Travelers Flashcards
Where should your Vaccines be documented in
- International Certificate of Vaccination or Prophylaxis [ICVP]
- “Yellow Card”
What is the most common travel-related illness?
- Travelers Diarrhea [30 - 70%]
What are some of the symptoms of traveler diarrhea and is the most common bacteria?
- Cramping, Loose Stools, Fever, Vomiting
- Dysentery if blood in stools
- Caused by E. Coli
What is the way that we prevent travelers diarrhea?
- Eat only COOKED foods [Avoid buffets]
- Bottle Water or Boil for 1 min [Avoid Ice]
- Prophylaxis: Bismuth Subsalicylate
Who should not take Bismuth Subsalicylate for Prophylaxis of Travelers Diarrhea?
- Apsirin Allergy, Pregnancy, Renal Insufficiency, Gout, Taking Anticoagulants
What are some of the Treatment options for Travelers Diarrhea?
- Hydration [essential - oral is the best]
- Antimotility [Loperamide - decreases the frequeny and urgency]
- Antibiotics [mod to severe TD - Azithormycin, Quinolones or Rifaximin]
What is the recommended dosing for Loperamide for Traveler Diarrhea?
- 4 mg at the first loose stool;
- 2 mg after each loose stool
- MAX: 16 mg/day [Rx] & 8 mg/day [OTC]
What is the baceria that can cause typhoid fever?
- Salmonella typhi
What is teh only way that Typhoid Fever can spread?
- ONLY by humans through; food/water contaminated withe feces
What is recommended for someone trying to prevent typhoid fever?
- Vaccines [only 50 - 80% effective though]
- Vivotif: Oral, Live-attenuated [complete > 1 week before trip]
- Typhim Vi: IM [Get > 2 weeks before trip]
What is the bacteria that causes Cholera?
- Vibrio Cholerae
What is the most common symptom for Cholera?
- Watery Diarrhea [Rice-Water Stools]
What is recommended for those going to a place with cholera risks?
- Vaxchora: Live-attenuated vaccine [single oral dose 10 days before trip]
What is recommended to get if you are going to a place with an increased polio risk?
- Single lifetime booster dose at least 4 weeks before trip
How are at the highest risk of getting hepatitis A?
- Those going from a delevop country to a developing country
What are the Inactivated Vaccines for Travelers?
- Hep A [Havrix]
- Hep B [Engerrix-B, Heplisav-B, Recombivax HB]
- Hep A/B [Twinrix]
- Japan Encephalitis [Ixiaro]
- Meningococcus [Menveo, MenQuadfi]
- Polio [IPOL]
- Typhoid-IM [Typhim VI]
What are the Live Vaccines for travelers?
- Cholera-PO [Vaxchora]
- Typhoid-IM [Vivotif]
- Yellow Fever [YF-VAX]
What is the way that Hepatitis B is transmitted?
- Through contaminated blood or body fluids [low risk if your not doing any high-risk activities]
For those that are traveling to place where Hepatitis B is high risk, who are recommended to get the vaccines?
- Planning to get medical care
- Providing medical care
- Unprotected sex
- Piercing or Tattoos
What is the recommended prevention for Hepatitis B for those traveling to high risk places?
- 3 Dose series over 6 months OR
- as many dose as possble before the trip
What is the bacteria that can cause Meningitis?
- N. Mengitidis
What are some of the Symptoms of Menigitis?
- Severe Headache, Fever, Nausea, Sniff Neck
What is the way that Meningitis is spread?
- Respiratory Secretion
What is important to know how insects spreads diseases?
- Insects are vectors [carries illness to other things
What insect is the most common transmitter and what are some things it can transmit?
- Mosquitoes
- Carries Japan Encephalitis, Yellow Fever, Dengue, Malaria, Zika
What are some of the ways to avoid mosquito bites?
- Sleep or stay in a screened area
- Mosquito repellents with 20-50% DEET onto skin
- Permethrin treated ON Clothes
What is the way that Dengue is transmitted?
- By Mosquitoes
What are some of the symptoms of Dengue?
- Shock, Severe bleeding, organ failure
What is the treatment/prevention for Dengue?
- Dengvaxia [only for those with past Dengue]
- Protection from mosquito
What is the way that Japanese Encephalitis is transmitted?
- By mosquitos
What is the way that Japanese Enchephalitis is treated/prevented?
- Best preventions is reduce exposure to mosquito
- Ixario is a vaccine
What is the way that Malaria is transmitted and what happens once it is transmitted?
- By anopheles mosquitoes
- Once in human, it multiles in liver and then goes to RBC to destory them
What is the common Bacteria that causes Malaria?
- P. Vavix is most common; P. Falciparum is most deadly
What is the treatment/prevention for Malaria?
- Prophylaxis is key as even with treatment is can be fatal
What is the Quick Start Phrophylaxis Agents for Malaria?
- Doxycycline [Stop 4w after travel]
- Atovaquone/Proguanil [Stop 1w after travel]
- Primaquine [Stop 1w after travel]
Starts 1-2 days before traveling
Daily Regimens; AVOID in pregnancy; causes Nausea
What are some of the Advance Start Prophylaxis Agents for Malaria?
- Cholorquine [Stop 4w after travel] (Renal Toxcity/Visual Changes)
- Mefloquine [Start >2w before & Stop 4w after travel] (Underlying Psychiatric, Seizures, Arrhythmias)
Start 1-2 weeks before traveling
Weekly, Safe in kids and children
What is the way that Yellow Fever is transmitted?
- By Mosquitoes [reducing exposure is key]
What are some things to avoid in Yellow Fever?
- Aspirin and Other NSAIDS [increased bleeding]
What is the way to treat/prevent Yellow Fever
- YF-VAX that goes on your Yellow Card [becomes vaild after 10 days]
CONTRAINDICATED: in those with hypersensitivity to Egg or severly immunocomprosed
What is the way that Zika Virus is transmitted?
- By Mosquitoes
- Can be sexually by mainly blood-transfusions
What is the treatment/prevention of Zika Virus?
- NO VACCINES
- Avoiding bites and using condoms
What is important to know about VTE and Traveling?
- Wearing compression stocking during long trips
- Lower Leg Exercises [walking, curling toes]
What is important to know about Altitude Sickness/Motion Sickness and Traveling?
- Primary Prophy: Acetazolamide 125mg BID starting the day before trip
CONTRAINDICATED with sulfa
