Given Topic

Here is the list of topic that participants will study during the Lecture Session

Introduction and General Perspective of Emporiatrics (Travel Medicine)

 

Travel Medicine is the branch of medicine that deals with the prevention and management of health problems of international travelers. It is concerned with both prevention and management of illness related to travel.

TM concerned with both prevention and management of illness related to travel Illness may result from exposure to infection, accidents, psychological upset, environmental hazards and political unrest. The specialty of TM therefore is truly interdisciplinary and international specialty involving numerous disciplines including , tropical medicine, infectious diseases, microbiology, public health and nursing. Continued surveillance of illness and disease both in the host countries and returning travelers is necessary to allow sound risk assessment to be made for intending travelers. This is a crucial area for development within the specialty.

Dissemination of information regarding real or potential risks can both prevent illness and increase detection of illness in travelers who have returned to their country of origin. This may have important public health implications when considering secondary cases or outbreaks as a results of travelers returning with infections.

Immunization and Chemoprophylaxis to Prevent Travel Related Illness

 

Pre-travel immunization divide into three categories : recommended as part of routine health maintenance irrespective of international travel; may be required into a country; and recommended because of risk during travel. Malaria is one of the most severe infectious diseases of travelers. Nearly all cases in travelers are preventable. Prevention and best management of malaria include awareness of risk, avoidance of mosquito bites, compliance with chemoprophylaxis, and prompt diagnosis in the event of a febrile illness either during or on return from travel.

Air Travel and Fit to Fly

 

Each year, approximately 3.3 billion people are estimated to travel by aircraft. Furthermore, the passenger numbers are expected to reach 7.3 billion by 2034, as predicted by the International Air Transport Association (IATA). While many of these people have medical conditions that pose no risk to themselves or to other passengers, there are some medical conditions that should preclude flying or require pre-flight evaluation. Most airlines have medical passenger policies to determine fitness to fly, in order to minimize the risk of disruption to other passengers and crew, the likelihood of the aircraft diversion, and risks to the passenger’s safety. A passenger medical information form is commonly used, which asks details from both patient and doctor, about diagnosis, prognosis, desired supplemental oxygen, food, etc. Reduced oxygen tension, pressure changes and reduced space and mobility are the principal effects on the health of the air-traveler. Modern commercial airliners fly with a cabin altitude of between 4000 and 8000 feet (1200 and 2400 m) when at cruising altitude (30.000-39.000 feet), which means a reduction in ambient pressure of the order of 20% compared with sea level and a consequent reduction in blood oxygen saturation of about 10%. The cabin air is relatively dry, and the limited room available in the non-premium cabin may be a factor to be considered. In determining the passenger’s fitness to fly, a basic knowledge of aviation physiology and physics can be applied to the pathology. Any trapped gas will expand in volume by up to 30% during flight, and consideration must be given to the effects of the relative hypoxia encountered at a cabin altitude of 8000 feet (2400 m) above mean sea level.

Traveler’s Diarrhea

Traveler’s diarrhea (TD) is the most common travel-related health problem that affects up to half of travelers during their first 2 weeks abroad. A case of TD is described as the sudden onset of loose, watery stools associated with abdominal pain, fever or tenesmus. Fever occurs commonly and blood is noted in stools rarely. Nausea and vomiting are also common in the first few hours, adding to the discomfort and water loss. TD usually presents as an acute illness, resolving completely in less than a week. Bacteria are the most common cause of TD and ETEC (enterotoxigenic E. coli) is the most common bacterial cause. Salmonella, Shigella and campylobacter make up the majority of remaining bacterial pathogens. Host factors such as age, pre-existing immunity, underlying medical conditions and genetic factors play a role in susceptibility to TD. Effective pre-travel counseling may motivate some travelers to avoid risky food and drink, which may in turn reduce diarrheal incidence. Since most TD is bacterial in origin, traveling with appropriate antibiotics for treatment and prevention is also important.

Animal Bites

Rabies, Herpes B and envenoming are the diseases that result from bites by rabid mammals or bites and stings by venomous animals, especially snakes and scorpions. In all cases, appropriate early treatment, including therapeutic anti-sera, can prevent life-threatening systemic spread of the virus or venom toxins. In recent years, the growth of the adventure travel market in particular eco-tourism, extreme dive and wilderness safari has increased opportunities for travelers to encounter dangerous species. For travelers to remote destinations pre-travel safety education should be extended to include first aid for bite and sting injuries and potentially, provisioning of standby antibiotics for prophylaxis of high-risk wounds. Lectures that will be given to you would include :

  1. Mammals Bite or Scratch Wounds
  2. Snake Bites
  3. Insect Bites and Scorpion Stings