Archive for March, 2009

Prevention of Diseases During Travel

Travelers (especially traveler from a developed country to a developing or underdeveloped country) are at high risk of contacting many diseases compare to the local population. Many of the diseases are infectious diseases and many are not related to disease agents. All the risks are due to indulgent of travelers to different activities in the place of their travel.

Travelers are at high risk of contacting an STD (sexually transmitted disease). Recent studies show that large number of travelers engage in casual sex and they can get reluctant to use condom consistently and get infected with STDs. To prevent STD all travelers should use condom during casual sex and also carry condom with them. Use of condom can also prevent spread of HIV. In USA an increasing number of travelers are diagnosed with schistosomiasis. Travelers should avoid bathing, swimming or wading in freshwater lakes, streams, or rivers in parts of tropical South America, the Caribbean, Africa, and Southeast Asia.

Prevention of travel associated injuries or injury during travel is also very important as study shows that the chances of getting injury is much higher among travelers. Common-sense precautions should be taken during travel like not riding a motor cycle without a helmet, avoiding overcrowded public transport etc. A traveler should not travel in developing countries by road after dark (especially alone), particularly in rural areas. Traveler should not go out of his/her shelter after dark and alone. Travelers are cautioned to avoid walking barefoot because of the risk of hookworm infection and Strongyloides infection and snake bites. Excessive alcohol use has been a significant factor in drowning, assaults, injuries and not to mention the chances of increased motor vehicle accidents. Excess alcohol should be avoided during travel and also excessive “tasting” of local drinks, because travelers may get a bigger “kick” due to local alcoholic drinks.

Prevention and Control of Typhoid

Theoretically typhoid is an eradicable (as smallpox) disease as Salmonella that cause enteric fever survive only in human hosts and are spread by contaminated food and water. But high prevalence of typhoid in developing countries and lack of adequate sewage disposal and water treatment make the goal of eradication of typhoid impracticable at present. So travelers from developed countries to developing country should monitor their food and water intake carefully and also get vaccinated for typhoid.

Typhoid vaccines:

At present 2 types of typhoid vaccines are commercially available: (1) Ty21a, an oral live attenuated vaccine of Salmonella Typhi (given on days 1, 3, 5, and 7, with a booster every 5 years) and (2) Vi CPS, a parenteral vaccine (given intramuscularly) consisting of purified Vi polysaccharide from the bacterial capsule (given in 1 dose, with a booster every 2 years). The older vaccine of whole cell typhoid/paratyphoid A and B vaccine (given intramuscularly) is no longer licensed due to its side effects. The minimum age for vaccination is 6 years for oral type or Ty21a and 2 years for Vi CPS. At present there is no vaccine licensed for paratyphoid. An acetone-killed whole-cell vaccine is available which is only used by the U.S. military.

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Health Benefits of Spa Baths

There are many benefits of spa baths and whirlpool baths. Many of the benefits are health benefits and beauty benefits. Baths have been in use since Roman times as far back as about 500 BC. Romans use hot baths as a form of relaxing, socializing and maintaining well being or maintaining good health. The practice of bath as a form or relaxing, socializing and health benefits are in use till date in some form or other.

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Diagnosis of Typhoid Fever

The clinical features of typhoid fever are nonspecific. So diagnosis of typhoid fever should be considered if a traveler returning from developing country with fever, especially from Indian subcontinent, and Latin America or in developing countries any patient with fever. Other diagnosis to be considered in case of fever and international travel are malaria, hepatitis, bacterial enteritis, dengue fever, rickettsial infections, leptospirosis, amebic liver abscesses, and acute HIV infection etc.

A positive blood culture is the only confirmatory test for diagnosis of typhoid fever and other laboratory tests are not diagnostic. There may be non specific laboratory changes like leukopenia and neutropenia in 15% to 25% of the cases of typhoid fever and also moderately elevated liver function tests and muscle enzyme levels.

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Typhoid Fever: Clinical Features

Typhoid Fever: an Understanding