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Travel medicine information

  1. 1. Guatemala<br />Preparing For Your Trip<br />
  2. 2. Where is Las Conchas, Guatemala?<br /><br />Las Conchas<br />
  3. 3. Packing Essentials <br />Adequate supply of prescription medications<br />Medication for diarrhea<br />Pepto Bismol, Loperamide, and antibiotics for traveler’s diarrhea <br />Medication for other common illnesses <br />Headache – Acetaminophen, Aspirin<br />Upset stomach – Pepto Bismol<br />Motion sickness - Meclizine, Dimenhydrinate, Promethazine<br />Sunglasses and hat<br />Loose fitting clothing for tropical weather<br />Antibacterial liquid/wipes<br />Sleeping net for bed<br />Protection from mosquitoes <br />Insect repellant <br />DEET for skin <br />Permethrin for clothes, sheets, sleeping nets <br />Sunblock <br />SPF of 15 or greater <br />
  4. 4. Before Your Trip <br />Vaccinations<br />The following vaccinations are recommended:<br />Be up-to-date on all vaccines required in U.S.<br />Hepatitis A<br />Hepatitis B<br />Typhoid <br />Rabies<br />Malaria Prophylaxis is strongly recommended.<br />
  5. 5. Before Your Trip—Routine Vaccines<br />Influenza<br />You need one dose every fall (or winter)<br />Pneumococcal<br />You need 1 or 2 doses if you smoke cigarettes or have certain chronic medical conditions<br />Varicella (chickenpox)<br />Consider this vaccine if you have never had chicken pox OR if vaccinated and you only received one dose<br />Tetanus, Diphtheria, pertussis (whooping cough)<br />Be sure to get a 1-time dose of “Tdap” (adult whooping cough vaccine)<br />You need a Td booster shot every 10 years<br />Measles, Mumps, Rubella <br />You need at least 1 dose of MMR if you were born in 1957 or later <br />more information available at:<br />
  6. 6. Before Your Trip—Hepatitis A<br />One of the most common vaccine-preventable infections acquired during travel <br />Spread person-to-person, or contaminated water/food<br />HepA is asymptomatic, but flu-like symptoms are not uncommon;<br /> lasts 3 to 6 months<br />Vaccinations available<br />HAVRIX—2 doses, 2nd dose 6 to 12 months after initial dose<br />VAQTA—2 doses, 2nd dose 6 to 18 months after initial dose<br />TWINRIX—protects against both HepA and HepB; 4 doses <br />Other preventable measures<br />Boil/cook all foods for at least 1 minute<br />Do not drink tap water or brush teeth with tap water<br />Do not consume raw vegetables, or fruits that cannot be peeled.<br />Avoid food and drinks from street vendors <br />Eat only foods that have been thoroughly cooked or still steaming hot<br />“Boil it, cook it, peel it, or forget it”<br />Treatment<br />None; only symptoms are treatable<br />
  7. 7. Before Your Trip—Hepatitis B<br />Transmission<br />Bodily fluids<br />Early signs and symptoms<br />Nausea, vomiting, abdominal pain, jaundice, skin rashes, joint pain, arthritis <br />Incubation period <br />90 days <br />Two categories <br />Acute: usually goes away after 2 or 3 weeks. Liver function returns to normal in 4 to 6 months <br />Chronic: may lead to cirrhosis and death <br />Vaccinations<br />Recombivax HB<br />Energix-B<br />Both vaccines are inactivated and dosing periods are at 0, 1, and 6 month intervals <br />Treatment <br />Acute: none<br />Chronic: antiviral medications <br />
  8. 8. Before Your Trip—Typhoid <br />Transmission<br />Consumption of water or food contaminated with infected human feces<br />Signs and Symptoms<br />Fever that gradually increases daily from low-grade to high, macular rash on trunk, headache, malaise, anorexia, enlargement of liver and spleen <br />Preventative Measures <br />“Boil it, cook it, peel it, or forget it”<br />Vaccinations <br />Vivotif: oral, live attenuated vaccine, must be refrigerated, dosage is 1 capsule every other day - 4 dosages <br />Typhim Vi: Vi capsular polysaccharide vaccine, IM injection every 2 years <br />Both are given 2 weeks prior to exposure <br />Treatment <br />Empiric treatment: Ciprofloxacin for duration of 3 to 5 days <br />Alternative: 3rd generation cephalosporin (Cefixime, Cefdinir)<br />
  9. 9. Before Your Trip—Rabies <br />Rabies can be found on all continents except Antarctica <br />In certain areas of the world, including Central and South America, rabies in dogs is still a major problem <br />Preventative measures<br />Best accomplished by avoiding bites from mammals <br />Wound cleansing and disinfection <br />Vaccination <br />Vaccinations<br />HDCV: human diploid cell vaccine; given IM at pre-exposure or post-exposure<br />PCEC: embryo cell vaccine; given IM at pre-exposure or post-exposure<br />Human Rabies Immune Globulin: local infusion at wound site + IM distal site; post-exposure<br />
  10. 10. Before Your Trip—Malaria <br />Location<br />Rural areas only at altitudes below 4,921 feet<br />No malaria in Guatemala City, Antigua, or Lake Antitlan<br />Drug Resistance <br />None <br />Malaria Type <br />P. vivax; 97%<br />P. falciparum; 3%<br />Prophylaxis for areas with malaria <br />Atovaquone/proguanil (Malarone)<br />Doxycycline<br />Mefloquine<br />Primaquine<br />Must be tested and documented to have normal glucose-6-phosphate dehydrogenase activity <br />
  11. 11. How Do I Stay Healthy?<br />Avoid mosquito bites <br />Avoid outbreaks<br />Be aware of peak exposure times and places <br />Wear appropriate clothing <br />Check for ticks <br />Use Bed nets <br />Spray Insecticides <br />Treat clothes with Permethrin<br />Apply DEET containing insecticide to skin<br />Avoid areas of standing water<br />Reside in well air-conditioned, enclosed areas<br />
  12. 12. How Do I Stay Healthy?<br />Prevent animal bites and scratches <br />Travelers to rabies-endemic countries should be warned about the risk of acquiring rabies and educated on avoiding bites (see “rabies” for additional information)<br />Street dogs represent the most frequent risk for bite exposure to travelers, followed by monkeys<br />Children are considered high risk because their small stature makes extensive bites more likely, they are attracted to animals, and there is the remote possibility that they may not report a possible exposure<br />
  13. 13. How Do I Stay Healthy?<br />Avoid contaminated food and water<br />Drink only bottled water or use water sanitizing techniques<br />Boil water<br />Do not use ice cubes <br />Avoid undercooked meat and fish<br />All fruits and vegetables should be cleaned and peeled; if not, avoid it<br />Do not consume food from street vendors <br />Do not consume unpasteurized dairy products <br />
  14. 14. How Do I Stay Healthy?<br />Other Important Tips<br />Be aware of possible natural disasters <br />Avoid injuries<br />Wear helmets, no drinking and driving, avoid overcrowded transportation, avoid night driving, consider hiring a driver, follow all traffic laws, wear a seatbelt<br />Keep feet clean and dry, and never go barefoot<br />Reduces the risk of fungal and parasitic infections <br />
  15. 15. How to Stay Safe<br />Always travel with your group<br />Stay on main roads<br />Be cautious of ANY stranger who approaches you<br />Avoid having devices such as cell phones, laptops, and iPods visible (never use them in public)<br />Never hail taxis – only use reputable tour organizations<br />Taxi Seguro – “safe taxi”<br />Travelling after dark is strongly discouraged<br />If by chance, you are victimized, do not resist<br />Avoid large gatherings of people – protests are common & may become violent<br />Crime and Safety<br />
  16. 16. Crime and Safety<br />Kidnapping<br />Keep a close eye on any children in the group<br />Don’t make any unnecessary contact with children<br />people are often accused of stealing children if they are seen talking or taking pictures with children<br />
  17. 17. U.S. Embassy<br />Guatemalan American Citizen Services<br />(502) 2326-4501 – normal business hours<br />Normal business hours <br />Monday – Thursday - 7:30 a.m. – 12 p.m. and 1 p.m. – 3 p.m.<br />Friday – 7:30 – 11:30 a.m.<br />(502) 2331-2354 – after normal business hours<br />Guatemalan Police number – equivalent to “911”<br />120<br />122<br />123<br />The Embassy is located at AvenidaReforma 7-01,  Zona 10, Guatemala City, Guatemala. The American Citizen Services Unit in the Embassy is accessed through the door on 7thCalle.<br />ASISTUR – Assistance to Tourists<br />1500 2421-2810<br />1500 5578-9836<br />Fax<br />1500 2421-2891<br />
  18. 18. References<br />We hope you enjoy your stay in Guatemala!<br />If you need additional information, please do not hesitate to use these resources:<br />Centers for Disease Control and Prevention:<br />World Health Organization:<br />US Department of State:<br />The Shalom Foundation:<br />
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