Travel medicine 1991: new frontiers

Article Abstract:

Travel medicine is a growing area of medicine, both in research and interest, as people are travelling to less traditional vacation spots, and are seeking advice and medications to prevent disease from their physicians. A recent forum on current issues in travel medicine was held in Atlanta. A number of speakers addressed malaria prevention. The traditional treatment for malaria was the drug chloroquine, but resistance to that drug is rising in the organism that causes malaria. Mefloquine is a newer drug, and the preferred agent when travelling to areas where malaria is endemic. Several people spoke of travellers' diarrhea, which is currently treated with bismuth subsalicylate, available over the counter, and the antidiarrheal agent loperamide. Certain antibiotics can also be prescribed for travellers, depending on their itinerary. Hepatitis A can be contracted in many developing countries, and the only effective prophylaxis is an injection of immunoglobulin before leaving on vacation; this injection is only effective for four to six months. Greater risks for contracting sexually transmitted diseases and AIDS were also discussed. Motor vehicle accidents are a major cause of illness among travellers, and culture shock is a common problem, particularly when travelling to an underdeveloped country. Surveys have shown that people often receive inappropriate inoculations and medications before travelling, suggesting that more formal recommendations and wider publication of them would be useful. (Consumer Summary produced by Reliance Medical Information, Inc.)

author: Lobel, Hans O., Kozarsky, Phyllis E.
Care and treatment, Editorial, Standards, Prevention, Diarrhea, Immunization, Hepatitis A

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Mortality from Plasmodium falciparum malaria in travelers from the United States, 1959 to 1987

Article Abstract:

Malaria is an acute and sometimes chronic infectious disease caused by the presence of a protozoan parasite within a patient's red blood cells. Malaria is characterized by cycles of chills, fever, and sweats. The disease involves progressive anemia, enlargement of the spleen, and deposition of a pigment called melanin in various organs, which results from the biological activity of the parasite. The causative organism is transmitted through bites of infected female mosquitoes and can also be transmitted by blood transfusions. Over 1 million United States citizens travel to malaria-endemic areas every year, and several hundred become infected with Plasmodium falciparum, the malaria-causing protozoa most commonly associated with severe illness and death. This review of all malaria fatalities reported to the Centers for Disease Control from 1959 to 1987 assessed the factors that contributed to mortality from Plasmodium falciparum in U.S. travelers. During the review period, a total of 68 deaths from P. falciparum malaria in U.S. citizens were reported, and the number of deaths tended to increase over time during this period. A delay in seeking medical care, misdiagnosis, older age, and failure to take antimalarial medication appeared to have contributed to mortality. It is advised that travellers to malaria-endemic areas consult their physician for antimalarial medication before departure and seek medical care promptly if they become ill during or after their trip. (Consumer Summary produced by Reliance Medical Information, Inc.)

author: Greenberg, Alan E., Lobel, Hans O.
Patient outcomes, Mortality, Statistics, Travelers

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Acute mountain sickness in a general tourist population at moderate altitudes

Article Abstract:

Acute mountain sickness may affect about a quarter of people traveling to moderate altitudes. Acute mountain sickness, which occurs following rapid ascent from low to high elevations, is characterized by headache, fatigue, shortness of breath and sleeplessness. Of 3,140 travelers to the Colorado Rocky Mountains to altitudes between 6,300 and 9,700 feet, 25% developed three or more symptoms of acute mountain sickness. Almost 75% reported at least one symptom. Headache was the most common symptom and vomiting was the least. Travelers who permanently resided at elevations below 3,000 feet were more likely to get sick as were people with a previous history of altitude sickness. People under age 60, those in poor or average physical condition and those with lung disease were also more likely to develop acute mountain sickness.

author: Moore, Lorna G., Yip, Ray, Honigman, Benjamin, Theis, Mary Kay, Koziol-McLain, Jane, Roach, Robert, Houston, Charles Hamilton
Risk factors, Mountain sickness, Altitude sickness

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subjects list: Health aspects, Travel, Malaria
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