CISTM8 President's Letter

Newsletter of the International Society of Travel Medicine 2003 January/February CISTM8 Only 4 months away! President’s Letter he International Society of Travel President’s Letter Medicine will hold its 8th regular January 2003 Tconference from May 7th to 11th, meeting in the United States for the first Dear Members, time in twelve years, and for the very first The year 2002 ended with a lot of uncertainties. The economic recession has time in New York City. Complete registra- hit many people, created great doubts about investments and reduced tion information is available on the website, www.istm.org. Participants may consumption. It has also decreased air traffic, and many airlines are facing register on-line, by fax or by mail. Hotel serious identity and economic crises, forcing some of them to restructure. reservations for the conference at the International terrorism is certainly not dead, and we are facing a possible headquarters hotel, the Marriott Marquis, war in the Middle East. in the heart of Times Square, may also be Is economic globalization to blame? Is the economy ruling the world made now. allowing no room for a sound social and political counterbalance to create The program includes not only discus- more long lasting and constructive development trends? Is our planet sions on classic travelers’ ailments such divided between good and bad nations? Can’t we find ways to increase as diarrhea, dengue, and yellow fever, but access to medicine for those who need it the most? will also look at more exotic issues. A ple- We in travel medicine know that globalization also brings good things. nary session will be devoted to extreme Easier access to travel allows people to meet, to discuss, and to discover and adventure travel and will be pre- sented by the medical director of the Ti- each other’s opinions and common interests. The amazing internet revolu- tanic Salvage Expedition. This session will tion permits individuals from all over the world to communicate and have include new prophylaxis and treatment access to information from the most remote places. Can’t this facilitate options in altitude-related illnesses. An mutual understanding instead of radicalization and oversimplification of expert from the King Fahad National the world’s diversity? Continued on page 9 Last October, in Shanghai, we met with Chinese colleagues and saw how dynamic they were in developing their country. By traveling and teaching overseas we discover new situations, other ways of experiencing questions Erratum. In the previous issue of and problems, and attempts to find innovative solutions to them. In the NewsShare, the article Psychological medical field we are in a unique position to make a difference and increase Aspects of Adventure Travel was initially awareness of situations which have to change. Let us see in our own modest posted without the author’s name. The field what we can do. One possibility is to make the travellers we see more author is David Shlim. We apologize for accountable and more responsible when they visit new countries, to make the omission. them respectful of the local people they meet. In New York we will launch a responsible traveller’s initiative to promote this. I would like to see the ISTM generate projects to improve the knowledge and competence of local medical professionals, not only for visiting travelers but also to improve the health of the local population. This can be a constructive contribution CISTM8 Only Four Months Away ... 1 within the modest means we have available. The ISTM board is working President’s Letter ...... 1 towards this, aware of its responsibility in this rapidly changing world. ISTM Certificate of Knowledge In the mean time, I wish you all a very fruitful and happy new year. May Exam Update ...... 2 2003 bring you the joy and achievements you wish for. I am also looking News from Around the World ...... 2 forward to seeing all of you in May in New York. Survival in the Tropical Rain Forests ...... 3 With my very best regards, Hiking the Inca Trail and the Dr. Louis Loutan Porters who Make it Possible ...... 6 President, ISTM Calendar ...... 7 Travel Medicine NewsShare 2003 January/February ISTM Certificate of Knowledge News from Around Exam Update the World

e’re now four months away from administering Australia – Meningococcal vaccine the first ISTM Certificate of Knowledge exam! Meningococcal C conjugate vaccine has The examination will be given on May 7, 2003, W been added to the Australian National the morning of the opening ceremony of CISTM8. All Immunization Program as of January 1st members should have received a Candidate Bulletin of 2003. The age groups approved for free Information (CBI) and exam application form with member- vaccination initially are the 1 - 5 and 15 - ship renewal packets, which were mailed out in late No- 19 year old groups, with varying catch- vember. If you did not receive a packet or would like a CBI up schedules in different States. The de- and application form, please email you name and postal ad- cision reflects the increasing incidence of dress to [email protected]. morbidity and mortality from the disease Fees for taking the exam and deadlines in which to register are listed below. Please note an in these age groups over the last few years. exam discount will be given to all those sitting for the examination who are also registered Whilst the risk of meningitis for short term for the conference! Physicians sitting for the exam will receive $100 U.S. back. Nurses, travelers to Australia is very low, longer pharmacists, physician assistants and others will receive $50 U.S. back. These payments term travelers should consider vaccina- will be made in cash immediately following the exam with proof of paid conference registration, especially under the age of 25 years tion. Please remember to bring your conference registration receipt with you to the exam- as the incidence is markedly higher in this testing site! age group. Three brands of vaccine effective against type C meningitis are avail- The examination, consisting of 200 single-answer, multiple-choice questions, will be given able (Baxter, Wyeth and Chiron). Travel- on May 7 from 8 a.m. – 12:45 p.m. at the Marriott Marquis Hotel. Check-in begins at 7 a.m. ers vaccinated with meningitis C vaccine, Everyone should be seated by 7:30 a.m. for pre-exam instructions. who require vaccination against other Please email any questions you have about the exam to [email protected]. We look forward serotypes should allow 6 months between to seeing you in New York in May! vaccinations. Sincerely, Dr Jonathan Cohen, Medical Director, Travel Clinics Australia, Melbourne. Phyllis Kozarsky on Behalf of the Exam Committee United Kingdom – More travel advice and fewer vaccinations are The fees for taking the ISTM Certificate of Knowledge needed. examination are as follows: The health risks associated with international travel range from minor symptoms to severe morbidity and death. In ISTM Members on or before January 31, 2003 2000, residents of the United Kingdom Physicians ...... $250.00 made 56.8 million visits abroad, 3.3 times Nurses, Pharmacists, Physician Assistants, Others ...... $125.00 the number made in 1980. Of all visits abroad, 72% were to countries in the Eu- ISTM Members on or after February 1, 2003 ropean Union and 9% were to North Physicians ...... $300.00 America. Nurses, Pharmacists, Physician Assistants, Others ...... $175.00 Hand in hand with an increase in travel we can expect a similar increase in travel Non-Members on or before January 31, 2003 related morbidity, and therefore a need for Physicians ...... $300.00 effective, accessible, and appropriate pre- Nurses, Pharmacists, Physician Assistants, Others ...... $175.00 travel health advice. We were encouraged by the recognition of travel medicine as

Non-Members on or after February 1, 2003 animportant role of the United Kingdom’s public health service. We were, however, Physicians ...... $350.00 disappointed at the review’s emphasis on Nurses, Pharmacists, Physician Assistants, Others ...... $225.00 Continued on page 3

“News from Around the World,” continued from page 2 Survival in Tropical Rain Forests vaccine preventable disease, including by Mel Otten, MD hepatitis A (81 cases in 2000), which from surveillance data provided by the Public ropical rain forests cover large but ever shrinking areas in the Americas, Africa and Health Laboratory Service shows a fall in Asia between latitude 25° North and 25° South. These forests have greater than cases over the 20 year period. Likewise, T250 centimeters or 100 inches of rain per year, with the rain fairly evenly distributed the number of cases of imported malaria throughout the year. (By comparison, deserts have less than 25 centimeters or 10 inches of has remained static over this time, despite rain per year.) The dominant organisms are trees of heights up to 90 meters (300 feet) with the threefold increase in travel. several layers of vegetation underneath. Each layer may contain its own variety of plant and animal life, and is the reason for the The Foreign and Commonwealth Office large number of organisms present. The terrain under the blanket The best consular report highlights 1843 deaths in of vegetation may be a flat river valley or high mountains, and United Kingdom residents abroad during often it is a combination of the two. The vegetation remains preparation

2001;road traffic accidents, drowning, and constant throughout the year, and vines and creepers make travel suicide were the commonest causes of very difficult. Mangrove and palm swamps, bamboo groves, and for hiking, death after medical causes. Diarrhea, al- savanna may also be present, making travel and navigation even thoughnot usually a cause of serious mor- more hazardous. But survival in rain forests is probably easier bird bidity, affects up to 70% of tourists on than it is in deserts, mountains, the arctic, or at sea. package holidays in tropical counties. watching, The principle hazards to humans in the rain forests are insects Risk assessment is important to rational- and rain. Motion pictures portray rain forests as having lots of canoeing ize pre-travel preparation, but the advice large animals such as tigers and jaguar, crocodiles and various needs to reflect the health risk and not venomous snakes. While these may, indeed, be present, they and other the interventions available. The empha- represent a very small danger when compared with the flies, mos- sis on vaccination for lowrisk travel may quitoes, ticks, leeches, fleas, ants, and centipedes. Also present activities in give a false sense of security and encour- are many irritating plants which may cause allergic dermatitis or age unsafeeating and drinking. Failing to painful puncture wounds. Nettles, rattan, thorns and bayonet a rain advise on the management of diarrhea, a grass may penetrate clothing and injure skin and eyes. Scratches, much more common event, may lead to abrasions, lacerations and macerated skin can become infected forest is to dehydration and admission to hospital. by bacteria, fungi, and other parasites. Morbidity associated with behavior –for Heat-related illnesses are common although not usually as se- get your example, sexually transmitted disease and vere as in the desert. The temperature on the forest floor seldom solar and skin associated problems, alco- exceeds 41° C (105° F), while desert temperatures often reach 50° body and holrelated traumas, and injuries from rec- (120°F). But the high humidity in rain forests can make sweating reational activities –up the main propor- ineffective and precautions should be taken to avoid heat stroke mind in tion of illness associated with travel. Pre- and heat exhaustion. Prickly heat, chafing from wet clothing and vention of these and the other diseases warm water and immersion foot are quite common, but usually good mentioned above requires effectiveadvice not life threatening. These may lead to cutaneous fungal infec- and good communication between trav- tions that are quite difficult to irradicate. condition. elers and their advisers. The emphasis on vaccinating travelers Preparing yourself for trips into rain forests rather than advising them is a widely held The best preparation for hiking, bird watching, canoeing and other activities in a rain misconception and needs to be corrected. forest is to get your body and mind in good condition. Walking on trails can be quite Health promotion and health education strenuous depending on the gradient and density of the vegetation. Aerobic conditioning need to be the focus of pre-travel consul- is a must. Upper body strength is especially valuable in the rare situations in which you tations. Risk assessment should be based become lost and must hack your way through undergrowth or climb over tree roots. on a broader view than administering drugs and vaccines. Becoming acclimatized to the heat and humidity will take several days at a minimum and, optimally, two to three weeks. Before setting off on a long trip, take short hikes to accus- BMJ 2003;326:52 ( 4 January) tom yourself to the noises, the insects, plants and difficult footing. Swimming is an invalu- N Hoveyda and Ron Behrens, London able survival skill and can save your life. Read as much about the area and memorize key School of Hygiene and Tropical Medi- terrain features from maps or charts. Know the common hazardous plants and animals and cine, Department of Infectious and Tropi- learn to identify them from field guides or have local residents point them out to you. cal Diseases, Clinical Research Unit, Continued on page 4 London

“Survival in Tropical Rain Forests,” continued from page 3

Learning about indigenous peoples, in- cause enough sweating to make you as ing a much larger kit that would contain cluding a few words of their language and wet as the rain would. A poncho is more as a minimum a jungle hammock, gill net, their customs is very important. This versatile and may allow more air to circu- machete with sharpening stone and file, gives you a better appreciation for the late, but generally is quite warm also. extensive first aid kit, extra clothing and area and helps establish good relations Carry a plastic bag or two to store extra boots, signal radio or ELT (emergency with the people who may have your sur- clothing. Most seasoned rain forest trav- locator transmitter), flares, food and cook- vival in their hands. File an itinerary with elers do not wear underwear as it does ing utensils. A 35mm aluminum film can a trustworthy person so rescuers will not dry as quickly as the outerwear and hold antimalarial tablets, antibiotics, and know where to begin looking for you if may cause chaffing and “jungle rot” or a few analgesic tablets. Use cotton to you do not return on time. tinea cruris. seal the top to absorb moisture.

Clothing Survival kit Survival Situations Necessities include long sleeves and long Carry quality, multipurpose first aid items, Administering first aid and getting to pants made from ripstop cotton, wide brim emergency shelter, tools, signal equip- safety are the first priorities in survival hat, mosquito head net and gloves. The ment, water, food, and navigational items. situations. Falling down a hillside or out tropical weight military issue trousers and The kit should be large enough to be com- of a canoe may be your introduction to jacket are ideal and are available in vari- plete yet small enough so that it can be rain forest survival. If you are in a plane ous colors and sizes. The trousers have on your person at all times. Obviously, or vehicle that may explode or catch fire, drawstrings on the legs to limit insect ac- carry the kit in a waterproof container or move away until you are sure it is safe. cess and have large cargo pockets which pack. Before each trip replace items used Basic first aid or medical care to the level are invaluable to any wilderness traveler. or damaged. Some of these items can be of expertise and equipment available The hat keeps off rain, sun and some in- carried in the pockets of the trousers or should be administered. If there are no sects while the gloves protect the hands jacket. Here is a basic list: immediate life threats, stop and take time from rattan, thorns and blisters. The mos- to survey the situation. Make note of your • pocketknife, Swiss Army type with quito headnet can be kept folded and assets, orient your map, inventory your lots of blades stored in a pocket when not needed. equipment, do whatever you can to avoid • canteen, 5 liters (5 quarts) collaps- Ankle high boots of synthetic nylon or panic. Panic can turn a relatively stable ible goretex and polypropylene or wool/ situation into a fatal one. • iodine crystals, for water purification polypropylene blend socks (at least two and cuts Shelter from insects and rain is your top pairs) are good foot protection. All cloth- • parachute cord, 15 meters (50 feet) priority. Protect all exposed skin with in- ing should be impregnated with insect re- • mosquito netting sect repellent and put on your mosquito pellent • compass head net. A lean-to type shelter can be High boots will help support the ankles • whistle made with a poncho and a length of para- and prevent the boots from being pulled • insect repellent chute cord. If a vehicle such as a plane or off in mud. Military jungle boots are high • bandaids automobile is available, use it for shelter. enough to tuck the pants legs in and have • waterproof matchbox It also may be a good source of tools and drain holes to allow water to drain. But • signal mirror equipment if you use your imagination such boots are heavy and not comfort- • sunscreen and improvise. A lean-to made by lean- able to walk in. Shoestrings should be • penlight ing palm fronds against a fallen tree may made from parachute cord to prevent rot • plastic bags be enough to protect you temporarily. If in the dampness. Change socks when- • map possible construct a sleeping area off of ever you stop. This also gives you a • safety pins the ground to protect yourself from crawl- chance to check for leeches and ticks. Air • fish hooks & line ing insects. This along with overhead pro- dry your feet and apply antifungal pow- • candy/peanut butter tection from the rain and your mosquito der. Tie the pair of socks that you remove • needles and thread netting will usually suffice as shelter. from your feet to the outside of your pack. • duct tape Water is readily available if you know At the next stop switch socks so that rela- • aluminum foil (.3 square meters (3 sq where to look. Obviously rivers, streams, tively dry socks are constantly worn. (Ob- ft) and lakes have water, but it must be puri- viously this system does not work in the All of these items fit in a relatively small fied either with iodine or by boiling. Many rain.) container that can be carried on the belt jungle plants contain potable water. For A goretex rain parka and trousers will keep along with the rain gear. Expedition travel example jungle lianas or vines contain off the rain but can be quite hot and may through remote areas necessitates carry- Continued on page 5

“Survival in Tropical Rain Forests,” continued from page 4 large amounts of water that can be ob- tained by first making a cut through the vine as high up as you can reach, then a cut as low as possible. The water will then flow from the top cut out the bottom cut and can be collected in a container or can be drunk directly from the vine. Many plants collect rain water, and bromeliads and bamboo will still have water trapped in them during dry periods. Do not drink milky or bitter plant fluid. Many formerly cultivated areas contain coconut palms that are excellent sources of fluid and nutrition, and the main exception to the “milky fluid” rule. There are a variety of plant foods available; banana, bamboo, cashew, taro, coconut, nipa, ferns, rattan, pili nut, man- goes, papaya, breadfruit and guavas. Learning to identify and preparing these plants beforehand will be time well spent. These plants can be a great supplement to a routine expedition diet. All rain forest animals are edible, but catching a monkey or wild pig, or know- ing what to do with a crocodile when you catch one can be a problem. Chances are where a distance of 100 yard can take Moving to a clearing will enhance your that you will not have a shot gun or rifle, hours. Avoid, if possible, areas along riv- chances of being seen from the air, but so go after the slower, less dangerous ers where vegetation is the thickest and natural clearings are difficult to locate from animals such as grubs, lizards, snakes and avoid high ridges, swamps and rattan; the ground. Clearing give a view of the fish. Cook all animal food thoroughly to travel in these areas will tire you out very sky and may serve as a landing zone for destroy parasites. After skinning and quickly. Go slow. Push aside vegetation helicopters and starting points for rescue gutting fish or lizards, wrap the meat in with a stick or cut it with a machete. Make teams. For these reasons travel may be aluminum foil or leaves along with a few frequent stops to check for attached in- the only option in a survival situation as vegetables and bake in hot coals. Insect sects and replenish lost fluids. Following opposed to remaining where you are in grubs and termite larvae can be found in game trails to rivers and then traveling the desert or arctic. Shining a signal mir- rotten logs and can be eaten raw, although down rivers by bamboo raft may be the ror in the direction of aircraft sounds or they are better cooked. best solution. Rivers often have villages toward the horizon may attract search and along them and rivers have an abundance rescue teams. Smoke from signal fires or Traveling through the rain forest can be of fish for food. Rivers also contain croco- flares may be used when aircraft are mov- extremely difficult and physically ex- diles, piranha, other dangerous fish and ing toward your position and a flashlight hausting. Before setting out, rest, drink rapids and waterfalls, so care must be can be used at night if a search craft is plenty of water, and eat what is available. taken. sighted. A compass is mandatory for navigation. Often the sun and stars cannot be seen Because of the thick canopy, signaling to Mel is the Director of the Division of Toxi- to give directions. If you do not have a rescuers is often a problem. Downed air- cology and Professor of Emergency Medi- map, hopefully you have memorized key craft, for example, are not easily seen from cine and Pediatrics at the University of terrain features such as roads, rivers, and the air. Smoke from flares or smudge fires Cincinnati, College of Medicine in Cin- villages when you were planning your may not penetrate the vegetation. A cinnati Ohio, USA. He is a past presi- trip. whistle or gunshot, although somewhat dent of the Wilderness Medical Society. muffled by the vegetation, can be heard a Trails and rivers make traveling easier than greater distance than a shout, but often trying to move through dense underbrush appear non-directional.

iking the Inca Trail is one of the nies relinquishing their responsibility most popular activities of travel- to feed their staff. ers to Peru. The trek usually takes H The porters’ pay is poor, and often they three to four days, and you will be able to have to pay for their own food and trans- enjoy the spectacular scenery of the port from this money. Furthermore, many Andean mountains. You will walk through companies expect that damaged or lost different ecological and climatic zones, equipment is to be paid for by porters at over high passes - up to 4200 meters - grossly inflated prices. This leaves very and through lush tropical forests, visit- little to take home to their families, some- ing beautiful ruins along the way. At the times nothing at all. end, your efforts will be rewarded with the breathtaking views of the ruins of • If you wish to give the porters a tip at Machu Picchu. For a trek such as this, the end of the trip, please be aware tents, gear and provisions have to be car- that tips given to the guide or cook for ried along and porters will be employed distribution to all is often not passed to carry the loads. offers). Tours that you may book from on. Similarly, any presents you may want to leave, such as warm clothing, You may already be aware of the porters’ home will still be delivered by a locally may be “collected” by supervisors working conditions in various other popu- contracted company. Generally, if you pay under the guise that the porters stole lar trekking areas such as the Himalayas. more, you find that a better porter to cli- it. Try to make clear that your gifts are The porters on the Inca Trail are mainly ent ratio is in place. However, it also meant for specific people. recruited from the poor peasant commu- means that additional items may be car- nities in the area, often leaving their farms ried such as toilet tents, folding chairs, Sick or injured porters may be left to their to supplement their meager incomes. They more food, and so on. Interestingly, the own devices and sent off the trail without work extremely hard to make your trail salaries paid to the porters are very low assistance. Porters have no insurance or experience memorable. On January 1, 2001, regardless of how much you pay for the assistance with medical costs. new regulations concerning the use of the trip. There are very responsible overseas • Please insist that sick or injured por- Inca Trail, including porter issues, were companies trying to minimize negative ters are looked after. launched. However, the implementation impacts of tourism on the hosts and to of these rules is not yet satisfactory. enforce rules related to fair treatment of Porters have little chance to complain local tourism workers. More expensive about unfair or exploitative treatment as As a responsible traveler, you may want operators may generally provide more for they would not be hired again. to know what you can do to support the the porters, but this is not automatically porters’ struggle for a ‘fair go’. The por- the case. Clients should still keep an eye • Please be kind to the porters. They are ters depend on this work, but some com- out for signs of maltreatment of porters. lovely people trying hard to make a panies treat them better than others. Be- living. If you notice anything on your low, you’ll find a few recommendations • Please try to book through reputable trip that you feel does not meet the that can help make their life a bit easier: companies rather than local standards of decent treatment of em- ‘cheapies’ which often use a very poor ployees, please report this to the local There is a load limit of 25 kg per porter porter to client ratio and leave the tour operator. Also report it to the over- imposed on the tour operators organiz- porters to fend for themselves. seas company, if you made your book- ing Inca Trail tours. However, this limit is ings in your home country. not enforced, making it virtually meaning- Many companies give porters minimal or less. no food, minimal or no fuel, and no shel- For more information on porters, visit the ter for the night. Porters are usually only web sites of organizations such as the • Please do not ask porters to carry your allowed to carry up to 5 kg for their own International Porter Protection Group backpack on top of their regular loads, needs. This means, they often go hun- (IPPG), www.ippg.net or Tourism Con- not even for additional payment. This gry, drink only cold water and sleep un- cern, www.tourismconcem.ora.uk/caml2ai would grossly exceed the permitted der boulders or tarpaulins. nsg /campaigns_porters.htm load limit. • If you have surplus food, perhaps you Irmgard is with the School of Nursing The costs of Inca Trail tours vary greatly want to share this on the trail. How- Sciences, James Cook University, from relatively expensive (often, reputable ever, this should not lead to compa- Townsville, Queensland, and writes fre- companies) to very cheap (local budget quently about travel medicine.

Note: This calendar is a service for members of ISTM. Listings are not necessarily endorsed by ISTM. Because of space limitations, meetings scheduled for 2004 and beyond will appear in the next issue of NewsShare.

Conferences Royal College of Physicians and Sur- Travel Medicine Short geons. Students may be invited to con- Course. London. April 7- 9th Swiss International tinue onto MSc in Travel Medicine 11, 2003. London School Short Course on Travel- through the University of Glasgow. Over- April of Hygiene and Travel lers’ Health. Basel, Swit- seas students particularly welcome to Medicine. Organizer: Feb zerland. February 24-28, 7-11 apply. Contact: Miss Amanda Burridge, Ron Behrens, M.D. For physicians and 2003. Comprehensive 24-28 Course Administrator, Travel Health De- nurses who provide pre-travel health ser- training in pre-travel advice, health prob- partment, Scottish Centre for Infection vices. Will provide general practitioners lems abroad, and the returning traveler. and Environmental Health, Clifton House, and practice nurses the opportunity to Under the patronage of the ISTM. For Clifton Place, GLASGOW, G3 7LN. Tel: develop and update their knowledge and physicians, nurses, other health profes- 0141 300 1132. Fax: 0141 300 1170. Email: skills in travel medicine. Course will run sionals and members of the travel indus- [email protected] Web Monday to Friday. Single day attendance try with strong interest in travel medicine. address: www.travelcourses.scieh. available. Course fee: £570. Day sessions: Official language: English. Swiss Tropi- scot.nhs.uk £155 per day session. Course PGEA ap- cal Institute, Course Secretariat, proved and CME accreditation requested. Socinstrasse 57, P.O. Box CH - 4002, Basel, Travel Medicine in the Contact: The Registry, London School of Switzerland. Tel: +41 61 284 82 80 Fax: +41 21st Century. Playa Con- Hygiene & Tropical Medicine, 50 Bedford 61 284 81 06 Email: [email protected] chal, Costa Rica, March Square, London WC1B 3DP. Tel: +44 (0)20 Web address: www.healthtraining.org/ March 22-26, 2003. Distin- 7299 4648. E-mail: shortcourses schools/basel/html#Crs1 guished faculty will dis- 22-26 @lshtm.ac.uk. Internet: http:// cuss the cutting-edge issues in travel Two-weekend Atten- www.lshtm.ac.uk. medicine. CME credits. Orvis Travel. His- dance Course in Travel toric Route 7A. Manchester, VT. USA CISTM8: 8th Conference Medicine with an 05254. (800) 547-4322. Email: of the International So- Feb 28 Interblock Self-study [email protected] Web address: ciety of Travel Medicine. Component. March www.orvis.com May New York. May 7-11, Johannesburg, South 2003. Leading experts Africa.2 February 28-March 2, 2003 and 10th Update: Travel and 7-11 from all parts of the world will present the May 9-11, 2003. Sponsored by the Uni- International Medicine. very latest in travel medicine. Many in- versity of the Witwatersrand, South Af- Seattle, USA. April 4-6, teractive sessions. Attendance qualifies rica in conjunction with James Cook Uni- April 2003. Lectures, expert for up to 21 hours of credit for Continu- versity, Australia. The two weekend panels, and workshops. 4-6 ing Medical Education. Contact: CISTM8 courses will be held at the WITS Univer- For physicians and nurses. Sponsor: Uni- Conference Secretariat: Talley Manage- sity in Johannesburg. Information: versity of Washington Continuing Medi- ment Group, Inc., 19 Mantua Rd. Mt. Michelle Shelby at sastm@worldonline cal Education. Contact: Sandy Pomerinke, Royal, NJ 08061 USA. Tel: (856) 423-7222 .co.za, Fax: +27(12) 347-4215. Web ad- 1325 Fourth Avenue, Suite 2000, Seattle, Ext 218. Fax: (856) 423-3420. Web address: dress: www.sastm.org.za WA 98101. Tel: 206-543-1050. Fax: 206- www.istm.org 221-4525. Email: [email protected] Postgraduate Diploma in Travel Medicine by Dis- March tance Learning. Glasgow, UK. March 10, 10, 03- 2003-February 2004. Year IMPORTANT DATES Feb 04 long, distance-learning Conference May 7-11, 2003 course for qualified medical practitioners, Regular Registration March 2003 nurses and other health care professionals with special interest in travel health. Abstract Submission January 2003 Diploma qualification awarded through Hotel Reservation March 2003

Foundation in Travel cine - pharmacists, microbiologists, Tropical Medicine Expe- Medicine by Distance nurses, and other health scientists. Lec- ditions to East Africa: 7th May Learning. Glasgow, UK. tures by leading specialists (Cuban and Expedition to Uganda, May 2003-October 2003. others) and visits to hospitals, research Feb February 2-February 14, 2003- Multidisciplinary six- laboratories, and community health cen- 2-14 2003 and 10th Expedition month course. Comprises ters. Lab training available on request in to Kenya, February 23-March 7, 2003. In Oct. four distance learning bacteriology& parasitology, and extra collaboration with the University of 2003 units of core material with module, public health. Official language: Nairobi and Dr. Kay Schaefer (MD, PhD, written assignments. Overseas students English. Medical education credits ap- MSc, DTM&H) Cologne, Germany. Offi- welcome. Contact: Miss Amanda plied for from Dutch accrediting authori- cial language: English. Two-week expedi- Burridge, Course Administrator, Travel ties. Course Coordinator: Peter de Beer, tion designed for limited number of phy- Health Department, Scottish Centre for MD; PO Box 1660;6201 BR Maastricht, sicians, public health experts and scien- Infection and Environmental Health, Netherlands. Email: [email protected] tists. Participants visit hospitals and Clifton House, Clifton Place, GLASGOW, and [email protected] Webadress of health projects in urban and rural areas. G3 7LN. Tel: 0141 300 1132. Fax: 0141 300 MST: www.tropenkliniek.nl IPK informa- Includes individual bedside teaching, 1170. Email: Tmdiploma@scieh tion: Director, Training programs, Dr. laboratory work, and lectures in epidemi- .csa.scot.nhs.uk Web address:www.travel Nereyda Cantelar see Webadress IPK : ology, clinical findings, diagnosis, treat- courses.scieh.scot.nhs.uk www.ipk. sld.cu ment and control of important tropical infectious diseases. Also, updates on 4th World Congress of Travel Medicine and visit to the “Flying Wilderness Medicine. Courses/Educational Travel. Doctors” headquarters in Nairobi. 50 con- Whistler, British Colum- The Gorgas Course in tact hours. Accredited certificate given. Aug bia. August 9-13, 2003. Clinical Tropical Medi- Contact: Dr. Kay Schaefer, Tel/Fax: +49- Held every four years by 9-13 cine Lima, and the Andes 221-3404905, E-Mail: contact@tropmedex the Wilderness Medical Society (WMS). Jan 27- and Amazon regions, .com Homepage: www.tropmedex.com For those working in wilderness medicine March Peru. Course scheduled and providing care in challenging areas for January 27- March 28, Update on Travel and around the world. Fairmont Chateau Whis- 2003,28 and for 2004. Sponsored by the Uni- Tropical Medicine. Siem tler. Contact: WMS, 3595 East Fountain versity of Alabama and the IAMAT Foun- Reap (Angkor Wat), Cam- Blvd., Suite A-1, Colorado Springs, CO dation. Includes lectures, case confer- Feb bodia. February 18-28, 80910. USA. Tel: +1-719-572-9255. Fax: +1- ences, diagnostic laboratory procedures, 18-28 2003. CME event spon- 719-572-1514. Web address: www.wms.org and bedside teaching in a 36-bed tropical sored by Centre for Travel and Tropical Medicine. Course organizer: Kevin C. Havana Travel &Tropical medicine unit. Official language: English. Kain, MD, FRCPC. Director, Centre for Medicine Course 2003. International Faculty. 380 contact Travel and Tropical Medicine, EN G-224, Havana, Cuba. November hours. Contact: David O. Freedman, M.D. Toronto General Hospital, 200 Elizabeth Nov 17-22, 2003. Organizer: Gorgas Memorial Institute, University of St. Toronto, ON, Canada M5G 2C4. Instituto de Medicina Alabama at Birmingham, 530 Third Av- 17-22 [email protected]. Information: Yue Tropical “Pedro Kouri” (IPK), Havana, in enue South, BBRB 203, Birmingham, AL Chi, Asia Adventures and Study Tours, collaboration with Medical Services for 35294. Fax: 205-934-5600 Or call: The Di- 455 Avenue Road, Suite 300, Toronto, ON, the Tropics (MST), Maastricht, Nether- vision of Continuing Medical Education Canada M4V 2J2 Tel. 416-322-6508 or 1- lands. For physicians - especially those at 800-UAB-MIST (U.S.) or 205-934-2687 866-564-1226. E-mail: info@ working in general practice, occupational, (from overseas). Email: [email protected] asiaadventures.ca aviation, tropical and public health medi- Web address: www.gorgas.org

“CISTM8 only 4 Months Away,” continued from page 1 ISTM STAFF ISTM EXECUTIVE BOARD PRESIDENT: Louis Loutan, M.D., Switzerland PAST-PRESIDENT: Charles Ericsson, M.D., USA COUNSELOR: Santanu Chatterjee, M.D., India COUNSELOR: David Freedman, M.D., USA COUNSELOR: Fiona Raeside Genasi, RN, UK COUNSELOR: Prativa Pandey, M.D., Nepal SECRETARY/TREASURER: Frank von Sonnenburg, M.D., Germany EDITOR, JOURNAL OF TRAVEL MEDICINE: Charles Ericsson, M.D., USA Guard Hospital in Saudi Arabia will dis- WEB EDITOR: Karl Neumann, M.D., USA cuss health care problems created by SPECIAL ADVISOR: Stephen Ostroff, M.D., USA large religious pilgrimages. Another ple- SPECIAL ADVISOR: Robert Steffen, M.D., Switzerland nary session will define the real risk of 7TH CISTM CHAIRPERSON: Frank von Sonnenburg, M.D., Germany travel versus risk perception. Some of the 8TH CISTM CHAIRPERSON: Bradley Connor, M.D., USA popular features at past meetings - Meet the Professor, Case of the Day, and Desti- ISTM COMMITTEE CHAIRS nation-specific Workshops - will be re- ELECTRONIC COMMUNICATIONS: David Freedman, M.D., USA peated. And special for this meeting will HEALTH OF MIGRANTS AND REFUGEES: Brian D. Gushulak MD., Canada be sessions on some of New York’s noto- HOST COUNTRIES: Santanu Chatterjee, M.D., India rious moments in health/travel history, INDUSTRY LIAISON: Robert Steffen, M.D., Switzerland including the last smallpox outbreak in MEMBERSHIP: Albie de Frey, South Africa New York City, vignettes about Typhoid LONG RANGE PLANNING: Michel Rey, M.D., France Mary, and quarantine issues of immi- PRACTICE AND NURSING ISSUES: Fiona Genasi, R.G.N., United Kingdom grants. PROFESSIONAL EDUCATION & TRAINING: Eli Schwartz, Israel PUBLICATIONS: Christoph Hatz, M.D., Switzerland The opening reception on Wednesday RESEARCH: Pat Schlagenhauf, M.D., Switzerland evening, May 7th, originally planned for TRAVEL INDUSTRY & PUBLIC EDUCATION: Bradley Connor, M.D., USA Ellis Island has been shifted to the Marriott Marquis’ glass-walled prom- ISTM SECRETARIAT enade overlooking the activity and lights of Broadway and Times Square. The shift ADMINISTRATIVE DIRECTOR: Susan Stokes, USA from Ellis Island resulted from the local ADMINISTRATIVE ASSISTANT: Brenda Bagwell, USA organizing committee reluctantly conclud- ing that arriving participants would pre- P.O. BOX 871089 fer not to have to transfer immediately to STONE MOUNTAIN, GA 30087-0028 USA a bus and ferry for the reception. This PHONE: 770-736-7060 exciting event, “Lights on Broadway/ FAX: 770-736-6732 Tastes of New York” will highlight the EMAIL: [email protected] various ethnic foods of New York City and will include music, dancing, and fes- tivities well into the evening. Japan: Yuka Ujita Two pre-meeting workshops on Wednes- Peru: Eduardo Gotuzzo day, May 7th, will cover gastrointestinal Editor: Karl Neumann, USA Philippines: Francois Ausseil and travel medicine questions in occupa- Assistant Editor: Eric Walker, UK Singapore: Helen M.L. Oh tion health. Assistant Editor: Peter Leggett, Australia Administrative Assistant: Camilo Benitez The Emory School of Medicine has des- Regional Editors: ISTM NewsShare ignated the conference as qualifying for Australia: Jonathan Cohen 108-48 70th Road up to 21 hours of credit for Continuing Colombia: Juan Gemot Forest Hills, NY, USA 11375 Hong Kong: Abu S. M. Abdullah Medical Education. Further details are Tel: 718-263-2072 India: Santanu Chaterjee available on the Web site. Fax:718-575-0290 Indonesia: Hanny G. Moniaga Please note that the hotel reservation cut- E-mail: [email protected] off date is April 16. © 2002 ISTM. All rights reserved. May not be reproduced without permission.