28- Travel medicine

Question 1

which vaccinations are generally recommended

Answer 1

hepA
hepB for those who might have contact with blood or body fluids
typhoid for travellers who are staying with relative, in smaller rural areas

Question 2

T/F all yellow fever vaccines are conjugated viral vaccines

Answer 2

F

no they are live attenuated

Question 3

vaccines based on destinations

Answer 3

japanese encephalitis, rabies

Question 4

prophylaxis types for malaria

Answer 4

atovaquone/proguanil
chloroquine
doxycyline
mefloquine
primaquine

Question 5

can permethrin for insect repellant be used on skin

Answer 5

no

Question 6

is yellow fever given to <9 months old

Answer 6

no

Question 7

T/F anti-malarial drugs are 100% protective

Answer 7

F

Question 8

pro con for atovaquone/proguanil

Answer 8

pro: good for last minute travellers cuz you can start taking it 1-2 days before travelling; good for short trips because you need to take the med for 7 days after travelling; well tolerated, can give to kids
- cons: not for pregnant or breast feeding, not for severe renal impairement, more expensive, daily

Question 9

pro con for chloroquine

Answer 9

pro: weekly doses, good for long trips, some pts may already be on HCQ, can be used in all pregnancy
con: cant be used in areas with chloroquine, mefloquine resistance; can exacerbate psoriasis, bad for short trips bc you take meds 4 weeks after travel, not for last minute travels bc you need to take it for 1-2 weeks prior to travel

Question 10

pro con for doxycyline

Answer 10

pro: good for last min traveler (1-2 days b4); least expensive; some already on doxy, can prevent additional infections from rickketsiae, leptospirosis
cons: not for pregnant women or kids under 8, daily, need to take it 4 weeks after travel, bad for yeast infections, sensitization to sun exposure, GI issues

Question 11

pro con mefloquine

Answer 11

pro: weekly, good for long trips, can be used during pregnancy
con: mefloquine resistance, not for psychiatric pts or seizure pts, cardiac pts, need to start it 2 weeks b4 (not for late travel), need to take it 4 weeks after travel

Question 12

pro con pimaquine

Answer 12

pro: most effective for P vivax, good for short trips 7 days after travelling, late travelers
con: not for G6PD def, cost, not for pregnant or breastfeeding, daily