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ویرایش: 4 نویسندگان: Jay S. Keystone, Phyllis E. Kozarsky, Bradley A. Connor, Hans D. Nothdurft, Marc Mendelson, Karin Leder سری: ISBN (شابک) : 9780323546966, 9780323547710 ناشر: Elsevier Inc. سال نشر: 2019 تعداد صفحات: 609 زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 55 مگابایت
در صورت تبدیل فایل کتاب Travel Medicine به فرمت های PDF، EPUB، AZW3، MOBI و یا DJVU می توانید به پشتیبان اطلاع دهید تا فایل مورد نظر را تبدیل نمایند.
توجه داشته باشید کتاب پزشکی مسافرتی نسخه زبان اصلی می باشد و کتاب ترجمه شده به فارسی نمی باشد. وبسایت اینترنشنال لایبرری ارائه دهنده کتاب های زبان اصلی می باشد و هیچ گونه کتاب ترجمه شده یا نوشته شده به فارسی را ارائه نمی دهد.
Cover Dedication Travel Medicine Copyright Page Preface List of Contributors Acknowledgments Section 1: Practice of Travel Medicine 1 Introduction to Travel Medicine Reference 2 Epidemiology Abstract Keywords Key points Introduction Cornerstones of Travel Health Epidemiology Mortality Accidents Infectious Diseases Other Illness and Mortality Aeromedical Evacuation Morbidity Travelers’ Diarrhea Malaria Vaccine-Preventable Infections Required Immunizations. Routine Immunizations. Recommended Immunizations. Other Infections Sexually Transmitted Diseases. Upper Respiratory Tract Infection (URTI). Other Arboviral Infections: Dengue, Chikungunya, Zika. Legionella. Leishmaniasis. Schistosomiasis. Trypanosomiasis. Noninfectious Health Problems Environmental. Host. Conclusion and Prioritization References 3 Starting, Organizing, and Marketing a Travel Clinic Abstract Keywords Key points Introduction The Practice of Travel Medicine Starting a Travel Health Program Frequently Asked Questions Who Is Qualified to Offer Travel Health Services? What Can Health Care Professionals Do to Develop Expertise in Travel Health? Are There Different Models of Care Delivery? What Policies, Procedures, and Resources Should Be in Place? Is Special Documentation Required? What Support Services Are Needed? Should a Clinic Offer Travel Health Services Full Time? What Are the Best Times for Clinic Sessions? What Vaccines Should Be Provided? Should the Clinic Offer Yellow Fever Vaccine? How Much Time Should Be Set Aside for Appointments? How Should a Clinic Determine Charges? What Is It Going to Cost to Establish a Travel Health Program? Organizing a Clinic: Equipment and Supplies Equipment Refrigerator and freezer. Computer. Supplies Vaccine supply. Vaccination supplies. Managing adverse events. Infection control and hazardous waste supplies. Other patient supplies. Documentation Information Resources for the Clinician Information Resources for the Traveler: Patient Education Legal Issues Professional Standards. Financial Considerations Fees and Revenue for a Travel Health Practice Fee-for-Service Care When a Clinic Participates in Insurance Plans Clinic Charges Selling Travel-Related Products Combining a Travel Clinic With Other Services Pretravel Physical Examinations and Posttravel Care Services to Travelers During Their Journeys Offsite Services Running a Travel Health Program Staff and Administrative Issues Before the Visit, Preparation of Reception Staff Key Issues During the Pretravel Consultation After the Consultation Reporting Vaccine Adverse Events Service Evaluation After the Trip Marketing and Promoting a Travel Health Program Word of Mouth Referrals Direct Marketing Methods: Internet, Print, and Media Other Marketing Approaches Mailings Contract Services Brochures Management Challenges Telephone, Email, and Text Advice Professional Development Conclusion References 4 Pretravel Consultation Abstract Keywords Key points Introduction Logistics and Mechanics of the Pretravel Consultation Components of Pretravel Consultation and Order of Importance Fitness to Travel Analysis of Expected Health Risks in Travelers General Considerations General Topics to Be Covered Application of Preventive Measures Health Problems During and After Travel Challenges Regarding Travel Advice Acknowledgments References Section 2: The Pretravel Consultation 5 Water Disinfection for International Travelers Abstract Keywords Key points Introduction Etiology and Risk of Waterborne Infection Water Treatment Methods for Short-Term and Long-Term Travelers and Expatriates Heat Clarification Sedimentation. Coagulation–Flocculation. Granular Activated Carbon. Filtration Halogens The Disinfection Reaction. Iodine Resins. Improving Halogen Taste. Halogen Toxicity. Miscellaneous Disinfectants Silver. Photocatalytic Disinfection. Ultraviolet. Solar UV Disinfection (SODIS). Citrus and Potassium Permanganate. Preferred Technique Sanitation Conclusion References 6 Insect Protection Abstract Keywords Key points Introduction Stimuli That Attract Insects Personal Protection Habitat Avoidance Physical Protection Insect Repellents Chemical Repellents DEET. Choosing a DEET Formulation. DEET Safety and Toxicity. IR3535. Picaridin. Botanical Repellents. Citronella. BiteBlocker. BioUD (2-undecanone). Lemon Eucalyptus. Geraniol. Efficacy of DEET Versus Botanical Repellents. Alternative Repellents. Insecticides Permethrin Reducing Local Mosquito Populations Relief From Mosquito Bites Summary—A Comprehensive Approach to Personal Protection References 7 Pretravel Considerations for Non-vaccine-Preventable Travel Infections Abstract Keywords Key points Introduction Dengue, Chikungunya, and Zika Overview The Mosquito Vectors: Aedes aegypti and A. albopictus Dengue Chikungunya Zika Prevention of Dengue, Chikungunya, and Zika Additional Considerations for the Prevention of Congenital Zika Infection Severe Respiratory Infections With Regional Endemicity Middle Eastern Respiratory Syndrome Avian Influenza Preventative Advice for Severe Respiratory Infections Other Regionally Important Infections in Travelers References 8 Travel Medical Kits Abstract Keywords Key points Introduction Summary of Factors Determining Medical and First-Aid Kit Construction Contents of Medical and First-Aid Kits The Basic Medical and First-Aid Kit More Comprehensive Kits Expedition and Group Kits References Section 3: Immunization 9 Principles of Immunization Abstract Keywords Key points Introduction Immunology of Vaccination Immunization Active Immunization Passive Immunization Immune Memory and Booster Doses. Vaccines Inactivated Vaccines. Live Attenuated Vaccines. Vaccine Administration Route of Immunization. Intramuscular route. Subcutaneous route. Intradermal route. Oral application. Simultaneous Administration/Interchangeability of Vaccines. Serologic Testing Before and After Immunizations. Vaccine Safety and Management of Adverse Reactions Special Conditions/Contraindications Immunizations in Travelers/Conclusion References 10 Routine Adult Vaccines Abstract Keywords Key points Introduction Tetanus, Diphtheria, Pertussis Indications Contraindications Precautions Dosing Schedules Measures of Immune Response and Duration of Immunity/Protection Adverse Effects Measles, Mumps, and Rubella Vaccine Indications Contraindications Precautions Dosing Schedule Adverse Effects Measures of Immune Response and Duration of Immunity/Protection Varicella and Herpes Zoster Vaccines Indications for Varicella Vaccination Contraindications: Varicella Vaccination Precautions Dosing Schedules Measures of Immune Response and Duration of Immunity/Protection Adverse Events Drug and Vaccine Interactions Herpes Zoster Vaccination Pneumococcal Vaccine Indications Contraindications Precautions Dosing Schedule Measures of Immune Response and Duration of Immunity/Protection Adverse Events Human PapillomaVirus Vaccine Indications Dosing Schedules Contraindications and Precautions Influenza Indications Dosing Schedules Contraindications and Precautions Conclusion References 11 Routine Travel Vaccines Abstract Keywords Key points Hepatitis A Vaccine Indications Contraindications Precautions Dosing Schedules Accepted Accelerated Schedule Measures of Immune Response and Duration of Immunity Adverse Events Drug and Vaccine Interactions Immune Globulin for Hepatitis a Prevention Indications Contraindications Precautions Dosing Schedules Adverse Events Drug and Vaccine Interactions Hepatitis B Vaccine Indications Contraindications Precautions Dosing Schedules Accelerated Schedules Measures of Immune Response and Duration of Immunity/Protection Adverse Events Drug and Vaccine Interactions Combined Hepatitis A and Hepatitis B Vaccine Indication Contraindications Precautions Dosing Schedules Accepted and Possible Accelerated Schedules Measures of Immune Response and Duration of Immunity/Protection Adverse Events Drug and Vaccine Interactions Typhoid Vaccine Indications Contraindications Precautions Dosing Schedules Vi Polysaccharide Typhoid Vaccine. Ty21a Oral Typhoid Vaccine. Measures of Immune Response and Duration of Immunity/Protection Vi Polysaccharide Typhoid Vaccine. Ty21a Oral Typhoid Vaccine. Adverse Events Drug and Vaccine Interactions Conclusion References 12 Recommended/Required Travel Vaccines Abstract Keywords Key points Introduction Practical Vaccine Considerations Adverse Events Attenuated Live Vaccines Required Vaccines Yellow Fever Vaccine Recommendations. Indications. Contraindications and Precautions Age. Pregnancy. Nursing mothers. Thymic disorder or dysfunction. Altered immune states. Hypersensitivity to eggs. Dosing Schedules. Measures of Immune Response and Duration of Immunity/Protection. Adverse Events. Drug and Vaccine Interactions. Recommended Vaccines Cholera Vaccines Indications. Contraindications and Precautions (Applies for All Vaccines) Dosing Schedules. Measures of Immune Response and Duration of Immunity/Protection. Adverse Events. Drug and Vaccine Interactions. Japanese Encephalitis Vaccine Inactivated Cell-Culture Vaccines Chimeric JE Vaccine (JE-CV) Live Attenuated SA-14-14-2 JE Vaccine Indications. Contraindications Dosing Schedules. Adverse Events. Drug and Vaccine Interactions. Meningococcal Vaccine Indications. Contraindications Precautions. Dosing Schedules. Measures of Immune Response/Duration of Immunity/ Protection. Adverse Events. Drug and Vaccine Interactions. Polio Vaccine Indications. Dosing Schedules. Accelerated Schedules for Primary IPV Immunization. Contraindications Precautions. Side Effects. Rabies Vaccine Indications. Contraindications Precautions. Dosing Schedules Preexposure vaccination. Boosting. Accepted and Possible Accelerated Schedules. Postexposure Vaccination. Measures of Immune Response and Duration of Immunity/ Protection. Adverse Events. Drug and Vaccine Interactions. Tickborne Encephalitis Vaccine Indications. Criteria Contraindications Dosing Schedules. Measures of Immune Response and Duration of Immunity/Protection. Adverse Events. Drug and Vaccine Interactions. References 13 Pediatric Travel Vaccinations Abstract Keywords Key points Introduction Vaccine Considerations in Infants and Children Polysaccharide Vaccines Conjugate Vaccines Intercurrent Illness and Vaccination Routine Pediatric Vaccines Diphtheria-Tetanus-Acellular Pertussis Vaccine (DTaP) Adolescent Pertussis Vaccine (Tdap) Measles–Mumps–Rubella Vaccine Polio Vaccine Pneumococcal Vaccine Influenza Vaccine Varicella Vaccine Hepatitis B Vaccine Rotavirus Vaccine Human Papilloma Virus Vaccine Indications. Meningococcal Vaccines Accelerating Routine Vaccines Pediatric Travel Vaccinations Required Vaccinations Yellow Fever Vaccine. Recommended Vaccinations Hepatitis A Vaccine. Hepatitis A–Hepatitis B Combination Vaccine. Hepatitis A–Typhoid Combination Vaccine Meningococcal Vaccines Typhoid Vaccine Rabies Vaccine Japanese B Encephalitis Vaccine Tickborne Encephalitis Vaccine BCG Summary References Section 4: Malaria 14 Malaria Abstract Keywords Key points Introduction Distribution of Malaria Species Who Is at Risk? Where Are Travelers at Risk of Acquiring Malaria? Drug-Resistant Malaria Chloroquine Mefloquine Doxycycline Atovaquone/Proguanil Primaquine References 15 Malaria Chemoprophylaxis Abstract Keywords Key points Approach to Malaria Prevention Assessing Individual Risk—Parasite, Place, and Person Preventing Mosquito Bites With Personal Protection Measures Taking the “THINK MALARIA” Approach if Fever Develops During or After Travel Using Malaria Chemoprophylaxis Current Chemoprophylactic Drug Regimens Chloroquine, Hydroxychloroquine, Chloroquine/Proguanil Description, Pharmacology, and Mode of Action. Efficacy and Drug Resistance. Tolerability. Contraindications, Precautions, and Drug Interactions. Indications and Administration. Mefloquine Description, Pharmacology, and Mode of Action. Efficacy and Drug Resistance. Prophylactic Failures and Resistance. Tolerability. Moderate/Severe Adverse Events. Serious Adverse Events. Neuropsychiatric Adverse Events. Contraindications, Precautions, and Drug Interactions. New contraindications New precautions. Pregnancy. Indications and Administration. Doxycycline Description. Pharmacology and Mode of Action. Efficacy and Drug Resistance. P. vivax. P. ovale, P. malariae, and P. knowlesi. Tolerability. Contraindications, Precautions, and Drug Interactions. Indications and Administration. Atovaquone/Proguanil Description. Pharmacology and Mode of Action. Efficacy and Drug Resistance. Tolerability. Contraindications, Precautions, and Drug Interactions. Indications and Administration. Primaquine Introduction and Description. Pharmacology and Mode of Action Efficacy and Drug Resistance. Tolerability. Contraindications and Precautions. Indications and Administration. Future Directions Tafenoquine Introduction and Description. Efficacy and Drug Resistance. Tolerability. Contraindications, Precautions, and Drug Interactions. Indications and Administration. New Pipeline Drugs for Malaria Chemoprophylaxis Chemoprophylaxis in Special Populations Pregnant and Breastfeeding Travelers Breastfeeding. Long-Term Travelers Business Travelers Migrant and VFR Travelers Infants/Children Differences in Guidelines and Recommendations on Malaria Chemoprophylaxis Primaquine. References 16 Self-Diagnosis and Self-Treatment of Malaria by the Traveler Abstract Keywords Key points Introduction Rapid Diagnostic Tests for Malaria Rationale Principle and Availability of Test Kits Performance of RDTs for Laboratory Diagnosis of Malaria Performance of RDTs for Self-Use by Travelers SBET for Malaria Principle and Rationale for Use. Recommendations for Choice of Drugs SBET Recommendations for Pregnant Women, Children, and Chronically Ill Patients Balancing of Recommendations Summary and Outlook Conclusion References 17 Approach to the Patient With Malaria Abstract Keywords Key points Introduction The Threat The Malarias Clinical Presentation of Uncomplicated Malaria Clinical Presentation of Severe and Complicated Malaria Diagnosis of Infection Clinical Diagnosis Microscopic Diagnosis. Rapid Diagnostic Tests Nucleic Acid Diagnostic Tests Treatment of Uncomplicated Malaria Treatment of Severe Malaria Treatment of Severe Malaria in Children Treatment of Malaria in Pregnancy Antirelapse Therapy With Primaquine Primaquine and G6PD Deficiency Managing Relapse Risk in Patients Unable to Receive Primaquine Conclusion References Section 5: Travelers\' Diarrhea 18 Epidemiology of Travelers’ Diarrhea Abstract Keywords Key points Introduction History Clinical Characteristics Etiology Bacteria Diarrhea Producing E. coli Campylobacter spp. Salmonella spp. Shigella spp. Vibrio spp. Viruses Parasites Giardia Entamoeba spp. Cyclospora Cystoisospora belli Cryptosporidium Blastocystis hominis Host Factors Age/Gender Travelers’ Diarrhea in Children Country of Origin Immunity Underlying Medical Conditions Specific Host Factors Environmental Factors Pretravel Advice Travel Packages and Meals Lodging Risk by Geographic Region Complications of Travelers’ Diarrhea Postinfectious Irritable Bowel Syndrome Association With Travelers’ Diarrhea Military Epidemiology Conclusion References 19 Prevention of Travelers’ Diarrhea Abstract Keywords Key points Introduction The Impact of Prevention Prevention Strategies Identifying Hosts at Risk Education and Behavior Modification Probiotics and Other Nonantibiotic Forms of Prophylaxis Vaccines Antimicrobial Agents Prophylaxis Versus Early Treatment Conclusion References 20 Clinical Presentation and Management of Travelers’ Diarrhea Abstract Keywords Key points Classical and Functional Impact–Based Definitions Syndromic Presentations and Etiology Acute and Chronic Complications Differential Diagnosis Management of Travelers’ Diarrhea Pretravel Counseling Fluids Mild Diarrhea Moderate Diarrhea Severe (Watery) Diarrhea and Dysentery Other Nonantibiotic Alternatives When to Seek Care Antibiotic Resistance as Both Cause and Consequence of Travelers’ Diarrhea Conclusion References 21 Persistent Gastrointestinal Symptoms in the Ill-Returning Traveler Abstract Keywords Key points Introduction Definitions and Epidemiology Persistent Gastrointestinal Symptoms Incidence Pathoetiologic Mechanisms Persistent Infection or Coinfection Parasites Giardia lamblia. Entamoeba histolytica. Dientamoeba fragilis. Microsporidia. Cyclospora cayetanensis. Cryptosporidium parvum. Cystospora Belli. Bacteria Enterobacteriaceae. Clostridium difficile. Unknown Pathogens Tropical Sprue. Brainerd Diarrhea. Postinfectious Processes Postinfectious Malabsorptive States. Postinfectious Functional Gastrointestinal Disorders Epidemiology and Pathogenesis. Chronic Gastrointestinal Diseases Unmasked by an Enteric Infection Idiopathic Inflammatory Bowel Disease. Celiac Sprue. Colorectal Cancer. Clinical Approach History and Physical Examination Noninvasive Laboratory Workup Stool Studies. Blood Testing. Endoscopic Evaluation. Therapy Conclusion References Section 6: Travelers With Special Needs 22 The Pregnant and Breastfeeding Traveler Abstract Keywords Key points Introduction Pretravel Preparation Access to Medical Care Abroad Travel by Air. Water Sports and Travel by Boat. Exercise. Travel by Automobile. Immunizations Infectious Diseases in Pregnancy Zika Virus and Pregnancy Malaria and Pregnancy Guidelines for Prevention Personal Protective Measures. Chemoprophylaxis. Treatment. Food and Water Precautions Travelers’ Diarrhea Water Purification Treatment Other Infectious Disease Risks Altitude and Pregnancy Pregnancy Planning Breastfeeding Drugs in Breast Milk Malaria Prevention Immunizations Practicalities Medications Other Issues Medical Kit Alternative Medications References 23 The Pediatric and Adolescent Traveler Abstract Keywords Key points Introduction Comfort and Safety Should Children Be Subjected to the Discomforts of International Travel? Is It Safe for Children to Travel Internationally? Schedules Air Travel Is It Safe for Infants to Travel in Commercial Airplanes or Go to High Altitudes? What Are the Risks of Injury During Air Travel? Assuming Reasonable Safety Precautions Are in Order, What Can Be Done to Ensure Comfort for a Child and Family Traveling by Air? Should Children Be Sedated During Long Flights? Does Jet Lag Occur in Children? What About Earaches With Air Travel? Motor Vehicles Motion Sickness Outdoor Activities Water. Skin Protection. Altitude. Animal Contact. What Precautions Should Be Taken for Children With Chronic Medical Conditions? Risk-Taking Behaviors Especially for Adolescents Medical Kit for Families Immunization Insect-Borne Diseases Treatment of Bites Additional Preventive Strategies for Specific Insect-Borne Diseases Malaria. Tickborne Diseases. Yellow Fever and Japanese Encephalitis; Dengue, Chikungunya, and Zika. Diarrhea Food and Water Hygiene Epidemiology of Diarrhea in Pediatric Travelers Treatment Which Antibiotic Should Be Used in Children? Screening What Should Be Done for Children Returning From International Journeys? Managing Illness in Arriving Pediatric Travelers Psychosocial Adjustment and Integration Into the New Setting Conclusion References 24 The Older Traveler Abstract Keywords Key points Introduction Why Are Elderly Travelers at Greater Risk? General Advice Choosing a Trip Fitness to Travel Making Travel Arrangements Health Insurance Medications and Medical Supplies Accessing Medical Services Abroad Practical Tips During Air Travel Medical Conditions Arising During Travel Motion Sickness In-Flight Medical Emergencies Venous Thromboembolic Disease Jet Lag Hyperthermia and Hypothermia Heat Stress. Cold Stress. Altitude Sickness Accidents and Injury Travel-Related Infections in the Elderly Malaria Travelers’ Diarrhea Sexually Transmitted Infections Vaccine-Preventable Infections Routine Immunizations Pneumococcal Vaccine. Travel Vaccines Hepatitis A and B. Japanese Encephalitis. Cholera Vaccine for Travelers’ Diarrhea. Typhoid Fever. Varicella. Yellow Fever. Conclusion Additional Resources References 25 The Physically Challenged Traveler Abstract Keywords Key points Introduction General Advice Choosing a Trip and Making Travel Arrangements Traveling With an Attendant The Physically Disabled Traveler Air Travel With a Wheelchair or Scooter Air Travel With Canes, Crutches, Walkers, and Other Medical Devices Cruising With a Wheelchair or Scooter The Hearing-Impaired Traveler The Speech-Impaired Traveler The Visually Impaired Traveler Service Animals The Developmentally or Cognitively Impaired Traveler Conclusion References 26 The Traveler With Preexisting Disease Abstract Keywords Key Points General Principles Before You Go The Voyage While in the Destination Country After the Trip Specific Medical Problems Cardiac Disease Anemia Respiratory Disease Renal Disease Diabetes Mellitus Gastrointestinal Disease Liver Disease Neurologic Disease Malaria Prophylaxis in Patients With Neurologic Diseases Allergies Conclusion References 27 The Immunocompromised Traveler Abstract Keywords Key points Introduction Corticosteroids, Disease-Modifying Antirheumatic Drugs, and Biologic Therapies Asplenic Travelers Transplant Recipients Cancer Chemotherapy Special Vaccine-Related Topics Pretravel Vaccination of the Immunocompromised Host Yellow Fever Measles Influenza Rabies Vaccination and Postexposure Prophylaxis Health Care Workers and Medical Missions Cholera Meningococcal Meningitis HIV and Bloodborne Risk Suspending Immunosuppression for Vaccination Vaccination of Family Members and Household Contacts Additional Considerations Medication-Related Issues in the Traveling Transplant Recipient Gastroenteritis Sun Protection Environmental Exposures, Animal Bites, Sexual Contact Tuberculosis Strongyloides Medical and Transplant Tourism Conclusions References 28 The Traveler With HIV Abstract Keywords Key points Introduction Health Risks to the Traveler Pretravel Advice Behavioral Precautions Vaccination Immune Status of the Traveler. Nature of Vaccine. Inactivated vaccines. Risk and Severity of Vaccine Preventable Disease in the HIV-Infected Traveler. Risk of HIV Rebound as a Consequence of Vaccination. Antiretroviral Prophylaxis to Prevent HIV in Travelers Drug Interactions Health Care Abroad Crossing International Borders Conclusion References 29 The Business Traveler Abstract Keywords Key points Introduction Health Risks of International Business Travelers Travel-Related Infections Environmental Risks Air Pollution Safety and Security Risks Medical Considerations for International Travel Pretravel Considerations for Health Risks Before International Travel Travel Health Considerations During Travel and at the Destination Posttravel Care Considerations Special Issues for Business Travelers Travel Kits Jet Lag Zika Medical Insurance Coverage for Business Travel Conclusion References 30 VIP Traveler Abstract Keywords Key points Introduction The Man, the Mission, and Medicine Mission-oriented Medicine and VIP Travel Medicine Operationalizing VIP Travel Support Medical Threat Assessment and Countermeasures Communicate: Translating the Medical Threat Assessment Into a Medical Travel Advisory Support Requirements The Plan Nothing More, Nothing Less Right Problem. Right Person. Right person: expeditionary medical staffing. Staffing options: right training. Staffing options: right team. Right Equipment. Common pitfalls. Right Place, Right Time. Rested and ready to respond. Right environment. Knowing Where to Get Help: Host Country Solutions What Next? Evacuation Planning Operational Security: Don’t Become a Liability Economics of VIP Travel Medicine Support Conclusion References 31 Health Aspects of International Adoption Abstract Keywords Introduction Preadoption The Children The Parents The Adoption The Children The Parents The Immediate Postadoption Visit General Evaluation. Screening for Infectious Diseases Skin and Intestinal Infections. Hepatitis A. Hepatitis B. Hepatitis C. HIV. Measles and Other Vaccine Preventable Diseases. Vaccinations in New Arrivals. Tuberculosis (TB). Syphilis. Malaria. Rarities. Conclusion References 32 Visiting Friends and Relatives Abstract Keywords Key points Introduction Who Are Visiting Friends and Relatives Travelers? Why Are Visiting Friends and Relatives a Risk Group for Travel-Related Illness? Epidemiology of Travel by Visiting Friends and Relatives Hepatitis A Enteric Fever Malaria Sexually Transmitted Infections and Bloodborne Viruses Tuberculosis in Ethnic Groups Other Infections Approaches to the Visiting Friends and Relatives Pretravel Consultation Improving Access to Pretravel Services Routine Immunizations Travel-Specific Immunizations Malaria Prevention General Travel Advice Conclusion Acknowledgment References Section 7: Travelers With Special Itineraries 33 Expatriates Abstract Keywords Key points Expatriates: Preparing and Caring Hidden Costs of Expatriation Premature Attrition Deaths, Accidents, and Injuries Predeparture Assessment The Purpose of Predeparture Medical Assessments Tuberculosis Skin Test Predeparture Psychologic Assessment Psychologic Interview. Psychologic Interview—When There Is No Time or Expertise. The Role of Psychometric Testing. Predeparture: Preparation Health Briefings Immunizations Hepatitis A and B. Japanese Encephalitis. Rabies. Malaria Rapid Diagnostic Testing. Diarrheal Diseases Sexually Transmitted Diseases Infection Control Policies Risk Behavior Security Issues and Evacuation Policies Psychologic Training and Preparation Information and General Counsel. Culture Shock and the U-Curve Hypothesis “Normal” Adjustment Difficulties Children Factors That Can Facilitate Cultural Adaptation Caring for Expatriates in International Settings Models of care that are utilized: Self-Care Telemedicine and the Internet Organizational Support Caring for Expatriates at the Time of Repatriation Returning Home Premature Repatriation and Medical Evacuation Who Requires a Medical Consultation on Return Home? Illness in Returning Expatriates Infectious Diseases Mental Health Factors Influencing Reintegration Issues for Families Easing Return References 34 The Migrant Traveler Abstract Keywords Key points Health Evaluation of Migrants Health Status of Migrants Infectious Diseases Tuberculosis. Chronic Viral Hepatitis. Human Immunodeficiency Virus. Intestinal Parasites Including Strongyloides and Schistosomiasis. Other Parasitic Infections. Immunizations Noncommunicable Diseases, Women’s Health, and Mental Health Noncommunicable Diseases. Women’s Health Issues. Mental Health Issues. Core Values and Best Practices in the Care of Immigrant Patients Optimizing Health During Pretravel and Posttravel Visits Conclusion References 35 Humanitarian Aid Workers Abstract Keywords Key points Introduction Mortality in Humanitarian Workers Morbidity in Humanitarian Workers Morbidity Among Rescue Teams and Volunteers Working in Acute Disaster-Stricken Areas Specific Diseases and Medical Conditions Malaria Tuberculosis Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Rabies Dental Care Mental Health Humanitarian Aid Workers—The Public Health Aspects Health Recommendations for the Relief Worker Traveling to Challenging Work Zones References 36 The Deployed Military Abstract Keywords Key points Introduction Noncombat-Related Injuries and Back Pain Combat-Related Injuries Psychiatric Disorders Malaria and Other Vectorborne Diseases Sexual Health Dermatologic Diseases Gastrointestinal and Respiratory Infections Conclusion Disclosure References 37 Expedition Medicine Abstract Keywords Key points Introduction Questions to Ask Risk Assessment and Preparation Personal Preparation First-Aid Kits Contents Design Supplies Liability On the Road Field Data Psychiatric Problems Polar Environments Mountaineering Desert Environments Jungle/Tropical Environments Kayaking and Rafting Scuba Diving Expeditions The Luxury Expedition Local Health Care Difficult Situations Medical Care of Others Safety and Security Repatriation Death Overseas Back Home Conclusion References 38 Ecotourism Abstract Keywords Key points Introduction Ecotourists Physical Risks Physical Risks From Other Species. Infectious Disease Risks Zoonotic Disease Risks. Risks to Other Species. Recommendations References 39 Medical Tourism Abstract Keywords Key points Introduction Medical Tourism Defined General Considerations Related to Medical Treatment Abroad Cosmetic Surgery Tourism Recommendations Dental Work Abroad Transplant Tourism Bariatric Tourism Reproductive Tourism Medications Adverse Effects and Complications Conclusions References 40 Cruise Ship Travel Abstract Keywords Key points Introduction The Cruise Industry The North American Cruise Industry The Passengers and Crew Cruise Health, Sanitation, and Safety Regulations International Regulations US Regulations Medical Care Aboard Cruise Ships Illness on Cruise Ships Respiratory Infections Influenza. Legionnaires Disease. Gastrointestinal Illness Waterborne Diseases. Foodborne Diseases. Norovirus. Miscellaneous Vaccine-Preventable Diseases (VPD) Injuries Seasickness Health Preparation and Prevention Measures for Cruise Travel in Large/Small Vessels Pretravel During Travel After Travel Conclusion Acknowledgment References 41 Mass Gatherings Abstract Keywords Key points Introduction Communicable Diseases Noncommunicable Diseases and Trauma Specific Mass Gatherings Hajj Pilgrimage Olympic Games, FIFA, and Other Sport Events Other Community Events Canceling Mass Gatherings Planning for Mass Gatherings Individual Pregathering Advice Conclusions References 42 High-Altitude Medicine Abstract Keywords Key points Introduction The High-Altitude Environment Acclimatization Effects of High Altitude on Exercise Sleep at High Altitude High-Altitude Syndromes High-Altitude Headache Epidemiology Pathophysiology of High-Altitude Headache Clinical Presentation and Diagnosis Treatment Prevention Acute Mountain Sickness and High-Altitude Cerebral Edema Epidemiology Pathophysiology of Acute Mountain Sickness/ High-Altitude Cerebral Edema Clinical Presentation and Diagnosis Treatment Prevention Preacclimatization High-Altitude Pulmonary Edema Epidemiology Pathophysiology Clinical Presentation and Diagnosis Treatment Prevention Other Altitude-Related Conditions Children at Altitude Acute Mountain Sickness Treatment Prevention Pulmonary Hypertension and High-Altitude Pulmonary Edema Treatment Prevention Periodic Breathing Travel Advice for Parents Effect of Altitude on Common Medical Conditions Pulmonary and Cardiac Problems Hematologic Disorders Neurologic Disorders Diabetes Ophthalmologic Conditions Obstetrics/Gynecology Psychiatric Conditions References Section 8: Environmental Aspects of Travel Medicine 43 Diving Medicine Abstract Keywords Key points Introduction Unique Environment and Physiologic Challenges The Ears, Nose, and Throat System and Diving Cardiovascular Fitness Respiratory Fitness Specific Considerations Asthma and Diving Diabetes and Diving Medication and Diving Age Aerobic Fitness and Watermanship Diving-Related Maladies Altitude Exposure After Diving Further Information and Advice Conclusion References 44 Extremes of Temperature and Hydration Abstract Keywords Key points Introduction “Normal” Body Temperature Monitoring Body Core Temperature Measuring Instruments. Measurement Sites. Thermoregulation Heat Balance Dry Heat Exchange Evaporative Heat Exchange (Sweating) Fever Environmental Conditions Assessment Heat Stress. Cold Stress. Acclimatization Heat Adaptation Cold Adaptation Steam Baths and Saunas Heat-Related Illnesses Heatstroke Pathophysiology. Early Presentation. Diagnosis. Clinical Picture. Treatment. Prognosis. Prevention. Other Heat-Related Concerns Heat Exhaustion. Heat Cramps. Heat Syncope. Heat Edema. Cold Injuries Hypothermia Diagnosis. Treatment. Complications Associated With Active Re-Warming. Frostbite Treatment. “Trench Foot” (Immersion Foot) Treatment. Chilblains Treatment. Preventing Cold Injuries Dehydration and Fluid Consumption Hypohydration Voluntary Dehydration Overhydration and Hyponatremia Isotonic Fluids (Sport Drinks) Rehydration Conclusion References 45 Jet Lag Abstract Keywords Definition Physiology Clinical Features Treatments Resetting the Clock Pretravel Sleep Schedule Adjustment. Sleep Schedule on Arrival. Light Therapy. Diet. Exercise. Melatonin and Melatonin Agonists (MMAs) for Resetting the Clock. Getting to Sleep (see Table 45.2) Hypnotics MMAs. Sedatives. Dual Orexin Receptor Antagonists (DORAs). Antihistamines. Antidepressants and Anxiolytics. Staying Awake Stimulants Caffeine. Amphetamines. Modafinil and Armodafinil. Nicotinamide Adenine Dinucleotide (NADH). Conclusion References 46 Motion Sickness Abstract Keywords Key points Introduction Triggers of Motion Sickness What Is Motion Sickness? Who Is Likely to Get Motion Sickness? What Is the Mechanism of Motion Sickness? The Vestibular System Nonmedicinal Prevention and Treatment Options Medications for Prevention and Treatment of Motion Sickness Treatment of Established Motion Sickness Adjunctive, New, and Experimental Agents Individualized Recommendations for Prevention or Treatment of Motion Sickness Conclusion References 47 The Aircraft Cabin Environment Abstract Keywords Key points Introduction The Pressurized Cabin Humidity Ozone Cosmic Radiation Pesticides in the Cabin Infectious Diseases and Cabin Air: Droplet and Airborne Spread Tuberculosis Influenza Measles Mumps Infectious Diseases and Contamination of Aircraft Interior Furnishings Ebola Virus, Middle East Respiratory Syndrome, and Other Intermittent Outbreaks of Concern to Air Travel Passenger Health Preflight Assessment and Medical Clearance Assessment Criteria Deep Vein Thrombosis and Prevention of Pulmonary Embolism Considerations of Physical Disability or Immobility Oxygen In-Flight Medical Emergencies Telemedicine Aircraft Emergency Medical Equipment Resuscitation Equipment Conclusions References Section 9: Health Problems While Traveling 48 Bites, Stings, and Envenoming Injuries Abstract Keywords Key points Introduction Nonvenomous Injuries Arthropod Bites Prevention of Arthropod Bites. Treatment of Arthropod Bites. Animal Attack Injuries Prevention of Animal Attack. Treatment of Animal Attack Injuries. Infection From Animal Attacks. Venomous Bites and Stings Prevention of Venomous Bites and Stings Venomous Arthropods Hymenoptera. Spiders and Scorpions. Venomous Reptiles Marine Animal Bites and Stings Prevention of Marine Animal Stings and Attacks Treatment of Marine Bites, Stings, and Attacks Marine Infections References 49 Seafood Poisoning Abstract Keywords Key Points Introduction Ciguatera Scombroid (Histamine Fish Poisoning) Pufferfish (Fugu) Poisoning Paralytic Shellfish Poisoning Neurotoxic Shellfish Poisoning Diarrheic Shellfish Poisoning Amnesic Shellfish Poisoning CONCLUSION References 50 Injuries and Injury Prevention Abstract Keywords Key points Introduction Fatal Injury Nonfatal Injuries A Global Public Health Approach for Travel Medicine Road Traffic Safety Seatbelts and Child Safety Seats Helmets Water-Related Injuries Alcohol as a Risk Factor Conclusion References 51 Mental Health Issues of Travelers Abstract Keywords Key points Introduction Sources of Stress in International Travel Epidemiology of Psychiatric Disorders and International Travel Clinical Operating Environments Overseas and Their Vicissitudes The Pretravel Risk Assessment Psychosis: Some Specifics and Relation to International Travel Mania Substance Use Disorders Relationship to International Travel. Posttravel Consultations References 52 Travelers’ Thrombosis Abstract Keywords Key points Introduction Venous Thrombosis Size of the Risk After Travel Factors Influencing the Risk Passenger-Related Risk Factors Travel-Related Risk Factors Mechanism Prevention Conclusions and Recommendations References 53 Health Care Abroad Abstract Keywords Key points Introduction* Risks of Needing Care Abroad Factors Influencing Development of Health Care Abroad Continued Globalism of Quality Growth of Medical Tourism Obtaining Care While Abroad Critical Incident Management Principles Preparation. Risk considerations. Health Care Resources. Self-care or buddy-care. Telemedicine services. Local physician offices/clinics. For-profit international health care organizations. Foreigners’ clinics. Hospital care. Planning for and Accessing Care. Self-care. Medical assistance plans. Other resources for locating care. Evacuation Issues Local Evacuation Issues Long-Distance Evacuation Paying for Care Critical Differences in Approaches to Health Care Abroad Cultural Differences Nursing Care No “Right to Care” Pharmacy and Medication Issues Conclusion References 54 Personal Security and Crime Avoidance Abstract Keywords Key points Introduction Before Departure Priorities Upon Arrival In the Hotel Out and About Taxis and Public Transport Theft Accidents Getting Sick Learn Local Regulations Early Mobile Phones and Electronic Devices Active Shooter Being a Hostage Conclusion References Section 10: Posttravel 55 Posttravel Screening Abstract Keywords Key points Introduction Who and When to Screen? Targeted Populations Asymptomatic Short-Term Traveler. Asymptomatic Long-Term Traveler or Expatriate. Asymptomatic Adventurous Traveler. Travelers With Self-Identified Risk Factors and/or Disease Symptoms During Travel. General Screening Medical Interview Physical Examination General Paraclinical Tests General Laboratory Tests. Blood Eosinophil Count. Abdominal Ultrasound. Resting Electrocardiogram. Specific Screening Tests in a Posttravel Evaluation Screening for Latent Tuberculosis Chest X-ray Tuberculin Skin Testing and Interferon-γ Release Assay Sexually Transmitted Infections Viral Hepatitis Dengue Zika. Foodborne Infections Screening for Parasitic Diseases Introduction. Strongyloidiasis. Schistosomiasis. (Neuro)cysticercosis. Other Intestinal Helminths. Invasive Amebiasis. Other Intestinal Protozoa. Infections With Blood-Dwelling or Tissue-Dwelling Parasites. Malaria. Leishmaniasis. Trypanosomiasis. Conclusions References 56 Fever in Returned Travelers Abstract Keywords Key points Introduction Epidemiology of Fever in Travelers Prevalence of Fever in Travelers Causes of Fever in Travelers Approach to the Patient With Fever The Travel and Exposure History Incubation Period Mode of Exposure Impact of Pretravel Vaccination Clinical Presentations Undifferentiated Fever Always Look for Malaria. Dengue. Chikungunya. Zika. Rickettsial Infections. Enteric Fever. Leptospirosis. Acute Schistosomiasis. Amebic Liver Abscess. Hemorrhagic Fevers Fever and CNS Changes Persistent and Relapsing Fevers Laboratory Clues Routine Laboratory Studies Elevated Liver Enzymes Fever and Eosinophilia Initial Diagnostic Workup Management Conclusion References 57 Skin Diseases Abstract Keywords Key points Epidemiological Data Dermatoses Diagnosed Abroad. Dermatoses Diagnosed Upon Return Tropical Dermatoses in the Traveler Hookworm-Related Cutaneous Larva Migrans Localized Cutaneous Leishmaniasis Myiasis Tungiasis Cutaneous Gnathostomiasis Other Tropical Dermatoses of Interest for Travelers Cosmopolitan Dermatoses Pyodermas Dermatophytosis Arthropod-Related Dermatoses Scabies Cercarial Dermatitis Sea-Bather’s Eruption Marine Life Dermatitis Photosensitivity and Photo-Induced Disorders Other Cosmopolitan Dermatoses of Interest to Travelers Diagnosis of a Skin Lesion in the Traveler Pruritus Creeping Eruption, Cutaneous Larva Migrans Urticaria Febrile Rash Edema Nodular Lymphangitis Sexually Transmitted Infections Conclusion References 58 Eosinophilia Abstract Keywords Key points Introduction Causes of Eosinophilia Overview Allergic Disorders/Asthma Drug Hypersensitivity Infection Helminths. Ectoparasites. Protozoa. Fungi. Other. Other Causes. Clinical Syndromes Skin/Soft Tissue Involvement Pulmonary Manifestations Gastrointestinal Symptoms Neurologic Disease Fever Other. Asymptomatic Eosinophilia Schistosomiasis. Filarial Infection. Strongyloidiasis. Hookworm Infection. Evaluation of Patients With Eosinophilia Approach to the Patient With Undiagnosed Eosinophilia Conclusion References 59 Respiratory Infections Abstract Keywords Key points Introduction Causative Agents and Clinical Presentation Epidemiology Risk Factors Transmission Management of Respiratory Tract Infections Prevention in Travelers Infections of the Respiratory Tract Associated With Epidemics Severe Acute Respiratory Syndrome Avian Influenza Influenza Middle East Respiratory Syndrome Coronavirus Legionellosis Tropical and Geographically Restricted Respiratory Infections Melioidosis Leptospirosis Anthrax Plague Paragonimiasis Coccidioidomycosis and Histoplasmosis Tuberculosis TB Among Travelers From Low-Endemic to High-Endemic Areas. Conclusion References Appendix Sources of Travel Medicine Information Key points Abstract Keywords Introduction Reference Texts Journals Travel Medicine Websites Point-of-Care Travel Clinic Destination Resources Electronic Discussion Forums Electronic Notifications and Feeds Index A B C D E F G H I J K L M N O P Q R S T U V W Y Z