Travelers’ health and safety


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What you need to know and prepare before your trip

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Travelers’ health and safety

  1. 1. Travelers’ health and safety<br />Dr Kenneth T. Tran, B.Pharm, MD<br />President, YCPA<br />Mars 2010<br />Thanks to<br />
  2. 2. Objectives<br />Understand travel-related risks<br />Recognize the importance of well planned trip<br />Comprehend the consequences of travel-related diseases and accidents<br />Appreciate the necessity of medical consultation before and after trip<br />Realize the need of appropriate coverage<br />
  3. 3. Everything is bookedEverything is packed<br />Ready to go…<br />
  4. 4. You are excited….<br />
  5. 5. What if….<br />
  6. 6. And what if….?<br />
  7. 7. You don’t want to come back like this…<br />
  8. 8. So, are you really ready?<br />Don’t you need a travel health consultation?<br />
  9. 9. More and more travelers…<br />
  10. 10. Probability of 6/49 jackpot<br />1/13,983,816 = 0.00000007151<br />(0.000007151%)<br />
  11. 11. Probability of death during a trip:<br />0.001%<br />Developing country: 0.8 – 1,5 per 100 000 per month<br />North America: 0.3 per 100 000 per month<br />Nepal: 15 per 100 000 per month<br />Swiss traveler<br />
  12. 12. 140 times more chance to die during a trip than win the 6/49<br />
  13. 13. Causes of Death during travel<br />Cardiovascular disease: 50%<br />Accidents: 25%<br />Infectious disease: 2%<br />US travelers abroad<br />
  14. 14. Felt subjectively ill<br />
  15. 15. Probability of medical event during a trip<br />1/3 travelers abroad experience a travel-related illness, usually diarrhea or an upper respiratory infection<br />5 in 1 million (pulmonary embolism with long distance air travel)<br />
  16. 16. 20-60%<br />10%<br />1%<br />0.1%<br />0.001%<br />
  17. 17. Why you need medical consultation<br />Medical<br />Coverage<br />
  18. 18. Medical<br />Travel-Related Vaccine-Preventable Diseases<br />Hepatitis A<br />Hepatitis B<br />Typhoid and Paratyphoid Fever<br />Yellow Fever<br />Japanese Encephalitis (JE)<br />Meningococcal Disease<br />Rabies<br />
  19. 19. HAV prevalence<br />
  20. 20. Medical<br />Travel-Related Vaccine-Preventable Diseases<br />Hepatitis A<br />Hepatitis B<br />Typhoid and Paratyphoid Fever<br />Yellow Fever<br />Japanese Encephalitis (JE)<br />Meningococcal Disease<br />Rabies<br />
  21. 21. HVB Prevalence<br />
  22. 22. Hepatitis B<br />Blood or blood-derived fluids contacts<br />Worldwide, 360 millions of hepatitis B carrier<br />120-130 millions in China (10% of China population)<br />
  23. 23. Medical<br />Travel-Related Vaccine-Preventable Diseases<br />Hepatitis A<br />Hepatitis B<br />Typhoid and Paratyphoid Fever<br />Yellow Fever<br />Japanese Encephalitis (JE)<br />Meningococcal Disease<br />Rabies<br />
  24. 24. Yellow fever<br />
  25. 25. Medical<br />Travel-Related Vaccine-Preventable Diseases<br />Hepatitis A<br />Hepatitis B<br />Typhoid and Paratyphoid Fever<br />Yellow Fever<br />Japanese Encephalitis (JE)<br />Meningococcal Disease<br />Rabies<br />
  26. 26. Risk of Japanese Encephalitis<br />Dependant of the period of the year<br />highest among travelers to rural areas<br />
  27. 27. Medical<br />Travel-Related Vaccine-Preventable Diseases<br />Hepatitis A<br />Hepatitis B<br />Typhoid and Paratyphoid Fever<br />Yellow Fever<br />Japanese Encephalitis (JE)<br />Meningococcal Disease<br />Rabies<br />
  28. 28. Rabies<br />Rabies is a serious problem in Asia <br />India: highest incidence of rabies in the world. with 30,000–50,000 human cases per year.<br />China: >3000 human deaths per year => No 1 killer among infectious disease. <br />
  29. 29. Medical consultation<br />Routine Vaccine-Preventable Diseases<br />Diphtheria<br />Human Papillomavirus (HPV)<br />Influenza (Seasonal, Avian, and Pandemic)<br />Measles (Rubeola)<br />Mumps<br />Pertussis<br />Pneumococcal Disease (Streptococcus pneumoniae)<br />Poliomyelitis<br />Rubella<br />Tetanus<br />Varicella (Chickenpox)<br />
  30. 30. When to go for consultation?<br />
  31. 31. Malaria-endemic countries<br />Western Hemisphere<br />Eastern Hemisphere<br />
  32. 32. Incidence rate per month of health problems during a stay in developing countries—2008<br />10%<br />
  33. 33. Medical consultation<br />Counseling and Advice for Travelers<br />STD: syphilis, HIV, gonorrhea, and chlamydia<br />Sunburn<br />Mosquitoes<br />Water Disinfection for Travelers<br />Food Poisoning from Marine Toxins: Ciguatera fish and Scombroid poisoning<br />Animal-Associated Hazards – dogs, monkey, snake<br />Deep Vein Thrombosis and Pulmonary Embolism<br />Scuba Diving – a minimal of 12-24 hours before flying<br />Medical Tourism<br />Drug–Vaccine and Drug–Drug Interactions<br />Travel Health Kits<br />Travel Insurance and Evacuation Insurance<br />
  34. 34. HIV global trends<br />33<br />million<br />
  35. 35. Prevalence of HIV<br />
  36. 36. Travel health kits<br />Medication for<br />Malaria, high-altitude, pain or fever, stomach upset, diarrhea, allergy, cold, motion sickness, oral rehydration salts, insecte bite<br />Basic First aid<br />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<br />Contact card<br />
  37. 37. Medical consultation<br />Self-Treatable Diseases<br />Travelers’ Diarrhea<br />Altitude Illness<br />Jet Lag<br />Motion Sickness<br />Respiratory Infections<br />
  38. 38. Altitude<br />
  39. 39. Altitude sickness<br />Initial symptoms: headache, nausea, and loss of appetite (4–8 hours after arrival)<br />The hypoxemia of high altitude  restless sleep, frequent awakening, and periodic breathing<br />Sometimes, severe forms of altitude illness: pulmonary edema and cerebral edema.<br />
  40. 40. Important to remenber<br />No vaccine is 100% effective<br />Precautions should still be taken in selecting food and drinks.<br />
  41. 41. Medical consultation after travel<br />Travellers with chronic disease<br />Weeks following return home: fever, persistent diarrhea, vomiting, jaundice, urinary disorders, skin disease, genital infection<br />Malaria treatment while traveling<br />>3 months in developing country<br />
  42. 42. Why you need medical consultation<br />Medical<br />Coverage<br />
  43. 43. Leading causes of injury death <br />33%<br />U.S. citizens in foreign countries 2003–2005<br />(Excluding Afghanistan or Iraq)<br />One accident every 1.4 million flights<br />17%<br />13%<br />1 in 5000: your chance of being killed in an automobile accident<br />Road Traffic<br />
  44. 44. Medical costs<br />Brief consultation 500RMB (75$CAN)<br />Standard consultation 850RMB (125$CAN)<br />Comprehensive Consultation 1100RMB (165$CAN)<br />Specialist consultation 1100-1250RMB<br />Psychologist consultation 1000RMB (150$)<br />Appendicectomy: 30 000 RMB (4500$CAN)<br />normal hour services fees<br />
  45. 45. Medical costs<br />800$US/day<br />Hospital expenses<br />Medical evacuation <br />or repatriation<br />100 000 to 240 000$US<br />
  46. 46. Insurance coverage<br />Appropriate Coverage<br />Medical evacuation and repatriation<br />Medical expenses<br />Pre-existing <br />Exclusion <br />Drunk driving<br />Car racing, skiing, scuba diving, bungee jumping<br />Other optional coverage <br />changes to the itinerary<br />Luggages loss<br />etc<br />
  47. 47. Conclusion<br />Medical consultation before trip<br />Routine vaccines to be updated<br />Vaccine-preventable diseases<br />Counseling and advice for travelers<br />Travel health kit<br />Preferably 6-8 wks before trip.<br />However last minute traveler can also benefit, even as late as the day before travel<br /><ul><li>Medical consultation after trip</li></li></ul><li>Conclusion<br />Appropriate insurance coverage<br />Medical evacuation and repatriation<br />Medical expenses<br />Preexisting<br />Exclusion<br />
  48. 48. A bus accident in Guangxi<br />
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  60. 60. References<br />Canadian Family Physician<br />American Family Physician<br />Centers for Disease Control and Prevention<br />Manual of Travel Medicine and Health,Robert Steffen, Herbert L. DuPont, Annelies Wilder-Smith<br />
  61. 61. Thank you!<br />YCPA<br />wishes you <br />a nice trip!<br />Safe and healthy!<br />