Travel medicine and infectious disease
-
Jet Lag Disorder (JLD) is a recognized circadian rhythm sleep disorder characterized by insomnia or excessive daytime sleepiness (and sometimes general malaise and somatic symptoms) associated with transmeridian jet travel. It is a consequence of circadian misalignment that occurs after crossing time zones too rapidly for the circadian system to keep pace. The thesis of this review is that a rational treatment approach for jet lag can be grounded in an understanding of the biology of the human circadian timekeeping system. ⋯ Both timed light exposure (or avoidance) and exogenous melatonin administration have been recruited as treatment modalities to accelerate circadian realignment, based on an understanding of their role in circadian physiology. In addition to circadian misalignment, other contributing causes to jet lag are considered including travel-related sleep deprivation and fatigue. Clinical field trials that have tested the application of circadian rhythm based interventions are then reviewed.
-
Travel Med Infect Dis · Jan 2009
Saving tourists: the status of emergency medical services in California's National Parks.
Providing emergency medical services (EMS) in popular tourist destinations such as National Parks requires an understanding of the availability and demand for EMS. This study examines the EMS workload, EMS transportation methods, EMS funding, and EMS provider status in California's National Park Service units. ⋯ Providing EMS for tourists can be a challenging task. As tourist endeavors increase globally and move into more remote environments, the level of EMS operations in California's NPS units can serve as a model for developing EMS operations serving tourist populations.
-
Recreational travel to wilderness destinations such as national parks is increasing. The inherent risks present in such destinations can result in injury and illness, have a significant impact on local medical resources, and end with expensive search and rescue operations. In order to increase our understanding of the activities and situations which lead to wilderness search and rescue incidents, this study examines search and rescue operations from National Park Service units in Alaska. ⋯ Search and rescue operations in Alaska can be expensive and end with severe health consequences. Preventive education efforts at park visitor centers and at the lower and upper base camps on Mt. McKinley should be continued. In addition, pre-departure travel education efforts via the internet should be expanded for all park units and match the detail provided on the Denali National Park and Preserve website.
-
Travel Med Infect Dis · Sep 2008
ReviewPre-travel vaccination and medical prophylaxis in the pregnant traveler.
Practitioners are often fearful of giving vaccinations and prophylactic medications to pregnant travelers. And yet pregnancy is often a time of heightened danger from travel-related infections and illnesses. ⋯ The authors present some non-medical interventions that may be used to limit exposure to a number of disease processes. They then review the available information regarding the safety and efficacy of routine and travel-related vaccines as well as prophylactic medications for malaria, diarrhea, motion sickness and altitude sickness. When there are no obstetrical or medical contraindications, travel-related illness can usually be safely prevented during pregnancy in much the same ways as in the non-pregnant state.
-
Travel Med Infect Dis · Sep 2008
Illness and injury to travellers on a premium expedition along the Asian Silk Route.
Commercial expeditions provide an opportunity for travellers to undertake various specialised travel to more adventurous and extreme destinations in the relative security of an expeditionary group with medical cover provided by an expedition physician. Little is known about the illnesses and injuries occurring on premium expeditions to Asia. This present study was designed to investigate the prevalence of injury and illness suffered by travellers on a premium expedition along the Asian Silk Route. ⋯ On this premium expedition, the health problems encountered were largely similar to those reported for other expeditions. The most common problems included respiratory, gastrointestinal, dermatological conditions and minor trauma in descending order. As well as being part of the service provided to travellers, the inclusion of an expedition physician on this premium expedition increased the independence of the travellers on this journey and decreased the reliance of the tour on local health services, a source which is often scarce or absent on more remote location expeditions.