ESTIMATES
According to WHO,there are approximately 600million international travellers anually Morbidity studies conducted by WHO
suggest that about half of the people from a developed country that stay one month in a developing country gets sick.
FACTORS AFFECTING INDIVIDUAL RISK
Internationally Quarantinable diseases
• Yellow fever• Plague• Cholera • Typhoid• Meningococcal meningitis• SARS• Influenza
FOOD/WATER BORNE DISEASES
Due To Contaminated Food Or Water Include :-
Travellers diarroheaTyphoidHepatitis ACholeraleptospirosis
TRAVELLERS DIARRHOEA
Traveller's diarrhoea (TD) is the most common illness affecting travelers
• It occurs within the first 14 days of travel, if it is caused by enterotoxic E. coli
• Typically, traveler’s diarrhea is self-limiting and will last 3-5 days.
Epidemiology
• Each year 20%–50% of international travelers ( >10 million people) develop traveler's diarrhea
• It is more common in the developing world, where rates exceed 60%, than in developed countries.
TYPHOID
Typhoid,is a worldwide bacterial disease, transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella enterica
EPIDEMOLOGY
• With an estimated 16–33 million cases of typhoid fever annually resulting in 216,000 deaths in endemic areas
• Its incidence is highest in children and young adults between 5 and 19 years old.
PROPHYLAXIS & TREATMENT
• Hygeinic food and water precautions should suffice
• antibiotics such as ciprofloxacin & levofloxacin can be used
• over the counter medicine like loperamide or which slows down overactive bowels should suffice mild to moderate diarrhea
Hepatitis A
• Hep A is transmitted via contaminated food and water and person-to-person.
• Morbidity increases with age and reports show 2% mortality in those greater than 40 years of age.
• Countries like South America, Mexico, China, India, Africa, and even Greenland have an elevated prevalence of Hep A.
• Vaccines are very effective and well tolerated and should be administered 2-4 weeks prior to visit.
VECTOR-BORNE DISEASES
(A) MALARIA Malaria in humans is caused by 1 of 4
protozoan species of the genus Plasmodium:
• P. falciparum• P.Vivax• P. Ovale• P. malariae
• All species are transmitted by an infective female Anopheles mosquito
EPIDEMIOLOGY
• Malaria transmission occurs in Africa, Central &South America, parts of the Caribbean, Asia
• causes 350–500 million infections worldwide and approx 1 million deaths annually
PREVENTIVE MEASURES FOR TRAVELERS
(a)MOSQUITO AVOIDANCE METHODS Mosquito bites can be reduced by remaining in well-screened areasusing mosquito bed netsusing a pyrethroid-containing insect spraywearing clothes that cover most of the bodymosquito repellent should be applied to exposed
parts of the skin (20-40% DEET)
(b)Chemoprophylaxis Prophylaxis should begin 7 days
before travel, during, and for 4 weeks after leaving the areas
Medications Used for ChemoprophylaxisAtovaquone & Proguanil.Chloroquine & HydroxychloroquineDoxycyclineMefloquine
Yellow Fever
• Yellow fever is an acute viral hemorrhagic disease cause by flavivirus
• The infection is transmitted by the bite of female mosquito Aedes aegypti
EPIDEMIOLOGY• Yellow fever is endemic in tropical and areas
of South America and Africa• WHO reports 200,000 cases of disease and
30,000 deaths a year• An estimated 90% of the infections occur on
the African continent• In 2008, the largest number of cases was
recorded in Togo.
Yellow fever Vaccination certificate is the only compulsory health certificate needed for international travel
This certificate has validity of 10 yrsThe vaccine used is attenuated live vaccineProtective effect starts 10days after
vaccination&lasts for atleast 10yrs
INTERNATIONAL CERTIFICATE OF VACCINATION
Injection of protective vaccination into the deltoid muscle
AIR-BORNE DISEASES
(a)Meningococcal meningitis
Meningitis is a fatal bacterial infection causing inflammation of lining of the brain and spinal cord.
Transmission by respiratory droplets , close personal contact
EPIDEMOLOGY
Meningitis risk is high in countries below sahara desert,
The region stretching from senegal in west africa to ethiopia in east africa is called the “MENINGITIS BELT”
VACCINATION
• Travellers at significant risk of infection should take either BIVALENT OR TETRAVALENT vaccines
• Bivalent vaccine for (A&C strains)• Tetravalent vaccine for (A,C,Y,w-135 strains)
• Vaccines take 7-10 days to take effect
TUBERCULOSIS(TB)
TB is an airborne droplet respiratory disease caused by M.TUBERCULOSIS
EPIDEMIOLOGY Endemic in Sub-Saharan Africa,
Russia&Asia.
Other Diseases Transmitted Through Blood Or Injuries
BLOOD BORNE DISESES 1.HIV2.HEPATITIS B&C3.STD’S
INJURY RELATED1.TETANUS
Pretravel consultation
Effective counseling begins with individual risk assesment for every traveller,taking into account:
destination country & related Risks,detailed itinerary, including specific citiestypes of accommodationseason&style of travel
Additional factors to be considered are ;
other medical conditions,medications being taken (to assess potential drug
interactions),
the cost of the medicines, & the potential side effects
conditions such as pregnancy malarial drug resistance at the destination may modify the risk assessment
Advice and recommendations should be within the travellers budget
MEDICAL TRAVEL KITS
These are designed to assist travelers in meeting medical needs when access to quality medical care is compromised.
Comprehensive medical kit --- Asia, Africa & South America
– Sterile needles and syringes– Antihistamines– Antifungal and antibiotic cream– Antinauseants, eg prochlorperazine
Additional items for less developed countries (gastro kit)– Loperamide– Tinidazole– Norfloxacin or azithromycin for children– ORS
Essential items for all travelers– Items to treat cuts, scratches, burns, strains, splinters– Paracetamol– Mosquito repellents– Consider condoms– Hand sanitizers
“THE YELLOW BOOK”
The Yellow Book is published every
two years by CDC as a reference for those who advise international travelers about health risks
SUMMARY
Common Illnesses Associated With TravellersVarious Edemic Areas&associated DiseasesHealth Measures&prophylaxis Needed for
prevention Health AdvicesMedical Travel Kits
REFERENCES
• PARK• WWW.CDC.GOV.ORG• WWW.WHO “TRAVEL GUIDE”• WIKIPEDIA• SURYAKANTHA