C. Sujatha, S. L. Krishnankutty, Khalid Khader, Anju K. Kanmani, A. Rahul, M. Suresh, R. Sudha, P. Indu
Introduction: As part of coronavirus disease 2019 (COVID-19) control strategies, entry screening was established at International airports. An assessment of the screening system will inform decision-making for improving entry screening for infectious diseases.
{"title":"Entry Screening at Airport as a COVID-19 Surveillance Tool: Evaluation of Thiruvananthapuram International Airport in Kerala, India","authors":"C. Sujatha, S. L. Krishnankutty, Khalid Khader, Anju K. Kanmani, A. Rahul, M. Suresh, R. Sudha, P. Indu","doi":"10.34172/ijtmgh.2021.13","DOIUrl":"https://doi.org/10.34172/ijtmgh.2021.13","url":null,"abstract":"Introduction: As part of coronavirus disease 2019 (COVID-19) control strategies, entry screening was established at International airports. An assessment of the screening system will inform decision-making for improving entry screening for infectious diseases.","PeriodicalId":32539,"journal":{"name":"International Journal of Travel Medicine and Global Health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69814851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Primary care practitioners and travel medicine physicians are primarily responsible for identifying individuals who may be unfit for overseas travel and consulting with them pre-travel. Pre-existing medical conditions such as cardiovascular disease, chronic respiratory conditions and diabetes mellitus (DM) have the potential to complicate travel journeys. A considerable percentage of travel-associated illness may be due to the decompensation of a pre-existing medical condition. This review seeks to address the challenges faced by travellers with each of these conditions, including recently updated and evidence-based practical approaches for travel with comorbidities. Methods: Sources for this review were identified through searches of PubMed/Google Scholar for materials published between 1st January 2000 and 31st December 2019, using combinations of search terms. Results: The volume of literature on travelling with a pre-existing condition exploded with more than 865 associated articles indexed on the PubMed alone as of March 2020. After screening titles, abstracts and, in some cases, the full text version of indexed articles, 121 articles were deemed relevant to the subject matter of this review. Conclusion: Rational approaches to pre-planning for travel with a medical condition will contribute to the prevention of problems while in transit as well as when at the travel destination. It is imperative for health care providers to be aware of the preventative measures and current recommendations that should be taken before and during travel to protect individuals with a chronic illness. Further research and studies should be directed to protect this vulnerable group of travellers.
{"title":"International Travel With a Chronic Medical Illness – Health Risks, Practical Challenges and Evidence-Based Recommendations","authors":"M. Darrat, G. Flaherty","doi":"10.34172/ijtmgh.2021.09","DOIUrl":"https://doi.org/10.34172/ijtmgh.2021.09","url":null,"abstract":"Introduction: Primary care practitioners and travel medicine physicians are primarily responsible for identifying individuals who may be unfit for overseas travel and consulting with them pre-travel. Pre-existing medical conditions such as cardiovascular disease, chronic respiratory conditions and diabetes mellitus (DM) have the potential to complicate travel journeys. A considerable percentage of travel-associated illness may be due to the decompensation of a pre-existing medical condition. This review seeks to address the challenges faced by travellers with each of these conditions, including recently updated and evidence-based practical approaches for travel with comorbidities. Methods: Sources for this review were identified through searches of PubMed/Google Scholar for materials published between 1st January 2000 and 31st December 2019, using combinations of search terms. Results: The volume of literature on travelling with a pre-existing condition exploded with more than 865 associated articles indexed on the PubMed alone as of March 2020. After screening titles, abstracts and, in some cases, the full text version of indexed articles, 121 articles were deemed relevant to the subject matter of this review. Conclusion: Rational approaches to pre-planning for travel with a medical condition will contribute to the prevention of problems while in transit as well as when at the travel destination. It is imperative for health care providers to be aware of the preventative measures and current recommendations that should be taken before and during travel to protect individuals with a chronic illness. Further research and studies should be directed to protect this vulnerable group of travellers.","PeriodicalId":32539,"journal":{"name":"International Journal of Travel Medicine and Global Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44577903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Children are frequent international travelers and may acquire serious infectious diseases during travel. We undertook a retrospective 10-year review examining children admitted to hospital with infectious diseases associated with international travel at a Canadian tertiary care pediatric hospital. Methods: Retrospective chart review was performed on select travel-related infectious diseases in children ranging in age from birth to <18 years who were admitted at the Hospital for Sick Children in Toronto between January 1st, 2009 and December 31st, 2018. Cases were identified using ICD-10 discharge codes. Patient demographics, travel history, epidemiological data, disease, and prophylaxis history were documented. Results: A total of 154 children were hospitalized with a travel-related infection over a 10-year period. The most common diagnoses were typhoid or paratyphoid fever (n = 58, 38%), malaria (n = 57, 37%), and hepatitis A (n = 14, 8%). The median age of those infected was 8 years (IQR 3-12). There were 120 (78%) children who were Canadian born, 31 (20%) immigrants and 3 (2%) who were visiting Canada. Of those who lived in Canada, 112 (90%) travelled for the purpose of visiting friends and relatives (VFR), 6 (5%) for tourism and 2 (2%) for humanitarian work. India was typically known for the acquisition of infection for typhoid or paratyphoid fever, and Nigeria for malaria. Hepatitis A was most commonly acquired in Pakistan. Conclusion: Imported infectious diseases continue to be a significant issue in travelers returning from trips suggesting improved preventative pre-travel care. VFR children are a group that should, in particular, be targeted for appropriate pre-travel advice and care.
{"title":"Infectious Disease Acquisition in Pediatric International Travelers: A 10-Year Review at a Canadian Tertiary Care Hospital","authors":"Stavros Lalos, Daniel S. Farrar, S. Morris","doi":"10.34172/IJTMGH.2021.05","DOIUrl":"https://doi.org/10.34172/IJTMGH.2021.05","url":null,"abstract":"Introduction: Children are frequent international travelers and may acquire serious infectious diseases during travel. We undertook a retrospective 10-year review examining children admitted to hospital with infectious diseases associated with international travel at a Canadian tertiary care pediatric hospital. \u0000Methods: Retrospective chart review was performed on select travel-related infectious diseases in children ranging in age from birth to <18 years who were admitted at the Hospital for Sick Children in Toronto between January 1st, 2009 and December 31st, 2018. Cases were identified using ICD-10 discharge codes. Patient demographics, travel history, epidemiological data, disease, and prophylaxis history were documented. \u0000Results: A total of 154 children were hospitalized with a travel-related infection over a 10-year period. The most common diagnoses were typhoid or paratyphoid fever (n = 58, 38%), malaria (n = 57, 37%), and hepatitis A (n = 14, 8%). The median age of those infected was 8 years (IQR 3-12). There were 120 (78%) children who were Canadian born, 31 (20%) immigrants and 3 (2%) who were visiting Canada. Of those who lived in Canada, 112 (90%) travelled for the purpose of visiting friends and relatives (VFR), 6 (5%) for tourism and 2 (2%) for humanitarian work. India was typically known for the acquisition of infection for typhoid or paratyphoid fever, and Nigeria for malaria. Hepatitis A was most commonly acquired in Pakistan. \u0000Conclusion: Imported infectious diseases continue to be a significant issue in travelers returning from trips suggesting improved preventative pre-travel care. VFR children are a group that should, in particular, be targeted for appropriate pre-travel advice and care.","PeriodicalId":32539,"journal":{"name":"International Journal of Travel Medicine and Global Health","volume":"9 1","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43127364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: This study reports the global occurrence of passenger and crew mortality on cruise ships. To date, no comprehensive study of passenger and crew mortality has been published. Methods: All data on passenger and crew mortality between 2000 and 2019 were obtained from 78 ocean and river cruise lines registered globally and analyzed by their age, gender, nationality, cruise line, and recorded cause of death. Results: There were 623 reported deaths. Out of all deaths, 89% were passenger deaths and 11% were crew deaths. United States residents accounted for 61% of passenger deaths and crew from India (18%) and the Philippines (17%) recorded the highest crew deaths. Falls overboard or onto lower decks (23%), suicide, murder, and a terror attack (19%), unspecified natural causes (18%), and cardiac incidents (16%) were the primary causes of passenger deaths. Suicide and murder (29%) and falls overboard or from height (24%) were the primary cause of crew member deaths. The most passenger deaths occurred on Carnival Cruise Lines (29%), Royal Caribbean Cruises (12%), and Norwegian Cruise Line (10%). The highest crew member deaths occurred on Carnival Cruise Line (19%) and Royal Caribbean Cruises (19%). Conclusion: Falls overboard or onto lower decks, cardiac incidents, and suicides are the leading cause of passenger deaths. Suicide and murder and falls are the leading cause of death for crew members. Travel health advisories targeting US citizen passengers and crew members from India and the Philippines are warranted. The addition of mental health care to ship infirmaries is also suggested.
{"title":"Death at Sea: Passenger and Crew Mortality on Cruise Ships","authors":"T. Heggie, Tracey Burton-Heggie","doi":"10.34172/IJTMGH.2020.25","DOIUrl":"https://doi.org/10.34172/IJTMGH.2020.25","url":null,"abstract":"Introduction: This study reports the global occurrence of passenger and crew mortality on cruise ships. To date, no comprehensive study of passenger and crew mortality has been published. Methods: All data on passenger and crew mortality between 2000 and 2019 were obtained from 78 ocean and river cruise lines registered globally and analyzed by their age, gender, nationality, cruise line, and recorded cause of death. Results: There were 623 reported deaths. Out of all deaths, 89% were passenger deaths and 11% were crew deaths. United States residents accounted for 61% of passenger deaths and crew from India (18%) and the Philippines (17%) recorded the highest crew deaths. Falls overboard or onto lower decks (23%), suicide, murder, and a terror attack (19%), unspecified natural causes (18%), and cardiac incidents (16%) were the primary causes of passenger deaths. Suicide and murder (29%) and falls overboard or from height (24%) were the primary cause of crew member deaths. The most passenger deaths occurred on Carnival Cruise Lines (29%), Royal Caribbean Cruises (12%), and Norwegian Cruise Line (10%). The highest crew member deaths occurred on Carnival Cruise Line (19%) and Royal Caribbean Cruises (19%). Conclusion: Falls overboard or onto lower decks, cardiac incidents, and suicides are the leading cause of passenger deaths. Suicide and murder and falls are the leading cause of death for crew members. Travel health advisories targeting US citizen passengers and crew members from India and the Philippines are warranted. The addition of mental health care to ship infirmaries is also suggested.","PeriodicalId":32539,"journal":{"name":"International Journal of Travel Medicine and Global Health","volume":"8 1","pages":"146-151"},"PeriodicalIF":0.0,"publicationDate":"2020-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43727777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Pretravel health assessments aim to promote risk reduction through preventive measures and safe behaviour. It also ensures that travellers are up-to-date with travel vaccine uptake. However, studies assess pretravel health-seeking practices from a variety of medical and nonmedical sources and vaccine uptake prior to travel to both developing and developed countries. The present study was an effort to address the awareness and practice of pre-travel health care among medical interns of a tertiary care hospital. Methods: A cross-sectional study was carried out in medical interns of tertiary care hospital. Study participants were Bachelor of Medicine and Bachelor of Surgery (MBBS) interns posted in the preventive medicine departments during the internship program in the same hospital. Awareness and practice of pre-travel health were assessed with help of a preformed self-assessment questionnaire. Results: Study had 59 (53.6%) males and 51 (46.4%) female respondents. All were of Indian origin and 69 (62.7%) had travelled internationally in the last 5 years. The mean age of study participants was 23.3±1.3yrs with range of 23-30 years. The majority (69.6%) of them had travelled abroad for holiday purposes. Most (73.9%) of them had travelled with family members. Out of 69 who had travelled internationally, 47 (68.1%) had visited a doctor for travel health advice prior to the trip and 29 (42%) had taken the required vaccination for the destination countries in their last international travels. The age and sex of the respondents did not have any statistically significant influence on the uptake of the travel vaccine. Conclusion: Study findings revealed inadequate awareness and practice of travel medicine among medical interns.
{"title":"Travel Health - Gaps in Awareness and Practices Among Medical Interns of a Tertiary Care Hospital in India","authors":"J. Landge, Kajal Shrivastava, Swati Ghonge","doi":"10.34172/IJTMGH.2020.26","DOIUrl":"https://doi.org/10.34172/IJTMGH.2020.26","url":null,"abstract":"Introduction: Pretravel health assessments aim to promote risk reduction through preventive measures and safe behaviour. It also ensures that travellers are up-to-date with travel vaccine uptake. However, studies assess pretravel health-seeking practices from a variety of medical and nonmedical sources and vaccine uptake prior to travel to both developing and developed countries. The present study was an effort to address the awareness and practice of pre-travel health care among medical interns of a tertiary care hospital. Methods: A cross-sectional study was carried out in medical interns of tertiary care hospital. Study participants were Bachelor of Medicine and Bachelor of Surgery (MBBS) interns posted in the preventive medicine departments during the internship program in the same hospital. Awareness and practice of pre-travel health were assessed with help of a preformed self-assessment questionnaire. Results: Study had 59 (53.6%) males and 51 (46.4%) female respondents. All were of Indian origin and 69 (62.7%) had travelled internationally in the last 5 years. The mean age of study participants was 23.3±1.3yrs with range of 23-30 years. The majority (69.6%) of them had travelled abroad for holiday purposes. Most (73.9%) of them had travelled with family members. Out of 69 who had travelled internationally, 47 (68.1%) had visited a doctor for travel health advice prior to the trip and 29 (42%) had taken the required vaccination for the destination countries in their last international travels. The age and sex of the respondents did not have any statistically significant influence on the uptake of the travel vaccine. Conclusion: Study findings revealed inadequate awareness and practice of travel medicine among medical interns.","PeriodicalId":32539,"journal":{"name":"International Journal of Travel Medicine and Global Health","volume":"8 1","pages":"152-156"},"PeriodicalIF":0.0,"publicationDate":"2020-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43361755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Typhoid fever is a potential febrile illness caused by Salmonella enterica serovar Typhi. It is mainly transmitted through contaminated food and water, and spreads from infected persons and chronic carriers. Humans are the only reservoir host. There were many multi-drug resistant S. Typhi cases reported in many parts of South Asia and Africa. However, since 2016there were reported case series of extended drug resistant S. Typhi from Pakistan (resistant to chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, fluoroquinolones and third generation cephalosporines). Genomic sequencing analysis of this organism was of haplotype H58 transmitted by a plasmid. Case Presentation: This is the first reported case of ceftriaxone-resistant typhoid fever in the Middle-East, who travelled from Pakistan to Qatar in September 2019. He recovered completely with injection meropenem and oral azithromycin. Conclusion: A detailed travel history and early diagnosis and treatment with appropriate drugs are inevitable in the management of such cases. Safe drinking water, improved sanitation and effective public health infrastructure will play a key role in the control of the disease.
{"title":"First Reported Case of Ceftriaxone-Resistant Typhoid Fever in the Middle-East","authors":"G. Bharathan, Binoy Kurian","doi":"10.34172/IJTMGH.2021.07","DOIUrl":"https://doi.org/10.34172/IJTMGH.2021.07","url":null,"abstract":"Introduction: Typhoid fever is a potential febrile illness caused by Salmonella enterica serovar Typhi. It is mainly transmitted through contaminated food and water, and spreads from infected persons and chronic carriers. Humans are the only reservoir host. There were many multi-drug resistant S. Typhi cases reported in many parts of South Asia and Africa. However, since 2016there were reported case series of extended drug resistant S. Typhi from Pakistan (resistant to chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, fluoroquinolones and third generation cephalosporines). Genomic sequencing analysis of this organism was of haplotype H58 transmitted by a plasmid. Case Presentation: This is the first reported case of ceftriaxone-resistant typhoid fever in the Middle-East, who travelled from Pakistan to Qatar in September 2019. He recovered completely with injection meropenem and oral azithromycin. Conclusion: A detailed travel history and early diagnosis and treatment with appropriate drugs are inevitable in the management of such cases. Safe drinking water, improved sanitation and effective public health infrastructure will play a key role in the control of the disease.","PeriodicalId":32539,"journal":{"name":"International Journal of Travel Medicine and Global Health","volume":"9 1","pages":"39-41"},"PeriodicalIF":0.0,"publicationDate":"2020-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44810957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Quigley, P. Nguyen, Haley Stone, Samsung Lim, C. Macintyre
Introduction: Cruise ship linked COVID-19 outbreaks have been identified as a potential source of community transmission of COVID-19 in Australia and worldwide. The risk factors and potential mitigation around COVID-19 infections on cruise ships and communities is a research gap. Methods: A correlation and regression analyses for risk factors for COVID-19 attack rates oncruise ships worldwide with reported COVID-19 from January 1, 2020 to May 11, 2020 were performed, with a more detailed analysis done for Australia. Geospatial emerging hot spot analysis during key time periods was used to assess temporal trends in spatial clustering of COVID-19 cases related to two cruise ship events in NSW, Australia. Results: For 36 cruise ships with global COVID-19 cases, available cabins had a moderate inverse correlation with the attack rate (-0.4154; 95% CI [-0.0002, -0.00003], P < 0.0118). The number of cabins, the number of decks with cabins, and passenger-to-space ratio were significantly associated with attack rate, however, the duration at sea was not. By May 2020, cruise ship passengers made up 14.9% of COVID-19 cases in Australia and 27% of the COVID-19 related deaths. Emerging hot spots of community transmission in Sydney occurred during 1-2 incubation periods of two cruise ship events. Conclusion: Mitigation of risk on cruise ships should focus on spatial design and reducing crowding, including rapid surveillance and on-board testing. To mitigate this risk during the era of COVID-19, all passengers disembarking an infected ship should be quarantined for at least the 14-day window period and tested for COVID-19, regardless of symptoms. Vaccination should be a pre-requisite for travel of any kind once available.
导言:与游轮相关的COVID-19疫情已被确定为澳大利亚和全球COVID-19社区传播的潜在来源。邮轮和社区上COVID-19感染的风险因素和潜在缓解措施是一个研究空白。方法:对2020年1月1日至2020年5月11日全球报告新型冠状病毒感染的游轮上COVID-19发病率的危险因素进行相关和回归分析，并对澳大利亚进行了更详细的分析。采用关键时间段的地理空间新兴热点分析，评估与澳大利亚新南威尔士州两起游轮事件相关的COVID-19病例空间聚类的时间趋势。结果:在全球有COVID-19病例的36艘游轮中，可用客舱与发病率呈中度负相关(-0.4154;95% ci [-0.0002， -0.00003]， p < 0.0118)。客舱数、客舱甲板数和客舱空间比与攻击率显著相关，但在海上停留的时间与攻击率无显著相关。截至2020年5月，游轮乘客占澳大利亚COVID-19病例的14.9%，占COVID-19相关死亡人数的27%。悉尼新出现的社区传播热点出现在两次游轮事件的1-2个潜伏期。结论:降低邮轮风险的重点应放在空间设计和减少拥挤上，包括快速监测和船上测试。为了在2019冠状病毒病期间降低这种风险，所有从受感染船舶上岸的乘客，无论出现什么症状，都应被隔离至少14天，并接受COVID-19检测。接种疫苗应是任何旅行的先决条件。
{"title":"Cruise Ship Travel and the Spread of COVID-19 – Australia as a Case Study","authors":"A. Quigley, P. Nguyen, Haley Stone, Samsung Lim, C. Macintyre","doi":"10.34172/IJTMGH.2021.03","DOIUrl":"https://doi.org/10.34172/IJTMGH.2021.03","url":null,"abstract":"Introduction: Cruise ship linked COVID-19 outbreaks have been identified as a potential source of community transmission of COVID-19 in Australia and worldwide. The risk factors and potential mitigation around COVID-19 infections on cruise ships and communities is a research gap. Methods: A correlation and regression analyses for risk factors for COVID-19 attack rates oncruise ships worldwide with reported COVID-19 from January 1, 2020 to May 11, 2020 were performed, with a more detailed analysis done for Australia. Geospatial emerging hot spot analysis during key time periods was used to assess temporal trends in spatial clustering of COVID-19 cases related to two cruise ship events in NSW, Australia. Results: For 36 cruise ships with global COVID-19 cases, available cabins had a moderate inverse correlation with the attack rate (-0.4154; 95% CI [-0.0002, -0.00003], P < 0.0118). The number of cabins, the number of decks with cabins, and passenger-to-space ratio were significantly associated with attack rate, however, the duration at sea was not. By May 2020, cruise ship passengers made up 14.9% of COVID-19 cases in Australia and 27% of the COVID-19 related deaths. Emerging hot spots of community transmission in Sydney occurred during 1-2 incubation periods of two cruise ship events. Conclusion: Mitigation of risk on cruise ships should focus on spatial design and reducing crowding, including rapid surveillance and on-board testing. To mitigate this risk during the era of COVID-19, all passengers disembarking an infected ship should be quarantined for at least the 14-day window period and tested for COVID-19, regardless of symptoms. Vaccination should be a pre-requisite for travel of any kind once available.","PeriodicalId":32539,"journal":{"name":"International Journal of Travel Medicine and Global Health","volume":"9 1","pages":"10-18"},"PeriodicalIF":0.0,"publicationDate":"2020-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45346182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An outbreak of coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (SARS-CoV-2) has created a global health crisis.1 Globally, there have been more than 53 million confirmed cases causing more than 1.2 million deaths.2 Although the World Health Organization (WHO) reports an overall decrease in weekly cases in Southeast Asia, COVID-19 cases are rising sharply in Nepal.3 As of November 12, 2020, Nepal has documented the pandemic in all seven provinces and 77 districts, confirming 204 242 cases and 1189 deaths (Figure 1).4 Out of the total number of confirmed cases, 164 592 cases have recovered while 38461 active cases are in self-quarantine via home isolation. Among critically ill patients with COVID-19, 379 are in the intensive care unit (ICU) from which 78 cases are on ventilation support.2,4 Due to the limited critical care delivery infrastructure, the COVID-19 pandemic has caused an unparalleled health crisis in Nepal. There is a lack of adequate PPE (personal protective equipment), standardized quarantine and isolation system, and insufficient testing kits for SARS-CoV-2 detection in the laboratory creating health havoc nationwide. Since the government has lifted the nearly four-month lockdown, the numbers of COVID-19 infected cases and death tolls are skyrocketing in Nepal. To identify people infected with SARS-CoV-2 and prevent the further spread of the disease, diagnostic testing remains crucial.5 Currently, a total of 67 COVID-19 designated diagnostic laboratories in Nepal, of which approximately a third are from the private sector. With the rise of newly infected cases throughout the nation, most of the diagnostic laboratories are facing shortages of reagent supply, instrument access, and increased staffing needs. Consequently, swab samples collected for testing are being piled up in the laboratories resulting in a serious delay in sample processing and their results.6,7 This situation has further resulted in frustration, boredom, and infection fears among people living in various quarantine and isolation centers across the country. The ongoing, unprecedented outbreak of COVID-19 is straining the laboratory services and other areas of healthcare interventions in Nepal. Even though the WHO considers the necessity for countries to prioritize diagnostic testing to contain the coronavirus spread,8 Nepalese government is not doing adequate testing while lacking timely decisions that are based on scientific evidence.9 Adequate testing means fewer people in unnecessary quarantine, lower load on hospitals, and faster contact tracing accordingly preventing onward transmission and spread of the disease. Therefore, the government of Nepal should emphasize more on molecular diagnostic technologies for COVID-19 and make the diagnostic facilities affordable and accessible in all districts of Nepal. Additionally, to limit the socio-economic and mental health burden of the ongoing pandemic,9 both the states and the federal government in htt
由新型冠状病毒（SARS-CoV-2）引起的2019冠状病毒病（新冠肺炎）的爆发引发了全球健康危机。1全球确诊病例超过5300万例，导致120多万人死亡。2尽管世界卫生组织（世界卫生组织）报告东南亚每周病例总体下降，新冠肺炎病例在尼泊尔急剧上升。3截至2020年11月12日，尼泊尔在所有七个省和77个区记录了疫情，确认了204242例病例和1189例死亡（图1）。4在确诊病例总数中，164592例病例已康复，38461例活跃病例正在通过居家隔离进行自我隔离。在新冠肺炎危重症患者中，379人在重症监护室（ICU），78人在那里接受通气支持。2,4由于重症监护基础设施有限，新冠肺炎大流行在尼泊尔造成了前所未有的健康危机。缺乏足够的个人防护装备、标准化的检疫和隔离系统，实验室检测严重急性呼吸系统综合征冠状病毒2型的检测试剂盒不足，这在全国范围内造成了健康灾难。自从政府解除近四个月的封锁以来，新冠肺炎感染病例和死亡人数在尼泊尔飙升。为了识别感染SARS-CoV-2的人并防止疾病的进一步传播，诊断检测仍然至关重要。5目前，尼泊尔共有67个新冠肺炎指定诊断实验室，其中约三分之一来自私营部门。随着全国新感染病例的增加，大多数诊断实验室都面临试剂供应短缺、仪器使用短缺和人员需求增加的问题。因此，为检测而采集的拭子样本被堆积在实验室中，导致样本处理及其结果严重延迟。6,7这种情况进一步导致了居住在全国各地隔离中心的人们的沮丧、无聊和感染恐惧。持续的、前所未有的新冠肺炎疫情给尼泊尔的实验室服务和其他医疗干预领域带来了压力。尽管世界卫生组织认为各国有必要优先进行诊断检测以遏制冠状病毒的传播，但8尼泊尔政府没有进行足够的检测，同时缺乏基于科学证据的及时决定，更快地追踪接触者，从而防止疾病的进一步传播和传播。因此，尼泊尔政府应更加重视新冠肺炎的分子诊断技术，并使诊断设施在尼泊尔所有地区都能负担得起和使用。此外，为了限制持续疫情的社会经济和心理健康负担，9各州和联邦政府http://ijtmgh.comInt J Travel Med Glob Health。2020年11月；8（4）：174-175 doi 10.34172/ijtmgh.2020.30 TMGH IInternational Journal of Travel Medicine and Global Health J
{"title":"COVID-19 in Nepal: Diagnostic and Management Dilemma","authors":"P. Subedi, Rajiv Khadge, S. Timilsina, K. Poudel","doi":"10.34172/IJTMGH.2020.30","DOIUrl":"https://doi.org/10.34172/IJTMGH.2020.30","url":null,"abstract":"An outbreak of coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (SARS-CoV-2) has created a global health crisis.1 Globally, there have been more than 53 million confirmed cases causing more than 1.2 million deaths.2 Although the World Health Organization (WHO) reports an overall decrease in weekly cases in Southeast Asia, COVID-19 cases are rising sharply in Nepal.3 As of November 12, 2020, Nepal has documented the pandemic in all seven provinces and 77 districts, confirming 204 242 cases and 1189 deaths (Figure 1).4 Out of the total number of confirmed cases, 164 592 cases have recovered while 38461 active cases are in self-quarantine via home isolation. Among critically ill patients with COVID-19, 379 are in the intensive care unit (ICU) from which 78 cases are on ventilation support.2,4 Due to the limited critical care delivery infrastructure, the COVID-19 pandemic has caused an unparalleled health crisis in Nepal. There is a lack of adequate PPE (personal protective equipment), standardized quarantine and isolation system, and insufficient testing kits for SARS-CoV-2 detection in the laboratory creating health havoc nationwide. Since the government has lifted the nearly four-month lockdown, the numbers of COVID-19 infected cases and death tolls are skyrocketing in Nepal. To identify people infected with SARS-CoV-2 and prevent the further spread of the disease, diagnostic testing remains crucial.5 Currently, a total of 67 COVID-19 designated diagnostic laboratories in Nepal, of which approximately a third are from the private sector. With the rise of newly infected cases throughout the nation, most of the diagnostic laboratories are facing shortages of reagent supply, instrument access, and increased staffing needs. Consequently, swab samples collected for testing are being piled up in the laboratories resulting in a serious delay in sample processing and their results.6,7 This situation has further resulted in frustration, boredom, and infection fears among people living in various quarantine and isolation centers across the country. The ongoing, unprecedented outbreak of COVID-19 is straining the laboratory services and other areas of healthcare interventions in Nepal. Even though the WHO considers the necessity for countries to prioritize diagnostic testing to contain the coronavirus spread,8 Nepalese government is not doing adequate testing while lacking timely decisions that are based on scientific evidence.9 Adequate testing means fewer people in unnecessary quarantine, lower load on hospitals, and faster contact tracing accordingly preventing onward transmission and spread of the disease. Therefore, the government of Nepal should emphasize more on molecular diagnostic technologies for COVID-19 and make the diagnostic facilities affordable and accessible in all districts of Nepal. Additionally, to limit the socio-economic and mental health burden of the ongoing pandemic,9 both the states and the federal government in htt","PeriodicalId":32539,"journal":{"name":"International Journal of Travel Medicine and Global Health","volume":"8 1","pages":"174-175"},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47230523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Sandell, Anne Regine Skogen, T. Lier, F. O. Pettersen
Introduction: Zoonotic Onchocerca lupi infection is a rare but emerging zoonotic disease affecting the eye, subcutaneous tissue and subdural cervical spine. Endemic areas of O. lupi are East and Central Europe, Turkey, Iran and the Northwest of the USA. Thirteen confirmed cases have been published in the world literature. Case Presentation: We present a case of subconjunctival O. lupi infection in the left eye of a Norwegian male. The infection was most likely imported from Turkey. The diagnosis was verified by direct microscopy and molecular analyses with polymerase chain reaction (PCR) with subsequent sequencing. The worm did not contain microfilaria and was surgically removed. The patient was treated with tapering doses of topical steroids. At 6 months follow-up, he was asymptomatic. Conclusion: Increasing numbers of O. lupi infections are reported and it is not clear whether the increasing number of infections is true or due to availability of novel diagnostic tools that correctly identify the cases. Humans cannot eliminate their exposure to vector-borne zoonotic diseases and increasing globalization increases the risk of infection. Both physicians and laboratory staff should be aware of the existence of zoonotic onchocerciasis in their countries.
{"title":"Human Ocular Onchocerca lupi Infection Diagnosed in Norway","authors":"T. Sandell, Anne Regine Skogen, T. Lier, F. O. Pettersen","doi":"10.34172/IJTMGH.2020.29","DOIUrl":"https://doi.org/10.34172/IJTMGH.2020.29","url":null,"abstract":"Introduction: Zoonotic Onchocerca lupi infection is a rare but emerging zoonotic disease affecting the eye, subcutaneous tissue and subdural cervical spine. Endemic areas of O. lupi are East and Central Europe, Turkey, Iran and the Northwest of the USA. Thirteen confirmed cases have been published in the world literature. Case Presentation: We present a case of subconjunctival O. lupi infection in the left eye of a Norwegian male. The infection was most likely imported from Turkey. The diagnosis was verified by direct microscopy and molecular analyses with polymerase chain reaction (PCR) with subsequent sequencing. The worm did not contain microfilaria and was surgically removed. The patient was treated with tapering doses of topical steroids. At 6 months follow-up, he was asymptomatic. Conclusion: Increasing numbers of O. lupi infections are reported and it is not clear whether the increasing number of infections is true or due to availability of novel diagnostic tools that correctly identify the cases. Humans cannot eliminate their exposure to vector-borne zoonotic diseases and increasing globalization increases the risk of infection. Both physicians and laboratory staff should be aware of the existence of zoonotic onchocerciasis in their countries.","PeriodicalId":32539,"journal":{"name":"International Journal of Travel Medicine and Global Health","volume":"8 1","pages":"170-173"},"PeriodicalIF":0.0,"publicationDate":"2020-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47347381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As countries worldwide are beginning to end their lockdowns due to the coronavirus disease 2019 (COVID-19) pandemic, travel and tourism are again becoming possible. However, pre-pandemic travel practices are not likely to resume for some time, at least until a COVID-19 vaccine becomes available. The current time is a crucial one that requires us to reconsider our strategies to protect health and prevent travel-related diseases. This article therefore addresses various considerations for the resumption of tourist activities and the near future of travel, such as pre-travel medical counseling, personal hygiene, luggage handling, food safety, and measures to ensure safety on airplanes and in hotels. These considerations may aid in delineating a way forward for the travel industry and for travelers alike. Author believes that this article is especially timely and of interest not only for travel medicine specialists but all participants in the field of travel business.
{"title":"How to Travel After the COVID-19 Pandemic?","authors":"P. Felkai","doi":"10.34172/IJTMGH.2021.01","DOIUrl":"https://doi.org/10.34172/IJTMGH.2021.01","url":null,"abstract":"As countries worldwide are beginning to end their lockdowns due to the coronavirus disease 2019 (COVID-19) pandemic, travel and tourism are again becoming possible. However, pre-pandemic travel practices are not likely to resume for some time, at least until a COVID-19 vaccine becomes available. The current time is a crucial one that requires us to reconsider our strategies to protect health and prevent travel-related diseases. This article therefore addresses various considerations for the resumption of tourist activities and the near future of travel, such as pre-travel medical counseling, personal hygiene, luggage handling, food safety, and measures to ensure safety on airplanes and in hotels. These considerations may aid in delineating a way forward for the travel industry and for travelers alike. Author believes that this article is especially timely and of interest not only for travel medicine specialists but all participants in the field of travel business.","PeriodicalId":32539,"journal":{"name":"International Journal of Travel Medicine and Global Health","volume":"9 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2020-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45099352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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