Personal General Health Care for The Traveler Before The Trip Pre-existing Medical Conditions
It is important that travelers have the best advice and care in planning for a productive and pleasant trip. If you plan to travel and have a pre-existing medical condition, consult a local medical doctor four to six weeks before departure; if possible, bring a brief medical history. It is beneficial to have your blood type identified, in case you need an urgent blood transfusion during your trip. Patients with chronic illness should bring an adequate supply of medication for the trip.
Optional / Recommended Vaccinations
The majority of vaccines are not required for entry into a country. The following vaccines are optional and/or recommended by the CDC depending on the prevalence of the disease in the country: - Diphtheria - Tetanus - Hepatitis A Prevention - Hepatitis B - Measles - Yellow Fever (required for entry into Uganda)
For a complete list and exhaustive descriptions of recommended vaccines, and for any questions, please visit www.cdc.gov Traveler’s First Aid Kit
At least some of the following items may prove useful during the trip:
Prescription Drugs (Consult your doctor to determine need) • anti-diarrheal medications—-diphenoxylate (Lomotil); loperarnide (Imodium) • trimethoprim-sulfamethoxazole (Bactrim, Septra) • anti-emetic suppository-prochlorper azine (Compazine) • motion sickness medication - meclizine (Antivert) or scopolamine discs (Transderm- scop) • sleeping pill (to combat jet lag) flurazepam (Dalmane) or triazolam (Halcion) Nonprescription Drugs • aspirin or acetaminophen in original container • antihistamintldecongestant (cold remedy) • bismuth subsalicylate——Pepto-Bismol® (suspension or tablets) • glucose-electrolyte powdered mix for dehydration (1~Iydra-Lyte or similar product) • water purification tablets or liquid additive • eye drops • antacids Topical Preparations • antibiotic ointment • insect repellant • calamine lotion • sunscreen • 0.5% cortisone cream (to relieve itching from insect bites or allergic dermatitis) • wound disinfectant Supplies • oral thermometer • scissors, razor blades • bandages, gauze, tape • safety pins • sterile disposable hypodermic needles and syringes • premoistened towelettes (wet-nap) During the Trip General Precautions
In order to maintain good health, be careful about the food and water you consume. Also, protect yourself against insect bites by using insect repellent. Also, learn and follow the local automobile and traffic safety rules for pedestrians. Be prepared to alter travel plans en route.
If you need medical care you can usually find medical care either by asking the hotel information staff or calling your country’s consulate for the names of recommended doctors. You will usually find English-speaking doctors at university hospitals or major hospitals.
• Avoid excessive food and alcohol intake. • Avoid prolonged sitting. • Medication: diphenhydramine, take as directed
The most common cause of traveler’s diarrhea, usually a self-limited illness of several days duration, is infection with bacterial organisms such as enterotoxinogenic E. Coli, shigella, salmonella, campylobacter and other bacteria. Viruses and parasites are less common causes of this disorder.
Travelers to areas where hygiene is poor are advised to avoid uncooked foods, unwashed salads, unpeeled fruit, and unboiled tap water including ice.
Oral rehydration is the cornerstone of the treatment of diarrhea. This can be accomplished by drinking water, tea, broth, or carbonated beverages. In severe cases, travelers may need commercial oral rehydration fluid or intravenous fluids.
It is most important to drink enough fluids to replenish the body’s loss of water, salt and sugar. Drink more than you think you lost. This compensates for loss of water through the skin or respiration. Commercial oral rehydration packets may be used to ensure more rapid absorption.
For watery diarrhea, taking bismuth subsalicylate (liquid Pepto-Bismol), 30 ml or two tablespoons every 30 minutes for up to eight doses may have benefit. If diarrhea is severe, accompanied by blood, mucus, fever and severe cramps, or lasts more than three days, consult a physician.
Early treatment with Bactrim is a reasonable alternative prophylaxis, but potential side effects such as a hypersensitiviiy reaction like skin rashes or hematologic reaction like agranulocytosis must be considered.
If the diarrhea persists or recurs, consult a physician and have stool checked for possible parasites.
Water / Food-Born Diseases
These diseases include: typhoid fever, hepatitis, amebiasis, roundworms, tape-worms, Guinea worm and other parasites. Preventive measures include avoiding the following sources:
Contaminated Water For safe drinking water, use any of the following methods: • Bottled water • Portable water purifier (usually available at sporting goods stores) • Chlorine: use CIorox: 4 drops/qt. water for 30 minutes • Iodine: 5 drops/qt. water. Let stand 30 minutes • Halazone tablets: water purification tablets • Boil water for 10 minutes
Ice Cubes: Avoid unless purified water was used.
Uncooked Vegtables and Fruit: • Wash well in clean or chlorinated water (as suggested above). • It is best if you peel fruits yourself after washing them.
Undercooked Meat and Poultry: • It is safer to cook them well, to kill any germs such as salmonella or parasites such as tapeworm.
Creamy Desserts, Cheeses, and Local Dairy Products: • Make sure they are not spoiled.
Motor vehicle accidents are the number one cause of overseas travel deaths. Always use a seat belt, and be aware of your surroundings.
AIDS (Acquired Immune-Deficiency Syndrome) is a contagious disease caused by an organism called Human Immuno-defidency Virus, or HIV for short. The disease destroys part of the body’s ability to build immunity to illness. This leaves the body unable to defend itself against infections and certain kinds of cancers. AIDS knows no geographic, social, racial, or cultural boundaries. However, you can protect yourself against this disease during your travels by knowing some simple rules. Fear of AIDS should not prevent travel to any part of the world.
HIV spreads more frequently through sexual activity. The virus can be transmitted from any infected person to his or her sexual partner. It is also spread by transfusion of infected blood, contaminated needles, or other skin-piercing and tattooing instruments. In addition, an AIDS-infected mother can transmit the virus to her child before, during or shortly after birth.
AIDS is not spread by casual contact such as by shaking hands, sitting next to someone or riding in the same vehicle or working with people affected by the virus. Nor is AIDS spread by insect bites or contact with animals.
AIDS is not spread by sharing facilities or equipment like swimming pools, bathrooms, doorknobs, and telephones. It is not spread by sharing food, cups, glasses, plates, water and air, touching or hugging, coughing, sneezing, or living with people with AIDS without sexual contact.
When traveling away from home, you can reduce the risk of serious injury, which may require blood transfusions, by taking ordinary, everyday precautions. Wear a seat belt and drive carefully.
If you are injured or ill, avoid or postpone any blood transfusion, unless it is absolutely required. In many places, before blood is used for transfusion, it is tested for AIDS virus contamination. If you need blood, try to ensure that screened blood is used. Since more and more countries around the world are now testing blood for the AIDS virus, blood transfusions will increasingly be protected from AIDS virus contamination.
Avoid injections for treatment, unless they are absolutely necessary. If you must have an injection, make sure the needle and syringe come straight from a sterile package or have been sterilized properly by steam, boiling water or chemicals). For example, a needle and syringe that have been cleaned and then boiled for 20 minutes will be safe for re-use.
You can protect yourself against AIDS——and therefore prevent AIDS——anywhere in the world. Don’t take risks during your travel that could send AIDS home with you. Since there is currently no cure and no vaccine for AIDS, education and prevention are our weapons to control AIDS and the HIV virus that causes it.
Heat Stroke and Heat Exhaustion
Avoid prolonged sun exposure, too much clothing and overly strenuous exercise in hot weather. Wear a hat, apply appropriate sunscreen, drink plenty of fluids, and get enough rest.
After the Trip Consult a medical doctor to assess any illness, especially fever, diarrhea, abdominal pain, weight loss, unusual skin lesions, or any significant change in general health. Inform the physician where and when you traveled to help him or her make the proper diagnosis.
LA CHERATECTOMIA FOTOTERAPEUTICA (PTK) NEL TRATTAMENTO DELLE EROSIONI CORNEALI RICORRENTI: CASE REPORT THE TREATMENT OF RECURRENT CORNEAL EROSION WITH PHOTOTERAPEUTIC KERATECTOMY (PTK): CASE REPORT Fioretto P*, Reccia R**, Maddaloni A* * Unità Operativa di Oculistica Casa di Cura “N.S. di Lourdes” ** Area Funzionale di Neuroftalmologia - Dipartimento di Scienze Oftalmologiche
DOBUTAMINE STRESS ECHOCARDIOGRAM BEING PREPARED FOR YOUR DOBUTAMINE STRESS ECHOCARDIOGRAM Your doctor has asked you to undertake a Dobutamine Stress Echocardiogram. This is an important test in helping your doctor reach a diagnosis for you. To make sure your test provides the best results, we would be grateful if you would:• Bring along this form together with the referral that your doct