Accidents occur more frequently in developing countries and the outcome may be more serious because of access to health care and health care quality. For example road deaths in low and middle income countries are 20 per 100,000 compared with 10 per 100,000 in high income countries.
A study of medical students travelling that was presented at the ISTM conference showed that 1% had road traffic accidents and 6.5% had other incidents involving personal safety and theft.
Monkey bites are surprisingly common among New Zealanders visiting Asia. It is sensible to stay away from monkeys and certainly not to feed them. If bitten wash the injury for at least 15 minutes then see a doctor as you will need rabies vaccinations and maybe antibiotics and a tetanus booster. It is not well known that macaque monkeys may carry a virus similar to herpes called herpes B virus. The illness has only been seen in humans infected by macaques in captivity so it is not really known if wild ones transmit it or not. Treatment with antiviral tablets may be taken after a bite to lower the risk of this infection.
Another CISTM session was on Traveller’s diarrhoea the most common problem of travellers. The bacterial causes of diarrhoea are becoming increasingly resistant to antibiotics so harder to treat. In addition recent studies have shown that travellers who take antibiotics to treat traveller’s diarrhoea are more likely to carry resistant bacteria in their bowel after they return home. So we should perhaps reserve antibiotics for diarrhoea for severe cases only.
A study was presented at the CISTM that showed a high rate of altitude illness among trekkers on Kili. Those who knew about altitude illness, took acetazolamide (diamox) and ascended over more than 5 days had fewer problems. Interestingly those who had done specific pretravel training had serious altitude illness more often than others perhaps because they attempted the climb more quickly because of their training.
In late May I was fortunate to attend the Conference of the International Society of Travel Medicine in beautiful Quebec. This meeting is held every 2 years and is the premier travel medicine conference. With 126 oral presentations and 132 posters I was spoilt for choice and my only complaint was the usual difficulty deciding which session to attend when 5 were happening concurrently. In my blog I will share with you some of the many things I learnt at the meeting.
Cruise Ship Travel
Norovirus can be a nuisance on cruise ships and a speaker recommended that you use your own cabin bathroom rather than shared ones if there is an outbreak. As alcohol hand wash doesn’t reliably kill norovirus it is better to wash hands than rely on alcohol hand wash. Washing should last 20 seconds (which is singing Happy Birthday through twice!)
The speakers weren’t very keen on scopoderm patches for seasickness preferring antihistamines.