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14Th International Congress on Infectious Diseases (ICID) Abstracts International Journal of Infectious Diseases (2010) 14S1, e2—e478 http://intl.elsevierhealth.com/journals/ijid 14th International Congress on Infectious Diseases (ICID) Abstracts Plenary 1 (Invited Presentation) Climate change, security issues, economic fluctuations, demographic shifts and the threat of emerging diseases will 01.001 also reshape the future of travel and mobility trends. All The Challenges of Travel Medicine in the 21st Century will influence travelers’ health and pose new challenges to travel medicine in the forthcoming decades. L. Loutan Geneva University Hospitals, Geneva, Switzerland doi:10.1016/j.ijid.2010.02.1476 Travel medicine has emerged as a new field of medicine, moving to an evidence based body of knowledge concerning ABC of travel medicine (I) (Invited Presentation) risk assessment and measures to protect the health of trav- 02.001 ellers. Most of travel medicine concentrates on tourists from Development of Travel Medicine in Latin America North America and Europe leaving for international destina- tions, many being low or middle income countries involving A. Lepetic a higher risk of acquiring infectious diseases. This paradigm is changing rapidly. With the increasing mobility of popu- GSK, Buenos Aires, Argentina lations, whether migrants, tourists, businessmen, students, No abstract received. soldiers, humanitarian workers, pilgrims, refugees or med- ical tourists, it is becoming evident that the diversification doi:10.1016/j.ijid.2010.02.1477 of globally mobile travelers is posing new challenges to the travel medicine community. Perception of risk, behaviour, 02.002 exposure to risks and access to health services vary enor- Approach to pre-travel consultation mously. Nonetheless all contribute to the global circulation and potential spread of known or emerging pathogens. From G. Acuna˜ an epidemiological and public health perspective a more Santiago, Chile global encompassing approach to health issues related to population mobility is urgently needed. La consejería pre-viaje debe considerar varios aspec- With globalisation new emerging economies are growing tos: la persona que consulta por lo general no está in many parts of the world, new patterns of travel and mobil- enferma, no entiende muy bien la necesidad de una consulta ity appear. The sharpest increases in travel are observed in médica. Asian and in Latin American regions where intra-regional and El Médico debe considerar condiciones del viajero (edad, in-country travel is rising. The majority of these new trav- sexo,posible embarazo, patologías previas y condiciones ellers are urban dwellers often unaware of the existing risks actuales, medicamentos que ingiere alergias, etc). gradients within their own country when they move to rural Es relevante el itinerario antes de llegar al destino y destinations. Thus travel medicine has to expand from the actividades en zona a visitar, condiciones de alojamiento, current international/across boarders approach to a prac- comida, y transporte. tice based on risk assessment analysis and prevention across El Centro debe contar con Vacunatorio ad-hoc, productos different prevalence gaps, wherever and for whomever they necesarios para profilaxis de Malaria, picadura de mosquitos, are of relevance. botiquín del viajero, purificadores de agua. 1201-9712/$32.00 doi:10.1016/j.ijid.2010.02.003 14th International Congress on Infectious Diseases (ICID) Abstracts e3 Se debe estar en conocimiento de la geografía del destino tury saw an increase in both anticipated and actual life y los posibles riesgos de salud y la maneras de prevenirlos expectancy figures, a phenomenon described as the ‘aging population’. In the year 2020, life expectancy at birth is pre- doi:10.1016/j.ijid.2010.02.1478 dicted to reach 70. Travel satisfies old age people needs for adventure in many ways. Most personal problems stem from 02.003 rushing to meet a schedule of pleasure and joy. And during Traveling with Kids travels everything is permitted, specially food and sedentary activities, most of them due to physical and health limits. C. Perret But how far can they go traveling? If they have to share Pontificia Universidad Catolica de Chile, Santiago, Chile their travel with prescribed medicines; diabetes; neurolog- ical problems; obesity and diets; vision and hearing loss; Travelling with kids is a great adventure that offers walking limitations versus jet lag; altitudes problems; air- opportunities for fun and to possibility to broaden ones cul- port/aircraft long stay/ pulmonary thromboembolism risks; tural outlook. But travel is not just fun, some risks related lazy attitudes during cruises; infection disease risks and to the travel exist and the whole family should be prepared adult immunization status. to prevent them or to have early treatment. Preparing a trip with kids involves considering several aspects, such as age, doi:10.1016/j.ijid.2010.02.1480 underlying diseases and destination. The main aspects we are going to review are: safety travel (motor vehicles, safety water and food, air travel, sun Epicenters of major diseases (I) (Invited Presenta- protection, motion sickness, high altitude, animal bites), tion) immunization, prevention of arthropods borne diseases and 03.001 diarrhea. Air transportation can produce boredom and ear pain. No pharmaceutical interventions have been proved to Central America and the Caribbean: Dengue and P.Vivax be good at preventing painful earache. Sedation is contro- malaria versial but if it is required, diphenhydramine is considered J. Torres a safe drug. Children should have their immunization schedule Tropical Medicine Institute, Caracas, Venezuela updated at the time of the trip. Insect borne disease can In recent decades, the incidence, distribution and clini- be prevented by using DEET repellents. DEET concentration cal severity of dengue have increased dramatically in most 30-35% is safe for use in children. It should not be applied tropical and subtropical areas worldwide. As a consequence, around the eyes, mouth or on the hands and forearms of and due to the expanding international tourism, health young children. Malaria chemoprophylaxis can be used in care providers in travel clinics of developed countries are children and are licensed for infants. increasingly confronted with dengue, reflecting its global Mefloquine, chloroquine and malarone are the alterna- impact. No specific prophylactic or therapeutic agents exist tives for children under 9 years old. for dengue infections. All four serotypes of dengue viruses Doxycicline can be used after that age. Maternal chemo- are widespread in Central America and the Caribbean basin. prophylaxis is not enough for breastfed infants. Difficulties Dengue is most common in cities but can be found in rural for children using chemoprophylaxis include bad taste, luck areas. It is rarely found in mountainous areas above 4,000 in pediatric preparations and toxicity risks. Diarrhea preven- feet. Dengue fever is the most common cause of fever in tion includes safety in water and food consumption. Therapy travelers returning to the USA from the Caribbean and Cen- should center on oral hydration. Self-treatment of trav- tral America. In some case studies, dengue has been the elers’ diarrhea with antibiotics should be considered, but second most common cause of hospitalization (malaria is antimotility agents should be avoided. Travel offers good the most common) among travelers returning from the trop- experiences for children and their families. Pre-travel eval- ics. Infection rates (based on anti-dengue serology) among uation and protective interventions can reduce the health febrile travelers returning from those areas may range from risks of travel. 2.9% to 8.0%. Similar results have been reported in travel- ers returning to Europe. Persons travelling to areas where doi:10.1016/j.ijid.2010.02.1479 dengue is endemic should avoid exposure to mosquitoes, 02.004 and health care providers should consider dengue as a dif- ferential diagnosis in febrile travelers returning from the The Elderly Traveler tropics after discounting malaria. Surveillance of imported S. Lemos Hinrichsen dengue is crucial to monitor the risk of infection for trav- elers and to strengthen clinical awareness of the disease. Universidade Federal de Peranbuco, and Universidade de The risk for a traveler acquiring malaria differs substantially Pernambuco, Sao Paulo, Brazil from different areas within the region and from traveler to Old age has been divided into different groups: biolog- traveler, even within a single country. In a large series of ical, physiological, emotional and functional. Advances in 10,745 cases of malaria among U.S. residents reported to science and technology, as well as improvements in health CDC from 1997 through 2006, 1,427 (13.3%) were acquired services available, have played an important role in the in the Caribbean and Centra/South America. Malaria has increasing number of elderly in the world. The 20 th cen- been reported in about 1 per 100,000 European travelers to Central America and the Caribbean. The risk of vivax e4 14th International Congress on Infectious Diseases (ICID) Abstracts malaria may be relatively high in some Central American graphic expansion into southeast, south and midwestern countries, including several large or middle size cities. Trav- region - Federal District, Goias, Sao Paulo, Minas Gerais, elers to malaria-risk areas, including infants, children, and Parana and Rio Grande do Sul states — related to out- former residents of Mexico and Central America, should take breaks in areas that were silent for several decades and an antimalarial drug. There is no chloroquine resistance in outside Amazon area. This study describes the re-emergence Central America, so this drug can still be recommended for of YF virus in enzootic cycles involving mosquitoes, pri- travelers to these countries. Malaria is not a risk in most of mates and humans cases in midwestern, southeast and the Caribbean islands, but P. falciparum is endemic to most south region during 2008 and 2009. During this period of Haiti and some areas of the Dominican Republic, where and explosive recording of monkey’s death was registry there is variable to low risk.
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