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2.
Artículo en Alemán | MEDLINE | ID: mdl-31811312

RESUMEN

The number of international travelers has been continuously increasing in recent decades. Among travelers, there are more and more people at an increased risk for acquiring diseases that could be prevented by vaccines or for the development of a severe course of disease. Risk groups in travel medicine are senior travelers, children, pregnant and breast-feeding women, persons with pre-existing medical conditions, and persons who visit their friends and relatives abroad (VFR). Individuals in these groups require attention during pretravel advice consultations, particularly with regards to recommended vaccinations. On the other hand, for some risk groups, particular vaccines cannot be given for safety reasons or because the response to vaccines is reduced. Not all risk groups or each vaccine have sufficient evidence available, so each patient's risks and benefits must be weighed during pretravel consultation. In this article, the particularities for each risk group with respect to pretravel immunization are highlighted.


Asunto(s)
Viaje , Vacunas , Niño , Femenino , Alemania , Humanos , Embarazo , Medicina del Viajero , Vacunación
3.
MMWR Morb Mortal Wkly Rep ; 68(46): 1062-1068, 2019 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-31751320

RESUMEN

An estimated 219 million cases of malaria occurred worldwide in 2017, causing approximately 435,000 deaths (1). Malaria is caused by intraerythrocytic protozoa of the genus Plasmodium transmitted to humans through the bite of an infective Anopheles mosquito. Five Plasmodium species that regularly cause illness in humans are P. falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi (2). The parasite first develops in the liver before infecting red blood cells. Travelers to areas with endemic malaria can prevent malaria by taking chemoprophylaxis. However, most antimalarials do not kill the liver stages of the parasite, including hypnozoites that cause relapses of disease caused by P. vivax or P. ovale. Therefore, patients with these relapsing species must be treated with two medications: one for the acute infection, and another to treat the hypnozoites (antirelapse therapy). Until recently, primaquine was the only drug available worldwide to kill hypnozoites. Tafenoquine, a long-acting 8-aminoquinoline drug related to primaquine, was approved by the Food and Drug Administration (FDA) on July 20, 2018, for antirelapse therapy (Krintafel) and August 8, 2018, for chemoprophylaxis (Arakoda) (3,4). This report reviews evidence for the efficacy and safety of tafenoquine and provides CDC guidance for clinicians who prescribe chemoprophylaxis for travelers to areas with endemic malaria and treat malaria.


Asunto(s)
Aminoquinolinas/uso terapéutico , Antimaláricos/uso terapéutico , Malaria/prevención & control , Guías de Práctica Clínica como Asunto , Prevención Secundaria , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Medicina del Viajero , Estados Unidos
4.
Mayo Clin Proc ; 94(11): 2314-2339, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31685156

RESUMEN

The pretravel management of the international traveler should be based on risk management principles. Prevention strategies and medical interventions should be based on the itinerary, preexisting health factors, and behaviors that are unique to the traveler. A structured approach to the patient interaction provides a general framework for an efficient consultation. Vaccine-preventable diseases play an important role in travel-related illnesses, and their impact is not restricted to exotic diseases in developing countries. Therefore, an immunization encounter before travel is an ideal time to update all age-appropriate immunizations as well as providing protection against diseases that pose additional risk to travelers that may be delineated by their destinations or activities. This review focuses on indications for each travel-related vaccine together with a structured synthesis and graphics that show the geographic distribution of major travel-related diseases and highlight particularly high-risk destinations and behaviors. Dosing, route of administration, need for boosters, and possible accelerated regimens for vaccines administered prior to travel are presented. Different underlying illnesses and medications produce different levels of immunocompromise, and there is much unknown in this discipline. Recommendations regarding vaccination of immunocompromised travelers have less of an evidence base than for other categories of travelers. The review presents a structured synthesis of issues pertinent to considerations for 5 special populations of traveler: child traveler, pregnant traveler, severely immunocompromised traveler, HIV-infected traveler, and traveler with other chronic underlying disease including asplenia, diabetes, and chronic liver disease.


Asunto(s)
Enfermedad Relacionada con los Viajes , Viaje , Vacunación/estadística & datos numéricos , Vacunas/uso terapéutico , Adulto , Niño , Femenino , Humanos , Embarazo , Medicina del Viajero/métodos
5.
BMC Public Health ; 19(1): 1397, 2019 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-31660916

RESUMEN

BACKGROUND: Travellers visiting friends and relatives (VFR) define a specific population of travellers exposed to higher risks for health and safety than tourists. The aim of this study was to assess differentials in pre-travel health care in VFR travellers compared to other travellers. METHODS: A retrospective cohort study was performed including attendees of the Travel Medicine Clinic of the Hospital Universitari de Bellvitge, Barcelona, Spain, between January 2007 and December 2017. RESULTS: Over the 10-year period, 47,022 subjects presented to the travel clinic for pre-travel health care, 13.7% of whom were VFR travellers. These showed higher rates of vaccination against yellow fever and meningococcus, but lower rates for hepatitis A, hepatitis B, influenza, rabies, cholera, polio, typhoid IM vaccine and tetanus vaccine boosters. Regarding malaria prevention measures, results highlighted that VFR travellers, when compared with tourists, were more likely to be prescribed with chemoprophylaxis, particularly with mefloquine, than with atovaquone/proguanil. CONCLUSIONS: Findings from this large-scale study indicated differences in vaccination rates and completion, as well as in chemoprophylaxis for malaria, between VFR and non-VFR travellers, fostering specific interventions for promoting adherence to pre-travel health advice among migrant travellers.


Asunto(s)
Migrantes/psicología , Medicina del Viajero/estadística & datos numéricos , Viaje/estadística & datos numéricos , Adulto , Familia , Femenino , Amigos , Hospitales Universitarios , Humanos , Malaria/prevención & control , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , España , Migrantes/estadística & datos numéricos , Vacunación/estadística & datos numéricos
6.
Rev Med Suisse ; 15(654): 1188-1192, 2019 Jun 05.
Artículo en Francés | MEDLINE | ID: mdl-31166671

RESUMEN

With the emergence of new antitumoral agents and their benefit on patient survival, general practitioners are increasingly facing the challenges of managing patients with oncologic conditions. As a result, they have a key role in the follow-up of these patients, who may be more vulnerable than general population due to their relative immunodeficiency, which has to be evaluated. In this article, we will review the preventive measures adapted to this specific population: vaccination, travel medicine, antimicrobial prophylaxis and lifestyle interventions.


Asunto(s)
Médicos Generales , Oncología Médica , Humanos , Medicina del Viajero , Vacunación
7.
Travel Med Infect Dis ; 30: 19-24, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31238107

RESUMEN

The next Pan American Games will be held in Peru in the period July-August 2019. Around 6680 participants from 41 countries are expected to take part in the event. There will be a total of 62 sport disciplines. This event poses specific challenges, given its size and the diversity of attendees. Such gatherings also have potential for the transmission of imported or endemic communicable diseases, including measles in view of the global outbreak situation, but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations taking into consideration the epidemiology and risks of the main communicable diseases at potential destinations in Peru, recommended immunizations and other preventives measures. These recommendations can be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Although Lima is malaria free, travelers visiting Peruvian high-risk areas for malaria should be assessed regarding the need for chemoprophylaxis. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing vector-borne infections. Other important recommendations for travelers should focus on preventing water- and food-borne diseases including travelers' diarrhea. This paper addresses pre-travel, preventive strategies to reduce the risk of acquiring communicable diseases during the Pan American Games and also reviews the spectrum of endemic infections in Lima and Peru to facilitate the recognition and management of infectious diseases in travelers returning to their countries of origin.


Asunto(s)
Control de Enfermedades Transmisibles , Transmisión de Enfermedad Infecciosa/prevención & control , Enfermedades Endémicas , Medicina del Viajero , Enfermedades Endémicas/prevención & control , Humanos , Perú/epidemiología , Deportes
10.
Internist (Berl) ; 60(7): 701-708, 2019 Jul.
Artículo en Alemán | MEDLINE | ID: mdl-31098645

RESUMEN

Advances in medical care have led to an increasing number of immunocompromised travellers. Travellers with immunodeficiencies have a higher risk of infections and can acquire infectious diseases that are rare in immunocompetent travellers. Of central interest are travellers' diarrhea, diseases of the respiratory tract, tuberculosis and inhalative mycoses as well as diseases transmitted by vectors such as malaria. For every such journey a timely consultation in travel medicine is indicated. First the individual risk must be assessed according to the degree of immunodeficiency. An individual counselling is then related to the itinerary, the travel destination and any activities planned. This information is the basis for an individual set of prophylactic measures with respect to infections and other risks through certain modes of behavior, medication, and vaccinations. Post-travel counselling and evaluation are equally important. This requires physicians experienced in both immunosuppression and travel medicine.


Asunto(s)
Huésped Inmunocomprometido , Medicina del Viajero/métodos , Viaje , Diarrea/prevención & control , Humanos , Malaria/prevención & control , Vacunación
11.
Harefuah ; 158(5): 327-331, 2019 May.
Artículo en Hebreo | MEDLINE | ID: mdl-31104395

RESUMEN

INTRODUCTION: The last century in Israel had seen a profound change in the field of travel-related infectious diseases. During the 19th century and throughout the first half of the 20th century, most scientific observations related to the various endemic infections in Palestine, and the risk they posed to the passengers/immigrants. Among the infectious hazards that have characterized the country, malaria, typhoid, cutaneous leishmaniasis, and bilharzia were especially noteworthy. With the establishment of the State of Israel and following the great waves of immigration to Israel, many endemic diseases declined or were completely eradicated, such as malaria. Since the 1980's, the emergence of the Israeli backpacking phenomenon was accompanied by a surge of imported infectious diseases, from Latin America, the Far East and Africa. Israeli travel medicine has documented these developments, with an important contribution to the literature on epidemiology, clinical aspects and the treatment and prevention of many travel-related infections.


Asunto(s)
Control de Enfermedades Transmisibles , Medicina del Viajero , Enfermedades Transmisibles/transmisión , Humanos , Israel , Viaje
13.
Ann Ist Super Sanita ; 55(1): 63-67, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30968839

RESUMEN

A travel medicine clinic is the proper medical centre aimed to provide updated recommendations before any journey. The study aim was to assess the number of accesses during 2016 at the Travel Medicine Clinic of the Local Health Unit in the Umbria Region. An electronic ad hoc database was developed. Paper-based data referring to 2016 were recorded in this electronic registry, developed on Microsoft Office Access®. In 2016, 891 subjects came in our clinic in order to get information before travelling. In our sample, 53.3% were male and the mean age was 35.33 years ± 0.58. Almost half had a higher education, and 20% were foreign. Vaccines against food- and water-borne diseases were the most frequently administered. Approximately, 74% of the attenders were suggested to do an anti-malaria prophylaxis (Mefloquine in one-half, approximately). Every traveller received a pre-travel counselling. Performance activity of our clinic and the adherence to preventive protocols in case of international travels, have been assessed.


Asunto(s)
Medicina del Viajero/estadística & datos numéricos , Adulto , Infecciones Bacterianas/prevención & control , Consejo , Femenino , Humanos , Italia , Malaria/prevención & control , Masculino , Sistema de Registros , Estudios Retrospectivos , Factores Socioeconómicos , Viaje , Vacunación/estadística & datos numéricos , Vacunas
14.
Eur J Clin Microbiol Infect Dis ; 38(8): 1395-1408, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30949898

RESUMEN

Melioidosis is a tropical bacterial infection, rarely encountered, and poorly known by clinicians. In non-endemic areas, a misdiagnosis can lead to a fatal outcome. This study aims to identify the main characteristics of imported and diagnosed melioidosis cases in Europe to increase clinician's awareness of this diagnosis. A literature review of imported and diagnosed human melioidosis cases in Europe was performed. PubMed and Web of Science search engines were used for retrieving articles from 2000 to November 2018. Seventy-seven cases of imported melioidosis into Europe described in the literature were identified. More than half of the cases were acquired in Thailand (53%) by men (73%). Patients were usually exposed to Burkholderia pseudomallei during a holiday stay (58%) of less than 1 month (23%) and were hospitalized during the month following their return to Europe (58%). Among travelers, melioidosis is less often associated with risk factor (16%), diabetes being the most frequently comorbidity related (19%). The clinical presentation was multifaceted, pneumonia being the most common symptom (52%), followed by cardiovascular form (45%) and skin and soft tissues damages (35%). The diagnosis was obtained by culture (92%), often supplemented by morphological, biochemical, and molecular identification (23%). Misdiagnoses were common (21%). Over half of the patients received a complete and adapted treatment (56%). Mortality is lower for returning traveler (6%). Imported melioidosis cases into Europe have their own characteristics. This possibility should be considered in patients with pneumonia, fever, and/or abscess returning from endemic areas even years after.


Asunto(s)
Enfermedades Transmisibles Importadas/epidemiología , Melioidosis/epidemiología , Viaje , Burkholderia pseudomallei , Enfermedades Transmisibles Importadas/microbiología , Europa (Continente)/epidemiología , Humanos , Melioidosis/diagnóstico , Factores de Riesgo , Tailandia , Medicina del Viajero
15.
Am J Trop Med Hyg ; 100(5): 1285-1289, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30915948

RESUMEN

We evaluated differences in pretravel care, exposures, and illnesses among pediatric and adult travelers, using a prospective, observational cohort. Eighty-one pediatric travelers were matched 1:1 with adult military dependents by travel region, destination's malaria risk, and travel duration. Pediatric travelers were more likely to have coverage for hepatitis A and B (90% versus 67% of adults; 85% versus 44%), visit friends and relatives (36% versus 16%), report mosquito bites (69% versus 44%), and have close contact with wild or domesticated animals (40% versus 20%) than adults (P < 0.05). Subjects < 10 years of age were less likely to be prescribed antibiotics (28% versus 95%; RR = 0.63; 95% CI: 0.46-0.85) and antidiarrheals (9% versus 100%; RR = 0.10; 95% CI: 0.03-0.29) for travelers' diarrhea (TD) self-treatment than adults. Travel medicine providers should emphasize strategies for vector avoidance, prevention of animal bites and scratches, and TD self-treatment in pediatric pretravel consultations.


Asunto(s)
Personal Militar , Enfermedad Relacionada con los Viajes , Viaje , Adolescente , Adulto , Animales , Antibacterianos/uso terapéutico , Antidiarreicos/uso terapéutico , Niño , Preescolar , Diarrea/prevención & control , Femenino , Hepatitis A/prevención & control , Humanos , Lactante , Malaria/prevención & control , Masculino , Estudios Prospectivos , Medicina del Viajero/métodos , Medicina del Viajero/estadística & datos numéricos , Vacunación/estadística & datos numéricos
16.
Tex Med ; 115(2): 47, 2019 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-30817839

RESUMEN

Polio once terrified Americans. In the late 1940s and early 1950s, the virus crippled around 35,000 Americans a year, according to the Centers for Disease Control and Prevention. Because polio often attacked abdominal muscles used to breathe, many died or permanently needed a respirator called an iron lung.


Asunto(s)
Comunicación , Relaciones Médico-Paciente , Poliomielitis/prevención & control , Vacunas contra Poliovirus/administración & dosificación , Humanos , Texas , Medicina del Viajero , Vacunación
17.
East Mediterr Health J ; 25(1): 40-46, 2019 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-30919924

RESUMEN

Background: Oman is witnessing an increase in outbound and inbound travelers. Aims: This study was undertaken to assess the current knowledge, attitude, and practice of travel medicine among primary care physicians (PCPs) working in the Muscat Governorate. Methods: We conducted a cross-sectional survey of 108 primary healthcare physicians in primary healthcare institutions in the Muscat Governorate in December 2014 using a self-administered questionnaire. Results: We had a response rate of 81%, 78% (n = 84) were females, 56.5% (n= 61) were Omani nationals. More than 50% (n= 54) of study participants had been in practice for more than 8 years. Sixty-eight (58.3%) reported having pre-travel consultations during the previous 1-month period and 86 (79.6%) had post-travel consultations. Most of the PCPs were aware of the issues that needed to be addressed in pre-travel consultation. Conclusions: This study showed that travel health is in an early stage of development in Oman and supports the need for the establishment of travel medicine services.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Médicos de Atención Primaria/estadística & datos numéricos , Medicina del Viajero , Competencia Clínica , Estudios Transversales , Femenino , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Omán , Médicos de Atención Primaria/psicología , Encuestas y Cuestionarios , Medicina del Viajero/estadística & datos numéricos
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