Vaccine terms and abbreviations
Preface
About the authors
Chapter 1 Principles of pre-travel health care
Understand the epidemiology of travel and travel-related conditions
Provide up-to-date information and advice
Start early
Allow sufficient time for the consultation
Individualise the advice
Identify high-risk travelers
Travellers with chronic conditions
Encourage personal responsibility for safe behaviour
Food and drink
Insects
Environmental exposures
Animal bits
Substance abuse
Sex
Oral contraceptive pill
Injury
Blood-borne infections
Consider costs
Provide written information
Recommend a medical kit
Recommend health insurance
Key readings
Chapter 2 Immunisation
Introduction to pre-travel vaccination
Categories of vaccines
Delay in vaccine doses
Simultaneous administration of different vaccines
Interaction between vaccines and tuberculin skin test
Interaction between vaccines and antimalarials
Interaction between vaccines and blood products
Interchangeability of vaccine products
Practical aspects of immunisation
Cholera
Disease
Epidemiology
Vaccine
Recommendations
Key readings
Diphtheria and tetanus
Background and epidemiology: diphtheria
Background and epidemiology: tetanus
Diphtheria- and tetanus-containing vaccines
Key readings
Hepatitis A
Disease
Epidemiology
Hepatitis A immunization
Recommendations
Combined hepatitis A and B immunization
Combined hepatitis A and typhoid immunization
Choice of hepatitis A vaccine
Immunoglobulin
Key readings
Hepatitis B
Epidemiology
Vaccines
Recommendations
Testing for immunity after immunisation
Management of non-responders
Key readings
Influenza
Epidemiology
Vaccine
Recommendations
Key readings
Japanese encephalitis
Disease
Epidemiology
Vaccines
Recommendations
Key readings
Measles, mumps and rubella
Background and epidemiology
Vaccine
Recommendations
Immune response and efficacy
Key readings
Meningococcal infection
Disease
Epidemiology
Vaccines
Recommendations
Key readings
Pertussis
Background and epidemiology
Vaccines
Recommendations
Immune response and efficacy
Key readings
Pneumococcal infection
Background and epidemiology
Vaccines
Key readings
Poliomyelitis
Epidemiology
Inactivated poliomyelitis vaccine (Salk-type or IPV)
Live oral poliomyelitis vaccine (Sabin-type or OPV)
Recommendations for travellers
Key readings
Rabies
Disease
Epidemiology
Vaccine
Pre-exposure vaccination
Recommendations
Post-exposure treatment
Key readings
Rotavirus infection
Background and epidemiology
Vaccines
Recommendations
Key readings
Tick-borne encephalitis
Disease
Epidemiology
Austrian and German vaccines
Russian and Chinese vaccines
Recommendations
Key readings
Tuberculosis
Disease
Epidemiology
Vaccine: BCG
Recommendations for BCG for travellers
Role of chest X-ray as a screening test
Summary
Key readings
Typhoid
Disease
Epidemiology
Vaccines
Recommendations for use of typhoid vaccines
Key readings
Varicella
Background and epidemiology
Vaccines
Recommendations
Immune response and efficacy
Key readings
Yellow fever
Disease
Epidemiology
Yellow fever vaccine (Stamaril)
Inactivated yellow fever vaccine
Recommendations
Key readings
Chapter 3 Malaria prevention
Introduction
Preventive measures
Awareness of risks
Early diagnosis and treatment
Minimising exposure to mosquitoes
Prophylactic drugs
General considerations
Drugs
How to choose malaria prophylaxis
Special situations
Recommendations
Standby emergency self-treatment
Drugs used for standby emergency self-treatment
Steps to take when prescribing SBET
Summary
Key readings
Chapter 4 Travellers’ diarrhoea
Incidence
Aetiology
Prevention
General measures
Water treatment
Vaccination
Management
Fluids
Food
Self-treatment
Treatment for prolonged diarrhoea
Chemoprophylaxis
Key readings
Chapter 5 Non-vaccine-preventable infectious problems
Destination
Types of activities
Infections acquired via ingestion
Vector-borne diseases
Diseases transmitted via recreational and occupational activities
Diseases transmitted via sexual or parenteral exposure
Specific infections
African trypanosomiasis (‘sleeping sickness’)
American trypanosomiasis (Chagas’ disease)
Amoebiasis
Brucellosis
Chikungunya virus
Ciguatera
Cutaneous larva migrans (CLM)
Dengue fever
Hepatitis E
Legionellosis (Legionnaires’ disease)
Leishmaniasis (cutaneous and visceral)
Leptospirosis
Lyme disease
Lymphatic filariasis, loiasis and onchocerciasis
Melioidosis
Myiasis (cutaneous)
Q fever
Rickettsial infections
SARS (severe acute respiratory syndrome)
Schistosomiasis (‘bilharzia’)
Strongyloidiasis
Viral haemorrhagic fevers
West Nile fever
Key readings
Chapter 6 Non-infectious problems
Fitness to fly
Air travel
Health effects of flying
Motion sickness
Incidence and risk factors
Symptoms and progression
Prevention
Medications
Recommendations
Treatment of established symptoms
Jet lag
Preparation
During the flight
On arrival
Melatonin
Key readings
Venous thrombosis and travellers
Background
Possible predisposing problems
What are the risks?
Recommendations for prophylaxis
Key readings
Altitude sickness
What is altitude sickness?
Incidence of altitude sickness
Normal symptoms at altitude
Acute mountain sickness (AMS)
Severe altitude sickness
Warning signs for travellers
Prevention
Drugs
Treatment
Altitude sickness in children
Key readings
Useful sources on the web
Chapter 7 Travellers with special needs
The pregnant traveller
Potential contraindications to travel
General advice
Air travel
Activities
Nausea and vomiting
Immunisation
Malaria
Food- and water-borne illness
Other infections
Childbirth
Breastfeeding
After delivery
Contraception
Key readings
Children
Immunisations
Travellers’ diarrhoea
Malaria
Special considerations
Key readings
Elderly travellers
Characteristics of elderly travellers
Pre-travel advice to elderly travellers
Key readings
Expatriates and long-term travellers
Health risks of expatriates
Preparation for the expatriate traveller
The pre-travel assessment
Immunisations
Malaria prevention
Diarrhoeal diseases
Sexually transmitted infections
Other infectious diseases
Other health risks
Conclusion
Key readings
Visiting friends and relatives
Pre-travel advice
Malaria
Hepatitis A
Other infections
Key readings
Travellers with cardiovascular problems
Patients with coronary artery disease
Severe angina or heart failure
Pacemakers
Key readings
Travellers with chronic lung disease
Air travel
Fitness to fly
Before travel
In-flight oxygen
During air travel
Key readings
Travellers with diabetes
General advice
Insulin dosage
Key readings
The HIV-infected traveller
General considerations
International travel restrictions
Immunisations
Malaria
Travellers’ diarrhea
Other infections
Preparation for possible illness
Key readings
The immunocompromised traveller
Forms of immune compromise
Immunisation
Malaria prevention
Travellers’ diarrhoea
Other health hazards
Preparation for possible illness
Key readings
The splenectomised traveller
Infections and asplenia
Bacterial infections
Antibiotic prophylaxis
Immunisation
Malaria
Tick bites
Key readings
Chapter 8 Health issues in returned travellers
Infections in travellers
Frequency of illness among travellers
History and physical examination
Evaluation of infections in returned travellers
Clinical syndromes
Fever
Some important diagnoses in febrile returned travellers
Diarrhoea
Respiratory infections
Skin problems
Neurological infections
Hepatitis
Screening the returned traveller who is well
Initial laboratory tests to consider in the unwell/febrile
Issues to consider in the unwell returned traveller
Key readings
Chapter 9 Resources for travel health information
Resources offering greater depth and detail
Resources offering more up-to-date information on changing risks
Surveillance and outbreak information
Medical journals
Resources for travellers themselves
Miscellaneous resources
Medical director
Appendix 1 Common travel destinations
Appendix 2 Countries: vaccine recommendations and rabies status
Appendix 3 Malaria risk by country and recommendations for
chemoprophylaxis
Appendix 4 Vaccines: Route, schedule, lower age limit, accelerated regimen
Appendix 5 Vaccine introduction and use in Australia
Maps
Global distribution of cholera
- Global distribution of Japanese encephalitis
- Global distribution of predominant meningococcal serogroups
- High risk areas for meningococcal meningitis
- Global distribution of hepatitis A
- Global distribution of hepatitis B
- Global distribution of poliomyelitis
- Global distribution of rabies
- Presence/absence of rabies as reported to WHO, 2007
- Global distribution of tuberculosis
- Yellow fever vaccine recommendations in Africa
- Yellow fever vaccine recommendations in the Americas
- Global distribution of malaria
- Geographic distribution of mefloquine-resistant malaria
- Relative rates of acquisition of gastrointestinal infection by destination
- Rates of parasitic pathogens per 1000 returned unwell travellers from a single region
- Rates of bacterial pathogens per 1000 returned unwell travellers from a single region
- Global distribution of schistosomiasis
- Estimated prevalence of HIV in people aged 15-49 years
- Global distribution of Chikungunya
- Global distribution of dengue
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