All travelers should be included in a discussion about vaccine indications and participate in the decision process, but we believe that VFR travelers to South Asia could benefit from vaccination, despite its limited efficacy in previous reports. In conclusion, younger VFR travelers
in areas that are endemic for typhoid fever seem to be at greater risk of acquiring infection and developing complications. Absolute eosinopenia and increased LFT values could be useful early diagnostic clues in a returning traveler with fever. In our study, there was a high rate of decreased susceptibility to fluoroquinolones, confirming Selleckchem NVP-BEZ235 that the use of third-generation cephalosporins and macrolides in patients from the Indian subcontinent is
most appropriate for the treatment of typhoid. Prevention in this group of travelers is critical and efforts should be targeted at better education and pre-travel immunization. The authors state that they have no conflicts of interest. “
“Millions of tourists and climbers visit high altitudes annually. Many unsuspecting and otherwise healthy individuals may get sick when sojourning to these high regions. Acute mountain sickness represents the find more most common illness, which is usually benign but can rapidly progress to the more severe and potentially fatal forms of high-altitude cerebral edema and high-altitude pulmonary edema. Data were identified by searches of Medline (1965 to May 2012) and references from relevant articles and books. Studies, reviews, and books specifically pertaining to the epidemiology, prevention, and
treatment of high-altitude illnesses in travelers were selected. This review provides information on geographical aspects, physiology/pathophysiology, clinical features, risk factors, and the prevalence of high-altitude illnesses and also state-of-the art recommendations for prevention and treatment of such illnesses. Given an increasing number of recreational activities at high and extreme altitudes, the general practitioner and specialist are in higher demand for medical recommendations regarding the prevention and treatment of altitude illness. Despite an ongoing scientific discussion and controversies about the pathophysiological causes of altitude illness, treatment and prevention recommendations are clearer with Gemcitabine price increased experience over the last two decades. More than 100 million people visit altitudes up to and higher than 2,500 m (∼8,000 ft) annually. Altitude regions are defined as high altitude (1,500–3,500 m; ∼5,000–11,500 ft), very high altitude (3,500–5,500 m; ∼11,500–18,000 ft), and extreme altitude (>5,500 m; >18,000 ft). Many unsuspecting and otherwise healthy individuals may suffer from high-altitude illnesses when sojourning to these high regions, including thousands of porters and pilgrims developing high-altitude illnesses at a similar incidence as trekkers from western countries.