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Travel Medicine for Physicians

John Sinnott, MD, FACP Associate Dean, International Affairs Director, Division of Infectious Disease University of South Florida College of Medicine. Travel Medicine for Physicians. Let’s Look at Travel. Research Before Traveling:. Europe: www.ricksteves.com Elsewhere: Lonely Planet Guide

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Travel Medicine for Physicians

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  1. John Sinnott, MD, FACPAssociate Dean, International AffairsDirector, Division of Infectious DiseaseUniversity of South Florida College of Medicine Travel Medicine for Physicians

  2. Let’s Look at Travel

  3. Research Before Traveling: Europe: www.ricksteves.com Elsewhere: Lonely Planet Guide CIA World Fact Book www.cia.gov/cia/publications/factbook US Department of State http://travel.state.gov/travel/cis_pa_tw/tw/tw_1764.html Tourism information www.towd.com Medical kits and other travel products http://www.adventuremedicalkits.com/ http://www.travmed.com/ Do not leave the US without reading about your destination!

  4. Online Resources for the Traveler Travel Gear: www.magellans.com Passports: http://travel.state.gov/passport/passport_1738.html Visas: http://travel.state.gov/visa/visa_1750.html Tourism info: www.towd.com Airports/flights: http://www.flytecomm.com/cgi-bin/trackflight www.quickaid.com – general airport info Weather: www.worldclimate.com www.weather.com www.accuweather.com

  5. Online Resources for the Traveler Money: www.x-rates.com Communications: http://www.countrycallingcodes.com/ - International calling code directory North America: www.allareacodes.com www.frequentflyer.oag.com – toll-free number site with hotels, car-rentals, airlines, etc. Phone cards: www.nobel.com Electrical systems: www.kropia.com/electric.htm Foreign languages: www.babelfish.altavista.com Metric conversions: www.sciencemadesimple.com On the Ground: www.amtrak.com www.aaa.com http://subway.umka.org/

  6. IN GENERAL: Trauma - Cars, falls, swimming Social - Sex, drugs = hazards General - Label meds, travel light ID - Malaria, zoonoses Eating - Hot food served hot, CO H2O Wildlife - Avoid animals, insects

  7. SCOPE OF PROBLEM - Yearly 24M travel to developed areas 6M ill (25%) 6M travel to developing countries 3M ill (50%) 2M exposed to malaria Mortality: 3000 (.0015%) 2000 MVA 600 Falls 200 ID 100 Misc (CDC, 2008)

  8. BEFORE TRAVELING:“Think the trip through” Place Developing vs. industrialized Hotels vs. “roughing it” Season: weather, vectors Air: jet lag, URI Ship: LRI, diarrhea Altitude: HAPE, HACE

  9. “Bucket Shops” Global Touch - http://www.globaltouch.net/ - Offers consolidator tickets to travel agents and the public. Justfares.com - http://www.justfares.com - Offers flights online or via live agents. OZ Flights - http://www.ozflights.co.uk/ - Offers flights from UK to Australia and New Zealand. Corporate Flyer - http://www.flyfirstclass.com/ - Discounted business and first class international airline tickets. Flight Coordinators - http://www.flightcoordinators.com/ - Offers international flights from the US. Executive Class Travel - http://www.executivetravelservice.com - Offers discounts on first class and business class tickets.

  10. Travel Club International - http://www.unpublishedairfare.comSpecializing in unpublished airfare to Europe, South America & Asia. IBN United - http://www.ibnunited.com/Air consolidator to selected European and Middle East destinations. Holiday Deal Finder - http://www.holidaydealfinder.co.ukOffers both scheduled air and charter flights from UK airports. AirFareOutlet.ca - http://www.AirfareOutlet.caOffers Air from major Canadian gateways, to destinations around the world. Compares consolidator fares against published fares. BizTravelDeals.com - http://www.biztraveldeals.comOffers First class, and Business class, consolidator airfares to all global destinations. “Bucket Shops”

  11. Sky Bird Travel and Tours - http://www.skybirdtravel.com/Consolidators that supplies international airfares to travel agents. Airline Tickets Direct - http://www.airlineticketsdirect.comBooks flights to or from Canada with major Canadian airlines. DiscoveryWorld.com - http://www.discoveryworld.com/Offering airfares to Europe, Asia, Australia, Africa, South and Central America leaving from all major US gateways. Airtravel Network - http://www.airtravel.netProvides airfare to several international destinations “Bucket Shops”

  12. flyfirstclass.com • How to get a good seat!! Double secret information • Sign up for airline FF program • Go to seatguru.com • Pick three choices then call airline and negotiate

  13. Seatguru.com

  14. Books for the Traveler 300 Incredible Things for Travelers on the Internet, Ken Leebow $8.95 The Rough Guide to Travel Online (Rough Guides $11.99)

  15. Trauma

  16. Medical student, Dominican Republic

  17. SOS Card

  18. CHECKLIST: Labeled meds _______ Liquid meds and pastes in baggie _______ Xerox passport ( 6 mos) _______ Get Visa _______ RX eyeglasses _______ MD, phone # _______ MED evac insurance _______ Trip Insurance _______ Vaccine Card _______ Int’l Drivers License _______ Eyeshades_______

  19. CHECKLIST: Neck cushion _______ Ear plugs _______ Carry-on with UW and coat _______ Hat _______ Sunglasses _______ Label outside of passport with passport # _______ Magnifying glass and sterile needle _______ Leave irreplaceable valuables at home _______ VISA Photos _______ Snacks _______ Travel adapters _________

  20. Put all liquids and pastes in a clear bag for Transportation Security Administration. Label all medicines.

  21. Consider a travel vest

  22. Don’t bring medications without a label!

  23. Bring a color copy of your passport. Label the outside of your passport with your passport number

  24. Invest in a passport holder

  25. Traveling essentials

  26. Splinter removal and foot protection

  27. Sexually Transmitted Diseases Sense of anonymity Less inhibited Condoms often unused “Hooking up”

  28. Take enough medicine not just to treat yourself, but to treat fellow travelers

  29. Doctor’s Meds: I A-B Ampicillin-sulbactam Quinolone: Lo + Hi dose, Xifaxan Neosporin/cortisone otic qtts Quinolone eye qtts Z-Pak – 2 Tamiflu – course for each traveler Supplies Suture – 4-0/nylon Paper tape, 4x4’s Ace wrap

  30. Doctor’s Meds: II Analgesia Oxycontin or Hydrocodone Compazine Spansules Cox-2 [NSAID] G-I: Metoclopramide Anti-motility Skin: Steroids: topical and oral Misc: Long acting injectable steroid Meds for Jet Lag: armodefinil / zolpidem / melatonin debate

  31. Doctor’s Meds: III Motion: Isoptohyascine .025% qtts SL or scop patches, ? methylphenidate Chronic meds: Put in 2 places for complete trip Sleep meds: zolpidem

  32. Neck cushion, eye mask, headset, ipod, earplugs

  33. General Security& Safety Concerns

  34. U.S. Department of State http://travel.state.gov/

  35. VACCINES: HD YF Cholera Typhoid MMR Polio Rabies Hep B, A Plague Meningococcus HIB Influenza Pneumococcal Japanese B encephalitis Gamma globulin http://wwwnc.cdc.gov/travel/content/vaccinations.aspx

  36. CDC Vaccination Recommendations http://wwwnc.cdc.gov/travel/content/vaccinations.aspx

  37. MEDS: MEDICAL PROPHYLAXIS Location? Malaria – Malarone [atovaquone + proguanil], Mefloquine, Doxy GI – Quinolone vs. Xifaxan Misc - Doxy

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