Archive for May, 2011

Travel Bulletin Dominican Republic: Cholera Taking Hold

Friday, May 27th, 2011 by

Source: Associated Press

Dominican physicians report that cholera has been reported in 28 of the country’s 32 provinces, and the number of new cases has risen about 50% over the last two weeks, according to the Dominican Health ministry. Since the outbreak began in November, there have been over a thousand cases and fourteen deaths, and there are fears that the situation may worsen with the onset of the hurricane season. The Dominican Republic shares the island of Hispaniola with Haiti, where the cholera epidemic has sickened over 250,000 and killed nearly 5,000. Cholera is a water-borne illness, which is spread through contaminated drinking water and food. Travelers should take strict precautions to avoid exposure and should seek treatment immediately with the onset of diarrhea.

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Dozens of Countries Launch Decade of Action for Road Safety

Thursday, May 26th, 2011 by

At the 64th session of the World Health Assembly in Geneva, which closed on Tuesday, one of the leading topics was international road safety.  With over 1.3 million deaths annually, and ranking as the leading cause of mortality among 15-29 year olds and the ninth leading cause of death for all ages, the task of making the world’s roads safe for travel is formidable, to say the least. 

On May 11th, partially in anticipation of the Global Health Summit, dozens of countries around the world kicked off the first global Decade of Action for Road Safety 2011-2020. The governments of dozens of countries as far reaching as Russia, Sri Lanka and Nigeria have committed to taking new steps to save lives on their roads. Some of the proposed actions include enacting legislation or stepping up enforcement of helmet, seat belt, child safety restraint, speeding, and alcohol intoxication laws.  Only 15% of countries currently have comprehensive measures addressing all of these factors.

Pedestrians, bicyclists and motorcyclists account for almost half of the deaths on the world’s roads.  In a massive effort to curtail these accidents, part of the funding for this initiative will go towards the construction of footpaths and cycle only lanes.  The World Health Organization (WHO), who will provide technical support and monitor the effort, believes that successful implementation of the proposed measures could save over five million lives between now and 2020. 

None of us should have to bear the grief and devastation caused by a road traffic crash,” said Dr Etienne Krug, WHO Director of the Department of Violence and Injury Prevention and Disability. “The steps outlined in the Global Plan for the Decade are immediately doable, and will do much to spare the suffering of so many.”

Photo by Goran Zec.

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Responsible Tourism Awards: Nominate a Deserving Resort for Worldwide Recognition

Wednesday, May 25th, 2011 by

Nominations close in less than four weeks for ecotourism lodges you may have visited that demonstrate outstanding achievement in responsible tourism. There are awards in thirteen categories and all are judged on their commitment to conserving cultural heritage, preserving local environments and contributing to the sustainable livelihoods of local people.

Since 2004 members of the public have nominated over 10,000 resorts resulting in over 200 winners from 51 countries. Winners are determined after careful evaluation by the International Centre for Responsible Tourism at Leeds Metropolitan University in the United Kingdom, which partners with Virgin Holidays and media properties Metro Newspaper, Geographical Magazine (Royal Geographical Society) and World Travel Market to publicize the program.

If you’ve had the pleasure of a truly memorable ecotour, take a few minutes to submit your nomination and let the rest of the world know who is leading the way to responsible tourism.

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Travel Bulletin Cambodia: Country Braces for Nightmare Dengue Season

Tuesday, May 24th, 2011 by

Dengue season—June and July—is approaching in Cambodia where the National Dengue Control Program (NDCP) is warning of an impending outbreak at least as severe as the 2007 epidemic when 40,000 people were hospitalized, 10,000 in one week. A spokesman for the NDCP says the number of cases in recent months has been unusually high, which has been a reliable predictor of large scale outbreaks in the past. Adding to the anxiety are the detection of a new serotype as well as Dengue hemorrhagic fever, which may make cases more deadly or difficult to treat. Prevention programs have been woefully underfunded. Ironically, Cambodia is home to a demonstration project costing $1 per household that has been effective in preventing local outbreaks by introducing guppy fish into water storage containers to eat the larvae of the mosquito that transmits Dengue.

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Web-based Symptom Checkers – Part 2: Better to Know Than to Guess

Wednesday, May 18th, 2011 by

Physicians in practice for many years will tell you that upon hearing a diagnosis, the first question that many patients ask is “is it serious?”  In fact, most people do not really care about what their illness is called, so long as they can expect a quick and total recovery.  This is also true for travelers who fall sick or sustain an injury while traveling and want to make an educated decision on whether or not to seek medical care or cut their trip short.

A few months ago, we reviewed on line symptom checkers with an eye towards efficacy and accuracy of self diagnosis.  A few standouts, such as “Everyday Health” were lauded for their thoroughness and clinical acumen, while most of the others were criticized for being too general and stopping far short of identifying the actual medical problem.

Perhaps the focus of our earlier review was ill placed.  What do people really want from a symptom checker?  Do they really need to know the name of their illness?  Does toxic epidermal necrolysis have a meaning to anyone other than a physician?  On the other hand, wouldn’t someone with this or another condition with similar symptoms like to know that it is serious, and mandates immediate professional attention?

We decided to take a second look at on line symptom checkers, this time with an eye for those able to quickly separate conditions that required immediate professional involvement from those which did not.  Not surprisingly, several of those which were dismissed in our earlier review as not being thorough enough were actually quite good at distinguishing between serious and relatively benign conditions.  Others with extensive algorithms, although entertaining and impressive to medical personnel, tax the attention span of most and take much too long to arrive at a diagnosis.

Using revised criteria, symptom checkers such as those found on the “Embody Health” website from the Mayo Clinic and Schmitt Thompson’s (available through a licensing agreement only) make recommendations whether or not to see a doctor after only two or three clicks.  WebMD’s symptom checker works in a similar fashion- encouraging a call for help based on the initial selection of a chief symptom.  The vomiting of blood, for instance, gets an immediate directive to seek medical attention.

There has been a virtual explosion of medical self help options over the past fifteen years. The introduction of on line symptom checkers is a more recent development, and is replacing labor intensive nurse hotlines in many markets. Perhaps the best symptom checkers are those which direct, but do not diagnose. Knowing exactly what you have, assuming you have answered all questions appropriately, is probably not as important as knowing whether or not to see a medical professional if you happen to be a long way from home.

Photo by southerntabitha.

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“Yellow Book” Expanded: CDC Updates International Travel Health Guide

Tuesday, May 17th, 2011 by

The Centers for Disease Control and Prevention (CDC) has announced that the 2012 edition of its definitive Yellow Book is now available in bookstores. This authoritative reference work is written by health professionals but is very accessible for international travelers who want to understand the risks of infectious disease around the world and how to manage common problems such as traveler’s diarrhea. The Yellow Book is reissued every two years. The 2012 edition includes these new features:

  • Updated maps on the distribution of dengue fever
  • More detailed maps for yellow fever and malaria
  • Preventing traveler’s diarrhea by understanding how food is prepared
  • Tips for traveling to mass gatherings such as the Hajj pilgrimage, the Olympics or the World Cup
  • Preparing for study abroad
  • How to manage when you are traveling during an international disease outbreak
  • In-depth discussions of itineraries that take you to the Caribbean, Egypt, Central America, Mexico and South Africa.

It’s now available through Amazon for $33.43 and soon the ebook version will be available, perfect for the traveler who wants to view it on their Kindle or iPad.

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Travel Bulletin Cairo: Demoralized Police Abandon Streets

Monday, May 16th, 2011 by

Recent reports from Cairo paint a grim picture of a massive crime wave and unchecked sectarian violence. Known for its abuses and arrogance, the Cairo police force, a target of the recent revolution, is now reeling from broken morale and lacks strong training in legitimate police methods. In an extraordinary announcement, Egypt’s new Prime Minister Essam Sharaf reiterated the government’s support for the police, something most citizens take for granted. Travelers to Cairo best beware in the weeks ahead.

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Moderation Yields the Healthy Business Traveler

Friday, May 13th, 2011 by

A recent study published in Science Daily indicates that the key to being a healthy business traveler is to travel with moderate frequency. Research conducted by Columbia University’s Mailman School of Public Health finds that those employees who travel more than 20 days a month and those that do not travel at all are more likely to exhibit poor health conditions than those who travel one to six days a month.

The unhealthier frequent travelers were found to suffer from:

  • Obesity
  • Heart Disease
  • High Cholesterol
  • High blood pressure

According to Wall Street Journal’s The Middle Seat Terminal blog, these conditions result from common traveler behaviors: eating poorly with high-fat, low-fiber, high-calorie meals, lack of sleep, too much sitting, and high alcohol consumption. To combat these tendencies, travelers are advised to travel with healthy snacks and to order healthier prepared foods (Smart Women Travelers and About.com offer practical suggestions in this area), and to take advantage of the fitness centers and exercise options through many hotels.

One silver lining for globetrotters: researchers consistently found that “health outcomes were worse for those not traveling than those traveling the most.”

How do you stay fit while you travel? 

Photo by permanently scatterbrained.

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