Journal of travel medicine
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Influenza outbreaks can occur among passengers and crews during the Alaska summertime cruise season. Ill travellers represent a potential source for introduction of novel or antigenically drifted influenza virus strains to the United States. From May to September 2013-2015, the Alaska Division of Public Health, the Centers for Disease Control and Prevention (CDC), and two cruise lines implemented a laboratory-based public health surveillance project to detect influenza and other respiratory viruses among ill crew members and passengers on select cruise ships in Alaska. ⋯ The high yield of positive results indicated that influenza was common among passengers and crews sampled with ARI. This finding reinforces the need to bolster influenza prevention and control activities on cruise ships. Laboratory-based influenza surveillance on cruise ships may augment inland influenza surveillance and inform control activities. However, these benefits should be weighed against the costs and operational limitations of instituting laboratory-based surveillance programs on ships.
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Gap year travellers can potentially be exposed to many infectious diseases and other travel-related health problems including injuries and psychological problems. Currently, there is little information on health and wellbeing of this particular group of travellers. ⋯ Gap year, pre-departure, preparation.
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Our knowledge of the health problems and infections encountered by international travellers has evolved considerably in the past decades. The growth of global networks such as the GeoSentinel Surveillance network, TropNet Europe, EuroTravNet and networks based in North America have provided valuable information on the frequency of a wide array of travel-related diseases and accidents, including details on the destination of travel and trends over time. ⋯ However, network data due to a lack of denominators usually cannot serve as a basis for a GRADE approach to guideline development. Although epidemiological network studies will continue to serve an important role in travel medicine we encourage an additional strong focus towards translational scientific research questions and towards the broader use of novel techniques to obtain more accurate epidemiological analyses to address the many unanswered questions in our field.
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Review Meta Analysis
A meta-analysis of the use of rifaximin to prevent travellers' diarrhoea.
Travellers' diarrhoea affects tens of millions of people travelling to less developed countries or regions annually. There are positive reports of the use of rifaximin, a non-absorbed, gut-selective antibiotic to prevent travellers' diarrhoea. This study will critically review and analyse clinical trials on the subject. ⋯ There is good evidence supporting the use of rifaximin as a chemoprophylactic agent against travellers' diarrhoea, especially in individuals who are at high risk of severe complications from acute infectious diarrhoea. Rifaximin has an excellent tolerability/safety profile and demonstrated efficacy against diarrhoeagenic Escherichia coli and even enteroinvasive bacteria such Campylobacter species. Future studies should study the most effective dosing regimen for rifaximin chemoprophylaxis, as well as profile local antimicrobial resistance/susceptibility data in less developed regions to further guide rifaximin use.
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Travel medicine research has remained relatively unchanged in the face of rapid expansion of international travel and is unlikely to meet health challenges beyond infectious diseases. Our aim was to identify the range of health outcomes during travel using real-time monitoring and daily reporting of health behaviours and outcomes and identify traveller subgroups who may benefit from more targeted advice before and during travel. ⋯ Our study offers a revolutionary look at an almost real-time timeline of health events and behaviours during travel using mHealth technology. Non-infectious disease related health issues were common in this cohort, despite being largely unaddressed in traditional travel medicine research and suggest a substantial potential for improving evidence-based travel medicine advice.