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Travelers’ health and safety

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What you need to know and prepare before your trip

What you need to know and prepare before your trip

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    Travelers’ health and safety Travelers’ health and safety Presentation Transcript

    • Travelers’ health and safety
      Dr Kenneth T. Tran, B.Pharm, MD
      President, YCPA
      Mars 2010
      Thanks to
    • Objectives
      Understand travel-related risks
      Recognize the importance of well planned trip
      Comprehend the consequences of travel-related diseases and accidents
      Appreciate the necessity of medical consultation before and after trip
      Realize the need of appropriate coverage
    • Everything is bookedEverything is packed
      Ready to go…
    • You are excited….
    • What if….
    • And what if….?
    • You don’t want to come back like this…
    • So, are you really ready?
      Don’t you need a travel health consultation?
    • More and more travelers…
    • Probability of 6/49 jackpot
      1/13,983,816 = 0.00000007151
      (0.000007151%)
    • Probability of death during a trip:
      0.001%
      Developing country: 0.8 – 1,5 per 100 000 per month
      North America: 0.3 per 100 000 per month
      Nepal: 15 per 100 000 per month
      Swiss traveler
    • 140 times more chance to die during a trip than win the 6/49
    • Causes of Death during travel
      Cardiovascular disease: 50%
      Accidents: 25%
      Infectious disease: 2%
      US travelers abroad
    • Felt subjectively ill
    • Probability of medical event during a trip
      1/3 travelers abroad experience a travel-related illness, usually diarrhea or an upper respiratory infection
      5 in 1 million (pulmonary embolism with long distance air travel)
    • 20-60%
      10%
      1%
      0.1%
      0.001%
    • Why you need medical consultation
      Medical
      Coverage
    • Medical
      Travel-Related Vaccine-Preventable Diseases
      Hepatitis A
      Hepatitis B
      Typhoid and Paratyphoid Fever
      Yellow Fever
      Japanese Encephalitis (JE)
      Meningococcal Disease
      Rabies
    • HAV prevalence
    • Medical
      Travel-Related Vaccine-Preventable Diseases
      Hepatitis A
      Hepatitis B
      Typhoid and Paratyphoid Fever
      Yellow Fever
      Japanese Encephalitis (JE)
      Meningococcal Disease
      Rabies
    • HVB Prevalence
    • Hepatitis B
      Blood or blood-derived fluids contacts
      Worldwide, 360 millions of hepatitis B carrier
      120-130 millions in China (10% of China population)
    • Medical
      Travel-Related Vaccine-Preventable Diseases
      Hepatitis A
      Hepatitis B
      Typhoid and Paratyphoid Fever
      Yellow Fever
      Japanese Encephalitis (JE)
      Meningococcal Disease
      Rabies
    • Yellow fever
    • Medical
      Travel-Related Vaccine-Preventable Diseases
      Hepatitis A
      Hepatitis B
      Typhoid and Paratyphoid Fever
      Yellow Fever
      Japanese Encephalitis (JE)
      Meningococcal Disease
      Rabies
    • Risk of Japanese Encephalitis
      Dependant of the period of the year
      highest among travelers to rural areas
    • Medical
      Travel-Related Vaccine-Preventable Diseases
      Hepatitis A
      Hepatitis B
      Typhoid and Paratyphoid Fever
      Yellow Fever
      Japanese Encephalitis (JE)
      Meningococcal Disease
      Rabies
    • Rabies
      Rabies is a serious problem in Asia
      India: highest incidence of rabies in the world. with 30,000–50,000 human cases per year.
      China: >3000 human deaths per year => No 1 killer among infectious disease.
    • Medical consultation
      Routine Vaccine-Preventable Diseases
      Diphtheria
      Human Papillomavirus (HPV)
      Influenza (Seasonal, Avian, and Pandemic)
      Measles (Rubeola)
      Mumps
      Pertussis
      Pneumococcal Disease (Streptococcus pneumoniae)
      Poliomyelitis
      Rubella
      Tetanus
      Varicella (Chickenpox)
    • When to go for consultation?
    • Malaria-endemic countries
      Western Hemisphere
      Eastern Hemisphere
    • Incidence rate per month of health problems during a stay in developing countries—2008
      10%
    • Medical consultation
      Counseling and Advice for Travelers
      STD: syphilis, HIV, gonorrhea, and chlamydia
      Sunburn
      Mosquitoes
      Water Disinfection for Travelers
      Food Poisoning from Marine Toxins: Ciguatera fish and Scombroid poisoning
      Animal-Associated Hazards – dogs, monkey, snake
      Deep Vein Thrombosis and Pulmonary Embolism
      Scuba Diving – a minimal of 12-24 hours before flying
      Medical Tourism
      Drug–Vaccine and Drug–Drug Interactions
      Travel Health Kits
      Travel Insurance and Evacuation Insurance
    • HIV global trends
      33
      million
    • Prevalence of HIV
    • Travel health kits
      Medication for
      Malaria, high-altitude, pain or fever, stomach upset, diarrhea, allergy, cold, motion sickness, oral rehydration salts, insecte bite
      Basic First aid
      Disposable gloves, bandages, gauze, adhesive tape, antiseptic, cotton swabs, tweezers, scissors, antifungal, antibiotic and cortisone ointments, sunscreen, saline eye drop, insect repellent, antibacterial hand wipes, water purification tablets, condoms, ear plug, thermometer
      Contact card
    • Medical consultation
      Self-Treatable Diseases
      Travelers’ Diarrhea
      Altitude Illness
      Jet Lag
      Motion Sickness
      Respiratory Infections
    • Altitude
    • Altitude sickness
      Initial symptoms: headache, nausea, and loss of appetite (4–8 hours after arrival)
      The hypoxemia of high altitude  restless sleep, frequent awakening, and periodic breathing
      Sometimes, severe forms of altitude illness: pulmonary edema and cerebral edema.
    • Important to remenber
      No vaccine is 100% effective
      Precautions should still be taken in selecting food and drinks.
    • Medical consultation after travel
      Travellers with chronic disease
      Weeks following return home: fever, persistent diarrhea, vomiting, jaundice, urinary disorders, skin disease, genital infection
      Malaria treatment while traveling
      >3 months in developing country
    • Why you need medical consultation
      Medical
      Coverage
    • Leading causes of injury death
      33%
      U.S. citizens in foreign countries 2003–2005
      (Excluding Afghanistan or Iraq)
      One accident every 1.4 million flights
      17%
      13%
      1 in 5000: your chance of being killed in an automobile accident
      Road Traffic
    • Medical costs
      Brief consultation 500RMB (75$CAN)
      Standard consultation 850RMB (125$CAN)
      Comprehensive Consultation 1100RMB (165$CAN)
      Specialist consultation 1100-1250RMB
      Psychologist consultation 1000RMB (150$)
      Appendicectomy: 30 000 RMB (4500$CAN)
      normal hour services fees
    • Medical costs
      800$US/day
      Hospital expenses
      Medical evacuation
      or repatriation
      100 000 to 240 000$US
    • Insurance coverage
      Appropriate Coverage
      Medical evacuation and repatriation
      Medical expenses
      Pre-existing
      Exclusion
      Drunk driving
      Car racing, skiing, scuba diving, bungee jumping
      Other optional coverage
      changes to the itinerary
      Luggages loss
      etc
    • Conclusion
      Medical consultation before trip
      Routine vaccines to be updated
      Vaccine-preventable diseases
      Counseling and advice for travelers
      Travel health kit
      Preferably 6-8 wks before trip.
      However last minute traveler can also benefit, even as late as the day before travel
      • Medical consultation after trip
    • Conclusion
      Appropriate insurance coverage
      Medical evacuation and repatriation
      Medical expenses
      Preexisting
      Exclusion
    • A bus accident in Guangxi
    • AMERICAN STABBED TO DEATH AT BEIJING OLYMPICS
    • References
      Canadian Family Physician
      American Family Physician
      Centers for Disease Control and Prevention
      Manual of Travel Medicine and Health,Robert Steffen, Herbert L. DuPont, Annelies Wilder-Smith
    • Thank you!
      YCPA
      wishes you
      a nice trip!
      Safe and healthy!