International travel patterns and travel risks for stem cell transplant recipients.

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Mikati, Tarek; Griffin, Kenneth; Lane, Dakotah; Matasar, Matthew; Shah, Monika K

2015-01-01

Stem cell transplantation (SCT) is being increasingly utilized for multiple medical illnesses. However, there is limited knowledge about international travel patterns and travel-related illnesses of stem cell transplant recipients (SCTRs). An observational cross-sectional study was conducted among 979 SCTRs at Memorial Sloan Kettering Cancer Center using a previously standardized and validated questionnaire. International travel post SCT, pre-travel health advice, exposure risks, and travel-related illnesses were queried. A total of 516 SCTRs completed the survey (55% response rate); of these, 40% were allogeneic SCTRs. A total of 229 (44.3%) respondents reported international travel outside the United States and Canada post SCT. The international travel incidence was 32% [95% confidence interval CI 28-36] within 2 years after SCT. Using multivariable Cox regression analysis, variables significantly associated with international travel within first 2 years after SCT were history of international travel prior to SCT [hazard ratio (HR) = 5.3, 95% CI 2.3-12.0], autologous SCT (HR = 2.6, 95% CI 1.6-2.8), foreign birth (HR = 2.3, 95% CI 1.5-3.3), and high income (HR = 2.0, 95% CI 1.8-3.7). During their first trip, 64 travelers (28%) had traveled to destinations that may have required vaccination or malaria chemoprophylaxis. Only 56% reported seeking pre-travel health advice. Of those who traveled, 16 travelers (7%) became ill enough to require medical attention during their first trip after SCT. Ill travelers were more likely to have visited high-risk areas (60 vs 26%, p = 0.005), to have had a longer mean trip duration (24 vs 12 days, p = 0.0002), and to have visited friends and relatives (69 vs 21%, p travel was common among SCTRs within 2 years after SCT and was mainly to low-risk destinations. Although the overall incidence of travel-related illnesses was low, certain subgroups of travelers were at a significantly higher risk. Pre-travel

Muscular Sarcocystosis in travelers returning from Tioman Island, Malaysia — 2011

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In October 2011, the GeoSentinel global surveillance system for travel-related morbidity detected an unusual cluster of illnesses among travelers returning from Tioman Island, Malaysia. Complete information was received for 17 of 32 (53%) patients reported to GeoSentinel; 9 probable and 1 confirmed ...

Risk factors for psychological stress among international business travellers

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Striker, J.; Luippold, R. S.; Nagy, L.; Liese, B.; Bigelow, C.; Mundt, K. A.

1999-01-01

OBJECTIVES: This study investigated sources of self reported psychological stress among international business travellers at the World Bank, following up on a previous study showing that travellers submitted more insurance claims for psychological disorders. Hypotheses were that work, personal, family, and health concerns, as well as time zone travel, contribute to travel stress. METHODS: A travel survey was developed from focus groups and consisted of questions about these potential sources of travel stress. Surveys were sent to a random sample of staff, stratified by number of travel missions, age range, and sex. Canonical correlation analyses estimated the association between key survey items on sources of stress and two measures of travel stress. RESULTS: 498 staff completed the survey. More than a third reported high to very high travel stress. Correlations between predictors and travel stress showed that social and emotional concerns (such as impact of travel on family and sense of isolation) contributed the most to such stress, followed by health concerns, and workload upon return from travel. Surprisingly, time zone travel did not contribute to the self reported stress of these travellers. There were few modifiers of stress, although respondents suggested that a day of rest after travel and reduced workloads would help. CONCLUSIONS: The current study confirms clinical impressions about several correlates of travel stress. Similar research with travellers in other organisations could help to determine whether the findings from this study are valid and what measures can be taken to reduce the psychological health risks to travellers.   PMID:10450241

Dengue Virus Type 2 in Travelers Returning to Japan from Sri Lanka, 2017.

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Tsuboi, Motoyuki; Kutsuna, Satoshi; Maeki, Takahiro; Taniguchi, Satoshi; Tajima, Shigeru; Kato, Fumihiro; Lim, Chang-Kweng; Saijo, Masayuki; Takaya, Saho; Katanami, Yuichi; Kato, Yasuyuki; Ohmagari, Norio

2017-11-01

In June 2017, dengue virus type 2 infection was diagnosed in 2 travelers returned to Japan from Sri Lanka, where the country's largest dengue fever outbreak is ongoing. Travelers, especially those previously affected by dengue fever, should take measures to avoid mosquito bites.

What proportion of international travellers acquire a travel-related illness? A review of the literature.

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Angelo, Kristina M; Kozarsky, Phyllis E; Ryan, Edward T; Chen, Lin H; Sotir, Mark J

2017-09-01

As international travel increases, travellers may be at increased risk of acquiring infectious diseases not endemic in their home countries. Many journal articles and reference books related to travel medicine cite that between 22-64% of international travellers become ill during or after travel; however, this information is minimal, outdated and limited by poor generalizability. We aim to provide a current and more accurate estimate of the proportion of international travellers who acquire a travel-related illness. We identified studies via PubMed or travel medicine experts, published between January 1, 1976-December 31, 2016 that included the number of international travellers acquiring a travel-related illness. We excluded studies that focused on a single disease or did not determine a rate based on the total number of travellers. We abstracted information on traveller demographics, trip specifics, study enrollment and follow-up and number of ill travellers and their illnesses. Of 743 studies, nine met the inclusion criteria. The data sources were from North America (four studies) and Europe (five studies). Most travellers were tourists, the most frequent destination regions were Asia and Africa, and the median trip duration ranged from 8-21 days. Six studies enrolled participants at the travellers' pre-travel consultation. All studies collected data through either extraction from the medical record, weekly diaries, or pre- and post-travel questionnaires. Data collection timeframes varied by study. Between 6-87% of travellers became ill across all studies. Four studies provided the best estimate: between 43-79% of travellers who frequently visited developing nations (e.g. India, Tanzania, and Kenya) became ill; travellers most frequently reported diarrhoea. This is the most comprehensive assessment available on the proportion of international travellers that develop a travel-related illness. Additional cohort studies would provide needed data to more precisely

Virus isolation for diagnosing dengue virus infections in returning travelers

NARCIS (Netherlands)

Teichmann, D.; Göbels, K.; Niedrig, M.; Sim-Brandenburg, J.-W.; Làge-Stehr, J.; Grobusch, M. P.

2003-01-01

Dengue fever is recognized as one of the most frequent imported acute febrile illnesses affecting European tourists returning from the tropics. In order to assess the value of virus isolation for the diagnosis of dengue fever, 70 cases of dengue fever confirmed in German travelers during the period

Emergence of new Salmonella Enteritidis phage types in Europe? Surveillance of infections in returning travellers

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Andersson Yvonne

2004-09-01

Full Text Available Abstract Background Among human Salmonella Enteritidis infections, phage type 4 has been the dominant phage type in most countries in Western Europe during the last years. This is reflected in Salmonella infections among Swedish travellers returning from abroad. However, there are differences in phage type distribution between the countries, and this has also changed over time. Methods We used data from the Swedish infectious disease register and the national reference laboratory to describe phage type distribution of Salmonella Enteritidis infections in Swedish travellers from 1997 to 2002, and have compared this with national studies conducted in the countries visited. Results Infections among Swedish travellers correlate well with national studies conducted in the countries visited. In 2001 a change in phage type distribution in S. Enteritidis infections among Swedish travellers returning from some countries in southern Europe was observed, and a previously rare phage type (PT 14b became one of the most commonly diagnosed that year, continuing into 2002 and 2003. Conclusions Surveillance of infections among returning travellers can be helpful in detecting emerging infections and outbreaks in tourist destinations. The information needs to be communicated rapidly to all affected countries in order to expedite the implementation of appropriate investigations and preventive measures.

Assessing the risk of work-related international travel.

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Druckman, Myles; Harber, Philip; Liu, Yihang; Quigley, Robert L

2014-11-01

To identify factors affecting the likelihood of requiring medical services during international business trips. Data from more than 800,000 international trips and medical assistance cases provided to 48 multinational corporations in 2009. Travel destination countries were grouped into four a priori risk-related categories. Travel to "low" medical risk countries in aggregate accounted for more hospitalizations and medical evacuations than travel to "high" medical risk countries. Nevertheless, the risk per trip was much higher for travel to higher medical risk countries. Corporations with employees on international travel should allocate sufficient resources to manage and ideally prevent medical issues during business travel. Travel medicine must focus on more than infectious diseases, and programs are necessary for both high- and low-risk regions. Improved understanding of travel-related needs determines resource allocation and risk mitigation efforts.

Vaccination knowledge, attitude and practice among Chinese travelers who visit travel clinics in Preparation for international travel.

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Zhang, Min; Zhang, Jianming; Hao, Yutong; Fan, ZhengXing; Li, Lei; Li, Yiguang; Ju, Wendong; Zhang, Hong; Liu, Wei; Zhang, Mengzhang; Wu, Di; He, Hongtao

2016-06-01

Although international travel has become increasingly more common in main land China, few data are available on vaccination knowledge, attitude and practice (KAP) among Chinese travelers. In each of 14 International Travel Healthcare Centers (ITHCs) situated in mainland China 200 volunteers were recruited for a cross-sectional investigation by questionnaire on KAP related to travel vaccinations. For the evaluation the study subjects were grouped by demographic data, past travel experience, travel destination, duration of stay abroad, purpose of travel. Among the 2,800 Chinese travelers who participated in the study, 67.1% were aware of national and travel vaccination recommendations. The knowledge about vaccine preventable diseases was low. The most common sources (73.4%) of information were requirements by destination countries obtained in connection with the visa application, Chinese companies employing workers/laborers for assignments overseas, and foreign schools. The overall acceptance rate of recommended vaccines was 68.7%, but yellow fever was accepted by 99.8% of the participants when recommended. Among 81.1% respondents who recalled to have received vaccinations in the past, only 25.9% of them brought the old vaccination records with them to their ITHC consultations. The results indicate that increased awareness of the importance of pre-travel vaccination is needed among the travellers in order to improve their KAP. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

Executive summary of imported infectious diseases after returning from foreign travel: Consensus document of the Spanish Society for Infectious Diseases and Clinical Microbiology (SEIMC).

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Pérez-Arellano, José Luis; Górgolas-Hernández-Mora, Miguel; Salvador, Fernando; Carranza-Rodríguez, Cristina; Ramírez-Olivencia, Germán; Martín-Echeverría, Esteban; Rodríguez-Guardado, Azucena; Norman, Francesca; Velasco-Tirado, Virginia; Zubero-Sulibarría, Zuriñe; Rojo-Marcos, Gerardo; Muñoz-Gutierrez, José; Ramos-Rincón, José Manuel; Sánchez-Seco-Fariñas, M Paz; Velasco-Arribas, María; Belhassen-García, Moncef; Lago-Nuñez, Mar; Cañas García-Otero, Elías; López-Vélez, Rogelio

2018-03-01

In a global world, knowledge of imported infectious diseases is essential in daily practice, both for the microbiologist-parasitologist and the clinician who diagnoses and treats infectious diseases in returned travelers. Tropical and subtropical countries where there is a greater risk of contracting an infectious disease are among the most frequently visited tourist destinations. The SEIMC considers it appropriate to produce a consensus document that will be useful to primary care physicians as well as specialists in internal medicine, infectious diseases and tropical medicine who help treat travelers returning from tropical and sub-tropical areas with infections. Preventive aspects of infectious diseases and infections imported by immigrants are explicitly excluded here, since they have been dealt with in other SEIMC documents. Various types of professionals (clinicians, microbiologists, and parasitologists) have helped produce this consensus document by evaluating the available evidence-based data in order to propose a series of key facts about individual aspects of the topic. The first section of the document is a summary of some of the general aspects concerning the general assessment of travelers who return home with potential infections. The main second section contains the key facts (causative agents, diagnostic procedures and therapeutic measures) associated with the major infectious syndromes affecting returned travelers [gastrointestinal syndrome (acute or persistent diarrhea); febrile syndrome with no obvious source of infection; localized cutaneous lesions; and respiratory infections]. Finally, the characteristics of special traveler subtypes, such as pregnant women and immunocompromised travelers, are described. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

International business travel: impact on families and travellers.

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Espino, C M; Sundstrom, S M; Frick, H L; Jacobs, M; Peters, M

2002-05-01

Spouses and staff of the World Bank Group (WBG) were questioned about the impact of international business travel on families and travellers. Dependent variables were self reported stress, concern about the health of the traveller, and negative impact on the family. We hypothesised that several travel factors (independent variables) would be associated with these impacts. These travel factors had to do with the frequency, duration, and predictability of travel and its interference with family activities. Survey forms were developed and distributed to all spouses of travelling staff as well as a small sample of operational staff. Kendall's tau b correlation coefficients of response frequencies were computed with the data from scaled items. Written responses to open ended questions were categorised. Response rates for spouses and staff were 24% and 36%, respectively. Half the spouse sample (n=533) and almost 75% of the staff sample (n=102) reported high or very high stress due to business travel. Self reported spouse stress was associated with six out of eight travel factors. Female spouses, those with children, and younger spouses reported greater stress. Self reported staff stress was significantly associated with four out of nine travel factors. Further insight into how business travel affects families and staff (including children's behavioural changes) and how families cope was gained through responses to written questions. The findings support the notion that lengthy and frequent travel and frequent changes in travel dates which affect family plans, all characteristic of WBG missions, negatively affects many spouses and children (particularly young children) and that the strain on families contributes significantly to the stress staff feel about their travel. Policies or management practices that take into consideration family activities and give staff greater leeway in controlling and refusing travel may help relieve stress.

Health and well-being factors associated with international business travel.

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Burkholder, Justin D; Joines, Ron; Cunningham-Hill, Mark; Xu, Baowei

2010-01-01

International travel by US business travelers is continuing to increase with the globalization of the economy. The objective of this study was to determine if the frequency and duration of international business travel is associated with differences in travelers' health and well-being. This study expands our limited knowledge of the impact of long-haul travel on healthy lifestyle choices and traveler's perceptions of their health and well-being. 12,942 unique health risk appraisal (HRA) records of US employees of a multinational corporation were analyzed according to self-reported (objective and subjective) travel history and lifestyle habits. Comparing 2,962 international travelers and 9,980 non-travelers, international business travel was significantly associated with a lower body mass index, lower blood pressure, excess alcohol consumption, sleep deprivation, and diminished confidence to keep up with the pace of work. This study demonstrated both positive and negative associations on the health risks and well-being of a large sample of US-based international business travelers from an US multinational company. This study identifies targeted areas for pretrip screening and counseling to proactively address potential negative effects of travel and may assist in the design of corporate travel health and employee assistance programs. © 2010 International Society of Travel Medicine.

Travel and migration associated infectious diseases morbidity in Europe, 2008

NARCIS (Netherlands)

Field, Vanessa; Gautret, Philippe; Schlagenhauf, Patricia; Burchard, Gerd-Dieter; Caumes, Eric; Jensenius, Mogens; Castelli, Francesco; Gkrania-Klotsas, Effrossyni; Weld, Leisa; Lopez-Velez, Rogelio; de Vries, Peter; von Sonnenburg, Frank; Loutan, Louis; Parola, Philippe; Simon, Fabrice; Weber, Rainer; Cramer, Jakob; Pérignon, Alice; Odolini, Silvia; Carosi, Giampiero; Chappuis, François

2010-01-01

Europeans represent the majority of international travellers and clinicians encountering returned patients have an essential role in recognizing, and communicating travel-associated public health risks. To investigate the morbidity of travel associated infectious diseases in European travellers, we

Molecular diagnostics of Rickettsia africae infection in travelers returning from South Africa to The Netherlands

NARCIS (Netherlands)

Wieten, Rosanne W.; Hovius, Joppe W. R.; Groen, Emilie J.; van der Wal, Allard C.; de Vries, Peter J.; Beersma, Matthijs F. C.; Tijsse-Klasen, Ellen; Sprong, Hein; Grobusch, Martin P.

2011-01-01

African tick-bite fever (ATBF) is frequently diagnosed in The Netherlands in travelers returning from South Africa. It is caused by Rickettsia africae and diagnosis is based on travel history and clinical presentation and usually confirmed by detecting serum antibodies against rickettsiae of the

Diarrheagenic Escherichia coli and acute and persistent diarrhea in returned travelers

NARCIS (Netherlands)

Schultsz, C.; van den Ende, J.; Cobelens, F.; Vervoort, T.; van Gompel, A.; Wetsteyn, J. C.; Dankert, J.

2000-01-01

To determine the role of diarrheagenic Escherichia coli in acute and persistent diarrhea in returned travelers, a case control study was performed. Enterotoxigenic E. coli (ETEC) was detected in stool samples from 18 (10.7%) of 169 patients and 4 (3.7%) of 108 controls. Enteroaggregative E. coli

You, too, can be an international medical traveler: Reading medical travel guidebooks

NARCIS (Netherlands)

Ormond, M.E.; Sothern, M.

2012-01-01

Drawing on literature on self-help and travel guide writing, this paper interrogates five international medical travel guidebooks aimed at encouraging American and British audiences to travel abroad to purchase medical care. These guidebooks articulate a three-step self-help “program” to produce a

International Travelers' Sociodemographic, Health, and Travel Characteristics: An Italian Study.

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Troiano, Gianmarco; Mercone, Astrid; Bagnoli, Alessandra; Nante, Nicola

Approximately the 8% of travelers requires medical care, with the diagnosis of a vaccine-preventable disease. The aim of our study was to analyze the socio-demographic, health and travel characteristics of the Italian international travelers. We conducted a cross sectional study from January 2015 to June 2016, at the Travel Medicine Clinic of Siena, asking the doctor to interview patients who attended the Clinic, recording socio-demographic and travel information, malaria prophylaxis, vaccinations. The data were organized in a database and processed by software Stata®. We collected 419 questionnaires. Patients chose 71 countries for their travels; the favorite destinations were: India (6.31%), Thailand (6.31%), and Brazil (5.10%). The mean length of stay was 36.17 days. Italians, students, and freelancers tended to stay abroad for a longer time (mean: 36.4 days, 59.87 days and 64.16 days respectively). 33.17% of our sample used drugs for malaria chemoprophylaxis: 71.9% of them used Atovaquone/Proguanil (Malarone®), 26.6% used Mefloquine (Lariam®), 1.5% other drugs. The vaccinations that travelers mostly got in our study were to prevent hepatitis A (n = 264), the typhoid fever (n = 187), the Tetanus + Diphtheria + Pertussis (n = 165), the Yellow fever (n = 118) and the cholera (n = 78). Twenty-eight (6.68%) refused some recommended vaccinations. The vaccines mostly refused were for Typhoid fever (n = 20), hepatitis a (n = 9), and cholera (n = 9). Our results demonstrated that Italian international travelers are at-risk because of their poor vaccinations adherence. This implies that pre-travel counseling is fundamental to increase the knowledge of the risks and the compliance of future travelers. Copyright © 2016 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Knowledge, attitudes, and practices evaluation about travel medicine in international travelers and medical students in Chile.

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Guerrero-Lillo, Lisette; Medrano-Díaz, Jorge; Pérez, Carmen; Chacón, Rodrigo; Silva-Urra, Juan; Rodriguez-Morales, Alfonso J

2009-01-01

Because information about travel medicine in Chile is lacking, a knowledge, attitudes, and practices evaluation in international travelers and medical students was done. The travelers and medical students did not know the travel medicine and sanitary conditions of their destinations, although they perceived travel-associated health risks, but <10% had any vaccination and 5% got sick during international trips.

Management of infections in critically ill returning travellers in the intensive care unit—I: considerations on infection control and transmission of resistance

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Hakan Leblebicioglu

2016-07-01

Full Text Available Depending on their destinations and activities, international travellers are at a significant risk of contracting both communicable and non-communicable diseases. On return to their home countries, such travellers may require intensive care. The emergence of severe acute respiratory syndrome coronavirus (SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV, and more recently Ebola haemorrhagic fever, has highlighted the risks. Other well-known communicable pathogens such as methicillin-resistant Staphylococcus aureus and carbapenemase-producing Enterobacteriaceae have been described previously. However, malaria remains by far the most important cause of death. The issues related to imported antibiotic resistance and protection from highly contagious diseases are reviewed here. Surveillance strategies based on epidemiological data (country visited, duration of travel, and time elapsed since return and clinical syndromes, together with systematic search policies, are usually mandatory to limit the risk of an outbreak. Single-bed hospital rooms and isolation according to symptoms should be the rule while awaiting laboratory test results. Because person-to-person contact is the main route of transmission, healthcare workers should implement specific prevention strategies.

Health hazards of international travel.

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Cossar, J H; Reid, D

1989-01-01

The growth of travel and the increasing numbers of those affected by travel-related illnesses, some of a serious nature, will cause this subject to demand the attention of the medical profession, the travel trade, travellers themselves and the health authorities of countries receiving tourists. Provision of appropriate advice for the traveller is a shared responsibility, best channelled mainly through travel agencies; it can moreover be shown to be cost-beneficial. Continued monitoring of illness in travellers and provision of information systems geared to this problem and its prevention are fully justified. They should be based on traditional channels of communication and currently-available modern technology, and be readily accessible to medical and related workers. Increased collaboration between medical workers, health educators and those involved in the travel trade would be a positive and useful contribution towards the reduction of illness and discomfort among travellers and the associated expense incurred by the various national health services concerned. There are clearly economic benefits from the development of international tourism, but these have to be balanced in countries accepting tourists by attention to the prevention of illnesses associated with travel.

First Imported Case of Chikungunya Virus Infection in a Travelling Canadian Returning from the Caribbean

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Christian Therrien

2016-01-01

Full Text Available This is the first Canadian case of Chikungunya virus (CHIKV infection reported in a traveller returning from the Caribbean. Following multiple mosquito bites in Martinique Island in January 2014, the patient presented with high fever, headaches, arthralgia on both hands and feet, and a rash on the trunk upon his return to Canada. Initial serological testing for dengue virus infection was negative. Support therapy with nonsteroidal anti-inflammatory drugs was administered. The symptoms gradually improved 4 weeks after onset with residual arthralgia and morning joint stiffness. This clinical feature prompted the clinician to request CHIKV virus serology which was found to be positive for the presence of IgM and neutralizing antibodies. In 2014, over four hundred confirmed CHIKV infection cases were diagnosed in Canadian travellers returning from the Caribbean and Central America. Clinical suspicion of CHIKV or dengue virus infections should be considered in febrile patients with arthralgia returning from the recently CHIKV endemic countries of the Americas.

Recommended vaccines for international travelers to India.

Science.gov (United States)

Verma, Ramesh; Khanna, Pardeep; Chawla, Suraj

2015-01-01

India's tourism industry generated 6.6% of the nation's Gross Domestic Product (GDP) during 2012. International travel to India is predicted to grow at an average annual rate of ∼ 8% over the next decade. The number of foreign tourists has increased by 9% to 5.8 million. Approximately 8% of travelers to developing countries require medical care during or after travel; the main diagnoses are vaccine-preventable diseases. Travelers to India can be exposed to various infectious diseases; water-borne, water-related, and zoonotic diseases may be imported to India where the disease is not endemic. The World Health Organization (WHO) emphasizes that all international travelers should be up to date with routine vaccinations. The recommended vaccinations for travelers to India vary according to the traveler's age, immunization history, existing medical conditions, duration, legal requirements for entry into countries being visited, travelers preferences, and values. Travelers should consult with a doctor so that there is sufficient time for completion of optimal vaccination schedules. No matter where traveling, one should be aware of potential exposure to certain organisms that can cause severely illnesses, even death. There is no doubt that vaccines have reduced or virtually eliminated many diseases that killed or severely disabled children and adults just a few generations ago. Thus, travelers must take recommended vaccines per schedule before traveling to India.

Travel and migration associated infectious diseases morbidity in Europe, 2008

NARCIS (Netherlands)

Field, V.; Gautret, P.; Schlagenhauf, P.; Burchard, G.D.; Caumes, E.; Jensenius, M.; Castelli, F.; Gkrania-Klotsas, E.; Weld, L.; Lopez-Velez, R.; de Vries, P.; von Sonnenburg, F.; Loutan, L.; Parola, P.

2010-01-01

Background: Europeans represent the majority of international travellers and clinicians encountering returned patients have an essential role in recognizing, and communicating travel-associated public health risks. Methods: To investigate the morbidity of travel associated infectious diseases in

Nocardia transvalensis keratitis: an emerging pathology among travelers returning from Asia

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Trichet Elodie

2011-10-01

Full Text Available Abstract Background The incidence rate of Nocardia keratitis is increasing, with new species identified thanks to molecular methods. We herein report a case of Nocardia transvalensis keratitis, illustrating this emerging pathology among travellers returning from Asia. Case presentation A 23-year-old man presented with a 10-week history of ocular pain, redness, and blurred vision in his right eye following a projectile foreign body impacting the cornea while motor biking in Thaïland. At presentation, a central epithelial defect with a central whitish stromal infiltrate associated with pinhead satellite infiltrates was observed. Identification with 16S rRNA PCR sequencing and microbiological culture of corneal scraping and revealed N. transvalensis as the causative organism. Treatment was initiated with intensive topical amikacin, oral ketoconazole and oral doxycycline. After a four-week treatment period, the corneal infiltrate decreased so that only a faint subepithelial opacity remained. Conclusion Nocardia organisms should be suspected as the causative agent of any case of keratitis in travelers returning from Asia. With appropriate therapy, Nocardia keratitis resolves, resulting in good visual outcome.

Nocardia transvalensis keratitis: an emerging pathology among travelers returning from Asia.

Science.gov (United States)

Trichet, Elodie; Cohen-Bacrie, Stéphan; Conrath, John; Drancourt, Michel; Hoffart, Louis

2011-10-31

The incidence rate of Nocardia keratitis is increasing, with new species identified thanks to molecular methods. We herein report a case of Nocardia transvalensis keratitis, illustrating this emerging pathology among travellers returning from Asia. A 23-year-old man presented with a 10-week history of ocular pain, redness, and blurred vision in his right eye following a projectile foreign body impacting the cornea while motor biking in Thaïland. At presentation, a central epithelial defect with a central whitish stromal infiltrate associated with pinhead satellite infiltrates was observed. Identification with 16S rRNA PCR sequencing and microbiological culture of corneal scraping and revealed N. transvalensis as the causative organism. Treatment was initiated with intensive topical amikacin, oral ketoconazole and oral doxycycline. After a four-week treatment period, the corneal infiltrate decreased so that only a faint subepithelial opacity remained. Nocardia organisms should be suspected as the causative agent of any case of keratitis in travelers returning from Asia. With appropriate therapy, Nocardia keratitis resolves, resulting in good visual outcome.

International travelers with infectious diseases determined by pathology results, Centers for Disease Control and Prevention - United States, 1995-2015.

Science.gov (United States)

Angelo, Kristina M; Barbre, Kira; Shieh, Wun-Ju; Kozarsky, Phyllis E; Blau, Dianna M; Sotir, Mark J; Zaki, Sherif R

2017-09-01

The failure to consider travel-related diagnoses, the lack of diagnostic capacity for specialized laboratory testing, and the declining number of autopsies may affect the diagnosis and management of travel-related infections. Pre- and post-mortem pathology can help determine causes of illness and death in international travelers. We conducted a retrospective review of biopsy and autopsy specimens sent to the Infectious Diseases Pathology Branch laboratory (IDPBL) at the Centers for Disease Control and Prevention (CDC) for diagnostic testing from 1995 through 2015. Cases were included if the specimen submitted for diagnosis was from a traveler with prior international travel during the disease incubation period and the cause of illness or death was unknown at the time of specimen submission. Twenty-one travelers, six (29%) with biopsy specimens and 15 (71%) with autopsy specimens, met the inclusion criteria. Among the 15 travelers who underwent autopsies, the most common diagnoses were protozoal infections (7 travelers; 47%), including five malaria cases, followed by viral infections (6 travelers; 40%). Biopsy or autopsy specimens can assist in diagnosing infectious diseases in travelers, especially from pathogens not endemic in the U.S. CDC's IDPBL provides a useful resource for clinicians considering infectious diseases in returned travelers. Published by Elsevier Ltd.

Health risks, travel preparation, and illness among public health professionals during international travel.

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Balaban, Victor; Warnock, Eli; Ramana Dhara, V; Jean-Louis, Lee Ann; Sotir, Mark J; Kozarsky, Phyllis

2014-01-01

Few data currently exist on health risks faced by public health professionals (PHP) during international travel. We conducted pre- and post-travel health surveys to assess knowledge, attitudes, and practices (KAP), and illnesses among PHP international travelers. Anonymous surveys were completed by PHP from a large American public health agency who sought a pre-travel medical consult from September 1, 2009, to September 30, 2010. Surveys were completed by 122 participants; travelers went to 163 countries. Of the 122 respondents, 97 (80%) reported at least one planned health risk activity (visiting rural areas, handling animals, contact with blood or body fluids, visiting malarious areas), and 50 (41%) reported exposure to unanticipated health risks. Of the 62 travelers who visited malarious areas, 14 (23%) reported inconsistent or no use of malaria prophylaxis. Illness during travel was reported by 33 (27%) respondents. Most of the PHP travelers in our study reported at least one planned health risk activity, and almost half reported exposure to unanticipated health risks, and one-quarter of travelers to malarious areas reported inconsistent or no use of malaria chemoprophylaxis. Our findings highlight that communication and education outreach for PHP to prevent travel-associated illnesses can be improved. Published by Elsevier Ltd.

Risk factors and pre-travel healthcare of international travellers attending a Dutch travel clinic: a cross-sectional analysis

NARCIS (Netherlands)

Wieten, Rosanne W.; van der Schalie, Maurice; Visser, Benjamin J.; Grobusch, Martin P.; van Vugt, Michèle

2014-01-01

The number of international travellers is currently estimated to exceed one billion annually. To address travel related health risks and facilitate risk reduction strategies, detailed knowledge of travellers' characteristics is important. In this cross-sectional study, data of a 20% sample of

First report of Nocardia asiatica olecranon bursitis in an immunocompetent traveler returning to Austria.

Science.gov (United States)

Leitner, Eva; Valentin, Thomas; Hoenigl, Martin; Lanz, Philipp; Flick, Holger; Zollner-Schwetz, Ines; Grisold, Andrea J; Feierl, Gebhard; Krause, Robert

2013-07-01

Nocardia spp. are rarely isolated in extrapulmonary clinical specimens. We describe the first case of olecranon bursitis caused by Nocardia asiatica. The patient, a traveler returning from Thailand, was successfully treated with linezolid.

A travel clinic in your office: grow your practice and protect international travelers.

Science.gov (United States)

Kirsch, Michael

2009-01-01

Medical practices today face economic challenges from declining reimbursements and rising overhead costs. Physicians need to develop new income sources to invigorate their practices and remain viable. Travel medicine-advising and immunizing international travelers-is a rapidly growing specialty in the United States that generates substantial cash reimbursements and professional satisfaction. Travel Clinics of America, a physician-operated company, specializes in helping physicians to incorporate travel medicine into their existing practices.

Travelers' health problems and behavior: prospective study with post-travel follow-up.

Science.gov (United States)

Vilkman, Katri; Pakkanen, Sari H; Lääveri, Tinja; Siikamäki, Heli; Kantele, Anu

2016-07-13

The annual number of international tourist arrivals has recently exceeded one billion, yet surprisingly few studies have characterized travelers' behavior, illness, and risk factors in a prospective setting. Particularly scarce are surveys of data spanning travel, return, and follow-up of the same cohort. This study examines behavior and illness among travelers while abroad, after return home, and at follow-up. Patterns of behavior connected to type of travel and illness are characterized so as to identify risk factors and provide background data for pre-travel advice. Volunteers to this prospective cohort study were recruited at visits to a travel clinic prior to departure. Data on the subjects' health and behavior were collected by questionnaires before and after journeys and over a three-week follow-up. In addition, the subjects were asked to fill in health diaries while traveling. The final study population consisted of 460 subjects, 79 % of whom reported illness during travel or on arrival: 69 % had travelers' diarrhea (TD), 17 % skin problems, 17 % fever, 12 % vomiting, 8 % respiratory tract infection, 4 % urinary tract infection, 2 % ear infection, 4 % gastrointestinal complaints other than TD or vomiting, and 4 % other symptoms. Of all subjects, 10 % consulted a doctor and 0.7 % were hospitalized; 18 % took antimicrobials, with TD as the most common indication (64 %). Ongoing symptoms were reported by 25 % of all travelers upon return home. During the three-week follow-up (return rate 51 %), 32 % of respondents developed new-onset symptoms, 20 % visited a doctor and 1.7 % were hospitalized. Factors predisposing to health problems were identified by multivariable analysis: certain regions (Southern Asia, South-Eastern Asia, and Eastern Africa), female gender, young age, and long travel duration. Despite proper preventive measures like vaccinations, malaria prophylaxis, and travel advice, the majority of our subjects fell ill during or

Yellow fever in a traveller returning from Suriname to the Netherlands, March 2017

NARCIS (Netherlands)

M. Wouthuyzen-Bakker (Marjan); M. Knoester; A.P. van den Berg; C.H. Geurts van Kessel (Corine); M.P.G. Koopmans D.V.M. (Marion); C. Van Leer-Buter (Coretta); B. Oude Velthuis; S.D. Pas (Suzan); W.L.M. Ruijs (Wilhelmina L.M.); J. Schmidt-Chanasit (Jonas); S.G. Vreden; T.S. van der Werf; C.B.E.M. Reusken (Chantal); W.F.W. Bierman (Wouter)

2017-01-01

textabstractA Dutch traveller returning from Suriname in early March 2017, presented with fever and severe acute liver injury. Yellow fever was diagnosed by (q)RT-PCR and sequencing. During hospital stay, the patient’s condition deteriorated and she developed hepatic encephalopathy requiring

Travel grant program for the IX International Congresses of Mycology and Bacteriology -- Final report

Energy Technology Data Exchange (ETDEWEB)

Granigan, Marion

2000-05-25

In 1999, the American Society for Microbiology (ASM) and the National Academy of Sciences' U.S. National Committee for the International Union of Microbiological Sciences (IUMS) jointly organized a competitive travel grant program to support the participation of U.S. scientists in the 9th International Congresses of the Bacteriological and Applied Microbiology, Mycology and Virology Divisions of the IUMS in Sydney, Australia, August 16-20, 1999. Funding was solicited for the program, and the ASM Minority and International Activities department administered the $40,000 raised. Travel grants in the amount of $2,000 were offered to U.S. investigators (citizens, including federal employees, and permanent residents working in the United States) in the early stages of their careers who planned to attend and present their research at the Congress. Teams of established and new investigators who applied jointly were eligible to received a combined $3,000 award. IUMS developed a questionnaire th at each applicant were required to complete and return, which asked each award recipient about their experience at the Congresses. Questionnaire results are included.

Yellow fever in a traveller returning from Suriname to the Netherlands, March 2017

NARCIS (Netherlands)

Wouthuyzen-Bakker, M.; Knoester, M.; Berg, A.P. van den; GeurtsvanKessel, C.H.; Koopmans, M.P.; Leer-Buter, C. Van; Velthuis, B.; Pas, S.D.; Ruijs, W.L.M.; Schmidt-Chanasit, J.; Vreden, S.G.; Werf, T.S. van der; Reusken, C.B.; Bierman, W.F.

2017-01-01

A Dutch traveller returning from Suriname in early March 2017, presented with fever and severe acute liver injury. Yellow fever was diagnosed by (q)RT-PCR and sequencing. During hospital stay, the patient's condition deteriorated and she developed hepatic encephalopathy requiring transfer to the

Yellow fever in a traveller returning from Suriname to the Netherlands, March 2017

NARCIS (Netherlands)

Wouthuyzen-Bakker, M.; Knoester, M.; van den Berg, A. P.; GeurtsvanKessel, C. H.; Koopmans, M. P.; Van Leer-Buter, C.; Velthuis, B. Oude; Pas, S. D.; Ruijs, W. L.; Schmidt-Chanasit, J.; Vreden, S. G.; van der Werf, T. S.; Reusken, C. B.; Bierman, W. F.

2017-01-01

A Dutch traveller returning from Suriname in early March 2017, presented with fever and severe acute liver injury. Yellow fever was diagnosed by (q) RT-PCR and sequencing. During hospital stay, the patient's condition deteriorated and she developed hepatic encephalopathy requiring transfer to the

Spectrum of illness among returned Australian travellers from Bali, Indonesia: a 5-year retrospective observational study.

Science.gov (United States)

Sohail, Asma; McGuinness, Sarah L; Lightowler, Rachel; Leder, Karin; Jomon, Bismi; Bain, Christopher A; Peleg, Anton Y

2018-06-05

Bali, Indonesia presents significant infectious and non-infectious health risks for Australian travellers. Understanding this spectrum of illnesses has the potential to assist clinicians in evaluating unwell returning travellers and guide provision of pre-travel advice. To describe the spectrum of illnesses seen in returned travellers from Bali. Using a novel text mining approach, we performed a retrospective, observational study of all adult emergency department (ED) presentations to a metropolitan health service in Melbourne, from 2011-2015. Outcome measures included demographic, clinical and laboratory features of travel-related illnesses. A total of 464 patients met inclusion criteria. Gastroenteritis (119/464, 26%), systemic febrile illness (88/464, 19%) and respiratory tract infection (51/464, 11%) were the most common diagnoses. Dengue was the most common laboratory-confirmed diagnosis (25/464, 5%). No cases of malaria were identified. Common non-infectious presentations included traumatic injury (47/464, 10%) and animal bites requiring rabies post-exposure prophylaxis (29/464, 6%). 110 patients (24%) were admitted to hospital; those presenting with systemic febrile illness were more likely to be admitted compared to those presenting with other illnesses (OR 3.42, CI 2.02-5.75, pBali by Australian travellers. While infections are important causes of illness, trauma and animal bites account for a significant number of hospital presentations. Our findings contribute to knowledge on the health risks for travellers to Bali, and will assist clinicians in relevant pre- and post-travel evaluations. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Medical insurance claims associated with international business travel.

Science.gov (United States)

Liese, B; Mundt, K A; Dell, L D; Nagy, L; Demure, B

1997-07-01

Preliminary investigations of whether 10,884 staff and consultants of the World Bank experience disease due to work related travel. Medical insurance claims filed by 4738 travellers during 1993 were compared with claims of non-travellers. Specific diagnoses obtained from claims were analysed overall (one or more v no missions) and by frequency of international mission (1, 2-3, or > or = 4). Standardised rate of claims ratios (SSRs) for each diagnostic category were obtained by dividing the age adjusted rate of claims for travellers by the age adjusted rate of claims for non-travellers, and were calculated for men and women travellers separately. Overall, rates of insurance claims were 80% higher for men and 18% higher for women travellers than their non-travelling counterparts. Several associations with frequency of travel were found. SRRs for infectious disease were 1.28, 1.54, and 1.97 among men who had completed one, two or three, and four or more missions, and 1.16, 1.28, and 1.61, respectively, among women. The greatest excess related to travel was found for psychological disorders. For men SRRs were 2.11, 3.13, and 3.06 and for women, SRRs were 1.47, 1.96, and 2.59. International business travel may pose health risks beyond exposure to infectious diseases. Because travellers file medical claims at a greater rate than non-travellers, and for many categories of disease, the rate of claims increases with frequency of travel. The reasons for higher rates of claims among travellers are not well understood. Additional research on psychosocial factors, health practices, time zones crossed, and temporal relation between travel and onset of disease is planned.

Malaria after international travel: a GeoSentinel analysis, 2003-2016.

Science.gov (United States)

Angelo, Kristina M; Libman, Michael; Caumes, Eric; Hamer, Davidson H; Kain, Kevin C; Leder, Karin; Grobusch, Martin P; Hagmann, Stefan H; Kozarsky, Phyllis; Lalloo, David G; Lim, Poh-Lian; Patimeteeporn, Calvin; Gautret, Philippe; Odolini, Silvia; Chappuis, François; Esposito, Douglas H

2017-07-20

More than 30,000 malaria cases are reported annually among international travellers. Despite improvements in malaria control, malaria continues to threaten travellers due to inaccurate perception of risk and sub-optimal pre-travel preparation. Records with a confirmed malaria diagnosis after travel from January 2003 to July 2016 were obtained from GeoSentinel, a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. Records were excluded if exposure country was missing or unascertainable or if there was a concomitant acute diagnosis unrelated to malaria. Records were analyzed to describe the demographic and clinical characteristics of international travellers with malaria. There were 5689 travellers included; 325 were children travel visit. More than half (62%) were hospitalized; children were hospitalized more frequently than adults (73 and 62%, respectively). Ninety-two per cent had a single Plasmodium species diagnosis, most frequently Plasmodium falciparum (4011; 76%). Travellers with P. falciparum were most frequently VFRs (60%). More than 40% of travellers with a trip duration ≤7 days had Plasmodium vivax. There were 444 (8%) travellers with severe malaria; 31 children had severe malaria. Twelve travellers died. Malaria remains a serious threat to international travellers. Efforts must focus on preventive strategies aimed on children and VFRs, and chemoprophylaxis access and preventive measure adherence should be emphasized.

Clinical Features and Laboratory Findings of Travelers Returning to South Australia with Dengue Virus Infection

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Emma J. Quinn

2018-01-01

Full Text Available Reported cases of dengue are rising in South Australia (SA in travellers returning from dengue-endemic regions. We have undertaken a retrospective analysis to identify the clinical and laboratory characteristics of patients returning to SA with suspected dengue virus (DENV infection. From 488 requests, 49 (10% were defined by serology as acute dengue, with the majority of patients (75% testing as non-structural protein 1 (NS1 and/or IgM positive. Dengue was most commonly acquired in Indonesia (42.9% with clinical features of fever (95%, headache (41% and myalgia/arthralgia (56%. The presence of rash (36% and laboratory findings of neutropenia, leukopenia, thrombocytopenia, but not elevated C-reactive protein, were distinct from findings in DENV-seronegative patients. Available dengue seropositive samples were analysed by RT-PCR, with 14/32 (43.8% positive by a serotype non-specific DENV assay, but 28/32 positive (87.5% when also assessed by serotype-specific RT-PCR. Serotype analysis revealed the predominance of DENV-1 and DENV-2 and the presence of DENV-3, but not DENV-4 or Zika virus (ZIKV. Thus, dengue in returned travellers in SA presents in a manner consistent with World Health Organization (WHO definitions, with symptoms, travel history and laboratory results useful in prioritising the likelihood of dengue. This definition will assist the future management in DENV-non-endemic regions, such as SA.

International Development Research Centre Corporate Policy Travel

International Development Research Centre (IDRC) Digital Library (Canada)

André Lavoie

manage and control their business travel-related expenses. 3. ... is paid by IDRC funds (internal or external) — i.e. contractors, participants, interviewees and .... be responsible for providing the Designated Travel Agency with any information ... The Manager, Corporate Accounting (Finance and Administration Division) shall:.

Prevalence of Stx-producing Shigella species isolated from French Travelers Returning from the Caribbean: An Emerging Pathogen with International Implications

Science.gov (United States)

Gray, Miranda D.; Lacher, David W.; Leonard, Susan R.; Abbott, Jason; Zhao, Shaohua; Lampel, Keith A.; Prothery, Estelle; Gouali, Malika; Weill, François-Xavier; Maurelli, Anthony T.

2015-01-01

Shiga toxins are potent cytotoxins that inhibit host cell protein synthesis, leading to cell death. Classically, these toxins are associated with intestinal infections due to Shiga toxin-producing Escherichia coli or Shigella dysenteriae serotype 1 and infections with these strains can lead to hemolytic uremic syndrome. Over the past decade there is increasing recognition that Shiga toxin is produced by additional Shigella species. We recently reported the presence and expression of stx genes in Shigella flexneri 2a clinical isolates. The toxin genes were carried by a new stx-encoding bacteriophage and infection with these strains correlated with recent travel to Haiti or the Dominican Republic. In this study we further explored the epidemiological link to this region by utilizing the French National Reference Center for Escherichia coli, Shigella and Salmonella collection to survey the frequency of Stx-producing Shigella species isolated from French travelers returning from the Caribbean. About 21% of the isolates tested were found to encode and produce Stx. These isolates included strains of S. flexneri 2a, S. flexneri Y, and S. dysenteriae 4. All of the travelers whom were infected with Stx-producing Shigella had recently traveled to Haiti, the Dominican Republic, or French Guiana. Furthermore, whole genome sequencing found that the toxin genes were encoded by a prophage that was highly identical to the phage we identified in our previous study. These findings demonstrate that this new stx-encoding prophage is circulating within that geographical area, has spread to other continents, and is capable of spreading to multiple Shigella serogroups. PMID:25980352

Demographics, health and travel characteristics of international travellers at a pre-travel clinic in Marseille, France.

Science.gov (United States)

Aubry, Camille; Gaudart, Jean; Gaillard, Catherine; Delmont, Jean; Parola, Philippe; Brouqui, Philippe; Gautret, Philippe

2012-09-01

With the aim to identify at-risk individuals among a cohort of international travellers, 3442 individuals who sought advice at Marseille travel health centre in 2009 were prospectively included. Demographics, travel characteristics, chronic medical conditions, vaccinations and antimalarial chemoprophylaxis were documented. Chronic medical conditions were reported by 11% of individuals, including hypertension (39%), asthma (20%), thyroid disease (15%) and depression (13%). 4% reported taking a daily medication, and psychotropic and cardiovascular medications were the most commonly used. Older travellers (≥60 years) accounted for 10% of the travellers and the prevalence of chronic medical conditions was 27% in this group. Individuals aged 15 years or less accounted for 13% of the travellers. Age, last minute travel (17%) and neurological and psychiatric diseases were the most frequent factors that influenced Yellow fever vaccination and malaria chemoprophylaxis, with more than one tenth of the travellers reporting at least one risk factor for which adjusted advice may be necessary. Migrants visiting their relatives in their origin country accounted for 14% of travellers and 73% of this group travelled with their family including young children. We demonstrate that a significant proportion of travellers are at-risk (43%) because of their travel conditions (VFR), their age, or their health status, and should be targeted for risk reduction strategies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Furuncular Myiasis Caused by Dermatobia hominis in a Traveler Returning from the Amazon Jungle.

Science.gov (United States)

Kuşcu, Ferit; Özsoy, Kerem Mazhar; Ulu, Aslıhan; Kurtaran, Behice; Kömür, Süheyla; İnal, Ayşe Seza; Taşova, Yeşim; Aksu, Hasan Salih Zeki

2017-09-01

A 39-year-old man who was returning from the Amazon Jungle and had no medical history presented with a furuncular lesion on his right parietal scalp. Despite receiving appropriate antimicrobial treatment, his lesion did not heal. After surgical intervention, a Dermatobia hominis larva was extracted. The human botfly D. hominis is the most common causative agent of furuncular myiasis among travelers returning from Central and South America. Surgery is the main treatment option, and secondary bacterial infection should be kept in mind.

Risk factors and pre-travel healthcare of international travellers attending a Dutch travel clinic: a cross-sectional analysis.

Science.gov (United States)

Wieten, Rosanne W; van der Schalie, Maurice; Visser, Benjamin J; Grobusch, Martin P; van Vugt, Michèle

2014-01-01

The number of international travellers is currently estimated to exceed one billion annually. To address travel related health risks and facilitate risk reduction strategies, detailed knowledge of travellers' characteristics is important. In this cross-sectional study, data of a 20% sample of travellers visiting the Academic Medical Center (AMC) travel clinic Amsterdam from July 2011 to July 2012 was collected. Itineraries and protection versus exposure rates of preventable infectious diseases were mapped and reported according to STROBE guidelines. 1749 travellers were included. South-Eastern Asia, South-America and West-Africa were most frequently visited. 26.2% of the population had pre-existing medical conditions (often cardiovascular). Young and VFR travellers had a longer median travel time (28 and 30 days) compared to the overall population (21 days). Young adult travellers were relatively often vaccinated against hepatitis B (43.9% vs. 20.5%, p travellers. Pre-travel guidelines were well adhered to. Young adult travellers had high-risk itineraries but were adequately protected. Improvement of hepatitis B and rabies protection would be desirable, specifically for VFRs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Loiasis in a Japanese Traveler Returning from Central Africa

Science.gov (United States)

Kobayashi, Tetsuro; Hayakawa, Kayoko; Mawatari, Momoko; Itoh, Makoto; Akao, Nobuaki; Yotsu, Rie R.; Sugihara, Jun; Takeshita, Nozomi; Kutsuna, Satoshi; Fujiya, Yoshihiro; Kanagawa, Shuzo; Ohmagari, Norio; Kato, Yasuyuki

2015-01-01

We encountered a probable case of loiasis in a returned traveler from Central Africa. A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin. She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem. Although no microfilariae were found in her blood, there was an elevated level of IgG antibodies against the crude antigens of Brugia pahangi, which have cross-reactivity with Loa loa. She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred. PMID:26161033

International Patients' Travel Decision Making Process- A Conceptual Framework.

Science.gov (United States)

Khan, Mohammad Jamal; Chelliah, Shankar; Haron, Mahmod Sabri

2016-02-01

Role of information source, perceived benefits and risks, and destination image has significantly been examined in travel and tourism literature; however, in medical tourism it is yet to be examined thoroughly. The concept discussed in this article is drawn form well established models in tourism literature. The purpose of this research was to identify the source of information, travel benefits and perceived risks related to movement of international patients and develop a conceptual model based on well-established theory. Thorough database search (Science Direct, utmj.org, nih.gov, nchu.edu.tw, palgrave-journals, medretreat, Biomedcentral) was performed to fulfill the objectives of the study. International patients always concern about benefits and risks related to travel. These benefits and risks form images of destination in the minds of international patients. Different sources of information make international patients acquaint about the associated benefits and risks, which later leads to development of intention to visit. This conceptual paper helps in establishing model for decision-making process of international patients in developing visit intention. Ample amount of literature is available detailing different factors involved in travel decision making of international patients; however literature explaining relationship between these factors is scarce.

41 CFR 302-3.512 - How many times are we required to pay for an employee's return travel?

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false How many times are we required to pay for an employee's return travel? 302-3.512 Section 302-3.512 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RELOCATION ALLOWANCES 3-RELOCATION...

Pre-Travel Health Preparation of Pediatric International Travelers: Analysis From the Global TravEpiNet Consortium.

Science.gov (United States)

Hagmann, Stefan; LaRocque, Regina C; Rao, Sowmya R; Jentes, Emily S; Sotir, Mark J; Brunette, Gary; Ryan, Edward T

2013-12-01

Children frequently travel internationally. Health-related data on such children are limited. We sought to investigate the demographics, health characteristics, and preventive interventions of outbound US international pediatric travelers. We analyzed data from 32 099 travelers presenting for pre-travel healthcare at the Global TravEpiNet (GTEN), a national consortium of 19 travel clinics, from January 1, 2009 to June 6, 2012. A total of 3332 (10%) of all GTEN travelers were children (traveled mostly for leisure (36%) or to visit friends or relatives (VFR) (36%). Most popular destination regions were Africa (41%), Southeast Asia (16%), Central America (16%), and the Caribbean (16%). Compared with children traveling for leisure, VFR children were more likely to present travel consultation (44% vs 28%), intended to travel for 28 days or longer (70% vs 22%), and to travel to Africa (62% vs 32%). Nearly half of the pediatric travelers (46%) received at least 1 routine vaccine, and most (83%) received at least 1 travel-related vaccine. Parents or guardians of one third of the children (30%) refused at least 1 recommended travel-related vaccine. Most pediatric travelers visiting a malaria-endemic country (72%) received a prescription for malaria chemoprophylaxis. Ten percent of travelers seeking pre-travel healthcare at GTEN sites are children. VFR-travel, pre-travel consultation close to time of departure, and refusal of recommended vaccines may place children at risk for travel-associated illness. Strategies to engage pediatric travelers in timely, pre-travel care and improve acceptance of pre-travel healthcare interventions are needed. © The Author 2013. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

International Patients’ Travel Decision Making Process- A Conceptual Framework

Science.gov (United States)

KHAN, Mohammad Jamal; CHELLIAH, Shankar; HARON, Mahmod Sabri

2016-01-01

Background: Role of information source, perceived benefits and risks, and destination image has significantly been examined in travel and tourism literature; however, in medical tourism it is yet to be examined thoroughly. The concept discussed in this article is drawn form well established models in tourism literature. Methods: The purpose of this research was to identify the source of information, travel benefits and perceived risks related to movement of international patients and develop a conceptual model based on well-established theory. Thorough database search (Science Direct, utmj.org, nih.gov, nchu.edu.tw, palgrave-journals, medretreat, Biomedcentral) was performed to fulfill the objectives of the study. Results: International patients always concern about benefits and risks related to travel. These benefits and risks form images of destination in the minds of international patients. Different sources of information make international patients acquaint about the associated benefits and risks, which later leads to development of intention to visit. This conceptual paper helps in establishing model for decision-making process of international patients in developing visit intention. Conclusion: Ample amount of literature is available detailing different factors involved in travel decision making of international patients; however literature explaining relationship between these factors is scarce. PMID:27114978

Rabies post-exposure prophylaxis in travellers returning from Bali, Indonesia, November 2008 to March 2010.

Science.gov (United States)

Gautret, P; Lim, P L; Shaw, M; Leder, K

2011-03-01

Since 2008, when the outbreak of rabies in Bali began, 45 patients have attended GeoSentinel or EuroTravNet sites for rabies post-exposure prophylaxis (PEP), representing 12.6% of all travellers seen for PEP in all network clinics during the same time period. This suggests that Bali is emerging as a commonly visited destination among travellers presenting for rabies PEP. The data demonstrate that the majority of animal-related injuries in travellers returning from Bali are associated with exposure to monkeys, and not dog bites/scratches. The clinical implications of this are discussed. © 2010 The Authors. Clinical Microbiology and Infection © 2010 European Society of Clinical Microbiology and Infectious Diseases.

Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: Case report and review of the literature.

Science.gov (United States)

Lewis, Joseph M; Folb, Jonathan; Kalra, Sanjay; Squire, S Bertel; Taegtmeyer, Miriam; Beeching, Nick J

Brucella spp. prosthetic joint infections are infrequently reported in the literature, particularly in returning travellers, and optimal treatment is unknown. We describe a prosthetic joint infection (PJI) caused by Brucella melitensis in a traveller returning to the UK from Thailand, which we believe to be the first detailed report of brucellosis in a traveller returning from this area. The 23 patients with Brucella-related PJI reported in the literature are summarised, together with our case. The diagnosis of Brucella-related PJI is difficult to make; only 30% of blood cultures and 75% of joint aspiration cultures were positive in the reported cases. Culture of intraoperative samples provides the best diagnostic yield. In the absence of radiological evidence of joint loosening, combination antimicrobial therapy alone may be appropriate treatment in the first instance; this was successful in 6/7 [86%] of patients, though small numbers of patients and the likelihood of reporting bias warrant caution in drawing any firm conclusions about optimal treatment. Aerosolisation of synovial fluid during joint aspiration procedures and nosocomial infection has been described. Brucella-related PJI should be considered in the differential of travellers returning from endemic areas with PJI, including Thailand. Personal protective equipment including fit tested filtering face piece-3 (FFP3) mask or equivalent is recommended for personnel carrying out joint aspiration when brucellosis is suspected. Travellers can reduce the risk of brucellosis by avoiding unpasteurised dairy products and animal contact (particularly on farms and abattoirs) in endemic areas and should be counselled regarding these risks as part of their pre-travel assessment. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

A New Method to Calculate Internal Rate of Return

Directory of Open Access Journals (Sweden)

azadeh zandi

2015-09-01

Full Text Available A number of methods have been developed to choose the best capital investment projects such as net present value, internal rate of return and etc. Internal rate of return method is probably the most popular method among managers and investors. But despite the popularity there are serious drawbacks and limitations in this method. After decades of efforts made by economists and experts to improve the method and its shortcomings, Magni in 2010 has revealed a new approach that can solves the most of internal rate of return method problems. This paper present a new method which is originated from Magni’s approach but has much more simple calculations and can resolve all the drawbacks of internal rate of return method.

An Approach to Establishing International Quality Standards for Medical Travel

Directory of Open Access Journals (Sweden)

Ondřej eKácha

2016-03-01

Full Text Available Traveling abroad to receive a non-elective treatment is expanding each year. Such rising popularity of medical travel and the absence of clear minimum quality requirements in this area urgently calls for setting international standards to ensure good practice and patient safety. The aim of this study is to identify the key domains in medical travel where such quality standards should be established. Drawing from the evidence-based OECD framework and an extensive literature review, this study proposes three critical areas for international quality standards in medical travel: minimum standards of health care facilities and third-party agencies, financial responsibility and patient-centeredness. Several cultural challenges are subsequently introduced that may pose a barrier to the development of the guidelines and should be additionally taken into consideration. Establishing international quality standards in medical travel enhances the benefits to patients and providers, which is urgently needed given the rapid growth in this industry.

Characterizing International Travel Behavior from Geotagged Photos: A Case Study of Flickr.

Science.gov (United States)

Yuan, Yihong; Medel, Monica

2016-01-01

Recent advances in multimedia and mobile technologies have facilitated large volumes of travel photos to be created and shared online. Although previous studies have utilized geotagged photos to model travel patterns at individual locations, there is limited research on how these datasets can model international travel behavior and inter-country travel flows-a crucial indicator to quantify the interactions between countries in tourism economics. Realizing the necessity to investigate the potential of geotagged photos in tourism geography, this research investigates international travel patterns from two perspectives: 1) We apply a series of indicators (radius of gyration (ROG), number of countries visited, and entropy) to measure the descriptive characteristics of international travel in different countries; 2) By constructing a gravity model of trade, we investigate how distance decay influences the magnitude of international travel flow between geographic entities, and whether (or how much) the popularity of a given destination (defined as the percentage of tourist income in national gross domestic product (GDP)) affects travel choices in different countries. The results provide valuable input to various commercial applications such as individual travel planning and destination suggestions.

Characterizing International Travel Behavior from Geotagged Photos: A Case Study of Flickr.

Directory of Open Access Journals (Sweden)

Yihong Yuan

Full Text Available Recent advances in multimedia and mobile technologies have facilitated large volumes of travel photos to be created and shared online. Although previous studies have utilized geotagged photos to model travel patterns at individual locations, there is limited research on how these datasets can model international travel behavior and inter-country travel flows-a crucial indicator to quantify the interactions between countries in tourism economics. Realizing the necessity to investigate the potential of geotagged photos in tourism geography, this research investigates international travel patterns from two perspectives: 1 We apply a series of indicators (radius of gyration (ROG, number of countries visited, and entropy to measure the descriptive characteristics of international travel in different countries; 2 By constructing a gravity model of trade, we investigate how distance decay influences the magnitude of international travel flow between geographic entities, and whether (or how much the popularity of a given destination (defined as the percentage of tourist income in national gross domestic product (GDP affects travel choices in different countries. The results provide valuable input to various commercial applications such as individual travel planning and destination suggestions.

International Safety Regulation and Standards for Space Travel and Commerce

Science.gov (United States)

Pelton, J. N.; Jakhu, R.

The evolution of air travel has led to the adoption of the 1944 Chicago Convention that created the International Civil Aviation Organization (ICAO), headquartered in Montreal, Canada, and the propagation of aviation safety standards. Today, ICAO standardizes and harmonizes commercial air safety worldwide. Space travel and space safety are still at an early stage of development, and the adoption of international space safety standards and regulation still remains largely at the national level. This paper explores the international treaties and conventions that govern space travel, applications and exploration today and analyzes current efforts to create space safety standards and regulations at the national, regional and global level. Recent efforts to create a commercial space travel industry and to license commercial space ports are foreseen as means to hasten a space safety regulatory process.

Independent Senior Women Who Travel Internationally: A Collective Case Study

Science.gov (United States)

Jarrett, Barbara

2010-01-01

Nine independent women over age 55 who traveled internationally were investigated through a qualitative case study. The purpose of the study was to explore the women's attitudes, actions, and motivations during and after their international travel experiences. The adult, aging, experiential, and transformational theories of researchers such as…

Personal security a guide for international travelers

CERN Document Server

Spencer, Tanya

2013-01-01

Personal Security: A Guide for International Travelers provides the perfect mix of lessons-learned, tools, and recommendations from experts so that readers can personalize their own approach to managing travel risks. If followed, the information provided will allow readers to get out and experience the local culture while still traveling safely.-Bernie Sullivan, Director Global Security, Hanesbrands Inc....a must-have for any traveler. Having worked in South and Southeast Asia, I know the advice provided in the book holds the key to keeping safe, avoiding dangerous situations, and managing threats when they occur. The book's methodological framework, combined with the author's extensive experience and hands-on knowledge, provide very practical and useful advice.-Kathrine Alexandrowiz, Independent consultant at Kathalyst, former coordinator for the "Regional Risk Management Project for NGOs in Asia Pacific" (ECHO)... a go-to guide for all travelers irrespective of mission or purpose. An excellent piece of work...

Zika virus and the risk of imported infection in returned travelers: Implications for clinical care

NARCIS (Netherlands)

Goorhuis, Abraham; Von Eije, Karin J.; Douma, Renée A.; Rijnberg, Noor; van Vugt, Michele; Stijnis, Cornelis; Grobusch, Martin P.

2016-01-01

Since late 2015, an unprecedented outbreak of Zika virus is spreading quickly across Southern America. The large size of the current outbreak in The Americas will also result in an increase in Zika virus infections among travelers returning from endemic areas. We report five cases of imported Zika

Evaluation of a real-time PCR assay for malaria diagnosis in patients from Vietnam and in returned travellers.

Science.gov (United States)

Vo, Thi Kim Duy; Bigot, Patricia; Gazin, Pierre; Sinou, Veronique; De Pina, Jean Jacques; Huynh, Dinh Chien; Fumoux, Francis; Parzy, Daniel

2007-05-01

Real-time PCR diagnosis of malaria has advantages over traditional microscopic methods, especially when parasitaemia is low and when dealing with mixed infections. We have developed a new real-time PCR with specific genes in each Plasmodium species present only in one copy to identify the four pathogenic Plasmodium spp. for humans. The sensitivity was less than 25 parasites/microl. No cross-hybridisation was observed with human DNA or among the four Plasmodium spp. Using LightCycler PCR and conventional microscopy, we compared the diagnosis of malaria in patients from Vietnam and in returned European travellers with suspicion of malaria. In patients from Vietnam with suspicion of malaria, one mixed infection was observed by PCR only; the remaining data (54 of 55 patients) correlated with microscopy. In 79 patients without symptoms, low parasitaemia was detected in 7 samples by microscopy and in 16 samples by PCR. In returned travellers, PCR results were correlated with microscopy for all four species in 48 of 56 samples. The eight discrepant results were resolved in favour of real-time PCR diagnosis. This new real-time PCR is a rapid, accurate and efficient method for malaria diagnosis in returned travellers as well as for epidemiological studies or antimalarial efficiency trials in the field.

Inflation risk and international asset returns

NARCIS (Netherlands)

G.A. Moerman (Gerard); M.A. van Dijk (Mathijs)

2010-01-01

textabstractWe show that inflation risk is priced in international asset returns. We analyze inflation risk in a framework that encompasses the International Capital Asset Pricing Model (ICAPM) of Adler and Dumas (1983). In contrast to the extant empirical literature on the ICAPM, we relax the

The causes of skin lesions in the returning travelers: with special reference to Egypt.

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Morsy, Tosson A

2012-04-01

Often people yearn of a greater travel adventure like a year in Africa to get away from their routine situations and locations, for a quick vacation or as a means of finding one's self, to enjoy new experiences, to learn and experience new languages, new food, and new cultures. While most people associate Sub-Saharan Africa with safaris, there are endless other possibilities for adventure. Some African countries have actual entry requirements and won't let you in unless you have proof you've been vaccinated against a specific disease. Every African country is unique in the quality of its parks and reserves, roads and other infrastructure, visitor accommodations and receptivity to tourists. Creating an itinerary and arranging travel logistics can intimidate even the most enthusiastic tourist. Others travel more nowadays for the better economy and the advancements in transportation make it easier to do so. If family members do not reside in the same country or are probably working abroad, other family members would want to visit them and would do so as frequently as their resources would allow. Visiting families and friends in different states or countries are probably the most important reasons for taking time off to travel. No doubt, travelling to different climates, cultures and environments abroad can expose to tropical infectious diseases and health risks. This review dealt with skin lesions in the returning travelers.

Travel-related health problems in Japanese travelers.

Science.gov (United States)

Mizuno, Yasutaka; Kudo, Koichiro

2009-09-01

Although the number of Japanese individuals traveling abroad has increased steadily, reaching approximately 17.3 million in 2007, the incidence of various travel-related health problems in Japan remains unknown. The travel-related health problems of Japanese travelers returning to Japan from abroad are analyzed by assessing the records. Data were collected retrospectively on returning travelers who visited the authors' travel clinic during the period from January 2005 through to December 2006 with any health problem acquired overseas. A total of 345 patients were included in this study (200 male, 145 female; average age, 34+/-12.3 years). Reasons for travel included leisure (45.8%); business (39.1%); visiting friends and relatives or accompanying other travelers (8.7%); volunteering (3.8%); and long stays in order to study or live (2.6%). The most visited destination was Asia (n=260), followed by Africa (n=105). The most commonly reported health problems were gastro-intestinal infections (39.1%), followed by respiratory tract infections (16.2%), animal bites (8.1%), and skin problems (5.8%). Together, malaria and dengue accounted for 10% of diagnoses in 125 febrile patients (36.2%). Although the profile of travel-related health problems in Japanese travelers is similar to that of Western travelers, the characteristics of travel were quite different. Therefore Japanese travel advice should be tailored to suit the Japanese traveler.

Does the use of alcohol-based hand gel sanitizer reduce travellers' diarrhea and gastrointestinal upset?: A preliminary survey.

Science.gov (United States)

Henriey, Delphine; Delmont, Jean; Gautret, Philippe

2014-01-01

Use of alcohol-based hand sanitizer is recommended by the CDC to reduce the risk for travellers' diarrhoea, but its effectiveness has not been assessed. We investigated the potential protective effect of hand sanitizer use on the occurrence of diarrhoea and/or vomiting in 200 international travellers, who were returning home, at an international airport. We also conducted a knowledge, aptitude and practice survey about hand gel use among international travellers consulting for pre-travel advice at a specialized clinic. 200 returning travellers were included of which 32.5% declared having used alcohol-based hand sanitizer during travel. Travellers who used hand sanitizer reported diarrhoea and vomiting significantly less frequently than those who did not (17% vs. 30%, OR = 0.47; 95% CI [0.21-0.97], p = 0.04). A total of 257 travellers consulting for pre-travel advice were included. A majority of travellers knew that hand sanitizer may be used for hand hygiene and had already used hand sanitizer; 72% planned to bring hand sanitizer during their next travel. Use of hand sanitizer is highly acceptable by travellers and is associated with a reduction in the incidence of travellers' diarrhoea and/or vomiting. Copyright © 2014 Elsevier Ltd. All rights reserved.

26 CFR 1.6091-3 - Filing certain international income tax returns.

Science.gov (United States)

2010-04-01

... corporations which claim the benefits of section 941 (relating to the special deduction for China Trade Act... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Filing certain international income tax returns... certain international income tax returns. The following income tax returns shall be filed as directed in...

Pretravel health advice among international travelers visiting Cuzco, Peru.

Science.gov (United States)

Cabada, Miguel M; Maldonado, Fernando; Quispe, Wanda; Serrano, Edson; Mozo, Karen; Gonzales, Elsa; Seas, Carlos; Verdonck, Kristien; Echevarria, Juan I; Gotuzzo, Eduardo

2005-01-01

Cuzco, a Peruvian city of historical interest located 3,326 m above sea level, is a frequent destination for tourists. We conducted a descriptive study to assess the extent and sources of pretravel health advice received by international travelers before their arrival to Cuzco. Data were collected as part of a health survey among travelers. Between August and November 2002, travelers between 15 and 65 years old were invited to fill out a questionnaire in the departing area of Cuzco's international airport. A total of 5,988 travelers participated. The mean age was 35.4 years (SD 11.4 yr); 50.6% were female and 50.8% were single. Tourism was the reason for traveling in 90.2% of the participants, and 89.3% of them were traveling with companions. Pretravel health information was received by 93.6%. The median number of information sources was two, with books (41.5%), travel medicine clinics (38.8%), the Internet (23.3%), and general practitioners (22.7%) as the main sources. Most frequently received recommendations were about safe food and water consumption (85%), use of insect repellents (66.0%), sunburn protection (64.4%), and condom use (22%). Only 16.5% took medication to prevent altitude sickness, and 14.2% took medication to prevent traveler's diarrhea. Variables independently associated with receiving pretravel health information from a health care professional were female gender, country of residence other than the United States, length of stay in Cuzco > 7 days, length of stay in other Peruvian cities > 7 days, tourism as the main reason for visiting Cuzco, traveling with companions, and consulting of more than one source of information. Most travelers arriving to Cuzco had received pretravel health information, and the majority obtained it from more than one source. Recommendations addressed for specific health risks, such as altitude sickness prophylaxis, were received by few travelers.

Nurse-delivered universal point-of-care testing for HIV in an open-access returning traveller clinic.

Science.gov (United States)

Herbert, R; Ashraf, A N; Yates, T A; Spriggs, K; Malinnag, M; Durward-Brown, E; Phillips, D; Mewse, E; Daniel, A; Armstrong, M; Kidd, I M; Waite, J; Wilks, P; Burns, F; Bailey, R; Brown, M

2012-09-01

Early diagnosis of HIV infection reduces morbidity and mortality associated with late presentation. Despite UK guidelines, the HIV testing rate has not increased. We have introduced universal HIV screening in an open-access returning traveller clinic. Data were prospectively recorded for all patients attending the open-access returning traveller clinic between August 2008 and December 2010. HIV testing was offered to all patients from May 2009; initially testing with laboratory samples (phase 1) and subsequently a point-of-care test (POCT) (phase 2). A total of 4965 patients attended the clinic; 1342 in phase 0, 792 in phase 1 and 2831 in phase 2. Testing rates for HIV increased significantly from 2% (38 of 1342) in phase 0 to 23.1% (183 of 792) in phase 1 and further increased to 44.5% (1261 of 2831) during phase 2 (P travelling to the Middle East and Europe were less likely to accept an HIV test with POCT. A nurse-delivered universal point-of-care HIV testing service has been successfully introduced and sustained in an acute medical clinic in a low-prevalence country. Caution is required in communicating reactive results in low-prevalence settings where there may be alternative diagnoses or a low population prevalence of HIV infection. © 2012 British HIV Association.

Surveillance for travel-related disease--GeoSentinel Surveillance System, United States, 1997-2011.

Science.gov (United States)

Harvey, Kira; Esposito, Douglas H; Han, Pauline; Kozarsky, Phyllis; Freedman, David O; Plier, D Adam; Sotir, Mark J

2013-07-19

In 2012, the number of international tourist arrivals worldwide was projected to reach a new high of 1 billion arrivals, a 48% increase from 674 million arrivals in 2000. International travel also is increasing among U.S. residents. In 2009, U.S. residents made approximately 61 million trips outside the country, a 5% increase from 1999. Travel-related morbidity can occur during or after travel. Worldwide, 8% of travelers from industrialized to developing countries report becoming ill enough to seek health care during or after travel. Travelers have contributed to the global spread of infectious diseases, including novel and emerging pathogens. Therefore, surveillance of travel-related morbidity is an essential component of global public health surveillance and will be of greater importance as international travel increases worldwide. September 1997-December 2011. GeoSentinel is a clinic-based global surveillance system that tracks infectious diseases and other adverse health outcomes in returned travelers, foreign visitors, and immigrants. GeoSentinel comprises 54 travel/tropical medicine clinics worldwide that electronically submit demographic, travel, and clinical diagnosis data for all patients evaluated for an illness or other health condition that is presumed to be related to international travel. Clinical information is collected by physicians with expertise or experience in travel/tropical medicine. Data collected at all sites are entered electronically into a database, which is housed at and maintained by CDC. The GeoSentinel network membership program comprises 235 additional clinics in 40 countries on six continents. Although these network members do not report surveillance data systematically, they can report unusual or concerning diagnoses in travelers and might be asked to perform enhanced surveillance in response to specific health events or concerns. During September 1997-December 2011, data were collected on 141,789 patients with confirmed or

Real-time polymerase chain reaction assay for the rapid detection and characterization of chloroquine-resistant Plasmodium falciparum malaria in returned travelers.

Science.gov (United States)

Farcas, Gabriella A; Soeller, Rainer; Zhong, Kathleen; Zahirieh, Alireza; Kain, Kevin C

2006-03-01

Imported drug-resistant malaria is a growing problem in industrialized countries. Rapid and accurate diagnosis is essential to prevent malaria-associated mortality in returned travelers. However, outside of a limited number of specialized centers, the microscopic diagnosis of malaria is slow, unreliable, and provides little information about drug resistance. Molecular diagnostics have the potential to overcome these limitations. We developed and evaluated a rapid, real-time polymerase chain reaction (PCR) assay to detect Plasmodium falciparum malaria and chloroquine (CQ)-resistance determinants in returned travelers who are febrile. A real-time PCR assay based on detection of the K76T mutation in PfCRT (K76T) of P. falciparum was developed on a LightCycler platform (Roche). The performance characteristics of the real-time assay were compared with those of the nested PCR-restriction fragment-length polymorphism (RFLP) and the sequence analyses of samples obtained from 200 febrile returned travelers, who included 125 infected with P. falciparum (48 of whom were infected CQ-susceptible [K76] and 77 of whom were CQ-resistant [T76] P. falciparum), 22 infected with Plasmodium vivax, 10 infected with Plasmodium ovale, 3 infected with Plasmodium malariae malaria, and 40 infected with other febrile syndromes. All patient samples were coded, and all analyses were performed blindly. The real-time PCR assay detected multiple pfcrt haplotypes associated with CQ resistance in geographically diverse malaria isolates acquired by travelers. Compared with nested-PCR RFLP (the reference standard), the real-time assay was 100% sensitive and 96.2% specific for detection of the P. falciparum K76T mutation. This assay is rapid, sensitive, and specific for the detection and characterization of CQ-resistant P. falciparum malaria in returned travelers. This assay is automated, standardized, and suitable for routine use in clinical diagnostic laboratories.

International Launch Vehicle Selection for Interplanetary Travel

Science.gov (United States)

Ferrone, Kristine; Nguyen, Lori T.

2010-01-01

In developing a mission strategy for interplanetary travel, the first step is to consider launch capabilities which provide the basis for fundamental parameters of the mission. This investigation focuses on the numerous launch vehicles of various characteristics available and in development internationally with respect to upmass, launch site, payload shroud size, fuel type, cost, and launch frequency. This presentation will describe launch vehicles available and in development worldwide, then carefully detail a selection process for choosing appropriate vehicles for interplanetary missions focusing on international collaboration, risk management, and minimization of cost. The vehicles that fit the established criteria will be discussed in detail with emphasis on the specifications and limitations related to interplanetary travel. The final menu of options will include recommendations for overall mission design and strategy.

US Implied Volatility as A predictor of International Returns

Directory of Open Access Journals (Sweden)

Mehmet F. Dicle

2017-12-01

Full Text Available This study provides evidence of the US implied volatility’s e ect on international equitymarkets’ returns. This evidence has two main implications: i investors may find that foreign equityreturns adjusting to US implied volatility may not provide true diversification benefits, and ii foreignequity returns may be predicted using US implied volatility. Our sample includes US volatility index(VIX and major equity indexes in twenty countries for the period between January, 2000 throughJuly, 2017. VIX leads eighteen of the international markets and Granger causes seventeen of themarkets after controlling for the S&P-500 index returns and the 2007/2008 US financial crisis. USinvestors looking to diversify US risk may find that international equities may not provide intendeddiversification benefits. Our evidence provides support for predictability of international equity returnsbased on US volatility.

Morbidity among Israeli paediatric travellers.

Science.gov (United States)

Rabinowicz, Shira; Schwartz, Eli

2017-09-01

International travel, particularly to developing countries, is becoming increasingly common among the Israeli population, including an increase in the number of travelling children. Since children are a distinct travellers' population, data about their post-travel morbidity are needed. A retrospective study which examined all children (0-19 years old) who presented to our centre after international travel from 1999 to 2015. About 314 children were seen. The mean age was 10 years (SD ± 5.8). Most of the patients (80.6%) were tourists, and the rest were expatriates. The main destinations visited were South-Asia (46.5%), Sub-Saharan Africa (33.4%), Latin-America (7%) and Europe (6.4%). Overall, the most common diagnoses were gastrointestinal (GI) (mainly chronic) disorders (30.6%), followed by febrile diseases (26.4%), among which 18.1% of patients were diagnosed with dengue fever and 12% with malaria. Dermatologic conditions accounted for 25.2%. Additional diagnoses were schistosomiasis (6.4%) and neuropsychiatric symptoms (2.2%). A substantial part, 10.8%, had eosinophilia, either symptomatic or asymptomatic. Travellers to Asia, compared to travellers to Africa, presented more commonly with GI illness (OR 2.02, 95% confidence interval 1.13-3.61), and dermatologic conditions (OR 1.94, 95% confidence interval 1.05-3.61). Morbidity was associated with a variety of transmission modes, such as food-borne illnesses (30.9%), bite and sting wounds (10.2%), mosquito-borne infections (8%), freshwater contact (6.7%) and tick-borne infections (2.2%). The main conditions seen in paediatric returning travellers were GI, febrile and dermatologic illnesses, some may be rare in their country of origin. Targeting care for the suspected pathogens based on updated knowledge of epidemiology and thorough travel history is essential. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

International cooperation for Mars exploration and sample return

Science.gov (United States)

Levy, Eugene H.; Boynton, William V.; Cameron, A. G. W.; Carr, Michael H.; Kitchell, Jennifer H.; Mazur, Peter; Pace, Norman R.; Prinn, Ronald G.; Solomon, Sean C.; Wasserburg, Gerald J.

1990-01-01

The National Research Council's Space Studies Board has previously recommended that the next major phase of Mars exploration for the United States involve detailed in situ investigations of the surface of Mars and the return to earth for laboratory analysis of selected Martian surface samples. More recently, the European space science community has expressed general interest in the concept of cooperative Mars exploration and sample return. The USSR has now announced plans for a program of Mars exploration incorporating international cooperation. If the opportunity becomes available to participate in Mars exploration, interest is likely to emerge on the part of a number of other countries, such as Japan and Canada. The Space Studies Board's Committee on Cooperative Mars Exploration and Sample Return was asked by the National Aeronautics and Space Administration (NASA) to examine and report on the question of how Mars sample return missions might best be structured for effective implementation by NASA along with international partners. The committee examined alternatives ranging from scientific missions in which the United States would take a substantial lead, with international participation playing only an ancillary role, to missions in which international cooperation would be a basic part of the approach, with the international partners taking on comparably large mission responsibilities. On the basis of scientific strategies developed earlier by the Space Studies Board, the committee considered the scientific and technical basis of such collaboration and the most mutually beneficial arrangements for constructing successful cooperative missions, particularly with the USSR.

Patient awareness of need for hepatitis a vaccination (prophylaxis) before international travel.

Science.gov (United States)

Liu, Stephen J; Sharapov, Umid; Klevens, Monina

2015-01-01

Although hepatitis A virus (HAV) infection is preventable through vaccination, cases associated with international travel continue to occur. The purpose of this study was to examine the frequency of international travel and countries visited among persons infected with HAV and assess reasons why travelers had not received hepatitis A vaccine before traveling. Using data from sentinel surveillance for HAV infection in seven US counties during 1996 to 2006, we examined the role of international travel in hepatitis A incidence and the reasons for patients not being vaccinated. Of 2,002 hepatitis A patients for whom travel history was available, 300 (15%) reported traveling outside of the United States. Compared to non-travelers, travelers were more likely to be female [odds ratio (OR) = 1.74 (95% confidence interval [95% CI], 1.35, 2.24)], aged 0 to 17 years [OR = 3.30 (1.83, 5.94)], Hispanic [OR = 3.69 (2.81, 4.86)], Asian [OR = 2.00 (1.06, 3.77)], and were less likely to be black non-Hispanic [OR = 0.30 (0.11, 0.82)]. The majority, 189 (61.6%), had traveled to Mexico. The most common reason for not getting pre-travel vaccination was "Didn't know I could [or should] get shots" [100/154 (65%)]. Low awareness of HAV vaccination was the predominant reason for not being protected before travel. Different modes of traveler education could improve prevention of hepatitis A. To highlight the risk of infection before traveling to endemic countries including Mexico, travel and consulate websites could list reminders of vaccine recommendations. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Yellow fever in a traveller returning from Suriname to the Netherlands, March 2017.

Science.gov (United States)

Wouthuyzen-Bakker, Marjan; Knoester, Marjolein; van den Berg, Aad P; GeurtsvanKessel, Corine H; Koopmans, Marion Pg; Van Leer-Buter, Coretta; Oude Velthuis, Bob; Pas, Suzan D; Ruijs, Wilhelmina Lm; Schmidt-Chanasit, Jonas; Vreden, Stephen Gs; van der Werf, Tjip S; Reusken, Chantal Bem; Bierman, Wouter Fw

2017-03-16

A Dutch traveller returning from Suriname in early March 2017, presented with fever and severe acute liver injury. Yellow fever was diagnosed by (q)RT-PCR and sequencing. During hospital stay, the patient's condition deteriorated and she developed hepatic encephalopathy requiring transfer to the intensive care. Although yellow fever has not been reported in the last four decades in Suriname, vaccination is recommended by the World Health Organization for visitors to this country. This article is copyright of The Authors, 2017.

Country size, currency unions, and international asset returns

OpenAIRE

Hassan, Tarek A.

2015-01-01

The fact that economies differ in size has important implications for international asset returns. I solve for the spread on international bonds and stocks in an endowment economy with complete asset markets and non-traded goods. The model predicts that larger countries have lower real interest rates because their bonds provide insurance against shocks that affect a larger fraction of the world economy. Larger countries' bonds must therefore pay lower excess returns in equilibrium and uncover...

The visiting internet Fiancé/ée (VIF): an emerging group of international travelers.

Science.gov (United States)

Sofarelli, Theresa A; Birich, Holly K; Hale, DeVon C

2014-01-01

Here we describe an emerging category of travelers called the Visiting Internet Fiancé/ée (VIF), characterized by their travel to pursue a romantic relationship with an individual they have only encountered online. The VIF is not well identified in travel medicine literature despite having a higher risk for several travel-related issues including sexually transmitted infections, monetary fraud, and international scams. We also propose specific counseling interventions designed to minimize the adverse outcomes faced by the VIF traveler. © 2014 International Society of Travel Medicine.

International travel and vaccinations.

OpenAIRE

Rizvon, M K; Qazi, S; Ward, L A

1999-01-01

With the increase in global travel, no disease is beyond the reach of any population. Traveling patients should be advised to follow food and water precautions and encouraged to receive the recommended immunizations. Travel medicine plays a vital role not only in limiting the morbidity of travel-related illnesses but also in limiting the spread of diseases. This article addresses the common issues related to travel, reviews the care of the immunocompromised traveler, and updates the available...

International travel between global urban centres vulnerable to yellow fever transmission.

Science.gov (United States)

Brent, Shannon E; Watts, Alexander; Cetron, Martin; German, Matthew; Kraemer, Moritz Ug; Bogoch, Isaac I; Brady, Oliver J; Hay, Simon I; Creatore, Maria I; Khan, Kamran

2018-05-01

To examine the potential for international travel to spread yellow fever virus to cities around the world. We obtained data on the international flight itineraries of travellers who departed yellow fever-endemic areas of the world in 2016 for cities either where yellow fever was endemic or which were suitable for viral transmission. Using a global ecological model of dengue virus transmission, we predicted the suitability of cities in non-endemic areas for yellow fever transmission. We obtained information on national entry requirements for yellow fever vaccination at travellers' destination cities. In 2016, 45.2 million international air travellers departed from yellow fever-endemic areas of the world. Of 11.7 million travellers with destinations in 472 cities where yellow fever was not endemic but which were suitable for virus transmission, 7.7 million (65.7%) were not required to provide proof of vaccination upon arrival. Brazil, China, India, Mexico, Peru and the United States of America had the highest volumes of travellers arriving from yellow fever-endemic areas and the largest populations living in cities suitable for yellow fever transmission. Each year millions of travellers depart from yellow fever-endemic areas of the world for cities in non-endemic areas that appear suitable for viral transmission without having to provide proof of vaccination. Rapid global changes in human mobility and urbanization make it vital for countries to re-examine their vaccination policies and practices to prevent urban yellow fever epidemics.

Health problems associated with international travel: a case of cutaneous myiasis in China due to Cordylobia anthropophaga imported from Uganda.

Science.gov (United States)

Ruan, Wei; Feng, Yan; Zhang, Lingling; Sun, Jimin; Yao, Linong

2014-12-01

More affordable international travel, global trade and commerce, and the exporting of labor have all contributed to international population mobility. Furthermore, population migration leads to the incidence or recurrence of once-controlled diseases. Evidence shows that the popularity of travel can impact health through imported infections and illness. Imported cutaneous myiasis, a type of skin lesion, has attracted the attention of the current authors. This condition often occurs among travelers and it has been reported in several non-endemic countries. However, diagnosis of myiasis and identification of the larvae are difficult. Advances in molecular detection techniques could provide a new way to identify larvae. This study used sequencing of the 28S rRNA gene and morphology to identify the larva infesting the upper arm of a Chinese woman returning from Uganda. The larva was identified as Cordylobia anthropophaga (C. anthropophaga) and the sequences were submitted to GenBank (accession number: KM506761). As foreign interaction increases, imported health problems may become more common in China. Knowledge about various pathogens needs to be increased and molecular methods need to be used to accurately identify those pathogens.

Encephalitis in a traveller with typhoid fever: efficacy of corticosteroids.

Science.gov (United States)

Mellon, Guillaume; Eme, Anne-Line; Rohaut, Benjamin; Brossier, Florence; Epelboin, Loïc; Caumes, Eric

2017-09-01

Typhoid fever is a bacterial infection caused by Salmonella typhi or S. paratyphi, recognized as a classical cause of fever in returning travellers. However, neuropsychiatric presentations are rarely reported in travellers diagnosed in western countries, whereas they are more commonly described in patients treated in endemic areas. We describe such a case and discuss the pathophysiologic mechanisms of this complication. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Globalization of leptospirosis through travel and migration.

Science.gov (United States)

Bandara, Medhani; Ananda, Mahesha; Wickramage, Kolitha; Berger, Elisabeth; Agampodi, Suneth

2014-08-12

Leptospirosis remains the most widespread zoonotic disease in the world, commonly found in tropical or temperate climates. While previous studies have offered insight into intra-national and intra-regional transmission, few have analyzed transmission across international borders. Our review aimed at examining the impact of human travel and migration on the re-emergence of Leptospirosis. Results suggest that alongside regional environmental and occupational exposure, international travel now constitute a major independent risk factor for disease acquisition. Contribution of travel associated leptospirosis to total caseload is as high as 41.7% in some countries. In countries where longitudinal data is available, a clear increase of proportion of travel-associated leptospirosis over the time is noted. Reporting patterns is clearly showing a gross underestimation of this disease due to lack of diagnostic facilities. The rise in global travel and eco-tourism has led to dramatic changes in the epidemiology of Leptospirosis. We explore the obstacles to prevention, screening and diagnosis of Leptopirosis in health systems of endemic countries and of the returning migrant or traveler. We highlight the need for developing guidelines and preventive strategies of Leptospirosis related to travel and migration, including enhancing awareness of the disease among health professionals in high-income countries.

Controlling pandemic flu: the value of international air travel restrictions.

Directory of Open Access Journals (Sweden)

Joshua M Epstein

2007-05-01

Full Text Available Planning for a possible influenza pandemic is an extremely high priority, as social and economic effects of an unmitigated pandemic would be devastating. Mathematical models can be used to explore different scenarios and provide insight into potential costs, benefits, and effectiveness of prevention and control strategies under consideration.A stochastic, equation-based epidemic model is used to study global transmission of pandemic flu, including the effects of travel restrictions and vaccination. Economic costs of intervention are also considered. The distribution of First Passage Times (FPT to the United States and the numbers of infected persons in metropolitan areas worldwide are studied assuming various times and locations of the initial outbreak. International air travel restrictions alone provide a small delay in FPT to the U.S. When other containment measures are applied at the source in conjunction with travel restrictions, delays could be much longer. If in addition, control measures are instituted worldwide, there is a significant reduction in cases worldwide and specifically in the U.S. However, if travel restrictions are not combined with other measures, local epidemic severity may increase, because restriction-induced delays can push local outbreaks into high epidemic season. The per annum cost to the U.S. economy of international and major domestic air passenger travel restrictions is minimal: on the order of 0.8% of Gross National Product.International air travel restrictions may provide a small but important delay in the spread of a pandemic, especially if other disease control measures are implemented during the afforded time. However, if other measures are not instituted, delays may worsen regional epidemics by pushing the outbreak into high epidemic season. This important interaction between policy and seasonality is only evident with a global-scale model. Since the benefit of travel restrictions can be substantial while

An outbreak of dengue virus (DENV) type 2 Cosmopolitan genotype in Israeli travellers returning from the Seychelles, April 2017.

Science.gov (United States)

Lustig, Yaniv; Wolf, Dana; Halutz, Ora; Schwartz, Eli

2017-06-29

Dengue virus infection was diagnosed in six Israeli travellers returning from the Seychelles in April 2017. Phylogenetic analysis identified identical sequences belonging to the Cosmopolitan genotype of dengue virus type 2 in all samples sequenced, thus providing evidence for a probable dengue type 2 outbreak in the Seychelles. This report further demonstrates the role of travellers as sentinels for arboviral infections, especially in countries with limited diagnostic capabilities. This article is copyright of The Authors, 2017.

Travel-related MERS-CoV cases: An assessment of exposures and risk factors in a group of Dutch travellers returning from the Kingdom of Saudi Arabia, May 2014

NARCIS (Netherlands)

E.B. Fanoy (Ewout B.); M.A.B. van der Sande (Marianne); M. Kraaij-Dirkzwager (Marleen); K. Dirksen (Kees); M. Jonges (Marcel); W. van der Hoek (Wim); M.P.G. Koopmans D.V.M. (Marion); D.V. Werf (Douwe Vander); G.J.B. Sonder (Gerard); C. van der Weijden (Charlie); J. van der Heuvel (Jet); L.B.S. Gelinck (Luc); J.W. Bouwhuis (Jolande); A.B. van Gageldonk-Lafeber (Rianne)

2014-01-01

markdownabstract__Background:__ In May 2014, Middle East respiratory syndrome coronavirus (MERS-CoV) infection, with closely related viral genomes, was diagnosed in two Dutch residents, returning from a pilgrimage to Medina and Mecca, Kingdom of Saudi Arabia (KSA). These patients travelled with a

Interim Procedures Safeguarding Mobile Devices during International Travel

Science.gov (United States)

This procedure is for safeguarding EPA information and systems for all employees, contractors, and other users while on international travel or to specifically designated locations within the United States and foreign embassies.

Diarrhea in the International Traveler.

Science.gov (United States)

Duchini; Rodgers

1999-06-01

International travelers to developing countries have a 40% risk of developing a diarrheal illness, usually acute and occasionally chronic. Preventive measures, including diet and lifestyle modifications, are highly recommended but may not be sufficient. Prophylaxis with bismuth subsalicylate or an antimicrobial should be considered in travelers with immunodeficiencies, co-morbid conditions, achlorhydria, or those who cannot afford a loss of time. Oral rehydration is the primary goal of therapy. Bismuth-subsalicylate is a first-line agent for treatment of milder cases with less than three watery bowel movements per day and prominent nausea. Use of an antibiotic is indicated for more severe cases or in the presence of fever, dysentery, or severe dehydration. A short course of a quinolone is highly effective, safe and well tolerated. Antimicrobial resistance among enteropathogens is growing and appropriate therapeutic modifications should be considered according to specific geographic areas. Metronidazole may be empirically added in those cases that do not respond to quinolones. Specific guidelines for particular pathogens are highlighted.

Investment Returns and Economic Fundamentals in International Art Markets

OpenAIRE

Renneboog, L.D.R.; Spaenjers, C.

2014-01-01

Abstract: Works of art are neither easily tradable across borders, nor evaluated according to globally identical standards. We examine geographical segmentation and its effects on price formation and returns in the international art auction market. We find (i) a close connection between the country of sale and the type (e.g., nationality) of artworks sold; (ii) substantial international variation in average returns to art investments over the period 1971-2007; (iii) an impact of both global a...

Should close contacts of returning travellers with typhoid fever be protected by vaccination?

Science.gov (United States)

Kantele, A

2015-03-17

Increasing international travel to areas endemic for typhoid fever correlates with increased risk for travellers to contract the disease. At home, the acutely ill/convalescent patients may pose some risk to their close contacts. In Finland an unofficial guideline suggests vaccination for close contacts of patients with acute typhoid fever; in other developed countries, routine typhoid vaccinations are only recommended to contacts of chronic carriers. This paper discusses the possibilities and limitations of prophylactic/post-exposure typhoid vaccination for contacts of patients with acute disease. Copyright © 2015 Elsevier Ltd. All rights reserved.

Zika virus infection in 18 travellers returning from Surinam and the Dominican Republic, The Netherlands, November 2015-March 2016

NARCIS (Netherlands)

Duijster, Janneke W.; Goorhuis, Abraham; van Genderen, Perry J. J.; Visser, Leo G.; Koopmans, Marion P.; Reimerink, Johan H.; Grobusch, Martin P.; van der Eijk, Annemiek A.; van den Kerkhof, Johannes H. C. T.; Reusken, Chantal B.; Hahné, Susan J. M.

2016-01-01

We report 18 cases of confirmed Zika virus (ZIKV) infection in travellers returning to the Netherlands from Surinam (South America, bordering northern Brazil) and the Dominican Republic. In a multi-centre study, we collected epidemiological, virological and clinical characteristics, as well as data

Extended-spectrum β-lactamase-producing Enterobacteriaceae colonisation in long-term overseas business travellers.

Science.gov (United States)

Mizuno, Yasutaka; Miura, Yuri; Yamaguchi, Tetsuo; Matsumoto, Tetsuya

International travel is considered a risk for colonisation with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE). To our knowledge, no studies to date have focused on ESBL-PE colonisation among long-term business travellers. Therefore this study aimed to clarify the characteristics associated with ESBL-PE colonisation in Japanese long-term business travellers. Japanese business travellers planning to stay abroad for ≥6 months were enrolled. Of the 192 travellers, 135 provided only post-travel stool samples and 57 provided both pre- and post-travel stool samples. Additionally, microbiological analyses of ESBL-PE strains, including susceptibility tests and polymerase chain reaction amplification of CTX-M genes and their sequencing were performed. A post-travel survey showed that of the 55 travellers (40.7%) who tested positive for ESBL-PE after travel, the highest proportion was travellers returning from East and Central Asia. CTX-M gene analyses showed that CTX-M-15 was the most frequently observed (55.0%). A pre- and post-travel survey showed that of the 22 travellers (44.9%) acquired ESBL-PE during their travel, with acquisition most frequently observed in travellers returning from South Asia. Risk-based evaluations of ESBL-PE colonisation should be performed not only for regular tourists but also for long-term business travellers. Copyright © 2016 Elsevier Ltd. All rights reserved.

A survey of the health experiences of international business travelers. Part One--Physiological aspects.

Science.gov (United States)

Rogers, H Lynn; Reilly, Sandra M

2002-10-01

Occupational health professionals need to know more about the health, worklife, and family life of international business travelers (IBTs). This descriptive correlational study, in two parts, examines the physiological and psychosocial experiences associated with business travel for a sample of 140 employees from western Canada's oil and gas industry. Results for Part One show that 76% of IBTs report travel related health problems, 74% have jet lag, 45% have travelers' diarrhea and gastrointestinal complaints, 12% to 16% have climate adaptation problems, and 2% report accidents and minor injuries. High risk behaviors include not carrying a first aid travel kit (54%); drinking more alcohol than ordinarily (21%); and neglecting food, water, and antimalarial precautions (6% to 14%). Other risk factors include age, length of stay, destination, pre-travel medical examinations, pre-travel advice, and eating and accommodation facilities. Findings show that IBTs are at risk for travel related physiological health problems. Implications for practitioners call for increased occupational health expertise in pre-travel preparation, follow up post-travel and regular health surveillance for employees who travel on international business.

Solidarity by demand? Exit and voice in international medical travel - The case of Indonesia

NARCIS (Netherlands)

Ormond, M.E.

2015-01-01

Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical travellers, study of its impacts on medical travellers' home contexts

International travel in the immunocompromised patient: a cross-sectional survey of travel advice in 254 consecutive patients.

Science.gov (United States)

Bialy, C; Horne, K; Dendle, C; Kanellis, J; Littlejohn, G; Ratnam, I; Woolley, I

2015-06-01

Our primary aim was to determine the rate of overseas travel in immunocompromised individuals attending appropriate clinics at an Australian tertiary care hospital. We also aimed to characterise health-seeking behaviour prior to travel and investigated sources of pre-travel advice, compared travel patterns and activities between three specific immunosuppressed groups, and examined pre-immunosuppression patient serology. We implemented a cross-sectional survey of patients between February and August 2012. This survey was implemented among three outpatient populations at Monash Medical Centre, an Australian tertiary care hospital. We recruited 254 immunosuppressed adults from three patient populations: human immunodeficiency virus-positive individuals, renal transplant patients and rheumatology patients requiring immunosuppressive therapy. No clinical intervention was performed. In the 10 years preceding the survey, 153 (60.2%) participants reported international travel. Of these, 105 (68.6%) were immunosuppressed at the time of travel. These patients were 47.6% male and 60% Australian born. Forty per cent were visiting friends and relatives as part of their travel. Fifty-four per cent of those immunocompromised at the time of travel were going to high-risk destinations. Pathology files indicated that serological screening was frequently not performed prior to immunosuppression in the renal transplant and rheumatology groups. Immunocompromised patients often travel to high-risk destinations with limited or inadequate pre-travel preparations. Doctors caring for the immunocompromised should be aware of travel risks, suitable vaccination protocols and when to refer to specialist travel clinics. © 2015 Royal Australasian College of Physicians.

Neoliberal governance and International medical travel in Malaysia

NARCIS (Netherlands)

Ormond, M.E.

2013-01-01

International medical travel (IMT), people crossing national borders in the pursuit of healthcare, has become a growing phenomenon. With many of the countries currently being promoted as IMT destinations located in the ‘developing’ world, IMT poses a significant challenge to popular assumptions

Knowledge and beliefs of international travellers about the transmission and prevention of HIV infection.

OpenAIRE

Allard, R; Lambert, G

1992-01-01

OBJECTIVES: To measure the perceived risk of acquired immunodeficiency syndrome (AIDS) among international travellers, to measure their knowledge of the transmission and prevention of HIV infection abroad and to identify some of the determinants of this knowledge. DESIGN: Survey. SETTING: Travellers' immunization clinic providing mostly primary preventive care to international travellers. PARTICIPANTS: All clients aged 18 to 50 years seen at the clinic between Oct. 2 and Dec. 21, 1989, before...

Zika virus infection in 18 travellers returning from Surinam and the Dominican Republic, The Netherlands, November 2015–March 2016

NARCIS (Netherlands)

J.W. Duijster (Janneke W.); A. Goorhuis (Abraham); P.J.J. van Genderen (Perry); L.G. Visser (Leo); M.P.G. Koopmans D.V.M. (Marion); J.H.J. Reimerink (Johan); M.P. Grobusch (Martin P.); A.A. Eijck (Annemiek); J.H.C.T. van Den Kerkhof (Johannes H. C. T.); C.B.E.M. Reusken (Chantal); S.J. Hahné (Susan); The Dutch Zikv Study Team

2016-01-01

textabstractPurpose: We report 18 cases of confirmed Zika virus (ZIKV) infection in travellers returning to the Netherlands from Surinam (South America, bordering northern Brazil) and the Dominican Republic. Methods: In a multi-centre study, we collected epidemiological, virological and clinical

International travel increase and malaria importation in Romania, 2008-2009.

Science.gov (United States)

Neghina, Raul; Neghina, Adriana M; Marincu, Iosif; Iacobiciu, Ioan

2011-09-01

This report aims to assess the epidemiological characteristics of imported malaria in Romania in the context of international travel increase, and to compare them with the data reported by other European countries. Data on malaria cases were provided by the National Centre for Surveillance and Control of the Communicable Disease, whereas the data regarding international travels to and from Romania were retrieved from the Romanian Statistical Yearbook. The number of Romanian citizens who traveled to Africa in 2007 increased by over 600% as compared to the previous year. During the years 2008-2009, 25 cases of imported malaria were registered in Romania, with no fatalities. All patients were male and most of them (84%) acquired the infection in Africa. Plasmodium falciparum was involved in 68% of cases. The majority of the affected patients (41%) were aged 31 to 40 years. Labor was the main reason for traveling (72%), and 92% of cases took either partial or no chemoprophylaxis. The continuous growth of professional and leisure voyages to malaria-endemic regions may lead to a dramatic increase of imported cases, especially if prophylactic measures are not strictly followed.

Meningococcal vaccination for international travellers from Greece visiting developing countries.

Science.gov (United States)

Pavli, Androula; Katerelos, Panagiotis; Smeti, Paraskevi; Maltezou, Helena C

2016-01-01

Meningococcal meningitis is a serious disease. Travel-associated infection for the general traveller is low; however regular epidemics in indigenous population, particularly in sub-Saharan Africa are responsible for significant morbidity and mortality. Our aim was to assess meningococcal vaccination for international travellers from Greece. A prospective questionnaire-based study was conducted during 2009-2013. A total of 5283 travellers were studied (median age: 39.2 years); Meningococcal tetravalent vaccine (A,C,W135,Y) was delivered to 1150 (21.8%) of them. Of those who travelled to the Middle East and sub-Saharan Africa, 73.1% and 21.2% received meningococcal vaccine, respectively. Of those travellers who travelled to sub-Saharan Africa from November to June and from July to October, 22.1% and 20.6% were vaccinated with meningococcal vaccine, respectively. Of all travellers who travelled for travelled for recreation, and 13.8% of those who travelled for work. Of travellers who stayed in urban, in rural, and in urban and rural areas, 32%, 11.6% and 12.7% were vaccinated, respectively. Meningococcal vaccine was delivered to 29.2%, 21.1%, 19.4% and 5.1% of those who stayed in hotels, at local people's home, in camps, and on ships, respectively. The association of meningococcal vaccine administration with the destination, duration and purpose of travel, area of stay and type of accommodation was statistically significant. There is a need to improve meningococcal vaccine recommendations for travellers from Greece, particularly for high risk populations, such as VFRs, business travellers and those visiting sub-Saharan Africa especially during the dry season. Copyright © 2016 Elsevier Ltd. All rights reserved.

Family compliance with counseling for children traveling to the tropics.

Science.gov (United States)

Caillet-Gossot, Stéphanie; Laporte, Rémi; Noël, Guilhem; Gautret, Philippe; Soula, Georges; Delmont, Jean; Faucher, Benoit; Parola, Philippe; Osei, Lindsay; Minodier, Philippe

2013-01-01

The number of people, both adults and children, traveling abroad, is on the rise. Some seek counseling at travel medicine centers before departure. A prospective study was conducted among children travel medicine center in Marseille, France, from February 2010 to February 2011. Parents were contacted by telephone 4 weeks after their return, and asked about compliance with pre-travel advice. One hundred sixty-seven children were evaluated after their trip. Compliance with immunizations, malaria chemoprophylaxis, and food-borne disease prevention was 71, 66, and 31%, respectively. Compliance with malaria chemoprophylaxis varied significantly with destination, and was higher for African destinations. Significant features associated with poor compliance with chemoprophylaxis were a trip to Asia or the Indian Ocean, age travel counseling in children traveling overseas was achieved only for drinking bottled water, using repellents, a routine vaccine update, and yellow fever immunization. © 2013 International Society of Travel Medicine.

The Carriage Of Multiresistant Bacteria After Travel (COMBAT) prospective cohort study: methodology and design.

Science.gov (United States)

Arcilla, Maris S; van Hattem, Jarne M; Bootsma, Martin C J; van Genderen, Perry J; Goorhuis, Abraham; Schultsz, Constance; Stobberingh, Ellen E; Verbrugh, Henri A; de Jong, Menno D; Melles, Damian C; Penders, John

2014-04-28

Antimicrobial resistance (AMR) is one of the major threats to public health around the world. Besides the intense use and misuse of antimicrobial agents as the major force behind the increase in antimicrobial resistance, the exponential increase of international travel may also substantially contribute to the emergence and spread of AMR. However, knowledge on the extent to which international travel contributes to this is still limited. The Carriage Of Multiresistant Bacteria After Travel (COMBAT) study aims to 1. determine the acquisition rate of multiresistant Enterobacteriaceae during foreign travel 2. ascertain the duration of carriage of these micro-organisms 3. determine the transmission rate within households 4. identify risk factors for acquisition, persistence of carriage and transmission of multiresistant Enterobacteriaceae. The COMBAT-study is a large-scale multicenter longitudinal cohort study among travellers (n = 2001) and their non-travelling household members (n = 215). Faecal samples are collected before and immediately after travel and 1 month after return from all participants. Follow-up faecal samples are collected 3, 6 and 12 months after return from travellers (and their non-travelling household members) who acquired multiresistant Enterobacteriaceae. Questionnaires are collected from all participants at each time-point. Faecal samples are screened phenotypically for the presence of extended-spectrum beta-lactamase (ESBL) or carbapenemase-producing Enterobacteriaceae. Positive post-travel isolates from travellers with negative pre-travel samples are genotypically analysed for ESBL and carbapenemase genes with microarray and gene sequencing. The design and scale of the COMBAT-study will enable us to provide much needed detailed insights into the risks and dynamics of introduction and spread of ESBL- and carbapenemase-producing Enterobacteriaceae by healthy travellers and the potential need and measures to monitor or manage these risks

Daily happiness and stock returns: Some international evidence

Science.gov (United States)

Zhang, Wei; Li, Xiao; Shen, Dehua; Teglio, Andrea

2016-10-01

In this paper, we examine the relations between the daily happiness sentiment extracted from Twitter and the stock market performance in 11 international stock markets. By partitioning this happiness sentiment into quintiles from the least to the happiest days, we first show that the contemporary correlation coefficients between happiness sentiment and index return in the 4 and most-happiness subgroups are higher than that in least, 2 and 3-happiness subgroups. Secondly, the happiness sentiment can provide additional explanatory power for index return in the most-happiness subgroup. Thirdly, the daily happiness can granger-cause the changes in index return for the majority of stock markets. Fourthly, we find that the index return and the range-based volatility of the most-happiness subgroup are larger than those of other subgroups. These results highlight the important role of social media in stock market.

Electronic network for monitoring travellers' diarrhoea and detection of an outbreak caused by Salmonella enteritidis among overseas travellers.

Science.gov (United States)

Osaka, K; Inouye, S; Okabe, N; Taniguchi, K; Izumiya, H; Watanabe, H; Matsumoto, Y; Yokota, T; Hashimoto, S; Sagara, H

1999-12-01

The Traveller's Diarrhoea Network, by which the Infectious Disease Surveillance Center is electronically connected with two major airport quarantine stations and three infectious disease hospitals, was launched in February 1988 in Japan. The data on travellers' diarrhoea detected is reported weekly by e-mail. Two clusters of infection among travellers returning from Italy were reported by two airport quarantine stations at the end of September 1998. A total of 12 salmonella isolates from 2 clusters were examined. All were identified as Salmonella enteritidis, phage type 4 and showed identical banding patterns on pulsed-field gel electrophoresis. A case-control study showed that the scrambled eggs served at the hotel restaurant in Rome were the likely source of this outbreak. This outbreak could not have been detected promptly and investigated easily without the e-mail network. International exchange of data on travellers' diarrhoea is important for preventing and controlling food-borne illnesses infected abroad.

Simultaneous outbreaks of dengue, chikungunya and Zika virus infections: diagnosis challenge in a returning traveller with nonspecific febrile illness

Directory of Open Access Journals (Sweden)

E. Moulin

2016-05-01

Full Text Available Zika virus is an emerging flavivirus that is following the path of dengue and chikungunya. The three Aedes-borne viruses cause simultaneous outbreaks with similar clinical manifestations which represents a diagnostic challenge in ill returning travellers. We report the first Zika virus infection case imported to Switzerland and present a diagnostic algorithm.

The 'selfie' phenomenon: reducing the risk of harm while using smartphones during international travel.

Science.gov (United States)

Flaherty, Gerard T; Choi, Joonkoo

2016-02-01

Photography is an integral component of the international travel experience. Self-photography is becoming a mainstream behaviour in society and it has implications for the practice of travel medicine. Travellers who take selfies, including with the use of selfie sticks, may be subject to traumatic injuries associated with this activity. This review article is the first in the medical literature to address this emerging phenomenon. Articles indexed on PubMed and Scopus databases through 2015 were retrieved, using the search terms 'travel', combined with 'selfie', 'self-photography', 'smartphone', 'mobile phone' and 'social media'. The reference lists of articles were manually searched for additional publications, and published media reports of travel-related self-photography were examined. The lack of situational awareness and temporary distraction inherent in selfie-taking exposes the traveller to potential hazards. A diverse group of selfie injuries has been reported, including injury and death secondary to selfie-related falls, attacks from wild animals, electrocution, lightning strikes, trauma at sporting events, road traffic and pedestrian accidents. Public health measures adopted by the Russian Federation in response to over 100 reported selfie injuries in 2015 alone are presented. The review also discusses the potential for direct trauma from the use of selfie sticks. Travel-related scenarios where selfies should be avoided include photographs taken from a height, on a bridge, in the vicinity of vehicular traffic, during thunderstorms, at sporting events, and where wild animals are in the background. Recommendations exist which discourage use of mobile phones in drivers and pedestrians. The travel medicine practitioner should routinely counsel travellers about responsible self-photography during international travel and should include this advice in printed material given to the patient. The travel and mobile phone industries should reinforce these health

Expatriates ill after travel: results from the Geosentinel Surveillance Network.

Science.gov (United States)

Lim, Poh-Lian; Han, Pauline; Chen, Lin H; MacDonald, Susan; Pandey, Prativa; Hale, DeVon; Schlagenhauf, Patricia; Loutan, Louis; Wilder-Smith, Annelies; Davis, Xiaohong M; Freedman, David O

2012-12-31

Expatriates are a distinct population at unique risk for health problems related to their travel exposure. We analyzed GeoSentinel data comparing ill returned expatriates with other travelers for demographics, travel characteristics, and proportionate morbidity (PM) for travel-related illness. Our study included 2,883 expatriates and 11,910 non-expatriates who visited GeoSentinel clinics ill after travel. Expatriates were more likely to be male, do volunteer work, be long-stay travelers (>6 months), and have sought pre-travel advice. Compared to non-expatriates, expatriates returning from Africa had higher proportionate morbidity (PM) for malaria, filariasis, schistosomiasis, and hepatitis E; expatriates from the Asia-Pacific region had higher PM for strongyloidiasis, depression, and anxiety; expatriates returning from Latin America had higher PM for mononucleosis and ingestion-related infections (giardiasis, brucellosis). Expatriates returning from all three regions had higher PM for latent TB, amebiasis, and gastrointestinal infections (other than acute diarrhea) compared to non-expatriates. When the data were stratified by travel reason, business expatriates had higher PM for febrile systemic illness (malaria and dengue) and vaccine-preventable infections (hepatitis A), and volunteer expatriates had higher PM for parasitic infections. Expatriates overall had higher adjusted odds ratios for latent TB and lower odds ratios for acute diarrhea and dermatologic illness. Ill returned expatriates differ from other travelers in travel characteristics and proportionate morbidity for specific diseases, based on the region of exposure and travel reason. They are more likely to present with more serious illness.

Pre-travel preparation practices among business travellers to tropical and subtropical destinations: results from the Athens International Airport Survey.

Science.gov (United States)

Pavli, Androula; Silvestros, Chrysovalantis; Patrinos, Stavros; Lymperi, Ioanna; Maltezou, Helena C

2014-01-01

The number of business travellers from Greece to tropical and subtropical areas has recently increased. The study aimed to assess travel health preparation practices of business travellers departing to Africa, the Middle East and Asia. A questionnaire-based survey was conducted at Athens International Airport, from 1st of November 2011 to 30th of April 2013. A total of 684 business travellers participated in the study; the majority were men (86.1%), of Greek nationality (95.3%), with tertiary education (90.8%) and employed (98%). Their mean age was 40 years; 62% and 26% of them were 35-49 and 19-34 years of age respectively. 84.8% were travelling alone. Most frequent destinations were the Middle East (46.8%) and sub-Saharan Africa (16%). For 23.5% of the travellers it was their first trip to a tropical or subtropical country. Only 58.8% pursued pre-travel health consultation; vaccination and malaria chemoprophylaxis were administered to 24.7% and 25.7% of the travellers, respectively. Hepatitis A and typhoid vaccination rates were lower than expected (70% and 35%, respectively). Nearly half of the travellers who visited malaria endemic areas did not receive any chemoprophylaxis. Having elementary education level, travelling to the Middle East or North Africa, travelling for less than 1 month duration, and staying in a house or a hotel were associated with a higher probability of not pursuing health consultation. Significant gaps were found in pre-travel health practices of business travellers departing to Africa, the Middle East and Asia. Strategies should be developed in order to improve awareness of business travellers. Copyright © 2013 Elsevier Ltd. All rights reserved.

Gay and bisexual men engage in fewer risky sexual behaviors while traveling internationally: a cross-sectional study in San Francisco.

Science.gov (United States)

Truong, Hong-Ha M; Fatch, Robin; Grasso, Michael; Robertson, Tyler; Tao, Luke; Chen, Yea-Hung; Curotto, Alberto; McFarland, Willi; Grant, Robert M; Reznick, Olga; Raymond, H Fisher; Steward, Wayne T

2015-05-01

International travel poses potential challenges to HIV prevention. A number of studies have observed an association between travel and behavioural disinhibition. In the present study, we assessed differences in sexual behaviour while travelling internationally and within the USA, compared with being in the home environment. A probability-based sample of men who have sex with men (MSM) from the San Francisco Bay Area who had travelled internationally in the previous 12 months was recruited through an adapted respondent-driven sampling methodology (N=501). Participants completed interviewer-administered, computer-assisted surveys. Detailed partner-by-partner behavioural data by destination type were collected on 2925 sexual partnerships: 1028 while travelling internationally, 665 while travelling within the USA and 1232 while staying in the San Francisco Bay Area. The proportion of partnerships during international travel that involved unprotected anal intercourse (UAI) was lower compared with during domestic travel and staying locally. International travel was associated with decreased odds of receptive UAI (AOR=0.65, p=0.02) compared with staying locally and there was a trend towards decreased odds of insertive UAI (AOR=0.70, p=0.07). MSM engaged in proportionately fewer sexual activities which present a high HIV transmission risk when travelling internationally, namely unprotected receptive and insertive anal intercourse and particularly with HIV serodiscordant partners. The lower sexual risk-taking during international travel was robust to controlling for many factors, including self-reported HIV serostatus, age, relationship status and type of partnership. These findings suggest that when travelling internationally, MSM may experience behavioural disinhibition to a lesser extent than had been described previously. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges.

Science.gov (United States)

Al-Abri, Seif S; Abdel-Hady, Doaa M; Al-Abaidani, Idris S

2016-06-01

Although the majority of travel-associated communicable diseases can be prevented, the public health burden of these diseases remains significant. Relatively little is known about how travelers know and perceive the health risks associated with travel and how they utilize preventive measures before and while traveling abroad. This study was conducted to determine the level of the knowledge, attitudes, and practices (KAP) of Muscat International Airport travelers about travel health in order to assess the knowledge gap and the need for travel health services in Oman. A cross-sectional study was conducted over a period of 1week using a self-administered questionnaire. The overall level of knowledge about vaccine-preventable diseases, food safety, and preventive measures against insect bites of the participants was inadequate. The practice concerning preventive travel health measures, such as the use of specific immunizations and antimalarial prophylaxis, was very limited, and influenced by some personal and travel-related factors. The inadequate level of travelers' knowledge and poor utilization of travel medicine services highlights the need for the provisions of specialized travel medicine services at the national level and to develop educational materials promoting the importance of pre-travel health advice. Copyright © 2016 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

International travel as medical research: architecture and the modern hospital.

Science.gov (United States)

Logan, Cameron; Willis, Julie

2010-01-01

The design and development of the modern hospital in Australia had a profound impact on medical practice and research at a variety of levels. Between the late 1920s and the 1950s hospital architects, administrators, and politicians travelled widely in order to review the latest international developments in the hospital field They were motivated by Australia's geographic isolation and a growing concern with how to govern the population at the level of physical health. While not 'medical research' in the conventional sense of the term, this travel was a powerful generator of medical thinking in Australia and has left a rich archival legacy. This paper draws on that archive to demonstrate the ways in which architectural research and international networks of hospital specialists profoundly shaped the provision of medical infrastructure in Australia.

Pre-travel health seeking practices of Umrah pilgrims departing from Assiut International Airport, Egypt.

Science.gov (United States)

Aziz, Mirette M; Abd El-Megeed, Hosnia S; Abd Ellatif, Mennat Allah M

2018-04-22

to assess the health seeking practices and their determinants among Umrah pilgrims departing from Assiut international Airport. We interviewed 300 pilgrims departing from Assiut International Airport while they were in the departure lounge, using a semi-structured questionnaire. Only 60%, 46.3% and 46.3% of Umrah pilgrims believed in importance of pre-travel vaccination, seeking health information, and health examination, respectively. The most frequently practiced pre-travel health related behaviour was getting vaccinated (56.3%), as compared to much lower frequencies of seeking health information (24%) or having a clinical health examination (26.7%). Private clinics, internet and the tourism companies were the main sources of health information of the pilgrims. Positive attitude of pilgrims about health seeking practices, the perception of health risk of travelling to Hajj/Umrah and having a chronic disease were the predictors of pre-travel health practices. Raising awareness among Hajj/Umrah pilgrims about the importance of seeking professional pre-travel health advice and communicating the risk of exposure to travel-related diseases to pilgrims could be important strategies to improve the uptake of preventive measures. Training of general practitioners in the public health sector about the travel health information would promote the travel health services. Copyright © 2018. Published by Elsevier Ltd.

Educating international students about tuberculosis and infections associated with travel to visit friends and relatives (VFR-travel).

Science.gov (United States)

Gibney, Katherine B; Brass, Amanda; Hume, Sam C; Leder, Karin

2014-01-01

International students in Victoria, Australia, originate from over 140 different countries. They are over-represented in disease notifications for tuberculosis and travel-associated infections, including enteric fever, hepatitis A, and malaria. We describe a public health initiative aimed to increase awareness of these illnesses among international students and their support staff. We identified key agencies including student support advisors, medical practitioners, health insurers, and government and professional organisations. We developed health education materials targeting international students regarding tuberculosis and travel-related infections to be disseminated via a number of different media, including electronic and printed materials. We sought informal feedback from personnel in all interested agencies regarding the materials developed, their willingness to deliver these materials to international students, and their preferred media for disseminating these materials. Education institutions with dedicated international student support staff and on-campus health clinics were more easily engaged to provide feedback and disseminate the health education materials than institutions without such dedicated personnel. Response to contacting off-campus medical practices was poor. Delivery of educational materials via electronic and social media was preferred over face-to-face education. It is feasible to provide health education messages targeting international students for dissemination via appropriately-staffed educational institutions. This initiative could be expanded in terms of age-group, geographic range, and health issues to be targeted. Copyright © 2013 Elsevier Ltd. All rights reserved.

Expatriates ill after travel: Results from the Geosentinel Surveillance Network

Directory of Open Access Journals (Sweden)

Lim Poh-Lian

2012-12-01

Full Text Available Abstract Background Expatriates are a distinct population at unique risk for health problems related to their travel exposure. Methods We analyzed GeoSentinel data comparing ill returned expatriates with other travelers for demographics, travel characteristics, and proportionate morbidity (PM for travel-related illness. Results Our study included 2,883 expatriates and 11,910 non-expatriates who visited GeoSentinel clinics ill after travel. Expatriates were more likely to be male, do volunteer work, be long-stay travelers (>6 months, and have sought pre-travel advice. Compared to non-expatriates, expatriates returning from Africa had higher proportionate morbidity (PM for malaria, filariasis, schistosomiasis, and hepatitis E; expatriates from the Asia-Pacific region had higher PM for strongyloidiasis, depression, and anxiety; expatriates returning from Latin America had higher PM for mononucleosis and ingestion-related infections (giardiasis, brucellosis. Expatriates returning from all three regions had higher PM for latent TB, amebiasis, and gastrointestinal infections (other than acute diarrhea compared to non-expatriates. When the data were stratified by travel reason, business expatriates had higher PM for febrile systemic illness (malaria and dengue and vaccine-preventable infections (hepatitis A, and volunteer expatriates had higher PM for parasitic infections. Expatriates overall had higher adjusted odds ratios for latent TB and lower odds ratios for acute diarrhea and dermatologic illness. Conclusions Ill returned expatriates differ from other travelers in travel characteristics and proportionate morbidity for specific diseases, based on the region of exposure and travel reason. They are more likely to present with more serious illness.

A Website: a Way to Promote the Products and the Services of Salim International Tours and Travel

OpenAIRE

Merari, Clarrisa; Ibrahim, Jusuf I

2015-01-01

Salim Tours and Travels offers various services such as reserving flight tickets (domestic and International), reserving hotel rooms, assisting clients to apply for passports or visas and providing International or domestic tours. Salim Tours and Travels is located on Panglima Sudirman 72-1, Surabaya, which is at the center of Surabaya. Salim Tours and Travel Agency was established on 2nd February, 2002 in Surabaya. Because of Tour and Travel have a good prospect in the future, Salim Tours ne...

Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak.

Science.gov (United States)

Bogoch, Isaac I; Creatore, Maria I; Cetron, Martin S; Brownstein, John S; Pesik, Nicki; Miniota, Jennifer; Tam, Theresa; Hu, Wei; Nicolucci, Adriano; Ahmed, Saad; Yoon, James W; Berry, Isha; Hay, Simon I; Anema, Aranka; Tatem, Andrew J; MacFadden, Derek; German, Matthew; Khan, Kamran

2015-01-03

The WHO declared the 2014 west African Ebola epidemic a public health emergency of international concern in view of its potential for further international spread. Decision makers worldwide are in need of empirical data to inform and implement emergency response measures. Our aim was to assess the potential for Ebola virus to spread across international borders via commercial air travel and assess the relative efficiency of exit versus entry screening of travellers at commercial airports. We analysed International Air Transport Association data for worldwide flight schedules between Sept 1, 2014, and Dec 31, 2014, and historic traveller flight itinerary data from 2013 to describe expected global population movements via commercial air travel out of Guinea, Liberia, and Sierra Leone. Coupled with Ebola virus surveillance data, we modelled the expected number of internationally exported Ebola virus infections, the potential effect of air travel restrictions, and the efficiency of airport-based traveller screening at international ports of entry and exit. We deemed individuals initiating travel from any domestic or international airport within these three countries to have possible exposure to Ebola virus. We deemed all other travellers to have no significant risk of exposure to Ebola virus. Based on epidemic conditions and international flight restrictions to and from Guinea, Liberia, and Sierra Leone as of Sept 1, 2014 (reductions in passenger seats by 51% for Liberia, 66% for Guinea, and 85% for Sierra Leone), our model projects 2.8 travellers infected with Ebola virus departing the above three countries via commercial flights, on average, every month. 91,547 (64%) of all air travellers departing Guinea, Liberia, and Sierra Leone had expected destinations in low-income and lower-middle-income countries. Screening international travellers departing three airports would enable health assessments of all travellers at highest risk of exposure to Ebola virus infection

Travel health attitudes among Turkish business travellers to African countries.

Science.gov (United States)

Selcuk, Engin Burak; Kayabas, Uner; Binbasioglu, Hulisi; Otlu, Baris; Bayindir, Yasar; Bozdogan, Bulent; Karatas, Mehmet

The number of international travellers is increasing worldwide. Although health risks related to international travel are important and generally well-understood, the perception of these risks was unclear among Turkish travellers. We aimed to evaluate the attitudes and health risk awareness of Turkish travellers travelling to African countries. A survey was performed of Turkish travellers bound for Africa from Istanbul International Ataturk Airport in July 2013. A total of 124 travellers were enrolled in the study. Among them, 62.9% had information about their destination but only 11.3% had looked for information on health problems related to travel and their destination. Of all travellers, 53.2% had at least one vaccination before travelling. The most commonly administered vaccine was for typhoid. Among the travellers, 69.3% and 80.6% had "no idea" about yellow fever vaccination and malaria prophylaxis, respectively. A positive correlation was found between a higher level of travellers' education and receiving the recommended vaccination for the destination. Our study revealed significant gaps in the vaccination and chemoprophylaxis uptake of Turkish travellers departing to Africa. An awareness and training program should be developed for travellers, as well as public health workers, to address health risks related to travel. Copyright © 2016 Elsevier Ltd. All rights reserved.

An Internationally Coordinated Science Management Plan for Samples Returned from Mars

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Haltigin, T.; Smith, C. L.

2015-12-01

Mars Sample Return (MSR) remains a high priority of the planetary exploration community. Such an effort will undoubtedly be too large for any individual agency to conduct itself, and thus will require extensive global cooperation. To help prepare for an eventual MSR campaign, the International Mars Exploration Working Group (IMEWG) chartered the international Mars Architecture for the Return of Samples (iMARS) Phase II working group in 2014, consisting of representatives from 17 countries and agencies. The overarching task of the team was to provide recommendations for progressing towards campaign implementation, including a proposed science management plan. Building upon the iMARS Phase I (2008) outcomes, the Phase II team proposed the development of an International MSR Science Institute as part of the campaign governance, centering its deliberations around four themes: Organization: including an organizational structure for the Institute that outlines roles and responsibilities of key members and describes sample return facility requirements; Management: presenting issues surrounding scientific leadership, defining guidelines and assumptions for Institute membership, and proposing a possible funding model; Operations & Data: outlining a science implementation plan that details the preliminary sample examination flow, sample allocation process, and data policies; and Curation: introducing a sample curation plan that comprises sample tracking and routing procedures, sample sterilization considerations, and long-term archiving recommendations. This work presents a summary of the group's activities, findings, and recommendations, highlighting the role of international coordination in managing the returned samples.

Carbon emission offsets for aviation-generated emissions due to international travel to and from New Zealand

International Nuclear Information System (INIS)

Smith, Inga J.; Rodger, Craig J.

2009-01-01

International air transport emissions are not subject to liability under the Kyoto Protocol. However, pressure is mounting globally for international aviation to be included in post-Kyoto arrangements. In the absence of international collective action, a number of so-called carbon offsetting schemes have emerged that allow individual travellers and companies to compensate for their international air travel emissions. These schemes offer technological solutions, such as planting sink forests to sequester emissions. To consider the implications of future collective action, this paper presents a case study assessment of the physical feasibility of five schemes for all short duration journeys to and from New Zealand. This is the first comprehensive national-level case study assessment of competing offsetting options for international aviation emissions in the peer-reviewed literature. The CO 2 -e emissions produced by the air travel of international visitors to New Zealand, and for New Zealand residents travelling overseas, is calculated in this paper to be 7893 and 3948 Gg, respectively, in 2005. It is then shown that no single offsetting scheme targeted inside the country appears physically and/or politically realistic. This indicates the sheer size of these emissions, and the challenge that the international community faces for collective action on this matter. (author)

Schistosomiasis and international travel.

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Corachan, Manuel

2002-08-15

Infection with Schistosoma species is acquired by exposure to fresh water that harbors cercariae released by infected snails. Although the route of infection is clear, clinical presentation of the established infection in the nonimmune tourist typically differs from that in the local population of areas of endemicity. For the health care practitioner, the traveler's syndrome presents distinctive management problems: water-transmitted bacterial and viral infections may coexist, and identification of the stage of disease at presentation, along with identification of the causative species, will maximize treatment options. Travel medicine clinics serve as epidemiological antennae, helping to identify the dynamics of species transmission in geographically distinct areas. Education of persons traveling to areas of endemicity and the development of mechanical protection against exposure are needed.

Essential travel medicine

CERN Document Server

Zuckerman, Jane N; Leggat, Peter

2015-01-01

This 1st edition of Essential Travel Medicine provides an excellent concise introduction to the specialty of Travel Medicine. This core text will enable health care practitioners particularly those new to the clinical practice of Travel Medicine, to gain a fundamental understanding of the diverse and complex issues which can potentially affect the health of the many millions of people who undertake international travel. Jane N Zuckerman is joined by Gary W Brunette from CDC and Peter A Leggat from Australia as Editors. Leading international specialists in their fields have contributed authoritative chapters reflecting current knowledge to facilitate best clinical practice in the different aspects of travel medicine. The aim of Essential Travel Medicine is to provide a comprehensive guide to Travel Medicine as well as a fundamental knowledge base to support international undergraduate and postgraduate specialty training programmes in the discipline of Travel Medicine. The 1st edition of Essential Travel ...

7 CFR 3402.6 - Overview of the special international study and/or thesis/dissertation research travel allowance.

Science.gov (United States)

2010-01-01

... thesis/dissertation research travel allowance. 3402.6 Section 3402.6 Agriculture Regulations of the... GRANTS PROGRAM Program Description § 3402.6 Overview of the special international study and/or thesis... special international study or thesis/dissertation research travel allowance, the Project Director must...

Changing Attitudes Toward Care of Aging Parents: The Influence of Education, International Travel, and Gender.

Science.gov (United States)

Compernolle, Ellen

Population aging is a key public health issue facing many nations, and is particularly pronounced in many Asian countries. At the same time, attitudes toward filial obligation are also rapidly changing, with a decreasing sense that children are responsible for caring for elderly parents. This investigation blends the family versus nonfamily mode of social organization framework with a life course perspective to provide insight into the processes of ideational change regarding filial responsibility, highlighting the influence of education and international travel. Using data from a longitudinal study in Nepal-the Chitwan Valley Family Study-results demonstrate that education and international travel are associated with a decrease in attitudes toward filial obligation. However, findings further reveal that the impact of education and international travel vary both across the life course and by gender.

Forced migration and mental health: prolonged internal displacement, return migration and resilience.

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Siriwardhana, Chesmal; Stewart, Robert

2013-03-01

Forced internal displacement has been rising steadily, mainly due to conflict. Many internally displaced people (IDP) experience prolonged displacement. Global research evidence suggests that many of these IDP are at high risk for developing mental disorders, adding weight to the global burden of disease. However, individual and community resilience may act as protective factors. Return migration may be an option for some IDP populations, especially when conflicts end, although return migration may itself be associated with worse mental health. Limited evidence is available on effects of resettlement or return migration following prolonged forced internal displacement on mental health. Also, the role of resilience factors remains to be clarified following situations of prolonged displacement. The public health impact of internal displacement is not clearly understood. Epidemiological and interventional research in IDP mental health needs to look beyond medicalised models and encompass broader social and cultural aspects. The resilience factor should be integrated and explored more in mental health research among IDP and a clearly focused multidisciplinary approach is advocated.

Travel medicine advice to UK based international motor sport teams.

Science.gov (United States)

Walters, A

2000-01-01

International motor sport teams travel extensively. Over the years, the design and build of racing cars has improved so that morbidity and mortality in motor sport has been lessened. Those team members supporting the competitors need to be physically and mentally fit to perform complicated tasks, despite having traveled. This group of travelers has not been studied to any extent previously. An anonymous questionnaire asking some basic travel medicine related questions was distributed to the support team members of a Rally team, and Formula One Grand Prix team. Both teams were based in the UK, and competed in all the rounds of their respective world championships. Ten Rally team members and 18 Formula One team members responded to the questionnaire. The results showed moderate coverage of commonly used vaccinations; appropriate use of antimalarials and insect repellents, but by no means by all team members; little or no problems with traveler's diarrhea; some tendencies to problems related to jet lag, but no real attempt to prevent the problem; and finally some attempt at skin protection against solar damage. Support teams are reasonably well prepared for the combination of, the rigors of frequent travel, and a demanding job. There is a deficit in vaccine coverage, especially of both hepatitis A and B, some education is needed in preventing skin problems later in life due to sun exposure, and further study of jet lag and its implications might be appropriate.

Arboviral and other illnesses in travellers returning from Brazil, June 2013 to May 2016: implications for the 2016 Olympic and Paralympic Games

NARCIS (Netherlands)

Gautret, Philippe; Mockenhaupt, Frank; Grobusch, Martin P.; Rothe, Camilla; von Sonnenburg, Frank; van Genderen, Perry J.; Chappuis, Francois; Asgeirsson, Hilmir; Caumes, Eric; Bottieau, Emmanuel; Malvy, Denis; Lopez-Vélez, Rogelio; Jensenius, Mogens; Larsen, Carsten Schade; Castelli, Francesco; Rapp, Christophe; Field, Vanessa; Molina, Israel; Gkrania-Klotsas, Effrossyni; Florescu, Simin; Lalloo, David; Schlagenhauf, Patricia

2016-01-01

We evaluated EuroTravNet (a GeoSentinel subnetwork) data from June 2013 to May 2016 on 508 ill travellers returning from Brazil, to inform a risk analysis for Europeans visiting the 2016 Olympic and Paralympic Games in Brazil. Few dengue fever cases (n = 3) and no cases of chikungunya were

Health problems associated with international business travel. A critical review of the literature.

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Rogers, H L; Reilly, S M

2000-08-01

1. Few studies examine the travel related health problems of international business travelers (IBTs). Research exists for other travelers, such as tourists, which begins to help clinicians understand the potential health problems faced by IBTs. 2. A review of the literature reveals 36% to 54% of travelers experience physical health problems such as traveler's diarrhea, insomnia, respiratory problems, and skin problems; 6% to 18% report accidents and injuries while abroad. 3. Psychosocial data are equally limited, but support the idea that IBTs may experience stress, anxiety, culture shock, and adjustment problems while overseas. 4. Multiple factors likely contribute to the physical and psychosocial health experiences of IBTs. The historical lack of data for this population of workers combined with the trend towards globalization confirm the need for further study from an occupational health perspective.

Evaluation of the Coca-Cola company travel health kit.

Science.gov (United States)

Harper, Lynne A; Bettinger, Julie; Dismukes, Roberta; Kozarsky, Phyllis E

2002-01-01

The Coca-Cola travel health kit has been used for about one decade for international travelers and required evaluation to see if the items contained were appropriate for the employees. Two hundred thirty-four travelers were sampled and filled out a voluntary survey including questions about demographic information, travel history, and usage and value of the contents of the travel health kit. One hundred eighty-one surveys were returned; 65% of the respondents were male, and the majority of travelers were between the ages of 36 and 45 years. The most useful items were analgesics and medications used for gastrointestinal problems. In general, the items identified as being the least useful were those requiring specialized use by a medical practitioner, such as needles and syringes. Suggestions of items to be added to the kit included vitamins, cough drops, sleep aids, and eye drops. A surprising result that Coca-Cola employees expressed the desire for brand name rather than generic items. Evaluation of the Coca-Cola Company travel health kit revealed it to be very useful to most corporate travelers. Suggestions that were made will be taken into consideration in designing a new kit, and consideration is being given to whether a basic travel health kit should be provided to which travelers can add other items depending on their personal needs.

International Travel by Speakers of Esperanto. Esperanto Documents, New Series, No. 9A.

Science.gov (United States)

Tyblewski, Tyburcjusz

This volume considers the value of Esperanto in relation to international tourism, and the characteristics of Esperantist tourists. Esperanto is seen as a solution to problems of language in international relations in general, and thus to international travel as well. The following are some of the general characteristics of the majority of…

Investment returns and economic fundamentals in international art markets

NARCIS (Netherlands)

Renneboog, L.D.R.; Spaenjers, C.; Velthuis, O.; Baia-Curioni, S.

Works of art are neither easily tradable across borders, nor evaluated according to globally identical standards. This chapter examines geographical segmentation and its effects on price formation and returns in the international art auction market. The chapter finds (1) a close connection between

Travel medicine

Science.gov (United States)

Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

2014-01-01

Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599

Investment Returns and Economic Fundamentals in International Art Markets

NARCIS (Netherlands)

Renneboog, L.D.R.; Spaenjers, C.

2014-01-01

Abstract: Works of art are neither easily tradable across borders, nor evaluated according to globally identical standards. We examine geographical segmentation and its effects on price formation and returns in the international art auction market. We find (i) a close connection between the country

Travel and migration associated infectious diseases morbidity in Europe, 2008

Directory of Open Access Journals (Sweden)

Lopez-Velez Rogelio

2010-11-01

Full Text Available Abstract Background Europeans represent the majority of international travellers and clinicians encountering returned patients have an essential role in recognizing, and communicating travel-associated public health risks. Methods To investigate the morbidity of travel associated infectious diseases in European travellers, we analysed diagnoses with demographic, clinical and travel-related predictors of disease, in 6957 ill returned travellers who presented in 2008 to EuroTravNet centres with a presumed travel associated condition. Results Gastro-intestinal (GI diseases accounted for 33% of illnesses, followed by febrile systemic illnesses (20%, dermatological conditions (12% and respiratory illnesses (8%. There were 3 deaths recorded; a sepsis caused by Escherichia coli pyelonephritis, a dengue shock syndrome and a Plasmodium falciparum malaria. GI conditions included bacterial acute diarrhea (6.9%, as well as giardiasis and amebasis (2.3%. Among febrile systemic illnesses with identified pathogens, malaria (5.4% accounted for most cases followed by dengue (1.9% and others including chikungunya, rickettsial diseases, leptospirosis, brucellosis, Epstein Barr virus infections, tick-borne encephalitis (TBE and viral hepatitis. Dermatological conditions were dominated by bacterial infections, arthropod bites, cutaneous larva migrans and animal bites requiring rabies post-exposure prophylaxis and also leishmaniasis, myasis, tungiasis and one case of leprosy. Respiratory illness included 112 cases of tuberculosis including cases of multi-drug resistant or extensively drug resistant tuberculosis, 104 cases of influenza like illness, and 5 cases of Legionnaires disease. Sexually transmitted infections (STI accounted for 0.6% of total diagnoses and included HIV infection and syphilis. A total of 165 cases of potentially vaccine preventable diseases were reported. Purpose of travel and destination specific risk factors was identified for several

Effectiveness of border screening for detecting influenza in arriving airline travelers.

Science.gov (United States)

Priest, Patricia C; Jennings, Lance C; Duncan, Alasdair R; Brunton, Cheryl R; Baker, Michael G

2015-10-01

We measured symptom and influenza prevalence, and the effectiveness of symptom and temperature screening for identifying influenza, in arriving international airline travelers. This cross-sectional study collected data from travelers to Christchurch International Airport, New Zealand, in winter 2008, via a health questionnaire, temperature testing, and respiratory sampling. Forms were returned by 15 976 (68%) travelers. Of these, 17% reported at least 1 influenza symptom, with runny or blocked nose (10%) and cough (8%) most common. Respiratory specimens were obtained from 3769 travelers. Estimated prevalence of influenza was 1.1% (4% among symptomatic, 0.2% among asymptomatic). The sensitivity of screening criteria ranged from 84% for "any symptom" to 3% for a fever of 37.8 °C or greater. The positive predictive value was low for all criteria. Border screening using self-reported symptoms and temperature testing has limitations for preventing pandemic influenza from entering a country. Using "any symptom" or cough would lead to many uninfected people being investigated, yet some infected people would remain undetected. If more specific criteria such as fever were used, most infected people would enter the country despite screening.

[Effectiveness of border screening for detecting Influenza in arriving airline travelers].

Science.gov (United States)

Priest, Patricia C; Jennings, Lance C; Duncan, Alasdair R; Brunton, Cheryl R; Baker, Michael G

2014-02-01

We measured symptom and influenza prevalence, and the effectiveness of symptom and temperature screening for identifying influenza, in arriving international airline travelers. This cross-sectional study collected data from travelers to Christchurch International Airport, New Zealand, in winter 2008, via a health questionnaire, temperature testing, and respiratory sampling. Forms were returned by 15 976 (68%) travelers. Of these, 17% reported at least 1 influenza symptom, with runny or blocked nose (10%) and cough (8%) most common. Respiratory specimens were obtained from 3769 travelers. Estimated prevalence of influenza was 1.1% (4% among symptomatic, 0.2% among asymptomatic). The sensitivity of screening criteria ranged from 84% for "any symptom" to 3% for a fever of 37.8 ºC or greater. The positive predictive value was low for all criteria. Border screening using self-reported symptoms and temperature testing has limitations for preventing pandemic influenza from entering a country. Using "any symptom" or cough would lead to many uninfected people being investigated, yet some infected people would remain undetected. If more specific criteria such as fever were used, most infected people would enter the country despite screening.

Schistosomiasis in european travelers and migrants

DEFF Research Database (Denmark)

Lingscheid, Tilman; Kurth, Florian; Clerinx, Jan

2017-01-01

Schistosomiasis remains one of the most prevalent parasitic diseases worldwide and the infection is frequently found in travelers and migrants. The European Network for Tropical Medicine and Travel Health conducted a sentinel surveillance study on imported schistosomiasis between 1997 and 2010...... or antigen testing. Schistosomiasis remains a frequent infection in travelers and migrants to Europe. Travelers should be made aware of the risk of schistosomiasis infection when traveling to sub-Saharan Africa. Posttravel consultations particularly for returning expatriates are useful given the high...

Toxigenic cutaneous diphtheria in a returned traveller.

Science.gov (United States)

Abdul Rahim, Nur R; Koehler, Ann P; Shaw, Doug D; Graham, Caitlin R

2014-12-31

Diphtheria is rarely reported in Australia. A case of cutaneous diphtheria was reported to the South Australian Department for Health and Ageing in April 2013 in an Australian-born 18-year-old female following travel in India. The case presented with a skin ulcer on her toe. Toxigenic Corynebacterium diphtheriae was isolated from a swab of the lesion. The case was treated with antibiotics. The public health response included infection control advice, assessing the case and household contacts for organism carriage and providing antimicrobial chemoprophylaxis to contacts. Although cutaneous diphtheria is not included as part of the Australian communicable disease surveillance case definition, this may be an oversight as international evidence demonstrates that it is a source of organism transmission and can potentially result in outbreaks among susceptible populations. This formed the rationale for the public health response to this particular case. The protocol for the public health management of diphtheria in South Australia has since been revised to include cutaneous lesions caused by the toxigenic strain of the organism as part of the surveillance case definition. This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent

The Concept of Travel Medicine and the Actual Situation of Travel-Related Illnesses.

Science.gov (United States)

Tunalı, Varol; Turgay, Nevin

2017-06-01

Travel medicine defines all diseases and medical situations that are related to travel. Travel medicine comprises infectious diseases, traumas, altitude sickness, sun burns, embolisms, jet lag, and many more travel-related situations. With the increasing possibility and ease of travel, the number of people who have travelled internationally has exceeded 1.13 billion in 2014, and the revenues of international travel have exceeded 1.25 trillion dollars. With every passing day, international travels are shifting toward the developing countries and to more exotic regions of the world, and travelers tend to be more adventurous and daring, thereby increasing risky behaviors during travels. Traveling plays an important role in transmitting infections such as Zika virus infection, Ebola, avian flu, severe acute respiratory syndrome, Chikungunya, and dengue fever and is the principal reason for the epidemics of these types of infections on a global scale. With this background, we suggest that travel medicine is an important but "neglected" medical discipline as the discipline of Parasitology itself like most parasitic diseases.

Rail travel: Conceptualizing a study on slow tourism approaches in sustaining rural development

Directory of Open Access Journals (Sweden)

Mohamad Noor Farah Atiqah

2014-01-01

Full Text Available Rail transportation in Peninsular Malaysia is a popular transportation mode for locals to return to their hometown but is not frequently used as the mode of transport when travelling for holidays. Rural towns in Peninsular Malaysia have immense opportunity to be promoted as a popular tourism destination without the need of intense modern development. Using train rather than taking a car or a bus would endorse the concept of slowness during travel enabling tourists to enjoy the time taken to travel rather than rushing to travel to a destination. Encouragement of travelling by rail to the rural towns will enable improved utilization of the existing rail network and further uplift the travel appeal to rural towns in Peninsular Malaysia. In order to promote the concept of slow tourism that would benefit the rural towns’ sustainability, the perception of tourists on travelling slowly by train should first be understood and taken for consideration. A qualitative methodology of in depth interviews with domestic and international tourists whom have travel on trains to the rural towns will be conducted.

Iodine-131 thyroid uptake results in travelers returning from Europe after the Chernobyl accident

International Nuclear Information System (INIS)

Castronovo, F.P. Jr.

1987-01-01

Thyroid screening measurements for 131 I were performed on 58 travelers returning from Eastern and Western Europe to Boston after the Chernobyl reactor accident on April 26, 1986. The travelers consisted of both Americans arriving home after business or vacation and European nationals visiting relatives in the Boston area. For purposes of dosimetry the population was divided into three subpopulations--adult (greater than 18 yr old), children (less than or equal to 18 yr old), and two individuals, 17 and 26 wk pregnant. Seventy-four percent of the population had detectable quantities of 131 I thyroid burdens, ranging from 1 nCi (37 Bq) to 900 nCi (33,300 Bq). The highest adult radiation dose equivalent was 5.18 mrem (51.8 mSv). The children, however, had considerably higher dose equivalents with one infant receiving 37 rem (370 mSv). Several other children were above 1 rem (10 mSv). The fetal dose equivalents were less than 14 mrem (140 mu Sv). The presence of rain dominated those testing positive for 131 I. Radioactive fallout from the Chernobyl accident contaminated a wide range of Europe and a large population subsequently ingested radioactivity. The children exhibited the highest thyroid radiation dose equivalents of the individuals monitored in the present study. The significance of this is presently unknown

Fundraising flights: a levy on international air travel for adaptation

Energy Technology Data Exchange (ETDEWEB)

Birch, Tom; Chambwera, Muyeye

2011-03-15

Adapting to climate change will not be cheap: it will cost an estimated tens of billions of dollars each year. But where will the money come from? The UN climate negotiations have set up dedicated funds for the task but domestic politics have resulted in insufficient, variable and unreliable contributions from governments. An innovative adaptation levy on international air travel could help fill the gap. A small charge to individual travellers would raise up to US$10 billion a year. The levy, which follows the 'polluter pays' principle, could be implemented very quickly and at minimal cost and would go a long way to raising sums that could make a significant difference.

Which Mechanisms Explain Monetary Returns to International Student Mobility?

Science.gov (United States)

Kratz, Fabian; Netz, Nicolai

2018-01-01

The authors develop a conceptual framework explaining monetary returns to international student mobility (ISM). Based on data from two German graduate panel surveys, they test this framework using growth curve models and Oaxaca-Blinder decompositions. The results indicate that ISM-experienced graduates enjoy a steeper wage growth after graduation…

Complicating common ideas about medical tourism: gender, class, and globality in Yemenis' international medical travel.

Science.gov (United States)

Kangas, Beth

2011-01-01

Three cases of international medical travelers from Yemen, a capital‐poor country in the southwest corner of the Arabian Peninsula, help to counter misconceptions within discussions of medical tourism. These misconceptions include the suggestion of leisure in medical tourism, the role of gender and class, and the ease with which we dismiss the health concerns of wealthy individuals. Instead, this article proposes, we should uncover commonalities and differences within international medical travel while avoiding slipping into generalities and stereotypical portrayals.

HIV, international travel and tourism: global issues and Pacific perspectives.

Science.gov (United States)

Lewis, N D; Bailey, J

AIDS, like plagues throughout human history, has been blamed repeatedly on foreigners. This has heightened ramifications, from the personal to the geopolitical, in an era of escalating population movement and rapid international travel. By the end of 1990, the World Health Organization had estimated that the total number of AIDS cases worldwide was close to 1.3 million. Recent estimates suggest that by the year 2000, 38-100 million adults and over 10 million children will have been infected with HIV. Seventy-five to eighty-five percent of that number will be from the developing world. AIDS has rapidly become pandemic, with wide-ranging consequences for humankind. Human population movement is an important component in the natural history of AIDS. With respect to this, a central consideration is the relationship between AIDS and international travel, especially tourism. In this paper, after reviewing HIV in the Asia-Pacific region, we present the epidemiology of HIV in the Pacific Islands, discuss its impact with particular reference to population movement, and explore some of the specific challenges that the Pacific Island region faces.

Pandemic influenza A(H1N1) outbreak among a group of medical students who traveled to the Dominican Republic.

Science.gov (United States)

Vilella, Anna; Serrano, Beatriz; Marcos, Maria A; Serradesanferm, Anna; Mensa, Josep; Hayes, Edward; Anton, Andres; Rios, Jose; Pumarola, Tomas; Trilla, Antoni

2012-01-01

From the beginning of the influenza pandemic until the time the outbreak described here was detected, 77,201 cases of pandemic influenza A(H1N1) with 332 deaths had been reported worldwide, mostly in the United States and Mexico. All of the cases reported in Spain until then had a recent history of travel to Mexico, the Dominican Republic, or Chile. We describe an outbreak of influenza among medical students who traveled from Spain to the Dominican Republic in June 2009. We collected diagnostic samples and clinical histories from consenting medical students who had traveled to the Dominican Republic and from their household contacts after their return to Spain. Of 113 students on the trip, 62 (55%) developed symptoms; 39 (45%) of 86 students tested had laboratory evidence of influenza A(H1N1) infection. Most students developed symptoms either just before departure from the Dominican Republic or within days of returning to Spain. The estimated secondary attack rate of influenza-like illness among residential contacts of ill students after return to Spain was 2.1%. The attack rate of influenza A(H1N1) can vary widely depending on the circumstances of exposure. We report a high attack rate among a group of traveling medical students but a much lower secondary attack rate among their contacts after return from the trip. These findings may aid the development of recommendations to prevent influenza. © 2011 International Society of Travel Medicine.

Habit Formation, Surplus Consumption and Return Predictability: International Evidence

DEFF Research Database (Denmark)

Engsted, Tom; Hyde, Stuart; Møller, Stig V.

On an international post World War II dataset, we use an iterated GMM pro- cedure to estimate and test the Campbell-Cochrane (1999) habit formation model. In addition, we analyze the predictive power of the surplus consumption ratio for future asset returns. We find that, although...... there are important cross-country differences, for the majority of countries in our sample the model gets empirical support in a variety of diffrent dimensions, including reasonable estimates of risk- free rates, and the model dominates the time-separable power utility model in terms of pricing errors. Further...... ratio is also a powerful predictor of future bond returns....

Fairer flying: an international air travel levy for adaptation

Energy Technology Data Exchange (ETDEWEB)

Chambwera, Muyeye; Muller, Benito

2008-11-15

For the world's poorest countries and communities, adaptation to climate change is urgently needed, but costly: estimates run into tens of billions of dollars a year. Given the shortfall in current international adaptation funding, how can resources for the developing world be raised? An adaptation levy on international air travel could help fill the gap. A small per-trip payment by passengers could contribute US$8 billion to US$10 billion a year towards adaptation. Similar schemes in France and elsewhere show that this kind of ethical solidarity and 'polluter pays' approach would be simple to implement in practical and institutional terms.

Longitudinal follow-up of Zika virus RNA in semen of a traveller returning from Barbados to the Netherlands with Zika virus disease, March 2016

NARCIS (Netherlands)

C.B.E.M. Reusken (Chantal); S.D. Pas (Suzan); C.H. Geurts van Kessel (Corine); R. Mögling (Ramona); J.J.A. van Kampen (Jeroen); T. Langerak (Thomas); M.P.G. Koopmans D.V.M. (Marion); A.A. Eijck (Annemiek); E.C.M. van Gorp (Eric)

2016-01-01

textabstractWe report the longitudinal follow-up of Zika virus (ZIKV) RNA in semen of a traveller who developed ZIKV disease after return to the Netherlands from Barbados, March 2016. Persistence of ZIKV RNA in blood, urine, saliva and semen was followed until the loads reached undetectable levels.

Longitudinal follow-up of Zika virus RNA in semen of a traveller returning from Barbados to the Netherlands with Zika virus disease, march 2016

NARCIS (Netherlands)

C.B.E.M. Reusken (Chantal); S.D. Pas (Suzan); C.H. Geurts van Kessel (Corine); R. Mögling (Ramona); J.J.A. van Kampen (Jeroen); T. Langerak (Thomas); M.P.G. Koopmans D.V.M. (Marion); A.A. Eijck (Annemiek); E.C.M. van Gorp (Eric)

2016-01-01

textabstractWe report the longitudinal follow-up of Zika virus (ZIKV) RNA in semen of a traveller who developed ZIKV disease after return to the Netherlands from Barbados, March 2016. Persistence of ZIKV RNA in blood, urine, saliva and semen was followed until the loads reached undetectable levels.

Tips for Travel

Science.gov (United States)

Avoid bringing bed bugs home by taking precautions when traveling such as inspecting bedding and luggage racks in hotel rooms, and upon returning home unpacking directly into a washing machine and dry at high temperatures.

Has the economic crisis led to a new risk profile for international travellers?

Science.gov (United States)

Roure, S; Pérez-Quílez, O; Vallès, X; Martínez-Cuevas, O; Sabrià, M; Valerio, L

2015-11-01

The economic world crisis has led to the migration of European workers to developing countries with a high incidence of infectious diseases. The objective of this study was to assess whether this context has produced an increase in the risks to international travellers for work reasons (TWR). Observational, retrospective study. The study population included TWR who were attended before travelling at an International Health Unit in the year 2007 (the year before the initiation of the European crisis) and in the year 2012 (when the structural crisis was established). A comparative socioeconomic analysis was performed as well as an analysis of the risk factors present in both groups. In 2007 and 2012 a total of 9,197 travellers were attended. Of these, there were 344 TWR (3.4%); 101 TWR (2.8%) in 2007 and 243 TWR (4.5%) in 2012 (pcrisis, there was a change in the profile of TWR. Their number has increased significantly, as has the proportion who present risk factors for contracting imported diseases. The International Health Units should adapt to these new circumstances and adopt preventive measures for this population. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Zika virus infection in travelers returning from countries with local transmission, Guangdong, China, 2016.

Science.gov (United States)

Jia, Haimei; Zhang, Meng; Chen, Maoyu; Yang, Zhiwen; Li, Jiansen; Huang, Guo; Guan, Dawei; Cen, Xiaoli; Zhang, Lijie; Feng, Qiwen; Yi, Jianron; Wu, De; Zhong, Haojie; Ma, Huilai; Song, Tie

Zika virus (ZIKV) is a mosquito-borne virus spreading rapidly in the Americas, Africa, and Asia. No indigenous ZIKV infection had been seen in China. We monitored ZIKV infection among travelers returning to Enping county from ZIKV transmitting countries from 1 March to 10 April 2016. We analyzed data including interviews; conducted laboratory test on blood, urine, saliva, conjunctival swab or semen specimens for evidence of ZIKV infection; evaluated household for presence of Aedes mosquitoes or larvae. A total of 925 individuals were screened, 507 (54.8%) were interviewed, 400 (43.2%) provided samples, of which 13 (3.3%) tested positive for ZIKV including 3 asymptomatic. Rash, conjunctivitis, sore throat, fever were the common symptoms; rash was more pronounced in adults than in children. ZIKV RNA was detected for 1-4 days in blood, but longer in urine and saliva (3-32 days and 2-10 days). Among interviewed, 57.0% had good knowledge about ZIKV, 45.8% were worried about ZIKV, 99.2% would go to hospital if they had infection. Aedes mosquitoes or larvae were detected in townships of infected returners. ZIKV was imported to China. Screening by symptoms alone is inadequate for detecting ZIKV infection. ZIKV surveillance, health-education, and vector control are necessary to decrease risk of ZIKV transmission. Copyright © 2017. Published by Elsevier Ltd.

Long distance travel ‘today’

DEFF Research Database (Denmark)

Christensen, Linda

2014-01-01

This paper presents an overview of the Dane’s long distance travel. It is a part of the Drivers and Limits project about long distance travel. Long distance travel is in the project defined as infrequent travel with overnight stay. Danes 15-85 years-old travel in average 5.5 long distance travel...... per year og which a third is for international destinations, a third is for domestic second homes and a third are other domestic trips. However, 87% of the kilometres are for international destinations and only 4% are for domestic second homes. Travel activity is very uneven distributed with only half...... of the population having had a journey during the last three month. At the other hand 60% have travelled internationally during the last year and only 2% have never travelled abroad. The paper presents among other things how the travel activity is distributed on travel purpose and mode and how the mode choice...

Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia.

Science.gov (United States)

Heywood, Anita E; Zhang, Meng; MacIntyre, C Raina; Seale, Holly

2012-02-17

Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia. In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history. A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8). Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P students reported low risk perception of travel threats and a low corresponding concern for these threats. Our study highlights the need to educate students about the risk

International Development Research Centre Governor Travel Policy

International Development Research Centre (IDRC) Digital Library (Canada)

André Lavoie

business. Governors are required to travel to conduct IDRC business, attend ... of Governors, liaise with Centre management, and perform specific representational functions on ..... Travel between Points of Origin and Destination - Air Travel.

Utilizing the Intercultural Effectiveness Scale (IES) to Enhance International Student Travel

Science.gov (United States)

Bates, Alicia; Rehal, Dalia Atef

2017-01-01

This paper highlights how one institution used the International Effectiveness Scale (IES) to support intercultural exploration and development for short-term undergraduate travel programs. Authors discuss utilization of the IES to explore students' intercultural development, how it can be applied to create an individualized action plan, and how…

Presence seeking and sensation seeking as motives for international travel.

Science.gov (United States)

Fontaine, G

1994-12-01

Although independent research has identified presence seeking and sensation seeking as important motives for a variety of activities, there is sufficient conceptual overlap to suggest the concepts describe in part the same motive or are related. The possible relationship was examined in motives of students for international travel. Nonsignificant correlations suggest that, at least for this activity, they are differentiable.

Fatal Yellow Fever in Travelers to Brazil, 2018.

Science.gov (United States)

Hamer, Davidson H; Angelo, Kristina; Caumes, Eric; van Genderen, Perry J J; Florescu, Simin A; Popescu, Corneliu P; Perret, Cecilia; McBride, Angela; Checkley, Anna; Ryan, Jenny; Cetron, Martin; Schlagenhauf, Patricia

2018-03-23

Yellow fever virus is a mosquito-borne flavivirus that causes yellow fever, an acute infectious disease that occurs in South America and sub-Saharan Africa. Most patients with yellow fever are asymptomatic, but among the 15% who develop severe illness, the case fatality rate is 20%-60%. Effective live-attenuated virus vaccines are available that protect against yellow fever (1). An outbreak of yellow fever began in Brazil in December 2016; since July 2017, cases in both humans and nonhuman primates have been reported from the states of São Paulo, Minas Gerais, and Rio de Janeiro, including cases occurring near large urban centers in these states (2). On January 16, 2018, the World Health Organization updated yellow fever vaccination recommendations for Brazil to include all persons traveling to or living in Espírito Santo, São Paulo, and Rio de Janeiro states, and certain cities in Bahia state, in addition to areas where vaccination had been recommended before the recent outbreak (3). Since January 2018, 10 travel-related cases of yellow fever, including four deaths, have been reported in international travelers returning from Brazil. None of the 10 travelers had received yellow fever vaccination.

Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia

Directory of Open Access Journals (Sweden)

Heywood Anita E

2012-02-01

Full Text Available Abstract Background Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia. Methods In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history. Results A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8. Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P Conclusions Our study highlights the need to educate students about the risk associated with travel and improve preventative

International Education Travel and Youth of Color: College Is Too Late!

Science.gov (United States)

McLellan, Carlton E.

2011-01-01

Drawing on literature analyzing impacts of academic and professional early preparation programs for urban students, and particularly those of color, this article argues for the use of similar strategies to encourage and prepare youth from those backgrounds for international education travel. The central argument is that educators must focus more…

Epidemiologic and biogeographic analysis of 542 VFR traveling children in Catalonia (Spain). A rising new population with specific needs.

Science.gov (United States)

Valerio, Lluís; Roure, Sílvia; Sabrià, Miquel; de Balanzó, Xavier; Moreno, Nemesio; Martinez-Cuevas, Octavio; Peguero, Carme

2011-01-01

Imported diseases recorded in the European Union (EU) increasingly involve traveling immigrants returning from visits to their relatives and friends (VFR). Children of these immigrant families can represent a population of extreme vulnerability. A randomized cross-sectional study of 698 traveling children under the age of 15 was performed. VFR traveling children and non-VFR (or tourist) children groups were compared. A total of 698 individuals were analyzed: 354 males (50.7%) and 344 females (49.3%), with a median age (interquartile range) of 4 (2-9) years. Of these, 578 (82.8%) had been born in the EU with 542 (77.7%) being considered as VFR, whereas 156 (22.3%) were considered tourists. VFR children were younger (4.7 vs 8.2 yr; p travel time interval was shorter (21.8 vs 32.2 d; p traveling children showed a greater risk of exposure to infectious diseases compared with tourists. Immigrant families may represent a target group to prioritize international preventive activities. © 2011 International Society of Travel Medicine.

Knowledge and beliefs of international travellers about the transmission and prevention of HIV infection.

Science.gov (United States)

Allard, R; Lambert, G

1992-02-01

To measure the perceived risk of acquired immunodeficiency syndrome (AIDS) among international travellers, to measure their knowledge of the transmission and prevention of HIV infection abroad and to identify some of the determinants of this knowledge. Survey. Travellers' immunization clinic providing mostly primary preventive care to international travellers. All clients aged 18 to 50 years seen at the clinic between Oct. 2 and Dec. 21, 1989, before their departure. Sixteen statements measured knowledge of transmission and prevention of HIV infection. Standardized scales measured health beliefs. The response rate was 81% (331/409). Compared with other diseases AIDS was perceived to be associated with a low risk except by those travelling to countries with a high prevalence of AIDS. Most of the clients were found to have a good knowledge of HIV transmission to travellers, although some myths remained popular and some real routes of transmission, especially blood, remained underrated. In all, 70% of the subjects believed in the efficacy of condoms when used with local people, as compared with 79% when used with other tourists; this difference was greatest among travellers who perceived AIDS as being particularly severe but difficult to prevent. The determinants of the knowledge of HIV transmission and prevention were a high level of education, a mother tongue other than French, unmarried status, a high prevalence of AIDS at the destination, the duration of the trip and a high perceived risk of HIV infection. Counselling should teach travellers (a) not to underestimate their risk of HIV infection during their trip, (b) to decrease the risk of requiring health care in developing countries and (c) to rely on their own prudent sexual behaviour rather than on their assessment of the level of risk posed by the environment.

Travel-related health risks in moderately and severely immunocompromised patients: a case-control study.

Science.gov (United States)

Dekkiche, Souad; de Vallière, Serge; D'Acremont, Valérie; Genton, Blaise

2016-03-01

The number of immunocompromised persons travelling to tropical countries is increasing. The hypothesis is that this population is at increased risk of travel-related health problems but there are few data to support it. The objective was to assess the risk of travel-related health problems in immunocompromised persons when compared with the general population of travellers. A retrospective matched case-control study was performed. Cases were moderately or severely immunocompromised persons travelling to tropical countries and controls were non-immunocompromised persons, matched for demographic and travel characteristics. All participants responded to a phone questionnaire, asking them about any health problem they may have encountered while travelling or during the month following their return. The primary outcome was the incidence of a significant clinical event defined as repatriation, hospitalization during the travel or during the month following the return if due to a travel-related health problem and medical consultations during the trip. One hundred and sixteen moderately or severely immunocompromised cases [HIV infection (15), active cancer (25), splenectomized (20), solid organ transplant recipients (4) and use of systemic immunosuppressive medication (52)] and 116 controls were included. Incidence rates of significant clinical events were higher in immunocompromised travellers (9/116, 7.8%) than in controls (2/116, 1.7%) [OR = 4.8 , 95% CI 1.01-22.70; P = 0.048]. Most cases were related to infectious diseases (5/9, 55.5%), others were pulmonary embolism (2/9, 22%), inflammatory disease and trauma (1/9, 11.1% each). There was no significant difference between the two groups regarding common health problems. Moderately and severely immunocompromised travellers are at increased risk of developing a serious health problem during or after a trip in a tropical country. They should be well informed about the specific risks they are particularly prone to

Illness in Travelers Returned From Brazil: The GeoSentinel Experience and Implications for the 2014 FIFA World Cup and the 2016 Summer Olympics

NARCIS (Netherlands)

Wilson, Mary E.; Chen, Lin H.; Han, Pauline V.; Keystone, Jay S.; Cramer, Jakob P.; Segurado, Aluisio; Hale, DeVon; Jensenius, Mogens; Schwartz, Eli; von Sonnenburg, Frank; Leder, Karin; Burchard, Gerd-Dieter; Anand, Rahul; Gelman, Stephanie S.; Kain, Kevin; Boggild, Andrea; Perret, Cecilia; Valdivieso, Francisca; Loutan, Louis; Chappuis, François; Schlagenhauf, Patricia; Weber, Rainer; Steffen, Robert; Caumes, Eric; Pérignon, Alice; Libman, Michael D.; Ward, Brian; Maclean, J. Dick; Grobusch, Martin C.; Goorhuis, Abram; de Vries, Peter; Gadroen, Kartini; Mockenhaupt, Frank; Harms, Gunder; Parola, Philippe; Simon, Fabrice; Delmont, Jean; Carosi, Giampiero; Castelli, Francesco; Connor, Bradley A.; Kozarsky, Phyllis E.; Wu, Henry; Fairley, Jessica; Franco-Paredes, Carlos; Using, Johan; Fröberg, Gabrielle; Askling, Helena Hervius; Bronner, Ulf; Haulman, N. Jean; Roesel, David

2014-01-01

Background. Brazil will host the 2014 FIFA World Cup and the 2016 Olympic and Paralympic Games, events that are expected to attract hundreds of thousands of international travelers. Travelers to Brazil will encounter locally endemic infections as well as mass event-specific risks. Methods. We

Characteristics and pre-travel preparation of travelers at a Canadian pediatric tertiary care travel clinic: A retrospective analysis.

Science.gov (United States)

Ma, Xiao Wei; Pell, Lisa G; Akseer, Nadia; Khan, Sarah; Lam, Ray E; Louch, Debra; Science, Michelle; Morris, Shaun K

2016-01-01

International travelers are susceptible to a wide spectrum of travel related morbidities. Despite rising number of international travelers in Canada, the demographics, risk profiles, and preventative strategies of high-risk traveler groups, including pediatric travelers visiting friends and relatives (VFRs) are not well described. A descriptive analysis was conducted on pre-travel consultations completed between January 2013 and August 2014 at a large pediatric tertiary care center in Toronto, Canada. Data on demographics, travel characteristics, and pre-travel interventions were extracted from 370 pre-travel consultations. Results were compared between all VFR and non-VFR travelers, as well as between children traveling to visit friends and relatives, for vacation, and for education and/or volunteer purposes. Forty-eight percent of consultations were for children travel to visit friends and/or relatives than for other purposes (29% vs 9%, p travel for >28 days than children traveling for vacation (43% vs 1%, p traveling for education/volunteer purposes (43% vs 21%, p = 0.03). Around half of cVFRs traveled to destinations in Asia (51%). The majority stayed with locals, friends and/or relatives (85%), and nearly all traveled to urban destinations (98%). The most prescribed interventions for children were azithromycin (84%), Dukoral (66%), and the hepatitis A vaccine (60%). Atovaquone/proguanil was the most commonly prescribed antimalarial for children. Children that travel to visit friends and relatives represent a unique travel group and may require specific considerations during pre-travel preparations. Our findings can help develop targeted pre-travel strategies for children VFRs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Danish long distance travel A study of Danish travel behaviour and the role of infrequent travel activities

OpenAIRE

Knudsen, Mette Aagaard; Rich, Jeppe; Nielsen, Otto Anker

2014-01-01

Historically there has been a lack of knowledge with respect to long distance travel. Due to the considerable contribution of long distance travel to total travelled kilometres and the related energy consumption from the transport sector and derived impacts on greenhouse emissions, this is problematic. The average travel distance has steadily increased during the latest decades together with the increasing motorisation of daily travel and international aviation. Previously most focus has been...

The role of international travel in the worldwide spread of multiresistant Enterobacteriaceae.

Science.gov (United States)

van der Bij, Akke K; Pitout, Johann D D

2012-09-01

From international tourists to war-displaced refugees, more people are on the move than ever before. This provides the opportunity for a variety of antimicrobial-resistant bacteria to be carried from one geographic location to another. The Enterobacteriaceae are among the most important causes of serious hospital-acquired and community-onset bacterial infections in humans, and resistance to antimicrobial agents in these bacteria has become an increasingly relevant problem. International travel and tourism are important modes for the acquisition and spread of antimicrobial-resistant Enterobacteriaceae, especially CTX-M-producing Escherichia coli. Infections with KPC-, VIM-, OXA-48- and NDM-producing Enterobacteriaceae in developed countries have been associated with visiting and being hospitalized in endemic areas such as the USA, Greece and Israel for KPCs, Greece for VIMs, Turkey for OXA-48, and the Indian subcontinent for NDMs. To combat the spread of antimicrobial-resistant Enterobacteriaceae, the French Healthcare Safety Advisory Committee recently issued national recommendations for screening and contact isolation precautions for patients transferred from, or hospitalized outside, France. For effective public and patient health interventions, it is important to understand the role of international travel in the spread of antimicrobial-resistant Enterobacteriaceae. We urgently need well-designed studies to evaluate the transmission potential and risks for colonization and infections due to multiresistant Enterobacteriaceae in travellers who have recently visited or have been hospitalized in endemic areas. The emergence of CTX-M-, KPC- and NDM-producing bacteria is a good example of the role that globalization plays in the rapid dissemination of new antibiotic resistance mechanisms.

Stylized facts in internal rates of return on stock index and its derivative transactions

Science.gov (United States)

Pichl, Lukáš; Kaizoji, Taisei; Yamano, Takuya

2007-08-01

Universal features in stock markets and their derivative markets are studied by means of probability distributions in internal rates of return on buy and sell transaction pairs. Unlike the stylized facts in normalized log returns, the probability distributions for such single asset encounters incorporate the time factor by means of the internal rate of return, defined as the continuous compound interest. Resulting stylized facts are shown in the probability distributions derived from the daily series of TOPIX, S & P 500 and FTSE 100 index close values. The application of the above analysis to minute-tick data of NIKKEI 225 and its futures market, respectively, reveals an interesting difference in the behavior of the two probability distributions, in case a threshold on the minimal duration of the long position is imposed. It is therefore suggested that the probability distributions of the internal rates of return could be used for causality mining between the underlying and derivative stock markets. The highly specific discrete spectrum, which results from noise trader strategies as opposed to the smooth distributions observed for fundamentalist strategies in single encounter transactions may be useful in deducing the type of investment strategy from trading revenues of small portfolio investors.

Individual traveller health priorities and the pre-travel health consultation.

Science.gov (United States)

Flaherty, Gerard T; Chen, Bingling; Avalos, Gloria

2017-09-01

The purpose of this study was to examine the principal travel health priorities of travellers. The most frequently selected travel health concerns were accessing medical care abroad, dying abroad, insect bites, malaria, personal safety and travel security threats. The travel health risks of least concern were culture shock, fear of flying, jet lag and sexually transmitted infections. This study is the first to develop a hierarchy of self-declared travel health risk priorities among travellers. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Travel health prevention.

Science.gov (United States)

Korzeniewski, Krzysztof

All around the world there has been a rapid growth in the number of international travels. According to the World Tourism Organisation the number of international tourist arrivals reached 1,235 billion in 2016 and continues to grow at a high rate. This has been much due to the development of air transport (including low-cost airlines), increasingly common economic migration, a growing number of travellers visiting friends and relatives, and an increase in medical tourism. With tropical destinations becoming increasingly popular among travellers, doctors have seen a rising number of patients who seek medical advice on health risks prevalent in hot countries and health prevention measures to be taken in tropical destinations, especially where sanitation is poor. The risk for developing a medical condition while staying abroad depends on a variety of factors, including the traveller's general health condition, health prevention measures taken before or during travel (vaccinations, antimalarial chemoprophylaxis, health precautions during air, road and sea travel, proper acclimatisation, prevention of heat injuries, protection against local flora and fauna, personal hygiene, water, food and feeding hygiene), as well as the prevalence of health risk factors in a given location. Health prevention is a precondition for safe travel and maintaining good physical health; in the era of a rapid growth in international tourism it has become of key importance for all travellers.

Danish travel activities: do we travel more and longer – and to what extent?

DEFF Research Database (Denmark)

Knudsen, Mette Aagaard

Two separate Danish National travel surveys are analysed to outline the amount and extent of national and international travelling during the latest 15-20 years; the national travel survey (TU) describes mainly national daily travel activities, whereas the holiday and business travel survey...... describes national and international travel activities including overnight stay(s). When sampling only respondents with trips above 100 kilometres, they only accounts for around 2% of all daily travel activities, however, this share appears to increase and suggest in general that we do travel longer....... But due to this limited share of trips, the overall impacts of longer distance travelling vanish when considering all daily travel activities. Especially as about 95% of all daily travel destinations range less than 50 kilometres away and in total induce an average trip length of 20 kilometres. If focus...

The Transmission of U.S. Election Cycles to International Stock Returns

OpenAIRE

Stephen R Foerster; John J Schmitz

1997-01-01

This paper examines the international pervasiveness and importance of the previously uncovered four-year U.S. election cycle whereby U.S. stock returns are significantly lower, and negative, in year 2 following U.S. presidential election relative to years 1, 3 and 4. All eighteen countries examined over the 1957 to 1996 time period possess lower local currency stock market capital gains returns in year 2 (-0.66%) relative to the average capital gains of years 1, 3 and 4 (11.68%). These predom...

41 CFR 302-3.209 - What is overseas tour renewal travel?

Science.gov (United States)

2010-07-01

... renewal travel? 302-3.209 Section 302-3.209 Public Contracts and Property Management Federal Travel... of Transfers Overseas Tour Renewal Agreement § 302-3.209 What is overseas tour renewal travel? Overseas tour renewal travel refers to travel of you and your immediate family returning to your home in...

Measures to facilitate the reintegration of returning migrant workers: international experiences.

Science.gov (United States)

Lohrmann, R

1988-06-01

Bilateral and multilateral measures implemented to assist migrants who return to their country of origin have been designed to respond to a number of different but specific situations. 2 bilateral agreements are briefly described: 1) an agreement between the Federal Republic of Germany and the Republic of Turkey signed in the early 1970s, and 2) an agreement between France and Algeria signed in 1980. 3 different types of multilateral activities are described: 1) the operation of the so-called Return of Talent program by the Intergovernmental Committee for Migration, 2) the Transfer of KNow-how Through Expatriate Nationals program of the UN Development Programme, and 3) the elaboration of a model machinery on return migration by the Organization for Economic Cooperation and Development. While the 1st 2 activities are operational programs, by which annually between 1000-2000 professionals are assisted in their permanent return to or temporary sojourn in their developing countries of origin, with the financial support of both the developed and the developing countries concerned, the 3rd initiative is a conceptual effort aimed at assisting governments to implement policy measures designed to make return migration commensurate with national development goals. 3 recent proposals include 1) the proposal for an international labor compensatory facility, 2) an international fund for vocational training, and 3) an international fund for manpower resources. A common factor shared by all these programs is that they have all involved on 1 side industrial receiving countries which feel themselves obliged to observe a number of principles guaranteed by law and which govern employment conditions and working relations. The reintegration measures implemented or proposed in cooperation with them have been adopted in full consideration of the prevailing standards of these countries, as different as they may be from 1 country to another. A common consideration has been that the

Immunocompromised Travelers: Demographic Characteristics, Travel Destinations, and Pretravel Health Care from the U.S. Global TravEpiNet Consortium.

Science.gov (United States)

Schwartz, Brian S; Rosen, Jessica; Han, Pauline V; Hynes, Noreen A; Hagmann, Stefan H; Rao, Sowmya R; Jentes, Emily S; Ryan, Edward T; LaRocque, Regina C

2015-11-01

An increasing number of immunocompromised individuals are pursuing international travel, and a better understanding of their international travel patterns and pretravel health care is needed. We evaluated the clinical features, itineraries, and pretravel health care of 486 immunocompromised international travelers seen at Global TravEpiNet sites from January 2009 to June 2012. We used bivariate analyses and logistic regressions using random intercept models to compare demographic and travel characteristics, vaccines administered, and medications prescribed for immunocompromised travelers versus 30,702 immunocompetent travelers. Immunocompromised travelers pursued itineraries that were largely similar to those of immunocompetent travelers, with nearly one-third of such travelers visiting countries with low human development indices. Biological agents, including tumor necrosis factor blockers, were commonly used immunosuppressive medications among immunocompromised travelers. A strong collaboration between travel-medicine specialists, primary care doctors, and specialist physicians is needed to prepare immunocompromised people for international travel. Incorporating routine questioning and planning regarding travel into the primary care visits of immunocompromised people may be useful. © The American Society of Tropical Medicine and Hygiene.

Pre-travel consultation: evaluation of primary care physician practice in the Franche-Comté region.

Science.gov (United States)

Piotte, Emeline; Bellanger, Anne-Pauline; Piton, Gaël; Millon, Laurence; Marguet, Philippe

2013-01-01

Primary care physicians (PCP) are first in line to provide adequate pre-travel medical advice. Little data are available on the content of pre-travel PCP consultations in France. We undertook an observational survey to assess the level of specific knowledge among PCPs on health advice, vaccinations, and malaria prophylaxis. Standardized questionnaires were sent to a random sample of 400 PCPs practicing in the Franche-Comté regions (eastern France) who were asked to complete and return it on a voluntary and anonymous basis. The questionnaire requested sociodemographic details, practice-related characteristics, and proposed three clinical situations with multiple choice questions (MCQ). To identify factors associated with a higher level of specific knowledge in travel medicine, results were studied by uni- and multivariate analyses. An overall score was calculated based on the MCQ answers and a motivation score was calculated based on parameters such as frequency and developments in pre-travel consulting at the practice, PCPs' personal experience as travelers, and the formal agreement of PCPs to administer yellow fever vaccination. The response rate was 37.5%, with 150 questionnaires returned completed and suitable for analysis. After multivariate logistic regression, the three variables associated with a higher score were: proximity of a vaccination center (p = 0.001), motivation score (p = 0.004), and absence of request for expert advice on malaria prophylaxis (p = 0.007). PCPs play an important role in travel medicine. This study showed that their high level of knowledge in travel medicine was mostly linked to their motivation to practice in this specialized discipline. © 2013 International Society of Travel Medicine.

Analyzing Variability in Ebola-Related Controls Applied to Returned Travelers in the United States.

Science.gov (United States)

Kraemer, John D; Siedner, Mark J; Stoto, Michael A

2015-01-01

Public health authorities have adopted entry screening and subsequent restrictions on travelers from Ebola-affected West African countries as a strategy to prevent importation of Ebola virus disease (EVD) cases. We analyzed international, federal, and state policies-principally based on the policy documents themselves and media reports-to evaluate policy variability. We employed means-ends fit analysis to elucidate policy objectives. We found substantial variation in the specific approaches favored by WHO, CDC, and various American states. Several US states impose compulsory quarantine on a broader range of travelers or require more extensive monitoring than recommended by CDC or WHO. Observed differences likely partially resulted from different actors having different policy goals-particularly the federal government having to balance foreign policy objectives less salient to states. Further, some state-level variation appears to be motivated by short-term political goals. We propose recommendations to improve future policies, which include the following: (1) actors should explicitly clarify their objectives, (2) legal authority should be modernized and clarified, and (3) the federal government should consider preempting state approaches that imperil its goals.

[Pre-travel advice and patient education of Hungarian travellers].

Science.gov (United States)

Lengyel, Ingrid; Felkai, Péter

2018-03-01

According to international surveys, over half of the travellers face some kind of health issue when travelling. The overwhelming majority of travel-related illnesses can be prevented with pre-travel medical consultations, but the syllabus and content of the consultation have to match the travel habits and culture of the given society. This publication explores the specificities and travel habits of Hungarian travellers. One hundred participants of a travel exhibition completed a survey about their international travel. As the survey was not representative, the data could only be processed through simple statistical methods. However, since the exhibition was presumably attended by those wishing to travel, the conclusions drawn from the results are worth publishing, since no similar survey in Hungary has been published before. Based on the suitable classification of age groups in travel medicine, 11% of the participants were adolescents / young adults (aged 15-24), 81% adults (25-59) and 8% elderly (60-74). Twenty-eight percent of the participants travel multiple times a year, 40% yearly and 32% of them less frequently; 16% of the adults, 8% of the adolescents and 4% of the elderly age group travel multiple times a year. The travel destinations of Hungarian travellers have remained practically unchanged since a study was conducted 13 years ago: the vast majority (95%) travelled within Europe, 2% to the United States, and 11% of them elsewhere. Since Hungarians do not travel to endemic areas, only 5% consulted their general practitioners (GPs) prior to travelling, and 29% did when they had to be vaccinated. Forty-two percent of those wishing to travel never consult their GPs, even though 29% of them are aware of some chronic illness. Instead, 51% gather their health information from the internet and only 6% from their doctors. By the contradiction between the poor health status of the majority of Hungarian travellers and the negligence of seeking pre-travel advice

Diagnosing Febrile Illness in a Returned Traveler

Centers for Disease Control (CDC) Podcasts

2012-03-01

This podcast will assist health care providers in diagnosing febrile illness in patients returning from a tropical or developing country.  Created: 3/1/2012 by National Center for Enteric, Zoonotic, and Infectious Diseases (NCEZID).   Date Released: 3/1/2012.

Ancylostoma ceylanicum, novel etiological agent for traveler's diarrhea-report of four Japanese patients who returned from Southeast Asia and Papua New Guinea.

Science.gov (United States)

Yoshikawa, Masahide; Ouji, Yukiteru; Hirai, Nobuyasu; Nakamura-Uchiyama, Fukumi; Yamada, Minoru; Arizono, Naoki; Akamatsu, Naoaki; Yoh, Takaharu; Kaya, Daisuke; Nakatani, Toshiya; Kikuchi, Eiryo; Katanami, Yuichi; Satoh, Kimitoshi; Maki, Ryosuke; Miyazato, Yusuke; Oba, Yuichiro; Kasahara, Kei; Mikasa, Keiichi

2018-01-01

Countries in the Southeast Asia region have a high prevalence of soil-transmitted helminth, such as roundworm, whipworm, and hookworms [ Ancylostoma duodenale , Necator americanus , Ancylostoma ceylanicum ]. Recent molecular-based surveys have revealed that A . ceylanicum , a zoonotic hookworm, is likely the second most prevalent hookworm species infecting humans in that part of the world, while others have noted that this infection is an emerging public health risk not only for indigenous people but also for visitors from other countries. We recently encountered four cases of A . ceylanicum infection in Japanese individuals who returned from Southeast Asia and Papua New Guinea. Case 1 was a 25-year-old male who stayed in a rainforest in Malaysia for 4 weeks, where he developed abdominal pain and diarrhea in the third week. Eleven adult worms (five males, six females) were expelled after treatment with pyrantel pamoate and identified as A . ceylanicum based on morphological characteristics and DNA sequences of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Case 2 was a 26-year-old male who spent 2 years as an overseas cooperation volunteer for agriculture in Papua New Guinea. He did not note any symptoms at that time, though eggs were detected in feces samples at a medical check-up examination after returning. Although collection of adult worms was unsuccessful, DNA analysis of the eggs for cox1 and the ribosomal internal transcribed spacer (ITS)-1 and ITS-2 genes demonstrated that they were A . ceylanicum. Case 3 was a 47-year-old male who spent 1 month in a rural village in Lao People's Democratic Republic and began suffering from watery diarrhea from the third week. A total of nine adult worms (three males, six females) were collected by endoscopic procedures and following treatment with pyrantel pamoate. Morphological examination and molecular analyses of the cox1 gene showed that they were A . ceylanicum. Case 4 was a 27-year-old male who

Danish long distance travel A study of Danish travel behaviour and the role of infrequent travel activities

DEFF Research Database (Denmark)

Knudsen, Mette Aagaard

2014-01-01

, this is problematic. The average travel distance has steadily increased during the latest decades together with the increasing motorisation of daily travel and international aviation. Previously most focus has been on domestic daily travel activities, but globalisation has, together with changes in price structures......), the TU overnight survey, and the Danish Tourism Statistics from the Business and Holiday Survey (HBS). This has enabled focus on infrequent travel activities segmented relative to travel purpose, distance threshold, or travelling with overnight stays. At an overall level the thesis has three main.......g. socio-economic variables. The analysis of Danish travel activities described in the three different travel surveys has outlined detailed information on Danish travel behaviour at an aggregated level during the past two decades. It has above all revealed the significant role of leisure travel. Private...

International Space Station Crew Return Vehicle: X-38. Educational Brief.

Science.gov (United States)

National Aeronautics and Space Administration, Washington, DC.

The International Space Station (ISS) will provide the world with an orbiting laboratory that will have long-duration micro-gravity experimentation capability. The crew size for this facility will depend upon the crew return capability. The first crews will consist of three astronauts from Russia and the United States. The crew is limited to three…

CARLSON WAGONLIT TRAVEL

CERN Multimedia

CARLSON WAGONLIT TRAVEL

2004-01-01

CARLSON WAGONLIT TRAVEL would like to remind you of the entry formalities applicable to those travelling to the United States. Nationals of Switzerland and of the following countries : Andorra, Australia, Austria, Belgium, Brunei, Denmark, Finland, France, Germany, Iceland, Ireland, Italy, Japan, Liechtenstein, Luxemburg, Monaco, Netherlands, New Zealand, Norway, Portugal, San Marino, Singapore, Slovenia, Spain, Sweden and the United Kingdom, entering the United States under the Visa Waiver Program (no visa requirement), must be in possession of an machine-readable passport that is valid for at least six months after the date of the return trip. Children, including infants, must have their own passport. An entry in the parents' passport is not sufficient. For entry into the United States, an e-ticket (fax or e-mail confirmation or passenger receipt) or a return ticket to the departure point or a ticket to a subsequent onward destination (valid for 90 days) must be presented together with the green ...

26 CFR 301.6103(h)(2)-1 - Disclosure of returns and return information (including taxpayer return information) to and by...

Science.gov (United States)

2010-04-01

... administration. 301.6103(h)(2)-1 Section 301.6103(h)(2)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... Returns Returns and Records § 301.6103(h)(2)-1 Disclosure of returns and return information (including..., shall, to the extent provided by section 6103(h)(2) (A), (B), and (C) and subject to the requirements of...

[Vaccinations and malaria prophylaxis for international travelers].

Science.gov (United States)

Alberer, Martin; Löscher, Thomas

2015-05-01

The prevention of infectious diseases by vaccination and by counselling about malaria prophylaxis is a central aspect of travel medicine. Besides mandatory vaccinations required for entry to certain countries various vaccinations may be indicated depending on destination and type of travel as well as on individual risks of the traveler. In addition, pre-travel counselling should always include a check-up of standard vaccinations. Protection against mosquito bites is the basis of malaria prophylaxis. The addition of chemoprophylaxis is warranted in high risk areas. When regular chemoprophylaxis is not applied it is recommended to carry an appropriate antimalarial drug which can be used for emergency stand-by treatment in case of unexplained fever and when medical attention is not available within 24 hours. Travelers should realize that self-treatment is a first-aid measure and that they should still seek medical advice as soon as possible. © Georg Thieme Verlag KG Stuttgart · New York.

Development of discrete choice model considering internal reference points and their effects in travel mode choice context

Science.gov (United States)

Sarif; Kurauchi, Shinya; Yoshii, Toshio

2017-06-01

In the conventional travel behavior models such as logit and probit, decision makers are assumed to conduct the absolute evaluations on the attributes of the choice alternatives. On the other hand, many researchers in cognitive psychology and marketing science have been suggesting that the perceptions of attributes are characterized by the benchmark called “reference points” and the relative evaluations based on them are often employed in various choice situations. Therefore, this study developed a travel behavior model based on the mental accounting theory in which the internal reference points are explicitly considered. A questionnaire survey about the shopping trip to the CBD in Matsuyama city was conducted, and then the roles of reference points in travel mode choice contexts were investigated. The result showed that the goodness-of-fit of the developed model was higher than that of the conventional model, indicating that the internal reference points might play the major roles in the choice of travel mode. Also shown was that the respondents seem to utilize various reference points: some tend to adopt the lowest fuel price they have experienced, others employ fare price they feel in perceptions of the travel cost.

Challenges to providing pre-travel care for travellers visiting friends and relatives: an audit of a specialist travel medicine clinic.

Science.gov (United States)

Rowe, Kate; Chaves, Nadia; Leder, Karin

2017-09-01

Travellers visiting friends and relatives (VFRs) often have complex pre-travel needs. We identified the characteristics, destinations, vaccinations and pre-travel advice provided to VFRs and compared these with non-VFR travellers. The significant differences we found suggest that future research should focus on improving the uptake of recommended interventions in VFR travellers. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Leptospirosis in Spanish travelers returning from Chiang Mai: A case series.

Science.gov (United States)

Rodriguez-Valero, Natalia; Moriñigo, Helena Moza; Martínez, Miguel J; Peiró, Aida; Oliveira, Ines; Bodro, Marta; Gómez-Junyent, Joan; Gascon, Joaquim; Muñoz, Jose

Leptospirosis is an important zoonosis worldwide, nevertheless is often poor recognized in non tropical settings. In Thailand is becoming an emerging disease and Chiang Mai could become a popular spot to acquire the disease amongst travelers. We describe three cases of imported leptospirosis undifferentiated fever after travelling to Thailand during the summer of 2015 diagnosed at two Spanish hospitals. Our three patients probably acquired leptospirosis while swimming in freshwater around Chiang Mai, a Thailand's northern region with moderate incidence of leptopirosis. Travelers had normal white blood cell counts and low platelets, suggesting leptospirosis after ruling out other imported diseases such as malaria, dengue or typhoid. As recent findings point out, low platelets and normal white blood cell counts are clinical features that could help the clinician to suspect Leptospirosis infection. It should be always considered as a cause of fever, particularly if travelers come from a tropical country and have had contact with water or flooding, especially during rainy season. Copyright © 2018 Elsevier Ltd. All rights reserved.

Risk factors for infections in international travelers: an analysis of travel-related notifiable communicable diseases.

Science.gov (United States)

Baer, Atar; Libassi, Lisa; Lloyd, Jennifer K; Benoliel, Eileen; Brucker, Rachel; Jones, Megan Q; Kwan-Gett, Tao Sheng; McKeirnan, Shelly; Pecha, Monica; Rietberg, Krista; Serafin, Lauri; Walkinshaw, Lina P; Duchin, Jeffrey S

2014-01-01

We sought to describe travel-related illness among our residents and gain insight into targeting pre-travel health advice to prevent travel-related illness. A supplemental travel questionnaire was developed and administered for cases with a legally notifiable communicable disease reported in 2011-2012, who spent at least part of their exposure period outside the United States. Among 451 cases meeting the eligibility criteria, 259 were interviewed. Forty four percent reported receiving pre-travel advice. Two-thirds adhered fully with risk behavior recommendations; 94% followed immunization recommendations partially or fully; and 84% adhered fully with malaria prophylaxis recommendations. The primary reasons for not obtaining pre-travel advice were being unaware of the need (47.5%), or believing they already knew what to do (34.5%). Adults (OR = 2.8, 95% CI = 1.4-5.5), males (OR = 1.8, 95% CI = 1.1-3.0), those born outside the United States (OR = 2.0, 95% CI = 1.1-3.7), and those with planning time under two weeks (OR = 4.8, 95% CI = 1.5-15.9) or travel duration less than 7 days (OR = 7.9, 95% CI = 3.0-20.9) were more likely to travel without seeking pre-travel advice. The majority of cases reported not receiving pre-travel advice. Understanding the predictors of failure to receive pre-travel advice may help target public health prevention efforts. Copyright © 2014 Elsevier Ltd. All rights reserved.

Common Factors in International Bond Returns

NARCIS (Netherlands)

Driessen, J.J.A.G.; Melenberg, B.; Nijman, T.E.

2000-01-01

In this paper we estimate and interpret the factors that jointly determine bond returns of different maturities in the US, Germany and Japan.We analyze both currency-hedged and unhedged bond returns.For currency-hedged bond returns, we find that five factors explain 96.5% of the variation of bond

Preparing for International Travel and Global Medical Care.

Science.gov (United States)

Mahadevan, Swaminatha V; Strehlow, Matthew C

2017-05-01

Thorough pretravel preparation and medical consultation can mitigate avoidable health and safety risks. A comprehensive pretravel medical consultation should include an individualized risk assessment, immunization review, and discussion of arthropod protective measures, malaria prophylaxis, traveler's diarrhea, and injury prevention. Travel with children and jet lag reduction require additional planning and prevention strategies; travel and evacuation insurance may prove essential when traveling to less resourced countries. Consideration should also be given to other high-risk travel scenarios, including the provision of health care overseas, adventure and extreme sports, water environments and diving, high altitude, and terrorism/unstable political situations. Copyright © 2017 Elsevier Inc. All rights reserved.

26 CFR 31.6051-2 - Information returns on Form W-3 and Internal Revenue Service copies of Forms W-2.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Information returns on Form W-3 and Internal Revenue Service copies of Forms W-2. 31.6051-2 Section 31.6051-2 Internal Revenue INTERNAL REVENUE SERVICE... returns on Form W-3 and Internal Revenue Service copies of Forms W-2. (a) In general. Every employer who...

78 FR 41129 - Market Test of Experimental Product - International Merchandise Return Service-Non-Published Rates

Science.gov (United States)

2013-07-09

...--Non-Published Rates AGENCY: U.S. Postal Service\\TM\\. ACTION: Notice. SUMMARY: The Postal Service hereby gives notice of a market test for International Merchandise Return Service--Non-Published Rates in... Return Service (IMRS) Non-published Rate (NPR) experimental product on August 15, 2013. The Postal...

Use of pre-travel vaccine-preventable disease serology as a screening tool to identify patients in need of pre-travel vaccination: a retrospective audit.

Science.gov (United States)

Turner, David P; McGuinness, Sarah L; Cohen, Jonathan; Waring, Lynette J; Leder, Karin

2017-05-01

Vaccination is a safe and effective public health intervention that not only protects individual travellers from vaccine-preventable diseases (VPDs), but prevents them from becoming a source of disease in their destination and on their return. Obtaining an accurate vaccination history from travellers during a pre-travel review can be difficult; serology may be used to identify patients who are non-immune to specific diseases in order to guide vaccination requirements. Clinically relevant data about the usefulness of serology in this setting are lacking. We performed a retrospective audit of pre-travel VPD serology requested by practitioners of a busy community-based travel clinic. All serological results for measles, mumps, rubella, varicella zoster virus, hepatitis A and B requested over a 5-year period were extracted and analysed. Results were stratified by gender and year of birth and compared using Stata. Four thousand four hundred and fifty-one serological assays from 1445 individual were assessed. Overall, 47% of patients tested had at least one negative serological result. High rates of seropositivity for measles, mumps and rubella were seen in those born prior to 1966 but >10% of travellers born after 1966 lacked serological evidence of protection against these diseases. Hepatitis A and B serological results revealed broadly lower rates of immunity in our community likely reflecting the absence of these vaccines from historical vaccine protocols. Serology can be a useful tool in the identification of non-immune travellers to enable targeted vaccination prior to travel. We recommend that travel health clinicians assess patients' vaccination and infection histories, and strongly consider serology or vaccination where there is doubt about immunity. This will help protect the traveller and prevent importation of disease into destination or home communities. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights

Risk of malaria in British residents returning from malarious areas.

Science.gov (United States)

Phillips-Howard, P A; Radalowicz, A; Mitchell, J; Bradley, D J

1990-01-01

OBJECTIVES--To identify which British residents travelling abroad are at greatest risk of malaria infection, and to determine the efficacy of malaria chemoprophylaxis for preventing P falciparum infections in tropical Africa. DESIGN--Prospective cohort study (case-base linkage) with routine national surveillance systems. Denominators (base population) were obtained from monitoring a random sample of returning British travellers with the international passenger survey. Numerators (cases) were obtained from reports of malaria infections in British residents, through the Malaria Reference Laboratory network. SETTING--International passenger survey conducted at passport control of international airports in Britain. Malaria reports received nationally were collated centrally in London. SUBJECTS--2948 British residents (0.2%) returning to Britain in 1987 randomly selected and questioned and 1052 British residents with microscopically confirmed malaria infections in 1987, whose case reports were reviewed and on whom additional data were collected by postal survey. MAIN OUTCOME MEASURES--Annual incidence subdivided by categories of risk. Chemoprophylactic efficacy for east and west Africa by principal regimens and compliance. RESULTS--Annual rates of reported infection per 100,000 travellers to Oceania were 4100; to west and east Africa were 375 and 172 respectively; to Latin America, the Far East, and the Middle East were 12, 2, and 1 respectively. Immigrants visiting friends and relatives in Ghana and Nigeria were at greatest risk (1303 and 952 per 100,000 respectively) in west Africa. Business travellers to Kenya experienced the highest attack rates in east Africa (465 per 100,000). Age-sex specific attack rates varied by region. No prophylaxis was reported to have been used by 23% of British visitors to west Africa, 17% to east Africa, 46% to central or southern Africa, and 58% visiting south Asia. The efficacy of chloroquine plus proguanil against P falciparum

International dispersal of dengue through air travel: importation risk for Europe.

Directory of Open Access Journals (Sweden)

Jan C Semenza

2014-12-01

Full Text Available The worldwide distribution of dengue is expanding, in part due to globalized traffic and trade. Aedes albopictus is a competent vector for dengue viruses (DENV and is now established in numerous regions of Europe. Viremic travellers arriving in Europe from dengue-affected areas of the world can become catalysts of local outbreaks in Europe. Local dengue transmission in Europe is extremely rare, and the last outbreak occurred in 1927-28 in Greece. However, autochthonous transmission was reported from France in September 2010, and from Croatia between August and October 2010.We compiled data on areas affected by dengue in 2010 from web resources and surveillance reports, and collected national dengue importation data. We developed a hierarchical regression model to quantify the relationship between the number of reported dengue cases imported into Europe and the volume of airline travellers arriving from dengue-affected areas internationally.In 2010, over 5.8 million airline travellers entered Europe from dengue-affected areas worldwide, of which 703,396 arrived at 36 airports situated in areas where Ae. albopictus has been recorded. The adjusted incidence rate ratio for imported dengue into European countries was 1.09 (95% CI: 1.01-1.17 for every increase of 10,000 travellers; in August, September, and October the rate ratios were 1.70 (95%CI: 1.23-2.35, 1.46 (95%CI: 1.02-2.10, and 1.35 (95%CI: 1.01-1.81, respectively. Two Italian cities where the vector is present received over 50% of all travellers from dengue-affected areas, yet with the continuing vector expansion more cities will be implicated in the future. In fact, 38% more travellers arrived in 2013 into those parts of Europe where Ae. albopictus has recently been introduced, compared to 2010.The highest risk of dengue importation in 2010 was restricted to three months and can be ranked according to arriving traveller volume from dengue-affected areas into cities where the vector is

International dispersal of dengue through air travel: importation risk for Europe.

Science.gov (United States)

Semenza, Jan C; Sudre, Bertrand; Miniota, Jennifer; Rossi, Massimiliano; Hu, Wei; Kossowsky, David; Suk, Jonathan E; Van Bortel, Wim; Khan, Kamran

2014-12-01

The worldwide distribution of dengue is expanding, in part due to globalized traffic and trade. Aedes albopictus is a competent vector for dengue viruses (DENV) and is now established in numerous regions of Europe. Viremic travellers arriving in Europe from dengue-affected areas of the world can become catalysts of local outbreaks in Europe. Local dengue transmission in Europe is extremely rare, and the last outbreak occurred in 1927-28 in Greece. However, autochthonous transmission was reported from France in September 2010, and from Croatia between August and October 2010. We compiled data on areas affected by dengue in 2010 from web resources and surveillance reports, and collected national dengue importation data. We developed a hierarchical regression model to quantify the relationship between the number of reported dengue cases imported into Europe and the volume of airline travellers arriving from dengue-affected areas internationally. In 2010, over 5.8 million airline travellers entered Europe from dengue-affected areas worldwide, of which 703,396 arrived at 36 airports situated in areas where Ae. albopictus has been recorded. The adjusted incidence rate ratio for imported dengue into European countries was 1.09 (95% CI: 1.01-1.17) for every increase of 10,000 travellers; in August, September, and October the rate ratios were 1.70 (95%CI: 1.23-2.35), 1.46 (95%CI: 1.02-2.10), and 1.35 (95%CI: 1.01-1.81), respectively. Two Italian cities where the vector is present received over 50% of all travellers from dengue-affected areas, yet with the continuing vector expansion more cities will be implicated in the future. In fact, 38% more travellers arrived in 2013 into those parts of Europe where Ae. albopictus has recently been introduced, compared to 2010. The highest risk of dengue importation in 2010 was restricted to three months and can be ranked according to arriving traveller volume from dengue-affected areas into cities where the vector is present. The

Travel Characteristics and Pretravel Health Care Among Pregnant or Breastfeeding U.S. Women Preparing for International Travel.

Science.gov (United States)

Hagmann, Stefan H F; Rao, Sowmya R; LaRocque, Regina C; Erskine, Stefanie; Jentes, Emily S; Walker, Allison T; Barnett, Elizabeth D; Chen, Lin H; Hamer, Davidson H; Ryan, Edward T

2017-12-01

To study characteristics and preventive interventions of adult pregnant and breastfeeding travelers seeking pretravel health care in the United States. This cross-sectional study analyzed data (2009-2014) of pregnant and breastfeeding travelers seen at U.S. travel clinics participating in Global TravEpiNet. Nonpregnant, nonbreastfeeding adult female travelers of childbearing age were used for comparison. We evaluated the prescription of malaria chemoprophylaxis and antibiotics for this population as well as the administration of three travel-related vaccines: hepatitis A, typhoid, and yellow fever. We also evaluated use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis and influenza vaccines, because these are widely recommended in pregnancy. Of 21,138 female travelers of childbearing age in Global TravEpiNet, 170 (0.8%) were pregnant and 139 (0.7%) were breastfeeding. Many traveled to destinations endemic for mosquito-borne illnesses, including malaria (pregnant: 95%; breastfeeding: 94%), dengue (pregnant: 87%; breastfeeding: 81%), or yellow fever (pregnant: 35%; breastfeeding: 50%). Compared with nonpregnant, nonbreastfeeding adult female travelers, eligible pregnant travelers were less likely to be vaccinated against hepatitis A (28% compared with 51%, Ptravelers did not receive influenza vaccination. Yellow fever vaccine was occasionally provided to pregnant and breastfeeding travelers traveling to countries entirely endemic for yellow fever (6 [20%] of 30 pregnant travelers and 18 [46%] of 39 breastfeeding travelers). Half of pregnant travelers and two thirds of breastfeeding travelers preparing to travel to malaria-holoendemic countries received a prescription for malaria prophylaxis. Most pregnant and breastfeeding travelers seen for pretravel health consultations traveled to destinations with high risk for vector-borne or other travel-related diseases. Destination-specific preventive interventions were frequently underused.

A profile of travelers--an analysis from a large swiss travel clinic.

Science.gov (United States)

Bühler, Silja; Rüegg, Rolanda; Steffen, Robert; Hatz, Christoph; Jaeger, Veronika K

2014-01-01

Globally, the Swiss have one of the highest proportions of the population traveling to tropical and subtropical countries. Large travel clinics serve an increasing number of customers with specific pre-travel needs including uncommon destinations and preexisting medical conditions. This study aims to identify health characteristics and travel patterns of travelers seeking advice in the largest Swiss travel clinic so that tailored advice can be delivered. A descriptive analysis was performed on pre-travel visits between July 2010 and August 2012 at the Travel Clinic of the Institute of Social and Preventive Medicine, University of Zurich, Switzerland. A total of 22,584 travelers sought pre-travel advice. Tourism was the main reason for travel (17,875, 81.5%), followed by visiting friends and relatives (VFRs; 1,715, 7.8%), traveling for business (1,223, 5.6%), and "other reasons" (ie, volunteer work, pilgrimage, study abroad, and emigration; 1,112, 5.1%). The main travel destination was Thailand. In the VFR group, the highest proportions of traveling children (258, 15.1%) and of pregnant or breastfeeding women (23, 3.9%) were observed. Mental disorders were more prominent in VFRs (93, 5.4%) and in travel for "other reasons" (63, 5.7%). The latter stayed for the longest periods abroad; 272 (24.9%) stayed longer than 6 months. VFR travelers received the highest percentage of yellow fever vaccinations (523, 30.5%); in contrast, rabies (269, 24.2%) and typhoid vaccinations (279, 25.1%) were given more often to the "other travel reasons" group. New insights into the characteristics of a selected and large population of Swiss international travelers results in improved understanding of the special needs of an increasingly diverse population and, thus, in targeted preventive advice and interventions. © 2014 International Society of Travel Medicine.

International R&D Spillovers and Marginal Social Returns on R&D

NARCIS (Netherlands)

Sterken, Elmer; Ogawa, Kazuo; Tokutsu, Ichiro

2016-01-01

We analyze the impact of international R&D spillovers on recipient countries in terms of social and private returns. We divide the aggregate R&D stock by the business, government and education sectors and examine the impact on Total Factor Productivity. We endogenize the accrual of the R&D stocks by

En route: Transport and embodiment in international medical travel journeys between Indonesia and Malaysia

NARCIS (Netherlands)

Ormond, M.E.

2015-01-01

International medical travel is increasingly big business. Using Indonesian patient-consumers’transport experiences in the pursuit of private medical care in Malaysia, this paper explores howtransport operators and infrastructure are responding and adjusting to the embodied specificities of the

Provision of travel medicine advice through community pharmacies: assessment of knowledge, attitudes and practices of pharmacists in Malaysia.

Science.gov (United States)

Taha, Nur Akmar; See, Yee Lian

2016-10-01

The risk for travel-related illnesses has increased with significant growth in international travel, but very few travellers seek travel advice. Community pharmacists can play a vital role in the provision of travel medicine advice due to their accessibility. This study aimed to assess travel medicine knowledge, attitudes and practices (KAP) among community pharmacists in Kuala Lumpur, Malaysia. A self-administered KAP questionnaire was distributed to a convenience sample of pharmacists in Kuala Lumpur identified from the list of licensed community pharmacists in Malaysia year 2014. Questionnaires were returned by 111 pharmacists of 143 distributed (response rate, 78%). Most of the respondents (82%) were not trained in travel medicine. Overall, mean knowledge score was 4.4 ( ± 1.7), indicating a moderate level of knowledge on a variety of travel-related health issues. Community pharmacists who graduated from foreign universities possessed significantly higher knowledge scores than did those who graduated locally (P pharmacy curricula, continuous pharmacy education or certified training may improve the quality of travel advice given and allow pharmacists to be recognised as a credible source of information on travel medicine. © 2016 Royal Pharmaceutical Society.

Travel-related illness at a tertiary care hospital in Osaka, Japan

OpenAIRE

Hadano,Yoshiro; Shirano,Michinori; Goto,Tetsushi

2016-01-01

Yoshiro Hadano, Michinori Shirano, Tetsushi Goto Center for Infectious Diseases, Osaka City General Hospital, Osaka, Japan Abstract: We analyzed the travel-related health problems in persons returning to Japan from overseas. Data were extracted retrospectively for all patients visiting the infectious diseases department of Osaka City General Hospital, Osaka, Japan, between July 2012 and September 2013. There were 209 sick returning travelers during the period of the study. ...

78 FR 70274 - United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism...

Science.gov (United States)

2013-11-25

... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism Advisory Board AGENCY: International Trade... the schedule and agenda for an open meeting of the United States Travel and Tourism Advisory Board...

78 FR 3398 - United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism...

Science.gov (United States)

2013-01-16

... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism Advisory Board AGENCY: International Trade... the schedule and agenda for an open meeting of the United States Travel and Tourism Advisory Board...

Travel itinerary uncertainty and the pre-travel consultation--a pilot study.

Science.gov (United States)

Flaherty, Gerard; Md Nor, Muhammad Najmi

2016-01-01

Risk assessment relies on the accuracy of the information provided by the traveller. A questionnaire was administered to 83 consecutive travellers attending a travel medicine clinic. The majority of travellers was uncertain about destinations within countries, transportation or type of accommodation. Most travellers were uncertain if they would be visiting malaria regions. The degree of uncertainty about itinerary potentially impacts on the ability of the travel medicine specialist to perform an adequate risk assessment, select appropriate vaccinations and prescribe malaria prophylaxis. This study reveals high levels of traveller uncertainty about their itinerary which may potentially reduce the effectiveness of their pre-travel consultation. © The Author 2016. Published by Oxford University Press on behalf of International society of travel medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Internal migration and the health of the returned population: a nationally representative study of China.

Science.gov (United States)

Zhang, Luwen; Liu, Shuaishuai; Zhang, Guoying; Wu, Shaolong

2015-07-28

China had 236 million internal migrants in 2012 and the majority of them migrated from rural to urban areas. The research based on medical and epidemical records found that the migrants had worse health than the urban residents, but the household and working place investigations reported better health status. The sick or unhealthy migrants are likely to return to their hometowns, which in turn may cause a report bias or over-estimation of the health status of rural-to-urban migrants in China. This paper explores the association of migration status and the physical and psychological health of Chinese internal migrants. Nationally representative household survey data from the China Labor-force Dynamics Survey 2012 (CLDS) were used to analyze the association between the migration status and the health status of internal migrants in China. Migration status of the respondents was measured by hukou status and migration experience and all respondents were divided into four groups: returned population, migrant population, urban residents, and rural residents. Health status of respondents was measured by self-reported physical and psychological health. Migration experience was associated with the physical health of the returned population. The physical health of the returned population was worse than the migrant population and was distinguished by age and sex. The physical health status of migrant population was significantly better than rural residents, but not significantly better than urban residents. However, the association between migration status and psychological health was not statistically significant. Besides migration status, the socioeconomic status (SES) had a positive correlation with both physical and psychological health status, while occupational hazards exerted negative influence. The results indicate a tight association between migration experience and health status. The internal unhealthy migrants were more likely to return to their hometown and the

Sickle cell children traveling abroad: primary risk is infection.

Science.gov (United States)

Runel-Belliard, Camille; Lesprit, Emmanuelle; Quinet, Béatrice; Grimprel, Emmanuel

2009-01-01

Pediatricians taking care of sickle cell children in France are concerned about giving travel advice. Very few articles are published and no study has been done about it. A lot of pediatricians are using their own experience to decide if sickle cell children can travel abroad. Studying the consequences of such travel for sickle cell children is important to discuss common recommendations. We conducted a prospective study from June 2006 to December 2007 on desires to travel expressed during our consultations with sickle cell children. We studied notable events that occurred during travel and at least 2 months after return. Of 52 desires to travel, 10 were cancelled. All of the 42 trips were to Africa. Median duration of travel was 1.29 months (0.5-3). Median age at travel was 7.6 years (0.2-17.7). Events during travel were two hospitalizations (4.8%), a transfusion (2.4%), and four paramedical or medical examinations (9.6%). After return, four events occurred: two SS children had Plasmodium falciparum malaria (4.8%) and two had digestive bacteremia (4.8%) in SC and Sbeta+ children. No event occurred during plane travel. None of our patients died. The primary risk for sickle cell children traveling to Africa is infection: malaria first and digestive septicemia second. These risks are increased by long travel and poor sanitary conditions. Each travel should be prepared a long time before departure, and each pediatrician should insist on malaria prophylaxis and sanitary conditions, especially for young children. Trips should be shorter than 1 month when possible. A longer prospective study will be done to confirm these results.

The impact of international service on the development of volunteers' intercultural relations.

Science.gov (United States)

Lough, Benjamin J; Sherraden, Margaret Sherrard; McBride, Amanda Moore; Xiang, Xiaoling

2014-07-01

Approximately one million people from the United States perform international volunteer service each year, representing a significant flow of ideas, people, resources, and aid across international borders. This quasi-experimental study assesses the longitudinal impact of international volunteer service on volunteers' intercultural relations, international social capital, and concern about international affairs. Using linear mixed regression models that control for a counterfactual comparison group of individuals that did not travel abroad, international volunteers are more likely to report significant increases in international social capital and international concern two to three years after returning from service. Results indicate that intercultural relations may also continue to increase years after returning from service. International service may be a useful approach to helping people gain skills and networks that are needed in an increasingly global society. Copyright © 2014 Elsevier Inc. All rights reserved.

The Role of Attachment, Travel Experiences and English Proficiency in International Students' Acculturative Stress and Depressive Symptoms

Science.gov (United States)

Smiljanic, Iskra

2017-01-01

This study examined the relationship between attachment, travel experiences, and English proficiency and international students' acculturative stress and depressive symptoms. A total of 91 graduate international students completed online surveys. Pearson correlations showed that both attachment anxiety and avoidance were positively correlated with…

75 FR 63811 - The U.S. Travel & Tourism Advisory Board: Information-Gathering Session of the U.S. Travel and...

Science.gov (United States)

2010-10-18

... DEPARTMENT OF COMMERCE International Trade Administration The U.S. Travel & Tourism Advisory Board: Information-Gathering Session of the U.S. Travel and Tourism Advisory Board AGENCY: International Trade...: The U.S. Travel and Tourism Advisory Board (``Board'') will convene a public information-gathering...

Travel-related leptospirosis: a series of 15 imported cases.

Science.gov (United States)

van de Werve, Charlotte; Perignon, Alice; Jauréguiberry, Stéphane; Bricaire, François; Bourhy, Pascal; Caumes, Eric

2013-01-01

Leptospirosis belongs to the spectrum of travel-related infections. We retrospectively studied all the consecutive cases of travel-related leptospirosis seen in our department between January 2008 and September 2011. Patients were included with a clinical picture compatible with the disease within 21 days after return, the presence of a thermoresistant antigen or IgM antibodies, Elisa ≥ 1 /400, and a positive microagglutination test (MAT) ≥ 1/100. Fifteen leptospirosis cases were evaluated. Exposure occurred in Asia (47%), Africa (20%), the Caribbean (20%), and Indian Ocean (13%). Fourteen patients were infected during water-related activities. On admission the most frequent symptoms were fever (100%), headache (80%), and digestive disorders (67%). Relevant laboratory findings included impaired liver function tests (100%), lymphocytopenia (80%), thrombocytopenia (67%), and elevated C-reactive protein (CRP) (67%). Our cases were confirmed by MAT that found antibodies against nine different serovars. Seven patients were cured with amoxicillin, four with doxycycline, two with ceftriaxone, one with ceftriaxone, doxycycline, and spiramycin, whereas one recovered spontaneously (retrospective diagnosis). Eight patients were hospitalized. All patients recovered. Our cases involved nine different serovars. They were related to travel in Asia, Africa, and the Caribbean. Bathing or other fresh-water leisure activities (canoeing, kayaking, rafting) are the most likely at-risk exposure. Any traveler with fever and at-risk exposure should be investigated for leptospirosis. © 2013 International Society of Travel Medicine.

Travel-related acquisition of diarrhoeagenic bacteria, enteral viruses and parasites in a prospective cohort of 98 Dutch travellers.

Science.gov (United States)

van Hattem, Jarne M; Arcilla, Maris S; Grobusch, Martin P; Bart, Aldert; Bootsma, Martin C; van Genderen, Perry J; van Gool, Tom; Goorhuis, Abraham; van Hellemond, Jaap J; Molenkamp, Richard; Molhoek, Nicky; Oude Lashof, Astrid M; Stobberingh, Ellen E; de Wever, Bob; Verbrugh, Henri A; Melles, Damian C; Penders, John; Schultsz, Constance; de Jong, Menno D

2017-09-01

Limited prospective data are available on the acquisition of viral, bacterial and parasitic diarrhoeagenic agents by healthy individuals during travel. To determine the frequency of travel associated acquisition of 19 pathogens in 98 intercontinental travellers, qPCR was used to detect 8 viral pathogens, 6 bacterial enteric pathogens and 5 parasite species in faecal samples collected immediately before and after travel. We found high pre-travel carriage rates of Blastocystis spp. and Dientamoeba fragilis of 32% and 19% respectively. Pre-travel prevalences of all other tested pathogens were below 3%. Blastocystis spp. (10%), Plesiomonas shigelloides (7%), D. fragilis (6%) and Shigella spp. (5%) were the most frequently acquired pathogens and acquisition of enteral viruses and hepatitis E virus in this relatively small group of travellers was rare or non-existent. Our findings suggest that the role of viruses as the cause of persisting traveller's diarrhoea is limited and bacterial pathogens are more likely as a cause of traveller's diarrhoea. The substantial proportion of travellers carrying Blastocystis spp. and D. fragilis before travel warrants cautious interpretation of positive samples in returning travellers with gastrointestinal complaints. Copyright © 2017 Elsevier Ltd. All rights reserved.

Arboviral and other illnesses in travellers returning from Brazil, June 2013 to May 2016: implications for the 2016 Olympic and Paralympic Games.

Science.gov (United States)

Gautret, Philippe; Mockenhaupt, Frank; Grobusch, Martin P; Rothe, Camilla; von Sonnenburg, Frank; van Genderen, Perry J; Chappuis, Francois; Asgeirsson, Hilmir; Caumes, Eric; Bottieau, Emmanuel; Malvy, Denis; Lopez-Vélez, Rogelio; Jensenius, Mogens; Larsen, Carsten Schade; Castelli, Francesco; Rapp, Christophe; Field, Vanessa; Molina, Israel; Gkrania-Klotsas, Effrossyni; Florescu, Simin; Lalloo, David; Schlagenhauf, Patricia

2016-07-07

We evaluated EuroTravNet (a GeoSentinel subnetwork) data from June 2013 to May 2016 on 508 ill travellers returning from Brazil, to inform a risk analysis for Europeans visiting the 2016 Olympic and Paralympic Games in Brazil. Few dengue fever cases (n = 3) and no cases of chikungunya were documented during the 2013-15 Brazilian winter months, August and September, the period when the Games will be held. The main diagnoses were dermatological (37%), gastrointestinal (30%), febrile systemic illness (29%) and respiratory (11%). This article is copyright of The Authors, 2016.

End to End Travel

Data.gov (United States)

US Agency for International Development — E2 Solutions is a web based end-to-end travel management tool that includes paperless travel authorization and voucher document submissions, document approval...

Pre-travel advice seeking from GPs by travellers with chronic illness seen at a travel clinic.

Science.gov (United States)

Gagneux-Brunon, Amandine; Andrillat, Carole; Fouilloux, Pascale; Daoud, Fatiha; Defontaine, Christiane; Charles, Rodolphe; Lucht, Frédéric; Botelho-Nevers, Elisabeth

2016-03-01

Travellers are ageing and frequently report chronic illness. Pre-travel health advice is crucial, particularly in this subgroup, and general practitioners (GPs) are first in line for treatment adjustment before departure. Our aim is to evaluate pre-travel health advice seeking from GPs by travellers with chronic illness seen at a travel clinic. A cross-sectional observational survey using a questionnaire was conducted between August 2013 and July 2014 in travellers attending the travel medicine clinic of a tertiary university hospital in France. During the study, 2019 travellers were included. Mean age was 39.4 years (±18.8). Three hundred and ninety-one (19.4%) travellers reported a history of a chronic illness. Arterial hypertension and diabetes mellitus were the most frequently reported illnesses, affecting, respectively, 168 (8.3%) travellers and 102 (5.1%). Hajj pilgrims were more likely to report a history of chronic illness than other travellers. Only 810 (40.1%) travellers sought pre-travel advice from their GP. Six hundred and fifty-two (40.1%) healthy travellers and 158 (40.5%) travellers reporting chronic illness sought pre-travel advice from their GP (P = 0.96). Travellers with a history of chronic illness do not seek pre-travel health advice from their GP more frequently than healthy travellers. Travel health specialists are generally not the best practitioners to manage the care of underlying medical conditions presenting risks during travel. However, GPs offer continuity and disease management expertise to improve the specificity of pre-travel planning. Thus, ongoing collaboration between the traveller, GP and travel health specialist is likely to yield the best outcomes. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

Health challenges of young travelers visiting friends and relatives compared with those traveling for other purposes.

Science.gov (United States)

Han, Pauline; Yanni, Emad; Jentes, Emily S; Hamer, Davidson H; Chen, Lin H; Wilson, Mary E; Macleod, William B; Ooi, Winnie W; Kogelman, Laura; Karchmer, Adolf W; Barnett, Elizabeth D

2012-09-01

The study objective was to assess differences in demographics and travel health challenges between youths ≤18 years old traveling internationally to visit friends and relatives (VFRs) compared with those traveling for other purposes (non-VFR). The Boston Area Travel Medicine Network consists of 5 clinics collecting anonymous data from international pretravel consultations. Data on all travelers ≤18 years of age seen between January 2008 and July 2010 were used. VFRs were compared with non-VFRs on demographics, primary language, trip characteristics, travel vaccinations administered, malaria prophylaxis and antidiarrheal medications prescribed. Thirty-five percent (610/1731) listed VFR as their purpose of travel. Almost half of VFRs were travel to countries that were yellow fever holoendemic, had malaria risk and were high-risk for typhoid (44% versus 20%, 39% versus 12%, 25% versus 15%, P travel-related morbidity, healthcare providers should be prepared to give travel advice to parents of VFR infants and children, particularly those US-born VFRs with foreign-born parents, regarding antimalarial and antidiarrheal medications and preventing yellow fever, malaria and typhoid.

Travel characteristics and risk-taking attitudes in youths traveling to nonindustrialized countries.

Science.gov (United States)

Han, Pauline; Balaban, Victor; Marano, Cinzia

2010-01-01

International travel to developing countries is increasing with rising levels of disposable income; this trend is seen in both adults and children. Risk-taking attitude is fundamental to research on the prevention of risky health behaviors, which can be an indicator of the likelihood of experiencing illness or injury during travel. The aim of this study is to investigate whether risk-taking attitudes of youths are associated with travel characteristics and likelihood of experiencing illness or injury while traveling to nonindustrialized countries. Data were analyzed from the 2008 YouthStyles survey, an annual mail survey gathering demographics and health knowledge, attitudes, and practices of individuals from 9 through 18 years of age. Travelers were defined as respondents who reported traveling in the last 12 months to a destination other than the United States, Canada, Europe, Japan, Australia, or New Zealand. Risk-taking attitude was measured by using a four-item Brief Sensation-Seeking Scale. All p values ≤ 0.05 were considered significant. Of 1,704 respondents, 131 (7.7%) traveled in the last 12 months. Females and those with higher household income were more likely to travel (odds ratio = 1.6,1.1). Of those who traveled, 16.7% reported seeking pretravel medical care, with most visiting a family doctor for that care (84.0%). However, one-fifth of respondents reported illness and injury during travel; of these, 83.3% traveled with their parents. Males and older youths had higher mean sensation-seeking scores. Further, travelers had a higher mean sensation-seeking score than nontravelers. Those who did not seek pretravel medical care also had higher mean sensation-seeking scores (p = 0.1, not significant). Our results show an association between risk-taking attitudes and youth travel behavior. However, adult supervision during travel and parental directives prior to travel should be taken into consideration. Communication messages should emphasize the

Pre-Exposure Rabies Vaccination among US International Travelers: Findings from the Global TravEpiNet Consortium

Science.gov (United States)

Dolan, Samantha B.; Sotir, Mark J.; Han, Pauline; Blanton, Jesse D.; Rao, Sowmya R.; LaRocque, Regina C.; Ryan, Edward T.

2014-01-01

Abstract Background: People who travel to areas with high rabies endemicity and have animal contact are at increased risk for rabies exposure. We examined characteristics of international travelers queried regarding rabies vaccination during pretravel consultations at Global TravEpiNet (GTEN) practices during 2009–2010. Material and Methods: We performed bivariate and multivariable analyses of data collected from 18 GTEN clinics. Travel destinations were classified by strength level of rabies vaccination recommendation. Results: Of 13,235 travelers, 226 (2%) reported previous rabies vaccination, and 406 (3%) received rabies vaccine at the consultation. Common travel purposes for these 406 travelers were leisure (26%), research/education (17%), and nonmedical service work (14%). Excluding the 226 who were previously vaccinated, 8070 (62%) of 13,009 travelers intended to visit one or more countries with a strong recommendation for rabies vaccination; 1675 (21%) of these 8070 intended to travel for 1 month or more. Among these 1675 travelers, 145 (9%) were vaccinated, 498 (30%) declined vaccination, 832 (50%) had itineraries that clinicians determined did not indicate vaccination, and 200 (12%) remained unvaccinated for other reasons. In both bivariate and multivariate analyses, travelers with trip durations >6 months versus 1–3 months (adjusted odds ratio [OR]=4.9 [95% confidence interval [CI] 2.1, 11.4]) and those traveling for “research/education” or to “provide medical care” (adjusted OR=5.1 [95% CI 1.9, 13.7] and 9.5 [95% CI 2.2, 40.8], respectively), compared with leisure travelers, were more likely to receive rabies vaccination. Conclusions: Few travelers at GTEN clinics received rabies vaccine, although many planned trips 1 month long or more to a strong-recommendation country. Clinicians often determined that vaccine was not indicated, and travelers often declined vaccine when it was offered. The decision to vaccinate should take into account the

Pre-exposure rabies vaccination among US international travelers: findings from the global TravEpiNet consortium.

Science.gov (United States)

Dolan, Samantha B; Jentes, Emily S; Sotir, Mark J; Han, Pauline; Blanton, Jesse D; Rao, Sowmya R; LaRocque, Regina C; Ryan, Edward T; Abraham, George M; Alvarez, Salvador; Ansdell, Vernon; Yates, Johnnie A; Atkins, Elisha H; Cahill, John; Birich, Holly K; Vitek, Dagmar; Connor, Bradley A; Dismukes, Roberta; Kozarsky, Phyllis; Dosunmu, Rone; Goad, Jeffrey A; Hagmann, Stefan; Hale, DeVon; Hynes, Noreen A; Jacquerioz, Frederique; McLellan, Susan; Knouse, Mark; Lee, Jennifer; LaRocque, Regina C; Ryan, Edward T; Oladele, Alawode; Demeke, Hanna; Pasinski, Roger; Wheeler, Amy E; Rao, Sowmya R; Rosen, Jessica; Schwartz, Brian S; Stauffer, William; Walker, Patricia; Vinetz, Joseph

2014-02-01

People who travel to areas with high rabies endemicity and have animal contact are at increased risk for rabies exposure. We examined characteristics of international travelers queried regarding rabies vaccination during pretravel consultations at Global TravEpiNet (GTEN) practices during 2009-2010. We performed bivariate and multivariable analyses of data collected from 18 GTEN clinics. Travel destinations were classified by strength level of rabies vaccination recommendation. Of 13,235 travelers, 226 (2%) reported previous rabies vaccination, and 406 (3%) received rabies vaccine at the consultation. Common travel purposes for these 406 travelers were leisure (26%), research/education (17%), and nonmedical service work (14%). Excluding the 226 who were previously vaccinated, 8070 (62%) of 13,009 travelers intended to visit one or more countries with a strong recommendation for rabies vaccination; 1675 (21%) of these 8070 intended to travel for 1 month or more. Among these 1675 travelers, 145 (9%) were vaccinated, 498 (30%) declined vaccination, 832 (50%) had itineraries that clinicians determined did not indicate vaccination, and 200 (12%) remained unvaccinated for other reasons. In both bivariate and multivariate analyses, travelers with trip durations >6 months versus 1-3 months (adjusted odds ratio [OR]=4.9 [95% confidence interval [CI] 2.1, 11.4]) and those traveling for "research/education" or to "provide medical care" (adjusted OR=5.1 [95% CI 1.9, 13.7] and 9.5 [95% CI 2.2, 40.8], respectively), compared with leisure travelers, were more likely to receive rabies vaccination. Few travelers at GTEN clinics received rabies vaccine, although many planned trips 1 month long or more to a strong-recommendation country. Clinicians often determined that vaccine was not indicated, and travelers often declined vaccine when it was offered. The decision to vaccinate should take into account the strength of the vaccine recommendation at the destination country, duration

48 CFR 731.205-46 - Travel costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Travel costs. 731.205-46 Section 731.205-46 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL....205-46 Travel costs. It is USAID policy to require prior written approval of international travel by...

A Draft Science Management Plan for Returned Samples from Mars: Recommendations from the International Mars Architecture for the Return of Samples (iMARS) Phase II Working Group

Science.gov (United States)

Haltigin, T.; Lange, C.; Mugnuolo, R.; Smith, C.

2018-04-01

This paper summarizes the findings and recommendations of the International Mars Architecture for the Return of Samples (iMARS) Phase II Working Group, an international team comprising 38 members from 16 countries and agencies.

Solidarity by demand? Exit and voice in international medical travel - the case of Indonesia.

Science.gov (United States)

Ormond, Meghann

2015-01-01

Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical travellers, study of its impacts on medical travellers' home contexts has been negligible and largely speculative. While proponents praise IMT's potential to make home health systems more responsive to the needs of market-savvy healthcare consumers, critics identify it as a way to further de-politicise the satisfaction of healthcare needs. This article draws from work on political consumerism, health advocacy and social movements to argue for a reframing of IMT not as a 'one-off' statement about or an event external to struggles over access, rights and recognition within medical travellers' home health systems but rather as one of a range of critical forms of on-going engagement embedded within these struggles. To do this, the limited extant empirical work addressing domestic impacts of IMT is reviewed and a case study of Indonesian medical travel to Malaysia is presented. The case study material draws from 85 interviews undertaken in 2007-08 and 2012 with Indonesian and Malaysian respondents involved in IMT as care recipients, formal and informal care-providers, intermediaries, promoters and policy-makers. Evidence from the review and case study suggests that IMT may effect political and social change within medical travellers' home contexts at micro and macro levels by altering the perspectives, habits, expectations and accountability of, and complicity among, medical travellers, their families, communities, formal and informal intermediaries, and medical providers both within and beyond the container of the nation-state. Impacts are conditioned by the ideological foundations underpinning home political and social systems, the status of a medical traveller's ailment or therapy, and the existence of organised support for recognition and

Dynamics of a lightning corona sheath—A constant field approach using the generalized traveling current source return stroke model

Science.gov (United States)

Cvetic, Jovan; Heidler, Fridolin; Markovic, Slavoljub; Radosavljevic, Radovan; Osmokrovic, Predrag

2012-11-01

A generalized lightning traveling current source return stroke model has been used to examine the characteristics of the lightning channel corona sheath surrounding a thin channel core. A model of the lightning channel consisting of a charged corona sheath and a narrow, highly conducting central core that conducts the main current flow is assumed. Strong electric field, with a predominant radial direction, has been created during the return stroke between the channel core and the outer channel sheath containing the negative charge. The return stroke process is modeled with the positive charge coming from the channel core discharging the negative leader charge in the corona sheath. The corona sheath model that predicts the charge motion in the sheath is used to derive the expressions of the sheath radius vs. time during the return stroke. According to the corona sheath model proposed earlier by Maslowski and Rakov (2006) and Maslowski et al. (2009), it consists of three zones, zone 1 (surrounding channel core with net positive charge), zone 2 (surrounding zone 1 with negative charge) and zone 3 (outer zone representing the virgin air without charges). We adopted the assumption of a constant electric field inside zone 1 of the corona sheath observed in the experimental research of corona discharges in a coaxial geometry by Cooray (2000). This assumption seems to be more realistic than the assumption of a uniform corona space charge density used previously in the study of Maslowski and Rakov (2006), Marjanovic and Cvetic (2009), and Tausanovic et al. (2010). Applying the Gauss' law on the infinitesimally small cylindrical section of the channel the expressions for time-dependence of the radii of zones 1 and 2 during the return stroke are derived. The calculations have shown that the overall channel dynamics concerning electrical discharge is roughly 50% slower and the maximum radius of zone 1 is about 33% smaller compared to the corresponding values calculated in the

Self-reported illness among Boston-area international travelers: A prospective study

Science.gov (United States)

Chen, Lin H.; Han, Pauline V.; Wilson, Mary E.; Stoney, Rhett J.; Jentes, Emily S.; Benoit, Christine; Ooi, Winnie W.; Barnett, Elizabeth D.; Hamer, Davidson H.

2017-01-01

Summary Background The Boston Area Travel Medicine Network surveyed travelers on travel-related health problems. Methods Travelers were recruited 2009–2011 during pre-travel consultation at three clinics. The investigation included pre-travel data, weekly during-travel diaries, and a post-travel questionnaire. We analyzed demographics, trip characteristics, health problems experienced, and assessed the relationship between influenza vaccination, influenza prevention advice, and respiratory symptoms. Results Of 987 enrolled travelers, 628 (64%) completed all surveys, of which 400 (64%) reported health problems during and/or after travel; median trip duration was 12 days. Diarrhea affected the most people during travel (172) while runny/stuffy nose affected the most people after travel (95). Of those with health problems during travel, 25% stopped or altered plans; 1% were hospitalized. After travel, 21% stopped planned activities, 23% sought physician or other health advice; one traveler was hospitalized. Travelers who received influenza vaccination and influenza prevention advice had lower rates of respiratory symptoms than those that received influenza prevention advice alone (18% vs 28%, P = 0.03). Conclusions A large proportion of Boston-area travelers reported health problems despite pre-travel consultation, resulting in inconveniences. The combination of influenza prevention advice and influenza immunization was associated with fewer respiratory symptoms than those who received influenza prevention advice alone. PMID:27687076

Exploring disagreement prevention and resolution in travel decision-making of young Chinese travellers

OpenAIRE

Song, Hanqun; Sparks, Beverley; Wang, Ying

2017-01-01

The young Chinese travel market is becoming increasingly significant in domestic and international tourism. However, there is limited research on the market. This study examines the decision-making processes of young Chinese travellers, with a particular interest in disagreement prevention and resolution. On the basis of interviews with 25 young Chinese travellers, this study found that while a small number of travellers did not perceive any disagreement, or did not voice their disagreement, ...

Reduction of travellers' diarrhoea by WC/rBS oral cholera vaccine in young, high-risk travellers.

Science.gov (United States)

Torrell, Josep Ma Ramon; Aumatell, Cristina Masuet; Ramos, Sergi Morchon; Mestre, Laura Gavaldà; Salas, Carme Micheo

2009-06-19

A bidirectional cohort study investigates whether pre-travel vaccination with whole cell/recombinant B subunit inactivated, killed oral cholera vaccine reduces the incidence of diarrhoea in young adult travellers to high-risk areas. Risk of travellers' diarrhoea was assessed according to destination and reason for travel in high-risk travellers of a travel clinic in Barcelona, Spain. Those at high-risk between January and December 2005 were advised on water/food safety and hygiene. High-risk travellers between January and December 2006 were additionally vaccinated with WC/rBS oral cholera vaccine. Data regarding diarrhoea were gathered by structured telephone interview or e-mailed questionnaire following the travellers' return. The incidence of diarrhoea in the group vaccinated with WC/rBS oral cholera vaccine (n=321) was 17.4%, compared with 39.7% in the non-vaccinated group (n=337) (adjusted risk ratio 0.40). The first episode was significantly shorter in the vaccinated group (mean 2.3 days) than in the non-vaccinated group (mean 3.8 days) (pyoung, high-risk travellers. Vaccination with the WC/rBS oral cholera vaccine as well as food safety and hygiene advice could offer effective means of reducing the risk of diarrhoea while abroad.

75 FR 14135 - U.S. Travel And Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board

Science.gov (United States)

2010-03-24

... DEPARTMENT OF COMMERCE International Trade Administration U.S. Travel And Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board AGENCY: International Trade Administration, U.S. Department of Commerce. ACTION: Notice of an open meeting. SUMMARY: The U.S. Travel and Tourism Advisory...

75 FR 16438 - U.S. Travel and Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board

Science.gov (United States)

2010-04-01

... DEPARTMENT OF COMMERCE International Trade Administration U.S. Travel and Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board AGENCY: International Trade Administration, U.S... Tourism Advisory Board (Board) will hold a meeting to discuss topics related to the travel and tourism...

75 FR 39496 - U.S. Travel and Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board

Science.gov (United States)

2010-07-09

... DEPARTMENT OF COMMERCE International Trade Administration U.S. Travel and Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board AGENCY: International Trade Administration, U.S. Department of Commerce. ACTION: Notice of an open meeting. SUMMARY: The U.S. Travel and Tourism Advisory...

Macroeconomic Variables, International Islamic Indices, and The Return Volatility in Jakarta Islamic Index

Directory of Open Access Journals (Sweden)

Yoghi Citra Pratama

2018-01-01

Full Text Available According to understand the behavior of Islamic equity markets the primary objective of this research is to analyze the effect of macroeconomic indicators and International Islamic Index on return volatility of Jakarta Islamic Index. The analysis method used in this study is AutoRegressive Conditional Heteroscedastic-Generalized AutoRegressive Conditional Heteroscedastic (ARCH-GARCH. The result of this research showed that all variables, i.e., BI rate, inflation rate, IDR-USD exchange rate, DJIUS index, DJIUK index, FTSJP index and FTSMY index have a simultaneously significant impact on return volatility of JII. While t-test results show that BI rate, IDR-USD exchange rate, DJIUK index and FTSMY index have a substantial effect on return volatility of JII.DOI: 10.15408/aiq.v10i1.5550

Valuation of travel time for international long-distance travel - results from the Fehmarn Belt stated choice experiment

DEFF Research Database (Denmark)

Mabit, Stefan Lindhard; Rich, Jeppe; Burge, Peter

2013-01-01

of travel time savings (VTTS). The final model, which was formulated as a nested logit model and included Box–Cox transformed travel time and cost attributes, revealed several interesting findings. Firstly, we found damping effects in both cost and time – most strongly in cost. Secondly, we found...... significant interactions among travel cost and time, and journey characteristics, such as distance and duration. This had direct impact on the VTTS, which was shown to decrease with distance and duration. Thirdly, we found that air travel implies a higher average VTTS, which is to be expected but rarely......The geographical scope of travel varies from short distances in urban areas to long distances across cities and countries. While urban travel has been widely analysed in the literature, travel over longer distances and particularly across countries, has received much less attention. While this may...

75 FR 80039 - U.S. Travel and Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board

Science.gov (United States)

2010-12-21

... DEPARTMENT OF COMMERCE International Trade Administration U.S. Travel and Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board AGENCY: International Trade Administration, U.S... agenda for an open meeting of the U.S. Travel and Tourism Advisory Board (Board). The agenda may change...

76 FR 21703 - U.S. Travel and Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board

Science.gov (United States)

2011-04-18

... DEPARTMENT OF COMMERCE International Trade Administration U.S. Travel and Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board AGENCY: International Trade Administration, U.S... agenda for an open meeting of the U.S. Travel and Tourism Advisory Board (Board). The agenda may change...

76 FR 53666 - U.S. Travel and Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board

Science.gov (United States)

2011-08-29

... DEPARTMENT OF COMMERCE International Trade Administration U.S. Travel and Tourism Advisory Board: Meeting of the U.S. Travel and Tourism Advisory Board AGENCY: International Trade Administration, U.S... agenda for an open meeting of the U.S. Travel and Tourism Advisory Board (Board). The agenda may change...

Size, Value, and Momentum in Polish Equity Returns: Local or International Factors?

Directory of Open Access Journals (Sweden)

Zaremba Adam

2017-09-01

Full Text Available This paper tests the performance of the Capital Asset Pricing Model (CAPM and the Fama-French three-factor and Carhart four-factor models on the Polish market. We use stock level data from April 2001 to January 2014 and find strong evidence for value and momentum effects, but only weak evidence for size premium. We formed portfolios double-sorted on size and book-to-market ratios, as well as on size and momentum, and we explain their returns with the above-mentioned asset pricing models. The CAPM is rejected and the three-factor and four-factor models perform well for the size and B/M sorted portfolios, but fail to explain returns on the size and momentum sorted portfolios. With the exception of the momentum factor, local Polish factors are not correlated with their European and global counterparts, suggesting market segmentation. Finally, the international value, size and momentum factors perform poorly in explaining cross-sectional variation in stock returns on the Polish market.

Measuring the travel behaviour impact of free-floating car-sharing

OpenAIRE

Becker, Henrik; Ciari, Francesco; Axhausen, Kay W.

2016-01-01

Free-floating car-sharing schemes operate without fixed car-sharing stations, ahead reservations or return-trip requirements. Providing fast and convenient motorization, they attract both public transport users and (former) car-owners. Thus, its impact on individual travel behavior depends on the user type. Estimating the travel behavior impact of these novel systems therefore requires quantitative data. Using a two-wave survey approach including travel diaries, this research shows, that free...

Travellers' diarrhoea: contemporary approaches to therapy and prevention.

Science.gov (United States)

DuPont, Herbert L

2006-01-01

Travellers' diarrhoea remains a major public health problem, contributing to significant morbidity and disability. Because bacterial enteropathogens cause a majority of this form of diarrhoea, antibacterial drugs are effective when used in chemoprophylaxis or for empirical treatment.A review of the MEDLINE listings for travellers' diarrhoea for the past 4 years was conducted; a library of >1,000 scientific articles on the topic was also considered in developing this review. Persons who travel from industrialised countries to developing countries of the tropical and semi-tropical world are the individuals who experience travellers' diarrhoea. While diarrhoea occurs with reduced frequency among persons travelling to low-risk areas from other low- or other high-risk areas, and there remain areas of intermediate risk, this review looks primarily at the illness occurring in persons from industrialised regions visiting high-risk regions of Latin America, Africa and Southern Asia. The material reviewed deals with the high frequency of acquiring diarrhoea during international travel to high-risk areas, seen in approximately 40%, and the expected bacterial causes of illness, of which diarrhoeagenic Escherichia coli is the most important. The host risk factors associated with increased susceptibility to diarrhoea include young age, lack of previous travel to high-risk regions in the past 6 months, indiscriminate food and beverage selection patterns, and host genetics. It appears feasible to decrease the rate of illness among the travelling public by careful food and beverage selection or through chemoprophylaxis with nonabsorbed rifaximin. Chemoprophylaxis with rifaximin should help to reduce the occurrence of travellers' diarrhoea and hopefully prevent post-diarrhoea complications, including irritable bowel syndrome. Early empirical therapy with antibacterial drugs, including rifaximin, a fluoroquinolone or azithromycin, will decrease the duration of illness and return

Responses of Lower-Body Power and Match Running Demands Following Long-Haul Travel in International Rugby Sevens Players.

Science.gov (United States)

Mitchell, John A; Pumpa, Kate L; Pyne, David B

2017-03-01

Mitchell, JA, Pumpa, KL, and Pyne, DB. Responses of lowerbody power and match running demands after long-haul travel in international rugby sevens players. J Strength Cond Res 31(3): 686-695, 2017-This study determined the effect of long-haul (>5 hours) travel on lower-body power and match running demands in international rugby sevens players. Lower-body power was assessed in 22 male international rugby sevens players (age 21.7 ± 2.7 years, mass 89.0 ± 6.7 kg, stature 180.5 ± 6.2 cm; mean ± SD) monitored over 17 rugby sevens tournaments. A countermovement jump was used to monitor lower-body power (peak and mean power) over repeated three week travel and competition periods (pretravel, posttravel, and posttournament). Small decreases were evident in peak power after both short and long-haul travel (-4.0%, ±3.2%; mean, ±90% confidence limits) with further reductions in peak and mean power posttournament (-4.5%, ±2.3% and -3.8%, ±1.5%) culminating in a moderate decrease in peak power overall (-7.4%, ±4.0%). A subset of 12 players (completing a minimum of 8 tournaments) had the effects of match running demands assessed with lower-body power. In this subset, long-haul travel elicited a large decrease in lower-body peak (-9.4%, ±3.5%) and mean power (-5.6%, ±2.9%) over the monitoring period, with a small decrease (-4.3%, ±3.0% and -2.2%, ±1.7%) posttravel and moderate decrease (-5.4%, ±2.5% and -3.5%, ±1.9%) posttournament, respectively. Match running demands were monitored through global positioning system. In long-haul tournaments, the 12 players covered ∼13%, ±13% greater total distance (meter) and ∼11%, ±10% higher average game meters >5 m·s when compared with short-haul (rugby sevens tournaments after long-haul travel.

26 CFR 301.6103(n)-1 - Disclosure of returns and return information in connection with written contracts or agreements...

Science.gov (United States)

2010-04-01

... administration purposes. 301.6103(n)-1 Section 301.6103(n)-1 Internal Revenue INTERNAL REVENUE SERVICE... and Returns Returns and Records § 301.6103(n)-1 Disclosure of returns and return information in... administration purposes. (a) General rule. (1) Pursuant to the provisions of section 6103(n) of the Internal...

THE PERCEIVED RISK OF TRAVELLING, WITH EMPHASIS ON TERRORISM

OpenAIRE

Stefanou, Areti

2009-01-01

Risk is an important factor when considering international tourism (Lepp and Gibson, 2003; Sonmez and Graefe, 1998b; 1998a; Sonmez, 1998), especially nowadays as a result of the increased magnitude and frequency of terrorism attacks when travelling. Such events have negatively affected individuals’ perceived risk in international travel, making terrorism risk a key element of the international travel scene. Perceived risk can influence a positive image, intention to travel to a particular des...

The quantified self during travel: mapping health in a prospective cohort of travellers.

Science.gov (United States)

Farnham, Andrea; Furrer, Reinhard; Blanke, Ulf; Stone, Emily; Hatz, Christoph; Puhan, Milo A

2017-09-01

Travel medicine research has remained relatively unchanged in the face of rapid expansion of international travel and is unlikely to meet health challenges beyond infectious diseases. Our aim was to identify the range of health outcomes during travel using real-time monitoring and daily reporting of health behaviours and outcomes and identify traveller subgroups who may benefit from more targeted advice before and during travel. We recruited a prospective cohort of travellers ≥ 18 years and planning travel to Thailand for travel clinics in Zurich and Basel (Switzerland). Participants answered demographic, clinical and risk behaviour questionnaires pre-travel and a daily health questionnaire each day during travel using a smartphone application. Environmental and location data were collected passively by GPS. Classification trees were used to identify predictors of health behaviour and outcomes during travel. Non-infectious disease events were relatively common, with 22.7% (17 out of 75 travellers) experiencing an accident, 40.0% ( n  = 30) a wound or cut and 14.7% ( n  = 11) a bite or lick from an animal. Mental health associated events were widely reported, with 80.0% ( n  = 60) reporting lethargy, 34.7% ( n  = 26) anxiety and 34.7% ( n  = 26) feeling tense or irritable. Classification trees identified age, trip length, previous travel experience and having experienced a sports injury in the past year as the most important discriminatory variables for health threats. Our study offers a revolutionary look at an almost real-time timeline of health events and behaviours during travel using mHealth technology. Non-infectious disease related health issues were common in this cohort, despite being largely unaddressed in traditional travel medicine research and suggest a substantial potential for improving evidence-based travel medicine advice. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights

Self-diagnosis of malaria by travellers: a cohort study on the use of malaria rapid diagnostic tests provided by a Swiss travel clinic.

Science.gov (United States)

Berthod, Delphine; Rochat, Jacynthe; Voumard, Rachel; Rochat, Laurence; Genton, Blaise; D'Acremont, Valérie

2017-10-28

The WHO recommends that all suspect malaria cases be tested before receiving treatment. Rapid diagnostic tests (RDT) for malaria can be performed reliably by community health workers with no formal medical background and thus, RDTs could also be provided to travellers for self-diagnosis during visits to endemic regions. RDTs were proposed during pre-travel consultations to pre-defined categories of travellers. A training run on their own blood was performed and, if carried out correctly, the traveller was given a written procedure on how to perform the test and act on its result. The travellers were then proposed to buy a malaria RDT kit and were interviewed upon their return. From February 2012 to February 2017, 744 travellers were proposed RDTs and 692 performed the training run (one could not complete it due to a hand tremor). Among the 691 subjects included, 69% travelled to moderate- or low-risk areas of malaria, 18% to high-risk areas and 13% to mixed-risk areas. The two most frequent categories of travellers to whom RDTs were proposed were long-term travellers (69%) and those travelling to remote areas (57%). 543 travellers (79%) were interviewed upon return. During their trip, 17% (91/543) had a medical problem with fever and 12% (65/543) without fever. Among 91 febrile patients, 57% (52/91) performed an RDT, 22% (20/91) consulted immediately without using the test, and 21% (19/91) did neither. Four RDTs (4/52; 8%) were positive: 2 in low-risk and 2 in high-risk areas (0.7% attack rate of self-documented malaria). Two travellers could not perform the test correctly and attended a facility or took standby emergency treatment. Four travellers with negative results repeated the test after 24 h; all were still negative. Carrying RDTs made travellers feel more secure, especially when travelling with children. 1/6 travellers experienced fever and 4/5 of those reacted appropriately: more than half used RDTs and a quarter consulted immediately. Four travellers

Characteristics of HIV infected individuals traveling abroad. Results from the +REDIVI Collaborative Network.

Science.gov (United States)

Pérez-Molina, Jose A; Martinez-Perez, Angela; Serre, Nuria; Treviño, Begoña; Ruiz-Giardín, José Manuel; Torrús, Diego; Goikoetxea, Josune; Echevarría, Esteban Martín; Malmierca, Eduardo; Rojo, Gerardo; Calabuig, Eva; Gutierrez, Belén; Norman, Francesca; Lopez-Velez, Rogelio

2016-02-01

The improvement in the prognosis of HIV infection, coupled with the increase in international travel and migration, has led to a rising number of HIV infected travelers. The objective of this study was to describe the epidemiological and clinical features of returning travelers, according to their HIV status. An observational prospective study was conducted including travelers and immigrants who traveled to visit friends and relatives (VFRs) registered in the +REDIVI collaborative network (January-2009; October-2014). +REDIVI is a national network that registers information regarding infections imported by travelers and immigrants at 21 different centers using a standardized protocol. A total of 3464 travellers were identified: 72 were HIV+ (2.1%) and 3.392 HIV- (98%). HIV+ vs. HIV- travelers were often older (40.5y vs. 34.2y P=.001), VFRs (79.1% vs. 44.4%; Ptravel advice (27% vs. 37%; P=.078). The main destinations for both groups were sub-Saharan Africa and Latin America. The most frequent reasons for consultation after travel were fever, request for a health examination, gastrointestinal complaints, and abnormal laboratory tests (mainly eosinophilia and anemia), which differed between groups. The most frequent diagnoses in HIV+ travelers were malaria (38.8%), newly diagnosed HIV infection (25%), and intestinal parasites (19.4%), while for HIV- travelers the main diagnoses were "healthy" (17.9%), malaria (14%), and intestinal parasites (17.3%). The typical profile of an HIV+ traveler in +REDIVI was that of a VFR traveler who did not seek pre-travel advice and made high-risk trips. This may increase the chance of acquiring travel-related infections which may pose a special risk for HIV-infected travelers. The post-travel visit was a good opportunity for HIV infection screening. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Travelers' knowledge, attitudes and practices on the prevention of infectious diseases: results from a study at Johannesburg International Airport.

Science.gov (United States)

Toovey, Stephen; Jamieson, Andrew; Holloway, Michele

2004-01-01

Although Johannesburg International Airport (JIA) acts as a hub for travel into Africa, little was known of the knowledge, attitudes, and practices (KAP) with respect to infectious disease prevention of departing travelers. The study was conducted among departing passengers at JIA from August to October 2003. Travelers aged at least 18 years, resident in non-malarious developed countries and departing from JIA for risk destinations, were given either a malaria (Q-mal, n=219) or vaccine-preventable disease (Q-vac, n=200) questionnaire. European Travel Health Advisory Board traveler KAP questionnaires were used. African destinations accounted for 99% of the total. Traveler mean age was 42 years, with 30% aged 50 years or above. Leisure (42%) and business (37%) were the commonest travel reasons; 8% of subjects were visiting friends or relatives. Forty-six per cent of travelers prepared for their trip at least 1 month in advance; 86% had sought pre-travel health advice, with travel clinics and the Internet being rated highest by travelers for quality of advice. World Health Organization immunization guidelines were followed poorly: only 37% and 27%, respectively, of travelers had demonstrable proof of protection against hepatitis A and B, with 40% of all Q-vac travelers unable to produce a vaccination certificate. Of travelers to yellow fever- endemic countries, 76% were able to produce a valid vaccination certificate; 22% of travelers to countries not endemic for yellow fever had nevertheless been specifically immunized against yellow fever for their journeys. Forty-nine per cent of Q-mal travelers carried either no or inappropriate antimalarials. Considerable deficiencies in KAP were documented with regard to travel vaccinations and malaria protection in travelers departing JIA. Improved vaccine uptake and antimalarial prescribing are required for travelers to Africa.

Executive Perceptions on International Education in a Globalized Environment: The Travel Industry's Point of View

Science.gov (United States)

Munoz, J. Mark; Katsioloudes, Marios I.

2004-01-01

Research on globalization has determined travel executives' perceptions of the psychological implications brought about by an interconnected global environment and the implications on international education. With the concepts of Clyne and Rizvi (1998) and Pittaway, Ferguson, and Breen (1998) on the value of cross-cultural interaction as a…

Why do medical tourists travel to where they do? The role of networks in determining medical travel.

Science.gov (United States)

Hanefeld, J; Lunt, N; Smith, R; Horsfall, D

2015-01-01

Evidence on medical tourism, including patient motivation, is increasing. Existing studies have focused on identifying push and pull factors across different types of treatment, for example cosmetic or bariatric surgery, or on groups, such as diaspora patients returning 'home' for treatment. Less attention has been on why individuals travel to specific locations or providers and on how this decision is made. The paper focused on the role of networks, defined as linkages - formal and informal - between individual providers, patients and facilitators to explain why and where patients travel. Findings are based on a recently completed, two year research project, which examined the effects of medical tourism on the UK NHS. Research included in-depth interviews with 77 returning medical tourists and over sixty managers, medical travel facilitators, clinicians and providers of medical tourism in recipient countries to understand the medical tourism industry. Interviews were conducted between 2011 and 2012, recorded and transcribed, or documented through note taking. Authors undertook a thematic analysis of interviews to identify treatment pathways by patients, and professional linkages between clinicians and facilitators to understand choice of treatment destination. The results highlight that across a large sample of patients travelling for a variety of conditions from dental treatment, cosmetic and bariatric surgery, through to specialist care the role of networks is critical to understand choice of treatment, provider and destination. While distance, costs, expertise and availability of treatment all were factors influencing patients' decision to travel, choice of destination and provider was largely the result of informal networks, including web fora, personal recommendations and support groups. Where patients were referred by UK clinicians or facilitators these followed informal networks. In conclusion, investigating medical travel through focus on networks of

HIV in elderly women after travelling abroad

DEFF Research Database (Denmark)

Jespersen, Sanne; Thorsteinsson, Kristina; David, Kim Peter

2016-01-01

We report two cases of HIV infection among female travellers of older age. A Danish woman in her eighties was diagnosed with acute HIV infection after travelling to West Africa. A sexual history was not recorded before her third hospital visit. A West African woman in her seventies who had been...... living in Denmark for 40 years was diagnosed with advanced HIV after having been to West Africa for family visits. We want to emphasize that women of older age also have sex that may put them at risk of HIV, that febrile returning travellers should be tested for HIV, and that presence of HIV indicator...

Supporting a Deep Space Gateway with Free-Return Earth-Moon Periodic Orbits

Science.gov (United States)

Genova, A. L.; Dunham, D. W.; Hardgrove, C.

2018-02-01

Earth-Moon periodic orbits travel between the Earth and Moon via free-return circumlunar segments and can host a station that can provide architecture support to other nodes near the Moon and Mars while enabling science return from cislunar space.

A Fatal Neuroinvasive West Nile Virus Infection in a Traveler Returning from Madagascar: Clinical, Epidemiological and Veterinary Investigations

Science.gov (United States)

Larrieu, Sophie; Cardinale, Eric; Ocquidant, Philippe; Roger, Matthieu; Lepec, Richard; Delatte, Hélène; Camuset, Guillaume; Desprès, Philippe; Brottet, Elise; Charlin, Cyril; Michault, Alain

2013-01-01

A 58-year-old woman living in Reunion Island and returning from Madagascar was hospitalized for neuroinvasive encephalitis and died 1 month later. West Nile virus (WNV) infection was biologically confirmed by detection of immunoglobulin M (IgM) reactive with WNV antigens in both cerebrospinal fluid and serum, and weak neutralizing activity was also detected. A veterinary survey performed in her traveling area showed a seroprevalence of WNV of 28.7% (95% confidence interval [CI] = 21.1–36.3) in adult poultry, confirming an active circulation of the virus. Development of a severe form could be related to a weak antibody response, because the patient presented low IgM and IgG titers. This case report underlines the constant risk of emergence of West Nile in Indian Ocean territories, including Reunion Island where competent vectors are widely present during the whole year. PMID:23751400

Travellers' profile, travel patterns and vaccine practices--a 10-year prospective study in a Swiss Travel Clinic.

Science.gov (United States)

Boubaker, Rim; Meige, Pierrette; Mialet, Catherine; Buffat, Chantal Ngarambe; Uwanyiligira, Mediatrice; Widmer, Francine; Rochat, Jacynthe; Fossati, Annie Hérard; Souvannaraj-Blanchant, Manisinh; Payot, Sylvie; Rochat, Laurence; de Vallière, Serge; Genton, Blaise; D'Acremont, Valérie

2016-01-01

vaccinations or because of real travel health concern or both. © International Society of Travel Medicine, 2016. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com.

Human travel and traveling bedbugs.

Science.gov (United States)

Delaunay, Pascal

2012-12-01

A dramatic increase of reported bedbug (Cimex lectularius and Cimex hemipterus) infestations has been observed worldwide over the past decade. Bedbug infestations have also been detected across a wide range of travel accommodations, regardless of their comfort and hygiene levels. Travelers are increasingly exposed to the risks of bedbug bites, infestation of personal belongings, and subsequent contamination of newly visited accommodations and their homes. We searched Medline publications via the PubMed database. National bedbug recommendations, textbooks, newspapers, and Centers for Disease Control websites were also searched manually. To detect infested sites, avoid or limit bedbug bites, and reduce the risk of contaminating one's belongings and home, bedbug biology and ecology must be understood. A detailed search of their most classic hiding niches is a key to finding adult bedbugs, nymphs, eggs, and feces or traces of blood from crushed bedbugs. Locally, bedbugs move by active displacement to feed (bite) during the night. Bed, mattress, sofa, and/or curtains are the most frequently infested places. If you find bedbugs, change your room or, even better, the hotel. Otherwise, travelers should follow recommendations for avoiding bedbugs and their bites during the night and apply certain simple rules to avoid infesting other sites or their home. Travelers exposed to bedbugs can minimize the risks of bites and infestation of their belongings, and must also do their civic duty to avoid contributing to the subsequent contamination of other hotels and, finally, home. © 2012 International Society of Travel Medicine.

26 CFR 1.6013-2 - Joint return after filing separate return.

Science.gov (United States)

2010-04-01

... the case of a joint return made under section 6013(b), the period of limitations provided in sections... (c)(1) of this section, relating to the application of sections 6501 and 6651 with respect to a joint... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Joint return after filing separate return. 1...

Observational Study of Travelers' Diarrhea.

Science.gov (United States)

Meuris

1995-03-01

Background: European air travelers returning from Algeria, Egypt, Mexico, Morocco, and Tunisia were interviewed about their experience of travelers' diseases upon arrival in Brussels. Diarrhea was mentioned by 37% of the adults and 27% of the children. These subjects were questioned about the types of measures taken, type and duration of drug treatment (if any), and about duration of diarrhea and side effects experienced. Methods: Final analysis was performed based on 2160 interviews. The largest proportion of diarrhea was reported in the age group 15-24 years (46%). Results: The majority of the 2160 subjects had opted for drug treatment (81%): 927 subjects for loperamide alone, 235 for loperamide in combination with nifuroxazide, and 178 for nifuroxazide alone. Other drugs had been used less frequently. The median time to recovery was 2.4 days with loperamide compared to 3.2 days with nifuroxazide and to 3.4 days for the no-treatment group. Conclusions: A stratification of the results by severity of the diarrhea suggests a rank of antidiarrheal potency as follows: loperamide > nifuroxazide > no-drug treatment. The side effect with the highest incidence was constipation (2.4% with loperamide). (J Travel Med 2:11-15, 1995) Travelers' diarrhea is usually defined as the passage of at least three unformed stools per day or any number of such stools when accompanied by fever, abdominal cramping, or vomiting. The definition may be broadened to include more trivial bowel disturbance.1,2 The duration of this self-limited disease generally is 3 to 5 days. Medical intervention aims at shortening the duration of disease, thus allowing the sufferer to resume his or her usual activities at an early stage. A shortened period of recovery to physical well-being has obvious favorable economic implications if the traveler is on business and may help the maintenance of a desired level of quality of life while a traveler is on holiday. An observational study of various medical

Have eggs. Will travel

DEFF Research Database (Denmark)

Kroløkke, Charlotte

2015-01-01

Feminist scholars have critically questioned the practices and ethics of reproductive mobility. While the reproductive mobility of fertility patients has been foregrounded, little is known of egg donor mobility including the experiences of travelling internationally to donate eggs. Based on written...... stories and photographic material provided by forty-two egg donors, this article uses feminist cluster analysis and the concept of eggpreneurship to illustrate how global egg donors negotiate reproductive agency and choice when they travel internationally to donate their eggs. In their stories, global egg...

Prolonged carriage and potential onward transmission of carbapenemase-producing Enterobacteriaceae in Dutch travelers.

Science.gov (United States)

van Hattem, Jarne M; Arcilla, Maris S; Bootsma, Martin Cj; van Genderen, Perry J; Goorhuis, Abraham; Grobusch, Martin P; Molhoek, Nicky; Oude Lashof, Astrid Ml; Schultsz, Constance; Stobberingh, Ellen E; Verbrugh, Henri A; de Jong, Menno D; Melles, Damian C; Penders, John

2016-07-01

The aim was to study acquisition and persistence of carbapenemase-producing Enterobacteriaceae (CPE) among travelers. Stools from 2001 travelers and 215 nontraveling household members, collected before and immediately post-travel as well as 1, 3, 6 and 12 months upon return, were screened for CPE. Five travelers, all visiting Asia outside the Indian subcontinent, acquired CPE. One traveler persistently carried the same OXA-244 CPE up to 6 months post-travel. Three months after travel, her co-traveling spouse also became positive for this OXA-244 CPE strain, suggesting clonal transmission within this household. Acquisition of CPE is not restricted to travelers to the Indian subcontinent and/or to travelers seeking healthcare during travel and can persist up to at least 6 months post-travel.

Should travellers to rabies-endemic countries be pre-exposure vaccinated? An assessment of post-exposure prophylaxis and pre-exposure prophylaxis given to Danes travelling to rabies-endemic countries 2000-12.

Science.gov (United States)

Christiansen, Annette H; Rodriguez, Anna B; Nielsen, Jens; Cowan, Susan A

2016-04-01

Since 2000, a steady increase of vaccines used for both rabies Post-exposure prophylaxis (PEP) and rabies Pre-exposure prophylaxis (PrEP) given to Danish travellers was observed. This study aims to evaluate whether the increase of PEP and PrEP was due to increased travelling, increased awareness of the need for PrEP, or more animal bites per travel, leading to more PEP being administered, in order to assess the need for changing the recommendations. We also described in which countries Danish travelers most frequently reported possible exposure to rabies, and evaluated the timeliness of rabies PEP, including rabies immunoglobulin (RIG). We included all Danes reported to the National Database for Rabies Treatment as having started rabies PEP either abroad or after returning to Denmark, between 2000 and 2012. Data on the yearly number of Danish travelers from 2004 to 2012 to Thailand were collected to calculate the incidence of animal bites at this destination. We also included data on rabies vaccines sold for PrEP or for booster vaccination in Denmark. PEP after possible exposure to rabies abroad increased yearly by 8.8 %. Likewise vaccines sold for PrEP increased by 8.2% annually. The number of Danish travelers to Thailand increased by 7.3% per year, resulting in a stable incidence of animal bites per 100,000 travelers. Seventy-five % started PEP in the country of exposure, while only 10 % received RIG. The yearly increase in PEP and PrEP are parallel to the yearly increase in number of travelers, and can thus be explained by the increased rate of traveling, and not by a rise in awareness of rabies risk or more bites per traveler.Even short term travelers should be given the option of including PrEP in their travel immunisation program, as PEP and especially RIG is not always available in rabies-endemic countries. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

FORMS OF YOUTH TRAVEL

OpenAIRE

Moisã Claudia Olimpia; Moisã Claudia Olimpia

2011-01-01

Taking into account the suite of motivation that youth has when practicing tourism, it can be said that the youth travel takes highly diverse forms. These forms are educational tourism, volunteer programs and “work and travel”, cultural exchanges or sports tourism and adventure travel. In this article, we identified and analyzed in detail the main forms of youth travel both internationally and in Romania. We also illustrated for each form of tourism the specific tourism products targeting you...

Home range and travels

Science.gov (United States)

Stickel, L.F.; King, John A.

1968-01-01

. Peromyscus generally used and maintained several or many different home sites and refuges in various parts of their home ranges, and frequently shifted about so that their principal activities centered on different sets of holes at different times. Once established, many Peromyscus remained in the same general area for a long time, perhaps for the duration of their lives. Extent of their travels in different directions and intensity of use of different portions of their home ranges varied within a general area in response to habitat changes, loss of neighbors, or other factors. Various authors have obtained both direct and indirect evidence of territoriality, in some degree, among certain species of Peromyscus. Young mice dispersed from their birth sites to establish home ranges of their own. Adults also sometimes left their home areas; some re-established elsewhere; others returned after exploratory travels. Most populations contained a certain proportion of transients; these may have been wanderers or individuals exploring out from established home ranges or seeking new ones. When areas were depopulated by removal trapping, other Peromyscus invaded. Invasion rates generally followed seasonal trends of reproduction and population density. Peromyscus removed from their home areas and released elsewhere returned home from various distances, but fewer returned from greater distances than from nearby; speed of return increased with successive trials. The consensus from present evidence is that ho-ming is made possible by a combination of random wandering and familiarity with a larger area than the day-to-day range. Records of juvenile wanderings during the dispersal phase and of adult explorations very nearly encompassed the distances over which any substantial amount of successful homing occurred. Methods of measuring sizes of home ranges and the limitations of these measurements were discussed in brief synopsis. It was co

Environmental Impact of Long Distance Travel

DEFF Research Database (Denmark)

Christensen, Linda

This paper presents an analysis of the CO2 emission resulting from long distance travel by Danes. The emissions are analysed as the Danes’ footprint the whole way from Denmark to the final destination. International travel represents 31% of the Danes’ CO2 emission from passenger travel and the cl...

Environmental Impact of Long Distance Travel

DEFF Research Database (Denmark)

Christensen, Linda

2016-01-01

This paper presents an analysis of the CO2 emission resulting from long distance travel by Danes. The emissions are analysed as the Danes’ footprint the whole way from Denmark to the final destination. International travel represents 31% of the Danes’ CO2 emission from passenger travel and the cl...

The reliability of pre-travel history to decide on appropriate counseling and vaccinations: a prospective study.

Science.gov (United States)

Rossi, Isabelle A; Genton, Blaise

2012-01-01

Although medical and travel plans gathered from pre-travel interviews are used to decide the provision of specific pre-travel health advice and vaccinations, there has been no evaluation of the relevance of this strategy. In a prospective study, we assessed the agreement between pre-travel plans and post-travel history and the effect on advice regarding the administration of vaccines and recommendations for malaria prevention. We included prospectively all consenting adults who had not planned an organized tour. Pre- and post-travel information included questions on destination, itineraries, departure and return dates, access to bottled water, plan of bicycle ride, stays in a rural zone, and close contact with animals. The outcomes measured included: agreement between pre- and post-travel itineraries and activities; and the effect of these differences on pre-travel health recommendations, had the traveler gone to the actual versus intended destinations for actual versus intended duration and activities. Three hundred and sixty-five travelers were included in the survey, where 188 (52%) were males (median age 38 years). In 81(23%) travelers, there was no difference between pre- and post-travel history. Disagreement between pre- and post-travel history were the highest for stays in rural zones or with local people (66% of travelers), close contact with animals (33%), and bicycle riding (21%). According to post-travel history, 125 (35%) travelers would have needed rabies vaccine and 9 (3%) typhoid fever vaccine. Potential overprovision of vaccine was found in travelers. A change in the malaria prescription would have been recommended in 18 (5%) travelers. Pre-travel history does not adequately reflect what travelers do. However, difference between recommendations for the actual versus intended travel plans was only clinically significant for the need for rabies vaccine. Particular attention during pre-travel health counseling should focus on the risk of rabies, the

Standardized training in nurse model travel clinics.

Science.gov (United States)

Sofarelli, Theresa A; Ricks, Jane H; Anand, Rahul; Hale, Devon C

2011-01-01

International travel plays a significant role in the emergence and redistribution of major human diseases. The importance of travel medicine clinics for preventing morbidity and mortality has been increasingly appreciated, although few studies have thus far examined the management and staff training strategies that result in successful travel-clinic operations. Here, we describe an example of travel-clinic operation and management coordinated through the University of Utah School of Medicine, Division of Infectious Diseases. This program, which involves eight separate clinics distributed statewide, functions both to provide patient consult and care services, as well as medical provider training and continuing medical education (CME). Initial training, the use of standardized forms and protocols, routine chart reviews and monthly continuing education meetings are the distinguishing attributes of this program. An Infectious Disease team consisting of one medical doctor (MD) and a physician assistant (PA) act as consultants to travel nurses who comprise the majority of clinic staff. Eight clinics distributed throughout the state of Utah serve approximately 6,000 travelers a year. Pre-travel medical services are provided by 11 nurses, including 10 registered nurses (RNs) and 1 licensed practical nurse (LPN). This trained nursing staff receives continuing travel medical education and participate in the training of new providers. All nurses have completed a full training program and 7 of the 11 (64%) of clinic nursing staff serve more than 10 patients a week. Quality assurance measures show that approximately 0.5% of charts reviewed contain a vaccine or prescription error which require patient notification for correction. Using an initial training program, standardized patient intake forms, vaccine and prescription protocols, preprinted prescriptions, and regular CME, highly trained nurses at travel clinics are able to provide standardized pre-travel care to

31 CFR 515.415 - Travel to Cuba; transportation of certain Cuban nationals.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Travel to Cuba; transportation of... CONTROL REGULATIONS Interpretations § 515.415 Travel to Cuba; transportation of certain Cuban nationals... or a returning resident of the United States, from Cuba to the United States, unless otherwise...

Effectiveness of pre-travel consultation in the prevention of travel-related diseases: a retrospective cohort study.

Science.gov (United States)

Tafuri, Silvio; Guerra, Rocco; Gallone, Maria Serena; Cappelli, Maria Giovanna; Lanotte, Serafina; Quarto, Michele; Germinario, Cinzia

2014-01-01

This study aims to evaluate the effectiveness of pre-travel counselling carried out in Travel Clinics. This is a retrospective cohort. Three hundred international travellers were enrolled; 150 people were from users of Bari Travel Clinic, 150 were users of a travel agency. Enrolled subjects were interviewed using a questionnaire. The average age of the enrolled subjects was 37.5 ± 13.9, without statistically significant differences between the two groups. 86% of cases and 19.3% of the controls reported the use of anti-malaria prophylaxis (p Travel Clinic users, 6% reported diarrhoea and these figures were 27% in the control group (p study demonstrated the effectiveness of pre-travel counselling; in the future, new studies must investigate the cost-effectiveness of pre-travel prevention measures.

Third International Scientific and Practical Conference «Space Travel is Approaching Reality» (Successful Event in Difficult Times

Directory of Open Access Journals (Sweden)

Matusevych Tetiana

2015-02-01

Full Text Available The article analyzes the presentations of participants of III International Scientific and Practical Conference «Space Travel – approaching reality», held on 6–7 November 2014 in Kharkiv, Ukraine

Economic analysis of solar industrial process heat systems: A methodology to determine annual required revenue and internal rate of return

Science.gov (United States)

Dickinson, W. C.; Brown, K. C.

1981-08-01

An economic evaluation of solar industrial process heat systems, is developed to determine the annual required revenue and the internal rate of return. First, a format is provided to estimate the solar system's installed cost, annual operating and maintenance expenses, and net annual solar energy delivered to the industrial process. The annual required revenue and the price of solar is calculated. The economic attractiveness of the potential solar investment can be determined by comparing the price of solar energy with the price of fossilfuel, both expressed in levelized terms. This requires calcuation of the internal rate of return on the solar investment or, in certain cases, the growth rate of return.

Effects of simulated domestic and international air travel on sleep, performance, and recovery for team sports.

Science.gov (United States)

Fowler, P; Duffield, R; Vaile, J

2015-06-01

The present study examined effects of simulated air travel on physical performance. In a randomized crossover design, 10 physically active males completed a simulated 5-h domestic flight (DOM), 24-h simulated international travel (INT), and a control trial (CON). The mild hypoxia, seating arrangements, and activity levels typically encountered during air travel were simulated in a normobaric, hypoxic altitude room. Physical performance was assessed in the afternoon of the day before (D - 1 PM) and in the morning (D + 1 AM) and afternoon (D + 1 PM) of the day following each trial. Mood states and physiological and perceptual responses to exercise were also examined at these time points, while sleep quantity and quality were monitored throughout each condition. Sleep quantity and quality were significantly reduced during INT compared with CON and DOM (P  0.05). Compared with baseline, physiological and perceptual responses to exercise, and mood states were exacerbated following the INT trial (P sleep disruption during travel and the subsequent exacerbated physiological and perceptual markers of fatigue. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

26 CFR 301.6103(j)(1)-1 - Disclosures of return information reflected on returns to officers and employees of the...

Science.gov (United States)

2010-04-01

... related activities. 301.6103(j)(1)-1 Section 301.6103(j)(1)-1 Internal Revenue INTERNAL REVENUE SERVICE... and Returns Returns and Records § 301.6103(j)(1)-1 Disclosures of return information reflected on... related activities. (a) General rule. Pursuant to the provisions of section 6103(j)(1) of the Internal...

Eosinophilic meningitis caused by infection of Angiostrongylus cantonensis in a traveler

Institute of Scientific and Technical Information of China (English)

GUAN Hongzhi; HOI Chupeng; CUI Liying; CHEN Lin

2013-01-01

A 55 - year - old female traveler returning from South China with acute onset of meningitis, presenting with eosinophilic pleocytosis in the cerebrospinal fluid was reported. The etiological diagnosis of angiostrongyliasis was confirmed by detection of specific serum antibody against Angiostrongylus cantonensis. Angiostrongyliasis should be considered as a major differential diagnosis for eosinophilic meningitis in the travelers to endemic regions.

The traveling salesman problem a computational study

CERN Document Server

Applegate, David L; Chvatal, Vasek; Cook, William J

2006-01-01

This book presents the latest findings on one of the most intensely investigated subjects in computational mathematics--the traveling salesman problem. It sounds simple enough: given a set of cities and the cost of travel between each pair of them, the problem challenges you to find the cheapest route by which to visit all the cities and return home to where you began. Though seemingly modest, this exercise has inspired studies by mathematicians, chemists, and physicists. Teachers use it in the classroom. It has practical applications in genetics, telecommunications, and neuroscience.

The Risk Return Relationship: Evidence from Index Return and Realised Variance Series

OpenAIRE

Minxian Yang

2014-01-01

The risk return relationship is analysed in bivariate models for return and realised variance(RV) series. Based on daily time series from 21 international market indices for more than 13 years (January 2000 to February 2013), the empirical findings support the arguments of risk return tradeoff, volatility feedback and statistical balance. It is reasoned that the empirical risk return relationship is primarily shaped by two important data features: the negative contemporaneous correlation betw...

Marine Scorpaenidae Envenomation in Travelers: Epidemiology, Management, and Prevention.

Science.gov (United States)

Diaz, James H

2015-01-01

The Scorpaenidae are a large family of venomous marine fish that include scorpionfish, lionfish, and stonefish. Although most stonefish are confined to the Indo-Pacific, scorpionfish are distributed in the tropics worldwide, and two species of Indo-Pacific lionfish were inadvertently introduced into the Eastern Atlantic in the 1990s. Since then, lionfish have invaded shallow reef systems in the Eastern Atlantic, Gulf of Mexico, and Caribbean Sea. All of these regions are popular travel destinations for beachcombing, fishing, swimming, and scuba diving-recreational activities that increase risks of Scorpaenidae envenomation. To meet the objectives of describing species-specific presenting clinical manifestations, diagnostic and treatment strategies, and outcomes of Scorpaenidae envenomation in travelers, Internet search engines were queried with the key words. Well-conducted, retrospective epidemiological investigations of Scorpaenidae envenomation case series concluded: (1) most cases occurred in young adult male vacationers visiting endemic regions; (2) victims sought medical attention for pain control within 2 hours of injury and presented with intense pain, edema, and erythema in affected extremities; (3) systemic manifestations and surgical interventions were relatively uncommon following initial management with hot water soaks and parenteral analgesics; (4) all cases required tetanus prophylaxis; deeply penetrating, lacerated, and necrotic wounds required antibiotic prophylaxis; and (5) equine Fab stonefish antivenom does have antigen-neutralizing cross-reactivities with both Indo-Pacific and Atlantic Scorpaenidae species and is indicated in severe scorpionfish and stonefish envenomation worldwide. Travel medicine practitioners should counsel their patients about Scorpaenidae envenomation risks in endemic regions and maintain a high index of suspicion regarding Scorpaenidae envenomation in all travelers returning from tropical beach and ocean holidays and

Tuberculosis screening of travelers to higher-incidence countries: A cost-effectiveness analysis

Directory of Open Access Journals (Sweden)

Menzies Dick

2008-06-01

Full Text Available Abstract Background Travelers to countries with high tuberculosis incidence can acquire infection during travel. We sought to compare four screening interventions for travelers from low-incidence countries, who visit countries with varying tuberculosis incidence. Methods Decision analysis model: We considered hypothetical cohorts of 1,000 travelers, 21 years old, visiting Mexico, the Dominican Republic, or Haiti for three months. Travelers departed from and returned to the United States or Canada; they were born in the United States, Canada, or the destination countries. The time horizon was 20 years, with 3% annual discounting of future costs and outcomes. The analysis was conducted from the health care system perspective. Screening involved tuberculin skin testing (post-travel in three strategies, with baseline pre-travel tests in two, or chest radiography post-travel (one strategy. Returning travelers with tuberculin conversion (one strategy or other evidence of latent tuberculosis (three strategies were offered treatment. The main outcome was cost (in 2005 US dollars per tuberculosis case prevented. Results For all travelers, a single post-trip tuberculin test was most cost-effective. The associated cost estimate per case prevented ranged from $21,406 for Haitian-born travelers to Haiti, to $161,196 for US-born travelers to Mexico. In all sensitivity analyses, the single post-trip tuberculin test remained most cost-effective. For US-born travelers to Haiti, this strategy was associated with cost savings for trips over 22 months. Screening was more cost-effective with increasing trip duration and infection risk, and less so with poorer treatment adherence. Conclusion A single post-trip tuberculin skin test was the most cost-effective strategy considered, for travelers from the United States or Canada. The analysis did not evaluate the use of interferon-gamma release assays, which would be most relevant for travelers who received BCG

Investigating Graduate Business Students' Perceptions of the Educational Value Provided by an International Travel Course Experience

Science.gov (United States)

Finley, Jane B.; Taylor, Susan Lee; Warren, D. Lee

2007-01-01

Researchers agree that students' critical thinking and decision making skills are enhanced through exposure to new cultures and global markets. Thus, one way of bringing about improvement in these areas is through international travel courses. The purpose of this study is threefold. One, to describe the process involved in the creation of a…

Can business road travel be safe? Experience of an international organization.

Science.gov (United States)

Goldoni Laestadius, Jasminka; Selod, Anne Gaëlle; Ye, Jian; Dimberg, Lennart; Bliss, Anthony G

2011-01-01

Globally, more than 1.2 million people die on the roads every year, and unfortunately so do one or two operational travelers for the World Bank Group (WBG). To investigate potentially preventable factors and improve the institution's road safety policies and practices, an electronic survey was designed in 2008 targeting about 16,000 WBG staff worldwide to inquire about road crashes and near crashes over the 3-year period. Also, questions were asked pertaining to contributing circumstances. Staff was encouraged to provide comments on prevention. A combined index based on the number of reported crashes and near crashes divided by person-days spent on mission in each country was used to rank the countries. A total of 3,760 responses were collected. There were 341 road crashes reported, about 1 in 175 missions. Seventy percent took place in taxis, and 40% of crash victims reported that seatbelts were not used. Contributing factors included driver's decision error, speeding, or road/weather conditions. On the basis of a combined index, a list of 36 high-risk countries is presented. A high correlation between crashes and near crashes (r = 0.89) justifies the method. Improved corporate policies will need to be developed to address preventable risk factors identified in the study. © 2011 International Society of Travel Medicine.

Business travel in Asia: blood tests required?

Science.gov (United States)

Karel, S

1988-03-01

Travellers to Asian countries face growing hostility as potential carriers of acquired immunodeficiency syndrome (AIDS). Visitors who plan to stay in China, India, the Philippines, or South Korea for more than 1 year must prove that they are AIDS-free. In addition, all foreign students who enter China and India must carry documents indicating that they tested negative for the AIDS virus. The upcoming Olympics poses a special health problem for South Korea, which has not so far required AIDS testing for short-term visitors. A World Health Organization consultation on AIDS infection and international travel has raised questions about the feasibility of an AIDS screening program. The estimated direct cost per traveller for AIDS testing would be US$10-20. Even if all foreign travellers were to be screened, 2 problems could still allow AIDS to enter these countries: black marketing of false health certificates and failing to test foreign nationals who have been abroad. Moreover, a restrictive screening policy for international travellers could result in a decline in tourism and international commerce. Business people who intend to travel to Asia for extended periods of time are advised to check with embassies before their departure to find out what AIDS-related clearances may be required.

50 CFR 23.44 - What are the requirements to travel internationally with my personally owned live wildlife?

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false What are the requirements to travel internationally with my personally owned live wildlife? 23.44 Section 23.44 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION, TRANSPORTATION...

14 CFR 1260.36 - Travel and transportation.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Travel and transportation. 1260.36 Section... AGREEMENTS General Provisions § 1260.36 Travel and transportation. Travel and Transportation October 2000 (a... international air transportation of personnel and property to the extent that service by those carriers is...

Promoting medical tourism to India: messages, images, and the marketing of international patient travel.

Science.gov (United States)

Crooks, Valorie A; Turner, Leigh; Snyder, Jeremy; Johnston, Rory; Kingsbury, Paul

2011-03-01

The practice of medical tourism depends on successfully informing potential patients about procedure options, treatment facilities, tourism opportunities, travel arrangements, and destination countries. The promotion of medical tourism includes a wide range of marketing materials such as flyers, booklets, and websites. Yet, there is a paucity of knowledge about the dissemination, content, and reception of these promotional materials. Drawing on a thematic content analysis of the promotional print material distributed at the first medical tourism trade show in Canada in 2009, the main purpose of this article is to identify and understand the messages and images that companies use to market India as a global destination. While researchers and news media frequently cite low cost procedures as a key determinant for international patient travel, particularly to developing nations, our analysis reveals few low cost-related images or messages in the promotional materials distributed at the trade show. To help explain this surprising disjuncture, we consider four related issues: (1) promotional materials may be designed to be circulated amongst potential patients' concerned family and friends who privilege knowing about things such as the use of advanced technologies; (2) developing nations need to portray safe and advanced treatment facilities in order to dispel potential patients' suspicions that their medical care is inferior; (3) companies may avoid making cost saving claims that cannot be fulfilled for all of their international patients, especially those traveling from developing nations; and (4) messages of low cost may detract from and even undermine messages about quality. We conclude by identifying numerous avenues for future research by social and health scientists, and by considering the implications of our findings for existing knowledge gaps and debates within health geography specifically. Copyright © 2011 Elsevier Ltd. All rights reserved.

The on-line asymmetric traveling salesman problem

NARCIS (Netherlands)

Ausiello, G.; Bonifaci, V.; Laura, L.

2008-01-01

We consider two on-line versions of the asymmetric traveling salesman problem with triangle inequality. For the homing version, in which the salesman is required to return in the city where it started from, we give a -competitive algorithm and prove that this is best possible. For the nomadic

The impact of injection anxiety on education of travelers about common travel risks.

Science.gov (United States)

Noble, Lorraine M; Farquharson, Lorna; O'Dwyer, Niamh A; Behrens, Ron H

2014-01-01

relationship was found between recall and anxiety, this may have been due to the sample and setting. © 2013 International Society of Travel Medicine.

Japanese encephalitis in a French traveler to Nepal.

Science.gov (United States)

Lagarde, S; Lagier, J-C; Charrel, R; Quérat, G; Vanhomwegen, J; Desprès, P; Pelletier, J; Kaphan, E

2014-02-01

Japanese encephalitis is frequent in Asia, with a severe prognosis, but rare in travelers. Culex mosquitoes transmit Japanese encephalitis virus. Risk factors are destination, duration of stay, summer and fall seasons, outdoor activities, and type of accommodation. We report the case of a French traveler to Nepal with neutralization-based serological confirmed Japanese encephalitis. He presented classical clinical (viral syndrome before an encephalitis status with behavioral disorder, global hypotonia, mutism, movement disorders, seizure, and coma), radiological (lesions of thalami, cortico-spinal tracts, and brainstem) and biological features (lymphocytic meningitis). Nowadays, the presence of Japanese encephalitis virus in Nepal, including mountain areas, is established but Japanese encephalitis remains rare in travelers returning from this area and neurologist physicians need to become familiar with this. We recommend vaccination for travelers spending a long period of time in Nepal and having at-risk outdoor activities.

Travails of travel. Subtle and obscure causes of illness.

Science.gov (United States)

Gordon, M E

1988-07-01

Knowledge of patients' travel history is an important facet of diagnosis. Malaria, Chagas' disease, toxoplasmosis, Lyme disease, arboviruses, and many other relatively unusual diseases can be contracted while the patient is traveling, and the symptoms, which may mimic another disease, may not become obvious until the patient returns. The Roman philosopher Marcus Aurelius Antoninus alerts us to easier resolutions of our daily diagnostic dilemmas: "Look within and let neither the peculiar quality of anything nor its value escape thee."

Travel advice for the immunocompromised traveler: prophylaxis, vaccination, and other preventive measures

Directory of Open Access Journals (Sweden)

Patel RR

2015-02-01

Full Text Available Rupa R Patel,1 Stephen Y Liang,1 Pooja Koolwal,2 Frederick Matthew Kuhlmann1 1Division of Infectious Diseases, 2Division of Medical Education, Washington University School of Medicine, St Louis, MO, USA Abstract: Immunocompromised patients are traveling at increasing rates. Physicians caring for these complex patients must be knowledgeable in pretravel consultation and recognize when referral to an infectious disease specialist is warranted. This article outlines disease prevention associated with international travel for adults with human immunodeficiency virus, asplenia, solid organ and hematopoietic transplantation, and other immunosuppressed states. While rates of infection may not differ significantly between healthy and immunocompromised travelers, the latter are at greater risk for severe disease. A thorough assessment of these risks can ensure safe and healthy travel. The travel practitioners’ goal should be to provide comprehensive risk information and recommend appropriate vaccinations or prevention measures tailored to each patient’s condition. In some instances, live vaccines and prophylactic medications may be contraindicated. Keywords: immunocompromised, vaccines, travel, malaria, diarrhea

Critical success factors for international travel fairs, using the Taipei International Travel Fair as an example

OpenAIRE

I.-Ying Chang

2014-01-01

The travel industry has experienced operating difficulties because of the intense competition within the industry, difficulties in developing new products as well as the overly transparent and continuously increasing operating cost that reduces the profit margin. As a result, it is urgent that the business operating bottleneck be overcome and some strategies be implemented. These include dumping the conventional operating model, reducing basic operating costs, increasing the profit margin, an...

Leishmaniasis, an emerging infection in travelers.

Science.gov (United States)

Pavli, Androula; Maltezou, Helena C

2010-12-01

Leishmaniasis is a vector-borne protozoan infection with a wide clinical spectrum, which ranges from asymptomatic infection to fatal visceral leishmaniasis. A review of the recent literature indicates a sharp increase in imported leishmaniasis cases in developed, non-endemic countries over the last decade, in association with increasing international tourism, military operations, and the influx of immigrants from endemic countries. South America is the main area for the acquisition of cutaneous leishmaniasis, and adventure travelers on long-term trips in highly-endemic forested areas are at particular risk. Popular Mediterranean destinations are emerging as the main areas of acquisition of visceral leishmaniasis for European travelers. Leishmaniasis should be considered in patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years ago. Appropriate counseling should be provided to adventure travelers, military personnel, researchers, and other groups of travelers likely to be exposed to sandflies in endemic areas. Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

26 CFR 301.6063-1 - Signing of partnership returns.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Signing of partnership returns. 301.6063-1 Section 301.6063-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED....6063-1 Signing of partnership returns. For provisions relating to the signing of returns of partnership...

Increasing notifications of dengue in Australia related to overseas travel, 1991 to 2012.

Science.gov (United States)

Knope, Katrina; Giele, Carolein

2013-03-31

Dengue is an important cause of illness in travellers returning to Australia. The risk of local transmission from imported cases is of particular concern, with several large and explosive outbreaks recorded in recent years in north Queensland in areas where the mosquito vector of dengue is present. The number and proportion of dengue cases that are overseas-acquired is increasing. The number of overseas cases in 2010 and 2011 had increased by 298% and 155% respectively compared with the 5 year mean. The number of overseas acquired cases in 2012 is likely to be the largest on record, with an average of 144 cases per month during the first 7 months of the year. More than half of all dengue cases with a known country of acquisition between 1999 and July 2012 were acquired in Indonesia. In Western Australia in 2010 and 2011, more than 80% of cases acquired in Indonesia were acquired in Bali and the trend has continued into 2012.1 While the frequency of travel by Australians to Indonesia has steadily increased since 2000, this does not completely explain the increased number of dengue cases in returning travellers. The relative risk of dengue in travellers returning from Indonesia between 2000 and 2011 compared with all other destinations was 8.3 (95% confidence interval 7.9-8.9).

IAEA activities in support of the international programmes to return fresh and spent research reactor nuclear fuel to the conuntry of origin

International Nuclear Information System (INIS)

Adelgang, P.; Tozser, S.; Marshall, F.; Borio di Tigliole, A.

2017-01-01

The IAEA has been involved for more than thirty years in supporting international nuclear non-proliferation efforts associated with reducing the amount of Highly Enriched Uranium (HEU), whose enrichment is ≥ 20% in 235U, in international commerce. In particular, IAEA projects and activities have directly supported the two main international efforts to return fresh and spent HEU research reactor fuel to the country where it was originally enriched: the United States Foreign Research Reactor Spent Nuclear Fuel (FRRSNF) Acceptance Programme and the United States-IAEA-Russian Federation tripartite initiative known as the Russian Research Reactor Fuel Return (RRRFR) Programme. This report gives an account of IAEA efforts in support of both programmes including a historical overview of fuel return shipments and a brief description of associated cooperation activities carried out by the IAEA. [es

International Development Research Centre Corporate Policy Travel

International Development Research Centre (IDRC) Digital Library (Canada)

André Lavoie

put in place procedures to issue advances to employees entitled to receive them; ... recover Canadian tax credits where expense reports include Canadian ... Any instances of abuse, fraud, or non-compliance with the IDRC travel policy will be ...

Travel and Hospitality | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 1 - 67 of 67 ... Search. Home · About IDRC · Accountability · Transparency ... IDRC also provides information on the total annual expenses for each of travel, hospitality and ... The information on this website is updated every three months.

Travel during Pregnancy

Science.gov (United States)

... 36 weeks of pregnancy. Some domestic airlines restrict travel completely or require a medical certificate during the last month of pregnancy. For international flights, the cutoff point often is earlier, sometimes as early as 28 ...

Prescribed Travel Schedules for Fatigue Management

Science.gov (United States)

Whitmire, Alexandra; Johnston, Smith; Lockley, Steven

2011-01-01

The NASA Fatigue Management Team is developing recommendations for managing fatigue during travel and for shift work operations, as Clinical Practice Guidelines for the Management of Circadian Desynchrony in ISS Operations. The Guidelines provide the International Space Station (ISS ) flight surgeons and other operational clinicians with evidence-based recommendations for mitigating fatigue and other factors related to sleep loss and circadian desynchronization. As much international travel is involved both before and after flight, the guidelines provide recommendations for: pre-flight training, in-flight operations, and post-flight rehabilitation. The objective of is to standardize the process by which care is provided to crewmembers, ground controllers, and other support personnel such as trainers, when overseas travel or schedule shifting is required. Proper scheduling of countermeasures - light, darkness, melatonin, diet, exercise, and medications - is the cornerstone for facilitating circadian adaptation, improving sleep, enhancing alertness, and optimizing performance. The Guidelines provide, among other things, prescribed travel schedules that outline the specific implementation of these mitigation strategies. Each travel schedule offers evidence based protocols for properly using the NASA identified countermeasures for fatigue. This presentation will describe the travel implementation schedules and how these can be used to alleviate the effects of jet lag and/or schedule shifts.

Does International Migration Pay Off? The Labor Market Situation of Finnish Return Migrants Based on Longitudinal Register Data

Directory of Open Access Journals (Sweden)

Saara Koikkalainen

2016-12-01

Full Text Available International mobility is a form of flexible labor market adaptation available for young Nordic nationals who have the privilege of relatively easy return if life abroad does not work out. The article considers mobility as a labor market transition and examines the pre- and post-migration situation of two Finnish return migrant groups—those who lived abroad in 1999 and in 2004—based on longitudinal register data. It considers the consequences of return for an individual migrant: is it a form of failure in labor market integration in the country of destination or rather a sign of success whereby the skills, resources, and experiences gained abroad are brought back to the country of origin. Migrants who leave Finland nowadays often opt to move to other Nordic countries and are younger, more educated, and have a better socio-economic status than previous migrant generations. The article demonstrates that international migration does not deteriorate the returnees’ labor market status. While re-entry into the Finnish labor market may take some time and flexibility, mobility seems to pay off and have beneficial consequences: return migrants earn higher taxable incomes and have lower unemployment rates than their peers who only stayed in the national labor markets..

The severe acute respiratory syndrome: impact on travel and tourism.

Science.gov (United States)

Wilder-Smith, Annelies

2006-03-01

SARS and travel are intricately interlinked. Travelers belonged to those primarily affected in the early stages of the outbreak, travelers became vectors of the disease, and finally, travel and tourism themselves became the victims. The outbreak of SARS created international anxiety because of its novelty, its ease of transmission in certain settings, and the speed of its spread through jet travel, combined with extensive media coverage. The psychological impacts of SARS, coupled with travel restrictions imposed by various national and international authorities, have diminished international travel in 2003, far beyond the limitations to truly SARS hit areas. Governments and press, especially in non SARS affected areas, have been slow to strike the right balance between timely and frequent risk communication and placing risk in the proper context. Screening at airport entry points is costly, has a low yield and is not sufficient in itself. The low yield in detecting SARS is most likely due to a combination of factors, such as travel advisories which resulted in reduced travel to and from SARS affected areas, implementation of effective pre-departure screening at airports in SARS-hit countries, and a rapid decline in new cases at the time when screening was finally introduced. Rather than investing in airport screening measures to detect rare infectious diseases, investments should be used to strengthen screening and infection control capacities at points of entry into the healthcare system. If SARS reoccurs, the subsequent outbreak will be smaller and more easily contained if the lessons learnt from the recent epidemic are applied. Lessons learnt during the outbreak in relation to international travel will be discussed.

Prevention and control of rabies in an age of global travel: a review of travel- and trade-associated rabies events--United States, 1986-2012.

Science.gov (United States)

Lankau, E W; Cohen, N J; Jentes, E S; Adams, L E; Bell, T R; Blanton, J D; Buttke, D; Galland, G G; Maxted, A M; Tack, D M; Waterman, S H; Rupprecht, C E; Marano, N

2014-08-01

Rabies prevention and control efforts have been successful in reducing or eliminating virus circulation regionally through vaccination of specific reservoir populations. A notable example of this success is the elimination of canine rabies virus variant from the United States and many other countries. However, increased international travel and trade can pose risks for rapid, long-distance movements of ill or infected persons or animals. Such travel and trade can result in human exposures to rabies virus during travel or transit and could contribute to the re-introduction of canine rabies variant or transmission of other viral variants among animal host populations. We present a review of travel- and trade-associated rabies events that highlight international public health obligations and collaborative opportunities for rabies prevention and control in an age of global travel. Rabies is a fatal disease that warrants proactive coordination among international public health and travel industry partners (such as travel agents, tour companies and airlines) to protect human lives and to prevent the movement of viral variants among host populations. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

26 CFR 25.6075-1 - Returns, time for filing gift tax returns for gifts made after December 31, 1981.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Returns, time for filing gift tax returns for gifts made after December 31, 1981. 25.6075-1 Section 25.6075-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES GIFT TAX; GIFTS MADE AFTER DECEMBER...

26 CFR 1.857-10 - Information returns.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Information returns. 1.857-10 Section 1.857-10 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Real Estate Investment Trusts § 1.857-10 Information returns. Nothing in §§ 1.857-8 and 1...

Differential diagnosis of illness in travelers arriving from Sierra Leone, Liberia, or Guinea: a cross-sectional study from the GeoSentinel Surveillance Network.

Science.gov (United States)

Boggild, Andrea K; Esposito, Douglas H; Kozarsky, Phyllis E; Ansdell, Vernon; Beeching, Nicholas J; Campion, Daniel; Castelli, Francesco; Caumes, Eric; Chappuis, Francois; Cramer, Jakob P; Gkrania-Klotsas, Effrossyni; Grobusch, Martin P; Hagmann, Stefan H F; Hynes, Noreen A; Lim, Poh Lian; López-Vélez, Rogelio; Malvy, Denis J M; Mendelson, Marc; Parola, Philippe; Sotir, Mark J; Wu, Henry M; Hamer, Davidson H

2015-06-02

The largest-ever outbreak of Ebola virus disease (EVD), ongoing in West Africa since late 2013, has led to export of cases to Europe and North America. Clinicians encountering ill travelers arriving from countries with widespread Ebola virus transmission must be aware of alternate diagnoses associated with fever and other nonspecific symptoms. To define the spectrum of illness observed in persons returning from areas of West Africa where EVD transmission has been widespread. Descriptive, using GeoSentinel records. 57 travel or tropical medicine clinics in 25 countries. 805 ill returned travelers and new immigrants from Sierra Leone, Liberia, or Guinea seen between September 2009 and August 2014. Frequencies of demographic and travel-related characteristics and illnesses reported. The most common specific diagnosis among 770 nonimmigrant travelers was malaria (n = 310 [40.3%]), with Plasmodium falciparum or severe malaria in 267 (86%) and non-P. falciparum malaria in 43 (14%). Acute diarrhea was the second most common diagnosis among nonimmigrant travelers (n = 95 [12.3%]). Such common diagnoses as upper respiratory tract infection, urinary tract infection, and influenza-like illness occurred in only 26, 9, and 7 returning travelers, respectively. Few instances of typhoid fever (n = 8), acute HIV infection (n = 5), and dengue (n = 2) were encountered. Surveillance data collected by specialist clinics may not be representative of all ill returned travelers. Although EVD may currently drive clinical evaluation of ill travelers arriving from Sierra Leone, Liberia, and Guinea, clinicians must be aware of other more common, potentially fatal diseases. Malaria remains a common diagnosis among travelers seen at GeoSentinel sites. Prompt exclusion of malaria and other life-threatening conditions is critical to limiting morbidity and mortality. Centers for Disease Control and Prevention.

International Development Research Centre Corporate Policy Travel

International Development Research Centre (IDRC) Digital Library (Canada)

André Lavoie

2018-04-01

Apr 1, 2018 ... endeavour to make travel arrangements as early as possible to enhance the .... The A-card is used to purchase all agency-booked air and rail tickets and to cover ..... that decision with his or her expense claim by providing the ...

Impact of advice given to travelers concerning the main infectious risks associated with traveling in the tropics.

Science.gov (United States)

Lestelle, C; Aymeric, S; Maakaroun-Vermesse, Z; Pouliquen, A; Bernard, L; Chandenier, J; Grammatico-Guillon, L

2015-06-01

The prevention of sanitary risks related to traveling in the tropics implies delivering a large amount of information to travelers. The objective of our study was to assess the knowledge acquired by travelers during a pre-travel consultation. A before and after study was conducted among 202 travelers having consulted at the Tours international vaccine center. We used self-administrated questionnaires (score out of 100 marks) concerning diet, hygiene, anti-vectorial prevention (AVP), and sexual-transmitted infections (STI). The scores obtained before and after consultation were compared globally and for each topic. The travelers' global knowledge had improved after consultation (66.1 vs. 75.5%; P traveling compared to humanitarian mission prepared ahead of departure time). The recommendations for diet were less well acquired in travelers > 50 years of age than in those travel consultation improves the travelers' knowledge for the main prevention measures but does not allow them to acquire all required knowledge. Taking into account the travelers' initial knowledge and their ability to learn could improve the impact of the pre-travel consultation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Educational Travel to Israel in the Era of Globalization

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Ezrachi, Elan

2015-01-01

Travel to Israel has been a central feature of Jewish and Zionist education yet it is time for this educational travel to be examined in the context of current cultural trends of travel and transnational experiences. The Jewish educational community has not yet internalized the impact of global trends on the field of travel to Israel from a…

Characteristics of health problems in returned overseas travelers at a tertiary teaching hospital in a suburban area in Japan.

Science.gov (United States)

Hirata, Kazuki; Ogawa, Taku; Fujikura, Hiroyuki; Ogawa, Yoshihiko; Hirai, Nobuyasu; Nakagawa-Onishi, Tomoko; Uno, Kenji; Takeyama, Masahiro; Kasahara, Kei; Nakamura-Uchiyama, Fukumi; Konishi, Mitsuru; Mikasa, Keiichi

2018-03-01

Few studies have analyzed the characteristics of patients who develop physical disorders after overseas travel. We retrospectively reviewed the medical records of 183 patients who visited Nara Medical University Hospital from 2008 to 2016 because of physical problems after traveling abroad. The main travel destinations were Southeast Asia (n = 100), Africa (n = 27), and South Asia (n = 23). The main reasons for the travel were leisure (n = 96), business (n = 51), and volunteer work (n = 19). The most common final diagnosis was gastrointestinal disease (n = 72), followed by febrile disease (n = 59) and respiratory disease (n = 19). There were eight malaria cases, including one patient who was infected after travel. Additionally, 61 of 71 cases of travelers' diarrhea and 15 of 21 cases of dengue fever occurred after travel. 26 cases of vaccine preventable diseases, such as hepatitis A, typhoid fever, and influenza, were observed. Consequently, healthcare providers should notify Japanese overseas travelers that there is a non-negligible health risk inherent to short-term travel, while stressing on the importance of pre-travel medical consultation. Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

75 FR 76940 - Specified Tax Return Preparers Required To File Individual Income Tax Returns Using Magnetic...

Science.gov (United States)

2010-12-10

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 1 and 301 [REG-100194-10] RIN 1545-BJ52 Specified Tax Return Preparers Required To File Individual Income Tax Returns Using Magnetic... for ``specified tax return prepares,''. FOR FURTHER INFORMATION CONTACT: Keith L. Brau at (202) 622...

77 FR 38039 - Corporation for Travel Promotion (dba Brand USA)

Science.gov (United States)

2012-06-26

... DEPARTMENT OF COMMERCE International Trade Administration Corporation for Travel Promotion (dba Brand USA) AGENCY: International Trade Administration, Commerce. ACTION: Notice of an opportunity for... Corporation for Travel Promotion (Board) (dba Brand USA). The purpose of the Board is to guide the Corporation...

78 FR 53728 - Corporation for Travel Promotion (dba Brand USA)

Science.gov (United States)

2013-08-30

... DEPARTMENT OF COMMERCE International Trade Administration Corporation for Travel Promotion (dba Brand USA) AGENCY: International Trade Administration, U.S. Department of Commerce. ACTION: Notice of an... the Corporation for Travel Promotion (dba Brand USA). The purpose of the Board is to guide the...

78 FR 44531 - Corporation for Travel Promotion (dba Brand USA)

Science.gov (United States)

2013-07-24

... DEPARTMENT OF COMMERCE International Trade Administration Corporation for Travel Promotion (dba Brand USA) AGENCY: International Trade Administration, U.S. Department of Commerce. ACTION: Notice of an... the Corporation for Travel Promotion (dba Brand USA). The purpose of the Board is to guide the...

Rickettsiae and rickettsial diseases in Croatia: Implications for travel medicine.

Science.gov (United States)

Dzelalija, Boris; Punda-Polic, Volga; Medic, Alan; Dobec, Marinko

To review the current state of knowledge concerning rickettsiae and rickettsioses in Croatia and to discuss their implications for travellers. The PubMed database was searched from 1991 to 2015 by combining the words "rickettsia," "rickettsiosis", "travellers" and "Croatia". Since 1969, Croatia appears to be free of epidemic typhus (ET) caused by Rickettsia prowazekii and the last case of Brill-Zinsser disease was recorded in 2008. Mediterranean spotted fever (MSF) caused by Rickettsia conorii is the most frequent human rickettsial infection in Croatia, followed by murine typhus caused by Rickettsia typhi. Human cases of MSF and murine typhus have been predominantly observed along the eastern Adriatic coast from Zadar to Dubrovnik and between Zadar and Split, respectively. Rickettsia akari, etiologic agent of rickettsialpox, was isolated from blood of a patient diagnosed with MSF in Zadar, but no cases of rickettsialpox were reported. Several species of pathogenic (Rickettsia slovaca, Rickettsia aeschlimannii, Ricketsia helvetica, and Ricketsia raoultii) and species of undetermined pathogenicity (Ricketsia hoogstraalii sp. nov.) rickettsiae were identified in ticks collected in different ecological regions of Croatia. A search of the literature revealed no evidence of rickettsial infection in travellers visiting Croatia. Three imported cases of Rickettsia africae were observed in travellers returning from South Africa. Rickettsiae and rickettsial diseases continue to be present in Croatia. As they can be acquired while travelling, physicians should consider rickettsial infection in the differential diagnosis of patients returning from Croatia and presenting with febrile illness. Copyright © 2016 Elsevier Ltd. All rights reserved.

A case of ciguatera fish poisoning in a French traveler.

Science.gov (United States)

Develoux, M; Le Loup, G; Pialoux, G

2008-11-06

Ciguatera is a toxic poisoning due to ingestion of fish and is rarely reported in France. Little is known about this imported tropical disease. We present a case observed in Paris in a traveller returning from the Dominican Republic.

The travel advice as an inhibiting factor of tourist movement

Directory of Open Access Journals (Sweden)

Mylonopoulos Dimitrios

2016-01-01

Full Text Available Tourism is significantly affected by unpredictable and uncertain factors such as the occurrence of a terrorist attack, an epidemic outbreak or a natural disaster, etc. The impact of these phenomena on the tourist movement of the country or the place where the event occurred is aggravated by the way it is presented by the media both locally and internationally. The adverse climate gets worse by the issuance of travel advice that usually accompanies such phenomena and has the effect of limiting or even halting tourist flows. In order to identify and study the different types of travel advice that have been issued during international tourism crisis incidents, an internet search was carried out using keywords. Moreover, a study on the travel advice issued by major tourists' origin states, as the USA, Australia, Canada, Germany, the United Kingdom, etc. was carried out. Incidents (terrorist attacks, epidemics, natural disasters which had a great impact on tourism were then selected. In addition, the issuance of travel advice, their different issuing authorities, the classification level and the impact on the tourism of the country or the place in question were examined. An analysis of the reaction and the instructions of major international organizations (World Health Organization, World Tourism Organization concerning the management of such crises, directly or indirectly affecting tourism, were also analyzed. The study of the relevant websites, the international literature and the recorded incidents shows that the issuing of travel advice has negative effects on many sectors of tourism activity and is a bottleneck for tourism development. In fact, in many cases, travel advice is used by countries to exert pressure on other countries in order to achieve a desired result. Due to the enormous economic and social effects when issuing travel advice, the states proper management is necessary in order to minimize the negative consequences and avoid

Pharmacy travel health services: current perspectives and future prospects

Directory of Open Access Journals (Sweden)

Houle SKD

2018-03-01

Full Text Available Sherilyn KD HouleSchool of Pharmacy, University of Waterloo, Waterloo, ON, CanadaAbstract: Rates of international travel are increasing annually, with particular growth observed in travel to Southeast Asia and to emerging economies. While all patients traveling across geographic regions are recommended to receive a pre-travel consultation to consider their individual risks, many do not, or receive care and recommendations that are not consistent with current evidence-based guidelines. As experts in drug therapy, and given the largely preventive nature of most travel health recommendations, pharmacists are well suited to help address this need. Pharmacists generally possess a high degree of knowledge and confidence with more commonly observed travel health topics in community practice such as travelers’ diarrhea; however, training in more specialized travel health topics such as travel vaccinations and traveling at altitude has generally been lacking from pharmacy curricula. Pharmacists with an interest in providing pre-travel consultations are encouraged to pursue additional training in this specialty and to consider Certificate in Travel Health designation from the International Society of Travel Medicine. Future roles for pharmacists to include the prescribing of medications and vaccines for travel and the in-pharmacy administration of travel vaccinations may improve patient access to pre-travel consultations and recommended preventive measures, improving the health of travelers and potentially reducing the burden of communicable disease worldwide. Pharmacists providing travel care to patients are also reminded to consider noninfectious risks of illness and injury abroad and to counsel patients on strategies to minimize these risks in addition to providing drug and vaccine recommendations.Keywords: pharmacist, community pharmacy, travel, vaccination

Road traffic and other unintentional injuries among travelers to developing countries

Science.gov (United States)

Stewart, Barclay; Yankson, Isaac Kofi; Afukaar, Francis; Medina, Martha Hijar; Cuong, Pham Viet; Mock, Charles

2015-01-01

Synopsis Injuries result in nearly 6 million deaths and incur 52 million disability-adjusted life years annually, comprising 15% of the global disease burden. More than 90% of this burden occurs in low- and middle-income countries (LMICs). Given this burden, it’s not unexpected that injuries are the leading cause of death among travelers to LMICs, namely from road traffic crashes and drowning. Opportunely, the majority of injuries are preventable. Therefore, pre-travel advice regarding foreseeable dangers and how to avoid them may significantly mitigate injury risk, such as: wearing seatbelts, helmets and personal flotation devices when appropriate; responsibly consuming alcohol; and closely supervising children. Upon return, travelers to LMICs are in a unique position; having shared injury risks while abroad, travelers can advocate for injury control initiatives that might make the world safer for travelers and local populations alike. PMID:26900117

Traveling with children: beyond car seat safety.

Science.gov (United States)

Polli, Janaina Borges; Polli, Ismael

2015-01-01

To spread knowledge and instigate the health professional to give advice on childcare during travels and on child transport safety. Literature review through the LILACS and MEDLINE(®) databases, using the terms: travel, safety, protective equipment, child, preventive medicine, retrieving articles published in the last 21 years. The authors analyzed 93 articles, of which 66 met the inclusion criteria after summaries were read. For drafting this article, the following sub-themes were proposed: getting ready to travel with children; knowing some of the transfer risks (air, land and water transportation) and exploring the destination with children (sun exposure, accommodations, altitude, food, traveler's diarrhea, insect bites) and return from the trip with children. Over the years, there has been an increase in the number of children who travel around the world. However, this population is still subject to health problems while traveling and may be even more susceptible than the adult age group. These problems arise from a variety of factors, including exposure to infectious organisms, the use of certain types of transportation, and participation in some activities, such as hiking at high altitudes, among others. However, when traveling with children, these risk factors can be overlooked; a trip that is considered safe for an adult might not be a good choice for this age group. The pediatric consultation should be a good opportunity to optimize preventive guidelines at the pre-trip planning. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

The return of international labour migrants in the ESCAP Region.

Science.gov (United States)

1986-03-01

The social phenomenon of massive temporary international labor migration from the ESCAP region has emerged extremely rapidly. Within 10 years, the number of persons from ESCAP countries grew from a negligible one to 3.5 million. Related research and government policies have lagged behind this latest surge in migration. Most research conducted has been small-scale and lacks an analytical or theoretical framework. Policy formulation for temporary labor migration is difficult because most of the rapid growth in the industry has occurred as a result of private efforts, with a minimum of government intervention. It is now difficult, for the government to provide effective regulations or measures to stimulate and assist the process. Regulations on compulsory remittances or overseas minimum wages have proved to be unrealistic and, if not rescinded, are routinely circumvented. The most effective policies to assist return migrants may not be those which are intended to do so, but those which control the earlier stages of the migration process, such as recruitment, working conditions, and banking arrangements. The most valuable policies may also include those affecting education, training, employment, and general socioeconomic growth. Governments are recommended to provide social services for migrants and their families who are experiencing problems, and to institute community programs in areas with a large number of labor migrants. Governmental efforts to promote forms of labor migration beneficial to the workers would be valuable and should include measures to identify overseas labor markets for employing its nationals, government ot government labor contracts, and government participation in joint-venture projects. International migration should be analyzed in the context of theories and social change in order for governments to formulate effective measures for the reintegration of returning workers. Labor migration on the current scale has many social implications for

26 CFR 301.6103(j)(1)-1T - Disclosures of return information reflected on returns to officers and employees of the...

Science.gov (United States)

2010-04-01

... related activities (temporary). 301.6103(j)(1)-1T Section 301.6103(j)(1)-1T Internal Revenue INTERNAL... ADMINISTRATION Information and Returns Returns and Records § 301.6103(j)(1)-1T Disclosures of return information... § 301.6103(j)(1)-1(a) through (b)(3)(xxiv). (xxv) From Form 6765 (when filed with corporation income tax...

Carbon emissions from international cruise ship passengers' travel to and from New Zealand

International Nuclear Information System (INIS)

Howitt, Oliver J.A.; Revol, Vincent G.N.; Smith, Inga J.; Rodger, Craig J.

2010-01-01

Greenhouse gas emissions from international transport contribute to anthropogenic global warming, yet these emissions are not liable under the Kyoto Protocol. International attention is being given to quantifying such emissions. This paper presents the results of research into international cruise ship journeys to and from New Zealand. CO 2 emissions from such journeys were calculated using an activity based, or 'bottom-up', model. Emissions factors for individual journeys by cruise ships to or from New Zealand in 2007 ranged between 250 and 2200 g of CO 2 per passenger-kilometre (g CO 2 per p-km), with a weighted mean of 390 g CO 2 per p-km. The weighted mean energy use per passenger night for the 'hotel' function of these cruise vessels was estimated as 1600 MJ per visitor night, 12 times larger than the value for a land-based hotel. Using a simple price elasticities calculation, international cruise journeys for transport purposes were found to have a greater relative decrease in demand than plane journeys when the impact of carbon pricing was analysed. The potential to decrease the CO 2 emissions per p-km was examined, and if passenger accommodation was compacted and some luxury amenities dispensed with values similar to those of economy-class air travel were obtained.

Destination specific risks of acquisition of notifiable food- and waterborne infections or sexually transmitted infections among Finnish international travellers, 1995-2015.

Science.gov (United States)

Zöldi, Viktor; Sane, Jussi; Kantele, Anu; Rimhanen-Finne, Ruska; Salmenlinna, Saara; Lyytikäinen, Outi

2017-10-10

Overnight international travels made by Finns more than doubled during 1995-2015. To estimate risks and observe trends of travel-related notifiable sexually transmitted and food- and water-borne infections (STIs and FWIs) among travellers, we analysed national reports of gonorrhoea, syphilis, hepatitis A, shigellosis, campylobacteriosis and salmonellosis cases and related them to travel statistics. Cases notified as travel-related to the Finnish infectious diseases register were used as numerators and overnight stays of Statistics Finland surveys as denominator. We calculated overall risks (per 100,000 travellers) and assessed trends (using regression model) in various geographic regions. Of all travel-related cases during 1995-2015, 2304 were STIs and 70,929 FWIs. During 2012-2015, Asia-Oceania showed highest risk estimates for gonorrhoea (11.0; 95%CI, 9.5-13), syphilis (1.4; 0.93-2.1), salmonellosis (157; 151-164), and campylobacteriosis (135; 129-141), and Africa for hepatitis A (4.5; 2.5-7.9), and shigellosis (35; 28-43). When evaluating at country level, the highest risks of infections was found in Thailand, except for hepatitis A ranking Hungary the first. During 2000-2011, significantly decreasing trends occurred for most FWIs particularly in the European regions and for STIs in Russia-Baltics. Our findings can be used in targeting pre-travel advice, which should also cover those visiting Thailand or European hepatitis A risk areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Importation of yellow fever into China: assessing travel patterns.

Science.gov (United States)

Wilder-Smith, Annelies; Leong, W Y

2017-07-01

Rapid increase in trade and a growing air passenger market encourages high travel volume between the regions associated with increasing risks of such importations including China. Eleven Chinese workers infected during the 2016 yellow fever (YF) outbreak in Angola imported YF into China highlighting the potential for spread into Asia. Using outbound and inbound travel data, we assessed travel patterns from and to YF endemic countries in relation to China. Among YF endemic countries, Angola has the second highest number of travellers into China and also receives the second highest number of Chinese visitors. We estimated that China needs around half a million YF vaccine doses to cover their population travelling to YF endemic countries. The recent importation cases into China also unmasked the low YF vaccination coverage among Chinese travellers and workers to Angola, indicating the need to ensure better adherence to the International Health Regulations. © International Society of Travel Medicine, 2017.. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

[A Case of Dengue Fever and Subsequent Long-lasting Depression Accompanied by Alopecia in a Japanese Traveler Returning from Bali, Indonesia].

Science.gov (United States)

Hitani, Akihiro; Yamaya, Waka; To, Masako; Kano, Ichino; Honda-Hosono, Natsue; Takasaki, Tomohiko; Haruki, Kosuke

2015-03-01

Recovery from dengue fever is generally rapid and uneventful. However, recuperation is often prolonged and may be accompanied by noticeable depression. We present herein on a traveler to Indonesia who developed long-lasting depression after the classic symptoms of dengue fever such as fever, arthralgia, and macropapular rash had resolved. A previously healthy 42-year old japanese woman presented to the Travel Clinic of Seirei Yokohama Hospital with complaints of 4 days of fever, joint aches, bone pain, and a macropapular rash on her torso. She had returned from Bali 5 days previously. During her 1-week stay, one day was spent in rural, mountainous areas where she was exposed to several mosquito bites. The 1st serum sample collected 4 days after the disease onset gave positive result in the rapid dengue IgM antibody test and the rapid dengue NS1 antigen immunechromatographic test. The DENV-1 genome was detected with RT-PCR. Her 13-year old son, who had accompanied her, was also diagnosed as having dengue fever and he recovered without event. The Above-mentioned symptoms resolved within one week. However, the patient suffered from prolonged depression. She also noticed loss of hair 3 months after the disease onset Administration of a Serotonin-Noradrenalin Reuptake Inhibitor and a minor tranquillizer required to allow her requied to lead a normal life. Although she gradually felt better, it took approximately 2 years until she had recovered completely without taking any antidepressant and minor tranquillizer. It is a well-known fact in endemic countries that dengue fever could have an significant impact on the patients' mental well-being. However, it appears that physicians in non-endemic countries are not fully aware of the prolonged depression, which can occur subsequent to the acute illness. Follow-up consultations of returing travelers who have recoverd from dengu fever should be arranged to monitor their mental and emotional states closely.

Leishmaniasis in travelers: a literature review.

Science.gov (United States)

Mansueto, Pasquale; Seidita, Aurelio; Vitale, Giustina; Cascio, Antonio

2014-01-01

Leishmaniasis is a vector-borne protozoan infection whose clinical spectrum ranges from asymptomatic infection to fatal visceral leishmaniasis. Over the last decades, an increase in imported leishmaniasis cases in developed, non-endemic countries, have been pointed-out from a review of the international literature. Among the possible causes are increasing international tourism, influx of immigrants from endemic regions and military operations. The main area for the acquisition of cutaneous leishmaniasis, especially for adventure travelers on long-term trips in highly-endemic forested areas, is represented from South America, whereas popular Mediterranean destinations are emerging as the main areas to acquire visceral variant. Leishmaniasis should be considered in the diagnostic assessment of patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years before. Adventure travelers, researchers, military personnel, and other groups of travelers likely to be exposed to sand flies in endemic areas, should receive counseling regarding leishmaniasis and appropriate protective measures. Copyright © 2014 Elsevier Ltd. All rights reserved.

Don't Let Measles Be Your Travel Souvenir

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... who have never had measles should be vaccinated. International Travel and Measles Traveling abroad for spring or ... site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple ...

A global travelers' electronic health record template standard for personal health records.

Science.gov (United States)

Li, Yu-Chuan; Detmer, Don E; Shabbir, Syed-Abdul; Nguyen, Phung Anh; Jian, Wen-Shan; Mihalas, George I; Shortliffe, Edward H; Tang, Paul; Haux, Reinhold; Kimura, Michio

2012-01-01

Tourism as well as international business travel creates health risks for individuals and populations both in host societies and home countries. One strategy to reduce health-related risks to travelers is to provide travelers and relevant caregivers timely, ongoing access to their own health information. Many websites offer health advice for travelers. For example, the WHO and US Department of State offer up-to-date health information about countries relevant to travel. However, little has been done to assure travelers that their medical information is available at the right place and time when the need might arise. Applications of Information and Communication Technology (ICT) utilizing mobile phones for health management are promising tools both for the delivery of healthcare services and the promotion of personal health. This paper describes the project developed by international informaticians under the umbrella of the International Medical Informatics Association. A template capable of becoming an international standard is proposed. This application is available free to anyone who is interested. Furthermore, its source code is made open.

THE DECISION MAKING OF BUSINESS TRAVELLERS IN SELECTING ONLINE TRAVEL PORTALS FOR TRAVEL BOOKING: AN EMPIRICAL STUDY OF DELHI NATIONAL CAPITAL REGION, INDIA

Directory of Open Access Journals (Sweden)

Bivek DATTA

2018-05-01

Full Text Available The purpose of this paper is to understand the decision making pattern of the Business Travellers in Delhi National Capital Region in India while booking their trips through Online Travel Portals. The study revolves around purchase decision pattern of Business Travellers by investigating their travel decision making style in selecting online travel portals for their trip booking. The authors have adopted the quantitative methodology to achieve the objective of the study. The study is confined purely to the Business Travellers who book their travel through online travel portals. The data was collected through a structured questionnaire. 300 Business Travellers were interviewed at the departure lounge of Indira Gandhi International Airport, New Delhi, India out of which 150 questionnaires were incomplete in many respects and could not be used and only 150 questionnaires were usable resulting in the response rate of 50%. The Analytical Hierarchy process method was adopted to analyze the relative weights assigned by Business Travellers. The present study identifies through literature review the nine fundamental values of internet purchase i.e. product quality, cost, time to receive the product, convenience, time spent, confidentiality, shopping enjoyment, security and environmental impact. The research findings indicate that business travellers value confidentiality, security and product quality the most while choosing the Online Travel Portal to book their trip. The study is primarily centered on the consumer typology approach to study the decision making patterns of business travellers whereas there are other variables such as lifestyle, personality, attitude which can also be investigated. The study is only restricted to Business Travellers decision making pattern pertaining to their travel booking whereas a study can also be undertaken on leisure travellers decision making pattern. The study is restricted to only Delhi National Capital Region

Bon voyage: an update on safe travel in pregnancy.

Science.gov (United States)

Jones, Claire Ann; Chan, Crystal

2014-12-01

Travel in pregnancy is common, particularly as international travel for work and leisure has become more commonplace. Few women are fully aware of the potential risks of travelling while pregnant, particularly the risk of delivering abroad. We describe here the medical risks and the many social, financial, and logistical considerations for travelling during pregnancy. Pertinent considerations include the risks of developing medical complications abroad, immunization considerations, access to obstetrical care in developing countries, travel medical insurance, and airline regulations.

Knowledge, attitudes, and practices of US practitioners who provide pre-travel advice.

Science.gov (United States)

Kogelman, Laura; Barnett, Elizabeth D; Chen, Lin H; Quinn, Emily; Yanni, Emad; Wilson, Mary E; Benoit, Christine; Karchmer, Adolf W; Ooi, Winnie W; Jentes, Emily S; Hamer, Davidson H

2014-01-01

As international travel increases, many health care professionals are being asked to provide pre-travel advice. We designed an anonymous web-based survey to assess the extent to which primary care providers (PCPs) provide travel medicine advice and how their understanding and delivery of itinerary-specific advice and management compare with that of travel medicine specialists. We surveyed randomly selected US PCPs registered in the Pri-Med Institute (now pmiCME) database and US travel medicine specialists from the International Society of Travel Medicine (ISTM), American Society of Tropical Medicine and Hygiene (ASTMH), and Centers for Disease Control and Prevention (CDC) yellow fever (YF) vaccine provider mailing lists. SAS software (SAS Institute, Cary, NC, USA) was used for all analyses. Of 14,932 e-mails sent to valid e-mail addresses, 902 yielded complete or partially completed surveys (6.0% response rate). Eighty percent of respondents personally provided pre-travel advice (95% of travel medicine specialists versus 73% of PCPs). About two thirds of PCPs (68%) providing pre-travel consultations saw travelers per year whereas 30% of travel medicine specialists saw travelers per year. More travel medicine specialists (59%) than PCPs (18%) saw >500 travelers per year. Familiarity with travel-specific vaccines (YF, Japanese encephalitis) and provision of written educational materials increased as volume of travelers increased. Familiarity with antimalarial side effects and malaria resistance patterns, and knowledge scores based on brief pre-travel scenarios were higher in travel medicine specialists, ASTMH or ISTM certificate holders, and respondents who saw more pre-travel patients. Many PCP survey participants provided pre-travel advice, but most saw few travelers. Volume of travelers and holding an ASTMH or ISTM certificate had the greatest influence on knowledge of travel medicine and provision of appropriate advice and recommendations. Creating easily

The practice of travel medicine in Europe.

Science.gov (United States)

Schlagenhauf, P; Santos-O'Connor, F; Parola, P

2010-03-01

Europe, because of its geographical location, strategic position on trade routes, and colonial past, has a long history of caring for travellers' health. Within Europe, there is great diversity in the practice of travel medicine. Some countries have travel medicine societies and provisions for a periodic distribution of recommendations, but many countries have no national pre-travel guidelines and follow international recommendations such as those provided by the WHO. Providers of travel medicine include tropical medicine specialists, general practice nurses and physicians, specialist 'travel clinics', occupational physicians, and pharmacists. One of the core functions of the European Centre for Disease Prevention and Control-funded network of travel and tropical medicine professionals, EuroTravNet, is to document the status quo of travel medicine in Europe. A three-pronged approach is used, with a real-time online questionnaire, a structured interview with experts in each country, and web searching.

[Amblyomma spp. case related to overseas travel].

Science.gov (United States)

Beyhan, Yunus Emre; Mungan, Mesut; Babür, Cahit

2014-01-01

Ticks are a threat to human health by blood sucking and vectoring many disease agents. Tick-borne diseases are seen all over the world and play an important role in the dissemination of diseases. Although many of the tick species are present in Turkey, Amblyomma genus is seen more in South America and Africa. In this case,a person returning to the country after travelling to Africa who presented to the hospital complaining of tick bites and brought ticks to the parasitology laboratory was identified as Ablyomma spp. nymph. This case is a report concerning care of tick bites when travelling abroad and shows that these ticks can transmit disease agents from abroad.

78 FR 77103 - United States Travel and Tourism Advisory Board

Science.gov (United States)

2013-12-20

... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism... extended deadline for application for membership on the United States Travel and Tourism Advisory Board... Travel and Tourism Advisory Board (Board). The November 25, 2013 notice provided that all applications...

Determination of travel time capsules hydraulic rabbit system channel 2 (JBB 02) at the G.A. Siwabessy reactor

International Nuclear Information System (INIS)

Sutrisno; Sunarko; Elisabeth Ratnawati

2014-01-01

Rabbit System is an irradiation facilities used for research on neutron activation. There are two types of Rabbit Systems including 4 pieces Rabbit Hydraulic Systems (JBB01 - JBB04) and Rabbit Pneumatic Systems (JBB05). Irradiation facility of hydraulic rabbit system is irradiation facility with media delivery in the form of capsules. Travel time delivery and the return capsule in hydraulic rabbit system facility depends on the magnitude of the observed flow rate on flow measurement instruments for water circulation. To determine the travel time should be observed flow rates varied by opening the valve (JBB02 AA007), so the delivery time and the return capsule in the rabbit facility hydraulic system can be known. Observations made from the results obtained travel time capsule delivery poly ethylene (PE) of the isotope cell to irradiation position appropriate to the graph Y=57,67 e -0,139.x , for capsules Aluminum (Al) appropriate graph Y= 68,178 e -0,189.x , while the travel time of the return capsule poly ethylene (PE) from the irradiation position to the isotope cell appropriate graph Y=56,459 e -13.x , for capsules Al appropriate graph Y= 65,51 e -183.x this result can be used as a reference for determining the travel time desired by the operator. (author)

Infectious Risks of Traveling Abroad.

Science.gov (United States)

Chen, Lin H; Blair, Barbra M

2015-08-01

A popular leisure activity, international travel can be associated with some infections. The most common travel-related illnesses appear to be gastrointestinal, dermatologic, respiratory, and systemic febrile syndromes. The pretravel medical consultation includes immunizations, malaria chemoprophylaxis, self-treatment for traveler's diarrhea, and advice on the prevention of a myriad of other infectious causes including dengue, chikungunya, rickettsiosis, leptospirosis, schistosomiasis, and strongyloidiasis. Travel to locations experiencing outbreaks such as Ebola virus disease, Middle East respiratory syndrome, avian influenza, and chikungunya call for specific alerts on preventive strategies. After travel, evaluation of an ill traveler must explore details of exposure, including destinations visited; activities; ingestion of contaminated food or drinks; contact with vectors, animals, fresh water, or blood and body fluids; and other potential exposures. Knowledge of the geographic distribution of infectious diseases is important in generating the differential diagnoses and testing accordingly. Empiric treatment is sometimes necessary when suspicion of a certain diagnosis is strong and confirmatory tests are delayed or lacking, particularly for infections that are rapidly progressive (for example, malaria) or for which timing of testing is prolonged (such as leptospirosis).

Business travelers: vaccination considerations for this population.

Science.gov (United States)

Chen, Lin H; Leder, Karin; Wilson, Mary E

2013-04-01

Illness in business travelers is associated with reduced productivity on the part of the employee as well as the employer. Immunizations offer a reliable method of preventing infectious diseases for international business travelers. The authors review the travel patterns of business travelers, available data on illnesses they encounter, their potential travel-associated risks for vaccine-preventable diseases and recommendations on immunizations for this population. Routine vaccines (e.g., measles, tetanus and influenza) should be reviewed to assure that they provide current coverage. The combined hepatitis A and hepatitis B vaccine with a rapid schedule offers options for those with time constraints. Other vaccine recommendations for business travelers need to focus on their destinations and activities and underlying health, taking into account the concept of cumulative risk for those with frequent travel, multiple trips or long stays.

Travel patterns and demographic characteristics of malaria cases in Swaziland, 2010-2014.

Science.gov (United States)

Tejedor-Garavito, Natalia; Dlamini, Nomcebo; Pindolia, Deepa; Soble, Adam; Ruktanonchai, Nick W; Alegana, Victor; Le Menach, Arnaud; Ntshalintshali, Nyasatu; Dlamini, Bongani; Smith, David L; Tatem, Andrew J; Kunene, Simon

2017-09-08

As Swaziland progresses towards national malaria elimination, the importation of parasites into receptive areas becomes increasingly important. Imported infections have the potential to instigate local transmission and sustain local parasite reservoirs. Travel histories from Swaziland's routine surveillance data from January 2010 to June 2014 were extracted and analysed. The travel patterns and demographics of rapid diagnostic test (RDT)-confirmed positive cases identified through passive and reactive case detection (RACD) were analysed and compared to those found to be negative through RACD. Of 1517 confirmed cases identified through passive surveillance, 67% reported travel history. A large proportion of positive cases reported domestic or international travel history (65%) compared to negative cases (10%). The primary risk factor for malaria infection in Swaziland was shown to be travel, more specifically international travel to Mozambique by 25- to 44-year old males, who spent on average 28 nights away. Maputo City, Inhambane and Gaza districts were the most likely travel destinations in Mozambique, and 96% of RDT-positive international travellers were either Swazi (52%) or Mozambican (44%) nationals, with Swazis being more likely to test negative. All international travellers were unlikely to have a bed net at home or use protection of any type while travelling. Additionally, paths of transmission, important border crossings and means of transport were identified. Results from this analysis can be used to direct national and well as cross-border targeting of interventions, over space, time and by sub-population. The results also highlight that collaboration between neighbouring countries is needed to tackle the importation of malaria at the regional level.

78 FR 70275 - United States Travel and Tourism Advisory Board

Science.gov (United States)

2013-11-25

... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism... an opportunity to apply for membership on the United States Travel and Tourism Advisory Board... Travel and Tourism Advisory Board (Board). The purpose of the Board is to advise the Secretary of...

Zika virus infection acquired during brief travel to Indonesia.

Science.gov (United States)

Kwong, Jason C; Druce, Julian D; Leder, Karin

2013-09-01

Zika virus infection closely resembles dengue fever. It is possible that many cases are misdiagnosed or missed. We report a case of Zika virus infection in an Australian traveler who returned from Indonesia with fever and rash. Further case identification is required to determine the evolving epidemiology of this disease.

Development of the PEBLebl Traveling Salesman Problem Computerized Testbed

Science.gov (United States)

Mueller, Shane T.; Perelman, Brandon S.; Tan, Yin Yin; Thanasuan, Kejkaew

2015-01-01

The traveling salesman problem (TSP) is a combinatorial optimization problem that requires finding the shortest path through a set of points ("cities") that returns to the starting point. Because humans provide heuristic near-optimal solutions to Euclidean versions of the problem, it has sometimes been used to investigate human visual…

Travel risk assessment, advice and vaccinations in immunocompromised travellers (HIV, solid organ transplant and haematopoeitic stem cell transplant recipients): A review.

Science.gov (United States)

Aung, A K; Trubiano, J A; Spelman, D W

2015-01-01

International travellers with immunocompromising conditions such as human immunodeficiency virus (HIV) infection, solid organ transplantation (SOT) and haematopoietic stem cell transplantation (HSCT) are at a significant risk of travel-related illnesses from both communicable and non-communicable diseases, depending on the intensity of underlying immune dysfunction, travel destinations and activities. In addition, the choice of travel vaccinations, timing and protective antibody responses are also highly dependent on the underlying conditions and thus pose significant challenges to the health-care providers who are involved in pre-travel risk assessment. This review article provides a framework of understanding and approach to aforementioned groups of immunocompromised travellers regarding pre-travel risk assessment and management; in particular travel vaccinations, infectious and non-infectious disease risks and provision of condition-specific advice; to reduce travel-related mortality and morbidity. Copyright © 2014 Elsevier Ltd. All rights reserved.

Approach to Immunization for the Traveling Child.

Science.gov (United States)

Myers, Angela L; Christenson, John C

2015-12-01

Children are traveling to regions of the world that could pose a risk of acquiring diseases such as malaria, dermatosis, and infectious diarrhea. Most of these can be prevented by modifying high-risk behaviors or through the use of medications. Many of these same regions are endemic with diseases that are preventable through vaccination. Clinicians must be able to effectively prepare their pediatric-age travelers for international travel. Preventive education, prophylactic and self-treating medications, and vaccinations are all important components of this preparation. Familiarity with the use of travel vaccines is imperative. Copyright © 2015 Elsevier Inc. All rights reserved.

Fecal-orally transmitted diseases among travelers are decreasing due to better hygienic standards at travel destination.

Science.gov (United States)

Baaten, Gijs G; Sonder, Gerard J B; Van Der Loeff, Maarten F Schim; Coutinho, Roel A; Van Den Hoek, Anneke

2010-01-01

To evaluate whether changes in attack rates of fecal-orally transmitted diseases among travelers are related to changes in pretravel vaccination practices or better hygienic standards at travel destination. National surveillance data on all laboratory-confirmed cases of travel-related hepatitis A, shigellosis, and typhoid fever diagnosed in the Netherlands from 1995 to 2006 were matched with the number of Dutch travelers to developing countries to calculate region-specific annual attack rates. Trends in attack rates of non-vaccine-preventable shigellosis were compared with those of vaccine-preventable hepatitis A and typhoid fever. Trends were also compared with three markers for hygienic standards of the local population at travel destinations, drawn from the United Nations Development Programme database: the human development index, the sanitation index, and the water source index. Attack rates among Dutch travelers to developing regions declined for hepatitis A, shigellosis, and typhoid fever. Region-specific trends in attack rates of shigellosis resembled trends of hepatitis A and typhoid fever. Declining attack rates of the three fecal-orally transmitted diseases correlated with improvements in socioeconomic, sanitary, and water supply conditions of the local population at travel destination. These findings suggest that improved hygienic standards at travel destination strongly contributed to the overall decline in attack rates of fecal-orally transmitted diseases among visiting travelers. © 2010 International Society of Travel Medicine.

Pre-travel advice at a crossroad: Medical preparedness of travellers to South and Southeast-Asia - The Hamburg Airport Survey.

Science.gov (United States)

Rolling, Thierry; Mühlenpfordt, Melina; Addo, Marylyn M; Cramer, Jakob P; Vinnemeier, Christof D

Specific travel-related recommendations exist for the prevention or self-treatment of infectious diseases contracted by travellers to the tropics. In the current study, we assessed the medical preparedness per these recommendations, focusing on whether travellers carried antidiarrheal and antimalarial medication with them stratified by type of pre-travel advice. We surveyed travellers departing from Hamburg International Airport to South or Southeast Asia, using a questionnaire on demographic, medical and travel characteristics. 975 travellers were analysed - the majority (817, 83%) being tourists. A large proportion packed any antidiarrheal medication (612, 63%) - most frequently loperamide (440, 72%). Only 176 of 928 (19%) travellers to destinations with low-to medium risk for malaria packed a recommended antimalarial medication. The majority (162, 17%) of them carried antimalarials as stand-by emergency treatment (SBET). 468 (48%) travellers had a pre-travel medical consultation. This lead to higher odds of carrying SBET- with the highest odds associated with a consultation at a travel medicine specialist (OR 7.83 compared to no consultation). Attending a travel medicine specialist was associated with better adherence to current recommendations concerning the carriage of stand-by emergency treatment of malaria. However, the proportion of travellers seeking pre-travel health advice was overall low in our population. Promoting pre-travel consultations may, therefore, lead to higher adherence to the current recommendations in travel medicine. Copyright © 2017 Elsevier Ltd. All rights reserved.

Promoting health and safety for traveling and commuting employees.

Science.gov (United States)

Pochat-Debroux, Sophia

2008-09-01

In a society that relies on a growing market economy and free enterprise, Americans spend inordinate time commuting and traveling for work. Aircraft and private vehicles are the two primary modes of work-related travel, with each having its own inherit risks and hazards. Although much has been written about international travel health, little has been published about protecting the health and safety of workers during domestic business travel. The intent of this article is to highlight the statistics associated with domestic business travel and present sound rationale for an inclusive and comprehensive domestic travel health and safety program for employees.

76 FR 58243 - Proposed Information Collection; Comment Request; Survey of International Air Travelers

Science.gov (United States)

2011-09-20

... on state and local economies, providing visitation estimates, key market intelligence, and identifying traveler and trip characteristics. The U.S. Department of Commerce assists travel industry...) has been developed that reflects input from over 70 respondents, including: Travel Industry (airlines...

26 CFR 301.6017-1 - Self-employment tax returns.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Self-employment tax returns. 301.6017-1 Section 301.6017-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) PROCEDURE...-1 Self-employment tax returns. For provisions relating to the requirement of self-employment tax...

26 CFR 301.6062-1 - Signing of corporation returns.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Signing of corporation returns. 301.6062-1 Section 301.6062-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED....6062-1 Signing of corporation returns. For provisions relating to the signing of corporation income tax...

Stem cell tourism--a web-based analysis of clinical services available to international travellers.

Science.gov (United States)

Connolly, Ruairi; O'Brien, Timothy; Flaherty, Gerard

2014-01-01

Stem cell therapies are advertised through online resources which describe a range of treatments with diverse clinical indications. Stem cell tourists may not be aware of the information they should seek when consulting these clinics, or of the potential risks involved. The aim of this study was to characterise the therapies offered by online stem cell clinics. A web based search utilising five search terms was employed. The first twenty pages of each search result were screened against 340 variables. 224 out of 1091 websites advertised stem cell clinics. 68 eligible sites covering 21 countries were evaluated. The top five clinical indications for stem cell therapy were multiple sclerosis, anti-ageing, Parkinson's disease, stroke and spinal cord injury. Adult, autologous stem cells were the most commonly utilised stem cell, and these were frequently sourced from bone marrow and adipose tissue and administered intravenously. Thirty-four per cent of sites mentioned the number of patients treated while one quarter of clinics provided outcome data. Twenty-nine per cent of clinics had an internationally recognised accreditation. Fifteen per cent of clinics stated that their therapies posed no risk. Eighty-eight per cent of clinics claimed treatment effectiveness, with 16% describing their curative potential. Over 40% of sites did not specify the number or duration of treatments. Fifty-three per cent of clinics requested access to patients' medical records, and 12% recommended patients discuss the proposed therapy with their doctor. No clinic recommended that travellers consult a travel medicine specialist or receive vaccinations prior to their intended travel. One quarter of sites discussed contraindications to treatment, with 41% of sites detailing follow up patient care. There is potential for stem cell tourists to receive misleading or deficient information from online stem cell clinics. Both the stem cell tourist and travel medicine practitioner should be educated

Effectiveness of travel restrictions in the rapid containment of human influenza: a systematic review

Science.gov (United States)

Mateus, Ana LP; Otete, Harmony E; Beck, Charles R; Dolan, Gayle P; Nguyen-Van-Tam, Jonathan S

2014-01-01

Abstract Objective To assess the effectiveness of internal and international travel restrictions in the rapid containment of influenza. Methods We conducted a systematic review according to the requirements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Health-care databases and grey literature were searched and screened for records published before May 2014. Data extraction and assessments of risk of bias were undertaken by two researchers independently. Results were synthesized in a narrative form. Findings The overall risk of bias in the 23 included studies was low to moderate. Internal travel restrictions and international border restrictions delayed the spread of influenza epidemics by one week and two months, respectively. International travel restrictions delayed the spread and peak of epidemics by periods varying between a few days and four months. Travel restrictions reduced the incidence of new cases by less than 3%. Impact was reduced when restrictions were implemented more than six weeks after the notification of epidemics or when the level of transmissibility was high. Travel restrictions would have minimal impact in urban centres with dense populations and travel networks. We found no evidence that travel restrictions would contain influenza within a defined geographical area. Conclusion Extensive travel restrictions may delay the dissemination of influenza but cannot prevent it. The evidence does not support travel restrictions as an isolated intervention for the rapid containment of influenza. Travel restrictions would make an extremely limited contribution to any policy for rapid containment of influenza at source during the first emergence of a pandemic virus. PMID:25552771

76 FR 50179 - U.S. Travel and Tourism Advisory Board

Science.gov (United States)

2011-08-12

... DEPARTMENT OF COMMERCE International Trade Administration U.S. Travel and Tourism Advisory Board... to apply for membership on the U.S. Travel and Tourism Advisory Board. SUMMARY: The Department of Commerce is currently seeking applications for membership on the U.S. Travel and Tourism Advisory Board...

75 FR 59227 - U.S. Travel and Tourism Advisory Board

Science.gov (United States)

2010-09-27

... DEPARTMENT OF COMMERCE International Trade Administration U.S. Travel and Tourism Advisory Board... To Apply for Membership on the U.S. Travel and Tourism Advisory Board. SUMMARY: The Department of Commerce is currently seeking applications to fill three vacant positions on the U.S. Travel and Tourism...

26 CFR 301.6019-1 - Gift tax returns.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Gift tax returns. 301.6019-1 Section 301.6019-1... ADMINISTRATION PROCEDURE AND ADMINISTRATION Information and Returns Returns and Records § 301.6019-1 Gift tax returns. For provisions relating to requirement of gift tax returns, see §§ 25.6019-1 to 25.6019-4...

Travel medicine and mHealth technology: a study using smartphones to collect health data during travel.

Science.gov (United States)

Farnham, Andrea; Blanke, Ulf; Stone, Emily; Puhan, Milo A; Hatz, Christoph

2016-06-01

mHealth methodology such as smartphone applications offers new opportunities to capture the full range of health risks during travel in real time. Our study aims to widen the scope of travel health research in tropical and subtropical destinations by using a smartphone application to collect detailed information on health behaviours, clinical symptoms, accidents and environmental factors during travel. We enrolled travel clinic clients in Zurich and Basel ≥18 years of age travelling to Thailand for travel. Participants were equipped with a smartphone and an application that (1) actively administers a daily self-report questionnaire on the health risks, behaviours and symptoms the traveller encountered, and (2) passively collects information on the traveller's location and environmental conditions by transformation of raw GPS data. A prospective cohort of 101 travellers planning travel to Thailand between January and June 2015 was recruited. Of the 101 enrolled travellers, 75 (74.3%) answered at least one questionnaire during travel, 10 (9.9%) had technical difficulties and 16 (15.8%) dropped out. Those who completed questionnaires were a median of 27.0 years old (range 18-57). Travellers filled out a median of 12.0 questionnaires during their trip (range 1-30), corresponding to a median completion rate of 85.0% days of travel. The typical example of a healthy female traveller shows that many and diverse health issues arise during a trip that clusters on certain days. The rich data on behaviour and local environment may be used to explain the occurrence and clustering of health issues. Use of a smartphone app to collect health information is technically feasible and acceptable amongst a traveller population, minimizes recall bias and greatly increases the quality and quantity of data collected during travel. mHealth technology shows great potential for innovation in travel medicine. © International Society of Travel Medicine, 2016. All rights reserved

Pre-travel advice concerning vector-borne diseases received by travelers prior to visiting Cuzco, Peru.

Science.gov (United States)

Mejia, Christian R; Centeno, Emperatriz; Cruz, Briggitte; Cvetkovic-Vega, Aleksandar; Delgado, Edison; Rodriguez-Morales, Alfonso J

2016-01-01

Peru is an increasingly popular tourist destination that poses a risk to travelers due to endemic vector-borne diseases (VBDs). The objective of our study was to determine which factors are associated with receiving pre-travel advice (PTA) for VBDs among travelers visiting Cuzco, Peru. A cross-sectional secondary analysis based on data from a survey among travelers departing Cuzco at Alejandro Velazco Astete International Airport during the period January-March 2012 was conducted. From the 1819 travelers included in the original study, 1717 were included in secondary data analysis. Of these participants, 42.2% received PTA and 2.9% were informed about vector-borne diseases, including yellow fever (1.8%), malaria (1.6%) and dengue fever (0.1%). Receiving information on VBDs was associated with visiting areas endemic to yellow fever and dengue fever in Peru. The only disease travelers received specific recommendations for before visiting an endemic area for was yellow fever. Only 1 in 30 tourists received information on VBD prevention; few of those who traveled to an endemic area were warned about specific risks for infectious diseases prior to their trip. These important findings show that most tourists who travel to Peru do not receive PTA for the prevention of infectious and VBD, which can affect not only the travelers but their countries of origin as well. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

International Patients on Operation Vacation: Medical Refuge and Health System Crisis; Comment on “International Patients on Operation Vacation – Perspectives of Patients Travelling to Hungary for Orthopaedic Treatments”

Directory of Open Access Journals (Sweden)

Neil Lunt

2015-05-01

Full Text Available An understanding of patient mobility, international patients and medical tourism includes supply and demand side considerations. As well as micro-level reports of motivation and satisfaction we must acknowledge broader system-level dynamics. Exploring these may unearth more complex geographies of patient travel.

Many Healthy Returns

Centers for Disease Control (CDC) Podcasts

International travel is usually very safe but there are things you should do to stay safe and healthy. Experts show you how to avoid problems when visiting developing nations. This includes being cautious about the food you eat and the water you drink, and to be aware of vehicles and road conditions to prevent problems.

DCHA Travel & Mission Support System

Data.gov (United States)

US Agency for International Development — DTRAMS is a travel data collection system for DCHA that collects information on both the basic details of an employee's trips (destination, length, purpose, etc.)...

Closing the gap in travel medicine: reframing research questions for a new era.

Science.gov (United States)

Chen, Lin H; Leder, Karin; Wilson, Mary E

2017-07-01

Travel medicine needs are changing. New patterns of travel, including greater travel by individuals from emerging economies with different values in costs, risks and benefits, must be considered. This review aims to (1) highlight selected studies that have been published that address previously identified gaps in knowledge; (2) propose possible ways to consider questions regarding travel medicine practice for travelers from emerging economies, underscoring priorities for research focusing on these important populations; (3) highlight potential deficiencies in relevance of current international guidelines as they pertain to travelers from emerging economies; (4) frame research questions for travelers from emerging economies and (5) consider roles for ISTM in closing the gap. We reviewed past travel medicine research priorities published in 2010 to identify publications that responded to some research questions posed. We also reviewed CDC and WHO recommendations and assessed their applicability to travelers from emerging economies. Recent publications have responded to some research questions, but gaps remain and new questions have emerged. Re-framing of several key research questions is needed for travelers from emerging economies. A new challenge looms for traditional travel medicine fields to identify and attend to knowledge and guideline gaps, particularly to rethink questions regarding travel medicine to make them relevant for travelers from emerging economies. The International Society of Travel Medicine is well positioned to assist emerging economies assess their resources and needs, formulate research priorities and tailor the development of travel medicine into a framework aligned to their requirements. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

On the rate of return and risk factors to international oil companies in Iran's buy-back service contracts

International Nuclear Information System (INIS)

Ghandi, Abbas; Lin Lawell, C.-Y. Cynthia

2017-01-01

We analyze the rate of return (ROR) and risk factors faced by Shell Exploration, an international oil company (IOC), in its Soroosh and Nowrooz buy-back service contract in Iran. In particular, based on our models of cash flow, we analyze the buy-back contract specific risk factors that can contribute to a reduction in the rate of return for the international oil company. Our cash flow models resemble the cash flow of buy-back service contracts before the Iranian government changed the way it determined the capital cost ceiling and pre-defined the oil price in these contracts in 2008–2009. Our actual and contractual cash flow models reveal that Shell Exploration's actual ROR was much lower than the contractual level. Furthermore, we find that among the risk factors that we considered, a capital cost overrun has the greatest negative effect on the IOC's ROR. Moreover, we show that there is a potential for modifying the contracts in order for the IOC to face an actual ROR closer to the contractual ROR even if the contract faces cost overrun or delay, without exceeding the maximum contractual ROR that the National Iranian Oil Company is willing to give. - Highlights: • Buy-back contract specific risk factors can reduce the rate of return. • Shell Exploration's actual ROR was much lower than the contractual level. • A capital cost overrun has the greatest negative effect on the rate of return. • Contracts can be modified to better share the risk.

Mitigation of the threat posed to transfusion by donors traveling to Zika-affected areas: a Canadian risk-based approach.

Science.gov (United States)

Germain, Marc; Delage, Gilles; O'Brien, Sheila F; Grégoire, Yves; Fearon, Margaret; Devine, Dana

2017-10-01

The recent spread of the Zika virus to the Americas and the recognition that it can cause severe disease in the developing fetus has prompted the adoption of measures to mitigate the risk that this virus might pose to transfusion safety. In nonendemic countries, the risk to transfusion results from donors traveling to an endemic region. Canada implemented a 21-day temporary deferral for prospective donors who traveled to such regions. We present the rationale for this policy, including a quantitative risk assessment supported by a Monte Carlo simulation. The model considered the following parameters, each with specified values and ranges: the probability that a donor recently returned from a Zika-endemic region, the duration of travel to this region, the daily risk of acquiring Zika while in an endemic region, and the incubation and viremic periods. We ran the simulation 20 times, each with 10 million iterations. In the absence of any travel deferral, 32 donors (range, 20-46 donors) would be able to donate while still being at risk of transmitting Zika, corresponding to a rate of 1:312,500 (range, 1:217,000 to 1:500,000). None of these donors would be viremic beyond 21 days after returning from their travel, with a risk estimated at less than 1:200,000,000. A 21-day temporary travel deferral offers an extremely wide margin of safety for the possible transmission of Zika by a donation obtained from someone who recently returned from a country where the virus is circulating. © 2017 AABB.

26 CFR 49.4262(b)-1 - Exclusion of certain travel.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Exclusion of certain travel. 49.4262(b)-1... Exclusion of certain travel. (a) In general. Under section 4262(b) taxable transportation does not include... computing tax on travel not excluded. (1) Where a payment is made for transportation which includes...

Emerging infectious disease outbreaks: estimating disease risk in Australian blood donors travelling overseas.

Science.gov (United States)

Coghlan, A; Hoad, V C; Seed, C R; Flower, R Lp; Harley, R J; Herbert, D; Faddy, H M

2018-01-01

International travel assists spread of infectious pathogens. Australians regularly travel to South-eastern Asia and the isles of the South Pacific, where they may become infected with infectious agents, such as dengue (DENV), chikungunya (CHIKV) and Zika (ZIKV) viruses that pose a potential risk to transfusion safety. In Australia, donors are temporarily restricted from donating for fresh component manufacture following travel to many countries, including those in this study. We aimed to estimate the unmitigated transfusion-transmission (TT) risk from donors travelling internationally to areas affected by emerging infectious diseases. We used the European Up-Front Risk Assessment Tool, with travel and notification data, to estimate the TT risk from donors travelling to areas affected by disease outbreaks: Fiji (DENV), Bali (DENV), Phuket (DENV), Indonesia (CHIKV) and French Polynesia (ZIKV). We predict minimal risk from travel, with the annual unmitigated risk of an infected component being released varying from 1 in 1·43 million to disease outbreak areas to source plasma collection provides a simple and effective risk management approach. © 2017 International Society of Blood Transfusion.

GH Travel & Mission Support System

Data.gov (United States)

US Agency for International Development — HTRAMS is a travel data collection system for GH that collects information on both the basic details of an employee's trips (destination, length, purpose, etc.) and...

PPL Travel & Mission Support System

Data.gov (United States)

US Agency for International Development — PTRAMS is a travel data collection system for PPL that collects information on both the basic details of an employee's trips (destination, length, purpose, etc.) and...

Strategies to Mitigate the Negative and Accentuate the Positive Impacts of International Service-Learning on Host Communities

Directory of Open Access Journals (Sweden)

Shari Galiardi

2012-04-01

Full Text Available International service-learning can have a transformative effect on student participants, but little research has been done on the impact of these experiences on host communities. The authors make the case that an emphasis on intentional personal, cultural, and group preparation is imperative to have the best possible impact on both the student and host community. Overarching strategies include: 1 preparing students for their experience prior to departure from both an individual and group development perspective; 2 designing reflection activities and discussions that include members of the host community; 3 facilitating open conversations about equitable relationships, international perspectives of Americans, and potential negative effects the group could have on the host community; 4 providing opportunities for post-travel dialogue and personal action plans for re-engaging with the local community upon return. The authors draw from both theoretical frameworks and many years of experience traveling abroad with students to underpin the strategies outlined in this article. KEYWORDSservice-learning; group development; international

Enquiries to the United Kingdom National Travel Advice Line by healthcare professionals regarding immunocompromised travellers.

Science.gov (United States)

Allen, Joanna E; Patel, Dipti

2016-03-01

travellers. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

77 FR 56811 - United States Travel and Tourism Advisory Board; Meeting

Science.gov (United States)

2012-09-14

... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism... the United States Travel and Tourism Advisory Board (Board). The Board will meet to present updates on... implementation of the National Travel and Tourism Strategy and the progress on implementing the President's...

An Integrated Model to Explain Inter-Relationships in Travel ...

African Journals Online (AJOL)

This study focuses on the decision making process of international tourists traveling to Tanzania. An integrated approach is proposed to understand the interrelationships among tourist motivations, expectations, place identity and place dependence. Specifically, travel motivations directly affect tourist's expectations and ...

76 FR 63574 - Tax Return Preparer Penalties Under Section 6695; Correction

Science.gov (United States)

2011-10-13

... Tax Return Preparer Penalties Under Section 6695; Correction AGENCY: Internal Revenue Service (IRS... to the tax return preparer penalties under section 6695 of the Internal Revenue Code. The proposed regulations are necessary to monitor and to improve compliance with the tax return preparer due to diligence...

Travellers and influenza: risks and prevention.

Science.gov (United States)

Goeijenbier, M; van Genderen, P; Ward, B J; Wilder-Smith, A; Steffen, R; Osterhaus, A D M E

2017-01-01

Influenza viruses are among the major causes of serious human respiratory tract infection worldwide. In line with the high disease burden attributable to influenza, these viruses play an important, but often neglected, role in travel medicine. Guidelines and recommendations regarding prevention and management of influenza in travellers are scarce. Of special interest for travel medicine are risk populations and also circumstances that facilitate influenza virus transmission and spread, like travel by airplane or cruise ship and mass gatherings. We conducted a PUBMED/MEDLINE search for a combination of the MeSH terms Influenza virus, travel, mass gathering, large scale events and cruise ship. In addition we gathered guidelines and recommendations from selected countries and regarding influenza prevention and management in travellers. By reviewing these search results in the light of published knowledge in the fields of influenza prevention and management, we present best practice advice for the prevention and management of influenza in travel medicine. Seasonal influenza is among the most prevalent infectious diseases in travellers. Known host-associated risk factors include extremes of age and being immune-compromised, while the most relevant environmental factors are associated with holiday cruises and mass gatherings. Pre-travel advice should address influenza and its prevention for travellers, whenever appropriate on the basis of the epidemiological situation concerned. Preventative measures should be strongly recommended for travellers at high-risk for developing complications. In addition, seasonal influenza vaccination should be considered for any traveller wishing to reduce the risk of incapacitation, particularly cruise ship crew and passengers, as well as those participating in mass gatherings. Besides advice concerning preventive measures and vaccination, advice on the use of antivirals may be considered for some travellers. © International Society of

The absolute risk of venous thrombosis after air travel: a cohort study of 8,755 employees of international organisations.

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Saskia Kuipers

2007-09-01

Full Text Available BACKGROUND: The risk of venous thrombosis is approximately 2- to 4-fold increased after air travel, but the absolute risk is unknown. The objective of this study was to assess the absolute risk of venous thrombosis after air travel. METHODS AND FINDINGS: We conducted a cohort study among employees of large international companies and organisations, who were followed between 1 January 2000 and 31 December 2005. The occurrence of symptomatic venous thrombosis was linked to exposure to air travel, as assessed by travel records provided by the companies and organisations. A long-haul flight was defined as a flight of at least 4 h and participants were considered exposed for a postflight period of 8 wk. A total of 8,755 employees were followed during a total follow-up time of 38,910 person-years (PY. The total time employees were exposed to a long-haul flight was 6,872 PY. In the follow-up period, 53 thromboses occurred, 22 of which within 8 wk of a long-haul flight, yielding an incidence rate of 3.2/1,000 PY, as compared to 1.0/1,000 PY in individuals not exposed to air travel (incidence rate ratio 3.2, 95% confidence interval 1.8-5.6. This rate was equivalent to a risk of one event per 4,656 long-haul flights. The risk increased with exposure to more flights within a short time frame and with increasing duration of flights. The incidence was highest in the first 2 wk after travel and gradually decreased to baseline after 8 wk. The risk was particularly high in employees under age 30 y, women who used oral contraceptives, and individuals who were particularly short, tall, or overweight. CONCLUSIONS: The risk of symptomatic venous thrombosis after air travel is moderately increased on average, and rises with increasing exposure and in high-risk groups.

Hepatitis A in Hispanic children who live along the United States-Mexico border: the role of international travel and food-borne exposures.