Travel health

incubation periods of imported IDs

• <7 days
  • dengue
  • rickettsiosis
  • influenza
  • dysentery
• 7-21 days
  • malaria
  • typhoid
  • leptrospirosis
  • VHF
• >21 days
  • malaria
  • hep A

case studies

pretravel

case 1

• give information possible diseases during the travel, such as zika, rabies, yellow fever, measles, exacerbation of his chronic illness exp. diabetes and coronary disease
• confirm his immunization status as much as possible and propose to do serological tests for measles and rubella
• give information about possible travel restriction regarding YF vaccine when to enter to Bolivia and discuss whether or not to get shot
• recommend vaccines of measles, rubella, PPSV23, tetanus toxoid and typhoid (because of antacid) according to his immunization status
• discuss with him whether to do rabies PrEP
• prescribe acetazolamide for 3-4 days, give direction to start 24hrs before ascending and keep for 2 days on high altitude, as well as to secure emergency descending when he gets AMS symptoms like headache, difficulty to sleep, malaise, loss of appetite
• advise when to use insulin and to keep diabetes emergency card with him
• advise to keep repellent during travel except for high altitude area

case 2

case 3

25 y/o British male

• 母子手帳= mother child health handbook

22 y/o Japanese male

• budget 50,000JPY
• MMRx1 6,000
• tetanusx1 3,000
• poliox1 5,000
• HepAx2 10,000
• HepBx2 10,000
• JEx1 5,000
• malaria chemp. according to advice to avoid forested area

posttravel

21 y/o Angolan female

68 y/o Japanese male

• rhabdomyolysis by P. knowlesi, very rare

19 y/o Chinese male

• VZV transmissibility decreases in more tropic areas
• VZV immunity is gotten later than temperate areas like in adolescent or later adult age