slides on emporiatrics for indian travellers,i was not able to find a decent slide so i compiled the epidemologicl data for various diseases hope u guys find it useful

1. BY
DHANUSH ANAND
NO.21

2. OBJECTIVES
Define emporiatrics
Epidemology & risk factors
Food/water borne diseases
Air-borne diseases
Droplet infections
Health counselling&travel notices
Medical travel kits
Travel notices

3. What is Emporiatrics ?
“Emporiatrics or travel medicine is the
branch of medicine that deals with the
prevention & management of health problems
of international travellers”

4. Basically, travel medicine can divide into 4 main topics:

5. GLOBAL ESTIMATES
According to WHO,there are approximately
600million international travellers anually
Morbidity studies conducted by WHO
suggest that about half of the people from a
developed country that stay one month in a
developing country gets sick.

6. FACTORS AFFECTING INDIVIDUAL RISK

7. Internationally Quarantinable diseases
• Yellow fever
• Plague
• Cholera
• Typhoid
• Meningococcal meningitis
• SARS
• Influenza

8. FOOD/WATER BORNE DISEASES
Due To Contaminated Food Or Water
Include :-
Travellers diarrohea
Typhoid
Hepatitis A
Cholera
leptospirosis

10. TRAVELLERS DIARRHOEA
Traveller's diarrhoea (TD) is the most
common illness affecting travelers
• It occurs within the first 14 days of travel, if it
is caused by enterotoxic E. coli
• Typically, traveler’s diarrhea is self-limiting
and will last 3-5 days.

11. Epidemiology
• Each year 20%–50% of international travelers
( >10 million people) develop traveler's diarrhea
• It is more common in the developing world,
where rates exceed 60%, than in developed
countries.

13. TYPHOID
Typhoid,is a worldwide bacterial disease,
transmitted by the ingestion of food or water
contaminated with the feces of an infected
person, which contain the
bacterium Salmonella enterica

14. EPIDEMOLOGY
• With an estimated 16–33 million cases of
typhoid fever annually resulting in 216,000
deaths in endemic areas
• Its incidence is highest in children and young
adults between 5 and 19 years old.

16. PROPHYLAXIS & TREATMENT
• Hygeinic food and water precautions should
suffice
• antibiotics such as ciprofloxacin &
levofloxacin can be used
• over the counter medicine like loperamide or
which slows down overactive bowels should
suffice mild to moderate diarrhea

17. Hepatitis A
• Hep A is transmitted via contaminated food and
water and person-to-person.
• Morbidity increases with age and reports show 2%
mortality in those greater than 40 years of age.
• Countries like South America, Mexico, China, India,
Africa, and even Greenland have an elevated
prevalence of Hep A.
• Vaccines are very effective and well tolerated and
should be administered 2-4 weeks prior to visit.

18. VECTOR-BORNE DISEASES
(A) MALARIA
Malaria in humans is caused by 1 of 4
protozoan species of the genus Plasmodium:
• P. falciparum
• P.Vivax
• P. Ovale
• P. malariae

19. • All species are transmitted by an infective
female Anopheles mosquito
EPIDEMIOLOGY
• Malaria transmission occurs in Africa, Central
&South America, parts of the Caribbean, Asia
• causes 350–500 million infections worldwide
and approx 1 million deaths annually

21. PREVENTIVE MEASURES FOR TRAVELERS
(a)MOSQUITO AVOIDANCE METHODS
Mosquito bites can be reduced by remaining
in
 well-screened areas
using mosquito bed nets
using a pyrethroid-containing insect spray
wearing clothes that cover most of the body
mosquito repellent should be applied to exposed
parts of the skin (20-40% DEET)

22. (b)Chemoprophylaxis
Prophylaxis should begin 7 days
before travel, during, and for 4
weeks after leaving the areas
Medications Used for Chemoprophylaxis
Atovaquone & Proguanil.
Chloroquine & Hydroxychloroquine
Doxycycline
Mefloquine

23. Yellow Fever
• Yellow fever is an acute viral hemorrhagic
disease cause by flavivirus
• The infection is transmitted by the bite of female
mosquito Aedes aegypti

24. EPIDEMIOLOGY
• Yellow fever is endemic in tropical and areas
of South America and Africa
• WHO reports 200,000 cases of disease and
30,000 deaths a year
• An estimated 90% of the infections occur on
the African continent
• In 2008, the largest number of cases was
recorded in Togo.

25. INTERNATIONAL CERTIFICATE OF
VACCINATION
Yellow fever Vaccination certificate is the
only compulsory health certificate needed for
international travel
 This certificate has validity of 10 yrs
 The vaccine used is attenuated live vaccine
 Protective effect starts 10days after
vaccination&lasts for atleast 10yrs

26. Injection of protective
vaccination into the deltoid
muscle

27. AIR-BORNE DISEASES
(a)Meningococcal meningitis
Meningitis is a fatal bacterial infection
causing inflammation of lining of the brain
and spinal cord.
Transmission by respiratory droplets , close
personal contact

28. EPIDEMOLOGY
 Meningitis risk is high in countries below
sahara desert,
 The region stretching from senegal in west
africa to ethiopia in east africa is called the
“MENINGITIS BELT”

30. VACCINATION
• Travellers at significant risk of infection should
take either BIVALENT OR TETRAVALENT
vaccines
• Bivalent vaccine for (A&C strains)
• Tetravalent vaccine for (A,C,Y,w-135 strains)
• Vaccines take 7-10 days to take effect

31. TUBERCULOSIS(TB)
TB is an airborne droplet respiratory
disease caused by M.TUBERCULOSIS
EPIDEMIOLOGY
Endemic in Sub-Saharan Africa,
Russia&Asia.

33. Other Diseases Transmitted Through Blood
Or Injuries
BLOOD BORNE DISESES
1.HIV
2.HEPATITIS B&C
3.STD’S
INJURY RELATED
1.TETANUS

34. Pretravel consultation
Effective counseling begins with individual risk
assesment for every traveller,taking into account:
destination country & related Risks,
detailed itinerary, including specific cities
types of accommodation
season&style of travel

35. Additional factors to be considered are ;
 other medical conditions,
 medications being taken (to assess potential drug
interactions),
 the cost of the medicines, & the potential side effects
 conditions such as pregnancy malarial drug resistance at
the destination may modify the risk assessment
 Advice and recommendations should be within the
travellers budget

36. MEDICAL TRAVEL KITS
These are designed to assist travelers in meeting
medical needs when access to quality medical care is
compromised.
Comprehensive medical kit --- Asia, Africa & South America
– Sterile needles and syringes
– Antihistamines
– Antifungal and antibiotic cream
– Antinauseants, eg prochlorperazine
Additional items for less developed countries (gastro kit)
– Loperamide
– Tinidazole
– Norfloxacin or azithromycin for children
– ORS

37. Essential items for all travelers
– Items to treat cuts, scratches, burns, strains, splinters
– Paracetamol
– Mosquito repellents
– Consider condoms
– Hand sanitizers
“THE YELLOW BOOK”
The Yellow Book is published every
two years by CDC as a reference for those who
advise international travelers about health
risks

38. SUMMARY
Common Illnesses Associated With Travellers
Various Edemic Areas&associated Diseases
Health Measures&prophylaxis Needed for
prevention
Health Advices
Medical Travel Kits

39. REFERENCES
• PARK
• WWW.CDC.GOV.ORG
• WWW.WHO “TRAVEL GUIDE”
• WIKIPEDIA
• SURYAKANTHA