Travel advice

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Travel advice

• DR L NAIR

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SOME TRUTHS ABOUT TRAVEL

• 100000 TRAVEL IN A YEAR
• 50000 -SOME HEALTH PROBLEM
• 8000 SEE A PHYSICIAN
• 5000 BED BOUND
• 1100 INCAPACITATED
• 300 ADMITTED
• 50 AIR EVACUATED
• 1 DIES Lancet 2003

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AREAS OF RELEVANCE

• INFECTIONS
• DVT
• MEDICAL/SURGICAL CONDITIONS
• SPORTING INJURIES
• ASSESSMENT AFTER RETURN

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Infections

• Tropical diseases
• STD
• Environmental infections
• Current outbreaks

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Infections

• TROPICAL

• MALARIA
• DIARRHOEAL D
• ENCEPHALITIS
• HEPATITIS
• TUBERCULOSIS

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Considerations in vaccine choice

• Destination
• Duration of travel
• Vaccine-availability and cost
• Allergies
• Pregnancy
• Existing medical conditions

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INFECTIONS

• SEXUALLY TRANSMITTED

• HIV
• HPATITIS
• OTHERS

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Environmental infections

• Diving, Swimming-
• leptospirosis, schistosomiasis,
• Hiking
• Cutaneous larva migrans, hookworms

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Current outbreaks

• Daily updates
• Advice against travel to areas of ongoing
  epidemics
• Foreign office/DOH guidelines and not media
  information

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Venous thrombo-embolism

• High risk individuals
• Pregnancy
• Oral contraceptives
• Elderly
• Cancers
• Smokers
• Past history

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Risk reduction

• Moving about
• Hydration
• Support stockings
• Aspirin- ?

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Medical conditions

• Respiratory- 11 of all in flight emergencies-
  Asthma, COPD, Respiratory symptoms on flying,
  Risk of PE
• Cardiac- CAHD, Cardiac failure
• Endocrine- Diabetes

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PRACTICAL ISSUES

• MEDICATIONS
• Availabilty, private prescriptions,special
  needs(O2)
• Emergencies
• Need to seek medical help, Reciprocal
  arrangements, Insurance

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SURGICAL

• POST- OPERATIVE
• Safe interval before travel, need for DVT
  prophylaxis,
• Grommets and hearing aids

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Dangerous sport

• Mountain climbing
• Deep seadiving
• Wintersports

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Pre-travel risk assessment

• Destination
• Purpose
• Mode
• Duration
• Special activities
• Special needs-medical/surgical
• High risks
• Available medical facilities

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RETURN FROM TRAVEL

• No routine assessment needed
• Any new symptoms- unexplained diarrhoea,
  jaundice, fatigue- specialist in travel and
  tropical medicine
• Chronic patients should be advised to consult
  soon after return

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New developments

• Travel medicine is a growing speciality and is
  recognised bu the DOH as important in identifying
  and containing disease spread.
• Growing immigrant population with newer diseases
• Newer combination vaccines by accelerated
  schedules
• Psychological impacts of air travel

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SO DOC WHAT YOU ARESAYING IS------

• I MAY BE
• BITTEN
• RUN OVER
• DROWNED
• SHOT--------------

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RELEVANT INFORMATION