Journal of travel medicine
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Cholera is endemic in ~50 countries worldwide and remains a disease associated with poverty, causing illness and death in the poorest and most vulnerable people. In travellers, cholera is considered a low-incidence disease, but the true impact on travellers is difficult to assess. Cholera vaccination may improve safety for certain European travellers at risk. Effective vaccines are available; however, vaccination recommendations in Europe vary considerably between countries. ⋯ With the ease of intra-European travel, it would seem sensible to harmonize the recommendations for cholera vaccination and risk perception across Europe, providing pre-travel health advisers with a trusted source of information that allows them to provide consistent recommendations.
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Meta Analysis
Risk of latent and active tuberculosis infection in travellers: a systematic review and meta-analysis.
Achieving tuberculosis (TB) elimination in low TB incidence countries requires identification and treatment of individuals at risk for latent TB infection (LTBI). Persons travelling to high TB incidence countries are potentially at risk for TB exposure. This systematic review and meta-analysis estimates incident LTBI and active TB among individuals travelling from low to higher TB incidence countries. ⋯ We found that travelling HCWs were at highest risk of developing LTBI. Individual risk activities and travel purpose were most associated with risk of TB infection acquired during travel.
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Chagas disease, as a consequence of globalization and immigration, is no more restricted to Central and Latin America. Therefore, congenital transmission represents a growing public health concern in non-endemic countries. ⋯ Prevalence of Chagas disease among LA pregnant women living outside endemic countries is high, particularly in Bolivian women. The rate of vertical transmission of T. cruzi infection is similar to the rate reported in South and Central American countries.
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Review
Are patients with cognitive impairment fit to fly? Current evidence and practical recommendations.
The worldwide prevalence of dementia is increasing and represents a major public health concern. In the last decades, air travel services have undergone an impressive expansion and one of ten passengers is aged 65 years and older. While air travel can be stressful at all ages and health conditions, older individuals with cognitive impairment carry a greater risk for air-travel-related complications. Consequently, demands to general practitioners for assessing their older patient's fitness to fly are increasing. ⋯ The decision to let a patient with cognitive impairment fly requires a solid understanding of the in-flight environmental changes and their impact on older patients with cognitive impairment. Moreover, a sound weighing of the risks and benefits while considering different aspects of the patient's history is demanded. In this regard, the role of the treating physicians and caregivers is essential along with the support of the medical department of the airline.
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Medical tourism has been increasing dramatically globally, with people travelling from developed countries to low-income or middle-income countries, often to avoid high costs or long delays associated with seeking healthcare in their countries of origin. The current review summarizes healthcare-related infections associated with medical tourism, focusing on cosmetic surgery and organ transplantation. ⋯ There is a need for public health strategies in order to prevent morbidity and mortality as well as future management and education of patients engaging in medical tourism.