Travel medicine 1072572 221655618 2008-06-25T14:07:38Z 67.94.159.162 /* External links */ '''Travel medicine''' or '''emporiatrics''' is the branch of [[medicine]] that deals with the prevention and management of health problems of [[international]] [[Travel|traveler]]s. ==Globalization and travel== Globalization facilitates the spread of disease and increases the number of travelers who will be exposed to a different health environment. Major content areas of travel medicine include the global epidemiology of health risks to the traveler, [[vaccine|vaccinology]], [[malaria]] prevention, and pre-travel counseling designed to maintain the health of the approximately 600 million international travelers. It has been estimated that about 80 million travelers go annually from developed to developing countries.<ref>[http://www.pitt.edu/~super1/lecture/lec19341/index.htm Supercourse on Travel Medicine]</ref> ==Mortality and morbidity== [[Mortality rate|Mortality]] studies indicate that the [[cardiovascular disease]] accounts for most deaths during travel (50-70%), while [[injury]] and [[accident]] follow (~25%). [[Infectious disease]] accounts for about 2.8-4% of deaths during/from travel. [[Morbidity]] studies suggest that about half of the people from a developed country that stay one month in a developing country will get sick.<ref>[http://www.pitt.edu/~super1/lecture/lec19341/index.htm Supercourse on Travel Medicine]</ref> [[Traveler's diarrhea]] is the most common problem encountered. ==Disciplines== The field of travel medicine encompasses a wide variety of disciplines including [[epidemiology]], [[infectious disease]], [[public health]], [[tropical medicine]], high altitude [[physiology]], travel related [[obstetrics]], [[psychiatry]], [[occupational medicine]], military and migration medicine, and [[environmental health]]. Special itineraries and activities include [[cruise ship]] travel, [[diving]], mass gatherings (e.g. the [[Hajj]]), and [[wilderness]]/remote regions travel. Basically, the travel medicine can divide into 4 main topics: the [[prevention]] (vaccination and travel advice), the [[assistance medicine]] (dealing with repatriation and medical treatment of travelers), the [[wilderness medicine]] (e.g. high-altitude medicine, cruise ship medicine, expedition medicine, etc.) and the [[insurance medicine]]. ==Focus== Travel medicine includes pre-travel consultation and evaluation, contingency planning during travel, and post-travel follow-up and care. Information is provided by the WHO that addresses health issues for travelers for each country as well as the specific health risks of air travel itself.<ref>[http://www.who.int/ith/en/ WHO Travel Information]</ref> Also, the [[Centers for Disease Control and Prevention|CDC]] publishes valuable and up-to-date information. (see external links). Key areas to consider are vaccination and the six I’s: # Insects: [[Insect repellent|repellent]]s, nets, medication # Ingestions: safety of water, food # Indiscretion: [[HIV]], [[sexually transmitted disease]] # Injuries: accident avoidance, personal safety # Immersion: [[schistosomiasis]] # Insurance: coverage and services during travel, access to care ==Specific disease problems== [[Yellow fever]] is endemic to certain areas in Africa and South America. The CDC site delineates the risk areas and provides information about vaccination and preventive steps. <ref>[http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=yellowfever.htm CDC re: Yellow Fever]</ref> [[Meningococcal meningitis]] is endemic in the tropical meningococcal belt of Africa. Vaccination is required for pilgrims going to [[Mecca]]. Detailed information is available on the CDC site. <ref>[http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=menin.htm&cssNav=browsecyb CDC re: Meningococcal Meningitis]</ref> [[Malaria]] prevention is done by preventing or reducing exposure to mosquitos (screened rooms, air-conditioning, nets) use of repellents (usually [[DEET]]). In addition chemoprophylaxis is started before the travel, during the time of potential exposure, and for 4 weeks (chloroquine, [[doxycycline]], or mefloquine) or 7 days (atovaquone/proguanil or primaquine) after leaving the risk area. See detailed CDC site.<ref>[http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=index.htm&cssNav=browsecyb CDC re:Malaria]</ref> ==Medication Kit== The traveler should have a medication kit to provide for necessary and useful medication. Based on circumstances it should include also malaria prophylaxis, [[condom]]s, and medication to combat [[traveler's diarrhea]]. In addition, a basic [[first aid kit]] can be of use. Studies have shown there are four main medical problems that travellers develop - diarrhoea or gut problems, respiratory problems, wounds and pain. The medical kit should at least address these common things. Research has also shown that the best treatment for travellers diarrhoea is to take an antibiotic (e.g. ciprofloxacin) plus a stopper ( e.g. loperamide). Due to bacterial resistance, different parts of the world require different antibiotics. It is best to consult a travel doctor to sort out the best medical kit for the exact destination and medical history of the person travelling. ==See also== * [[Tropical medicine]] * [[Tropical disease]] * [[Montezuma's revenge]] * [[Prince Leopold Institute of Tropical Medicine]] * [[Royal Society of Tropical Medicine and Hygiene]] * [[Carte Jaune]] ==References== <references/> ==External links== * [http://www.who.int/countries/en/ Countries] - [[World Health Organization]] - includes information on outbreaks and health information * [http://www.Tropeninstitut.de/ Institute for tropical medicine Dr. Gontard] - provides information about health risks which might arise during stays in foreign countries and points out preventive measures * [http://www.cdc.gov/travel/ Travelers' Health] - [[Centers for Disease Control and Prevention]] - includes information on outbreaks, specific diseases, recommended vaccinations * [http://medlineplus.nlm.nih.gov/medlineplus/travelershealth.html Traveler's Health] - [[MedlinePlus]] * [http://www.safewateronline.com/ Safe Water for International Travelers] includes a Worldwide Rating of Drinking Water Safety and waterborne diseases prevention. *[[GIDEON-Global Infectious Disease Epidemiology Network |Global Infectious Diseases and Epidemiology Network]] - a travel medicine resource known as GIDEON. * [http://www.travelvaccinelongisland.com/ Long Island Travel Medicine] includes a vaccine preparedness list for travel to areas in the Middle East and Africa. * [http://www.passporthealthusa.com/ Passport Health] is the largest provider of travel medical services in the United States with 165 convenient locations nationwide. ===Organizations=== * [https://www.istm.org/ The International Society of Travel Medicine] **[https://www.istm.org/trav_med_exam/body.aspx Travel Medicine Body of Knowledge] * [http://www.astmh.org/ The American Society of Tropical Medicine and Hygiene] [[Category:Medical specialties]] [[Category:Travel]] [[de:Reisemedizin]] [[he:רפואת מטיילים]] [[ja:渡航医学]]