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World Travel Atlas Select Focus Maps. Course Content – First Block 

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Presentation on theme: "World Travel Atlas Select Focus Maps. Course Content – First Block "— Presentation transcript:

1 World Travel Atlas Select Focus Maps

2 Course Content – First Block 

3 World Travel Atlas Select Focus Maps

4 World Travel Atlas Select Focus: Major Health Risks over the World  ATLAS p. 39  Malaria  Pathogen: parasites of Plasmodium  Vector: (female) Anopheles (=> mosquito strain)  Benignant Forms (M. tertiana, M. quartana) - Plasmodium vivax, Plasmodium malariae  Malignant Form (M. tropica) - Plasmodium falciparum  Symptoms - fever, headache, chills, tiredness and vomiting - appear 10 to 15 days after a person is infected - malaria can cause severe illnesses, often fatal  if not promptly treated Anopheles

5 World Travel Atlas Select Focus: Major Health Risks over the World  ATLAS p. 39  Malaria – Cycle

6 World Travel Atlas Select Focus: Major Health Risks over the World  Malaria - Global and Regional Health Risk  40% of the world’s population are at risk (mostly those living in the world’s poorest countries )  Every year, more than 500 million people become severely ill with malaria  The vast majority of cases occur in children under the age of 5 years; pregnant women are also especially vulnerable.  Most cases and deaths are in sub-Saharan Africa (85– 90% of malaria fatalities occur). However, Asia, Latin America, the Middle East and parts of Europe are also affected  Travellers from malaria-free regions going to areas where there is malaria transmission are highly vulnerable – they have little or no immunity and are often exposed to delayed or wrong malaria diagnosis when returning to their home country.

7 World Travel Atlas Select Focus: Major Health Risks over the World  ATLAS p. 39  Malaria - Health Risk areas  Malaria occurs in over 100 countries  widespread in many tropical and subtropical countries  Large areas of Central and South America, Hispaniola (Haiti and the Dominican Republic), Africa, the Middle East, the Indian subcontinent, Southeast Asia, and Oceania are considered malaria- risk areas.  Some regions have a fairly constant number of cases throughout the year – these are malaria endemic – whereas in other areas there are “malaria” seasons, usually coinciding with the rainy season.

8 World Travel Atlas Select Focus: Major Health Risks over the World  ATLAS p. 39  Malaria – Health Risk areas  Malaria transmission differs in intensity and regularity depending on local factors such as: - rainfall patterns, - proximity of mosquito breeding sites and mosquito species.  High risk transmission areas: Sub-Saharan Africa, Sumatra, Borneo, Papua Guinea, Area along Thailand and Burma’s border, India (+/-), Amazonas area, Solomon Islands / Vanuatu  Low risk transmission areas (see maps)  M. more common in rural areas than in cities; ( contrast to Dengue Fever - urban areas - greater risk).  E.g. the cities of the Vietnam, Laos and Cambodia are essentially malaria- free, but the disease is present in many rural regions  Africa malaria is present in both rural and urban areas, though the risk is lower in the larger cities

9 World Travel Atlas Select Focus: Major Health Risks over the World  ATLAS p. 39 No Malaria Low-risk areas High-risk areas High-risk areas – Chemoprophylaxis recommended

10 World Travel Atlas Select Focus: Major Health Risks over the World  ATLAS p. 39

11 World Travel Atlas Select Focus: Major Health Risks over the World  ATLAS p. 39

12 World Travel Atlas Select Focus: Major Health Risks over the World  ATLAS p. 39

13 World Travel Atlas Select Focus: Major Health Risks over the World  Malaria - Antimalarial Prophylactic Measures  Exposure Prophylaxis:  Avoidance of Bites (long-sleeved clothing, a mosquito net which should be impregnated with insecticide)  Insect Repellents:  use repellent on exposed skin  spraying insecticides in the room  Chemoprophylaxis  Pathogen-specific Tablets (e.g. Chloroquin, Proguanil, Mefloquin, etc.)  The tablets you require depend on the country to which you are travelling  no preventive vaccine (possibly available by 2010)

14 World Travel Atlas Select Focus: Major Health Risks over the World  Malaria - Antimalarial Therapy  CHEMOTHERAPY Pathogen-specific Tablets or Injections (e.g. Halofantrin,Doxycyclin, Lapdap*, Fosclin*, Artemisia- Derivatives*) *Note: Latest medications  The drug treatment of malaria depends on the type and severity of the attack.  For more information (Malaria Foundation International)

15 World Travel Atlas Select Focus: Major Health Risks over the World  Drug resistance problem  spread of anti-malarial drug resistance over the past few decades  It is the plasmodia that cause malaria that develop resistance to anti- malarial drugs not the mosquitoes that transmit the disease.  The parasite's resistance to medicines continues to undermine malaria control efforts. EXAMPLES  Resistance to CHLOROQUINE began from two epi-centres; Columbia (South America) and Thailand (South East Asia) in the early 1960s. Since then, resistance has been spreading world wide.  Recently, cases of MEFLOQUINE resistance have been reported from areas of Thailand bordering with Burma and Cambodia.

16 World Travel Atlas Select Focus: Major Health Risks over the World  Drug resistance problem

17 World Travel Atlas Select Focus: Major Health Risks over the World  Pathogen Resistance: Sickle-cell disease (Blood disease)  Sickle-cell disease is a group of genetic disorders caused by sickle haemoglobin  people concerned: only in tropical Africa‘s endemic Malaria zones (30%)  2 different types:  Heterozygous mutated cells (99% of people concerned): unimportant level of anaemia BUT greatly reduced chance of serious malaria tropica infection  Homozygous mutated cells (<1%): full sickle-cell disease, rarely live beyond adolescence, no Malaria immunity

18 World Travel Atlas Select Focus: Major Health Risks over the World  Socio-economic effects  Malaria causes an average loss of 1.3% annual economic growth in countries with intense transmission  Malaria traps families and communities in a downward spiral of poverty  affecting marginalized populations and poor people who cannot afford treatment or who have limited access to health care.  In some countries with a very heavy malaria burden, the disease may account for as much as 40% of public health expenditure  Malaria has lifelong effects through increased poverty, impaired learning and decreases attendance in schools and the workplace.

19 World Travel Atlas Select Focus: Major Health Risks over the World  Other Health Risks  Sleeping disease  Yellow Fever  Typhoid Fever  DENGUE FEVER (“Dandy Fever”, “Break Bone Fever”)  HIV/AIDS  HEPATITIS A  HEPATITIS B  HEPATITIS C, D, E

20 World Travel Atlas Select Focus: Major Health Risks over the World  Other Health Risks  POLIO  DIPHTHERIA  TETANUS  SARS (Serious Acute Respiratory Syndrome)  AVIAN FLU  JAPANESE B ENCEPHALITIS

21 World Travel Atlas Select Focus: Major Health Risks over the World SLEEPING SICKNESS  Vector: Glossina (“Tsetse Fly”)  Pathogen: Trypanosoma gambiense(Protozoa)  Terminal disease, if untreated  Endemically affected area: Tropical Africa  Initial symptoms: Fever, weakness, tremors, headaches, drowsiness  Final stage: Encephalomyelitis, prolonged coma, death caused by heart failure

22 World Travel Atlas Select Focus: Major Health Risks over the World Yellow Fever  Endemic/Infected zones: tropical areas of Africa and South America (WTA p.39)  Receptive zones  Pathogen: Y. F. Virus  Vector: Aédes aegypti  Carriers: Primates (humans, monkeys)  Lethality Rate: 10 – 50%  Immunization: Vaccine (long-lasting effect!)  Symptoms: Nausea, vomiting, intestinal bleeding, jaundice, circulatory breakdown

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24 World Travel Atlas Select Focus: Major Health Risks over the World Typhoid Fever  Serious intestinal condition  Highly contagious  Pathogen: Salmonella typhi  Transmission: Inadvertent ingestion of germ-contaminated food and liquids  Prevalence: Developing nations  Symptoms: Fever, fatigue, headaches  Proactive Measure: Vaccination (3-year immunization!)  Therapy: Antibiotics  3 – 5% of patients end up as permanent carriers

25 World Travel Atlas Select Focus: Major Health Risks over the World Hepatitis  is an inflammation of the liver  most commonly caused by a viral infection  5 main hepatitis viruses: A, B, C, D and E.  Hepatitis A and E are typically caused by ingestion of contaminated food or water.  Hepatitis B, C and D usually occur as a result of contact with infected body fluids (e.g. from blood transfusions or invasive medical procedures using contaminated equipment). Hepatitis B is also transmitted by sexual contact.  Symptoms: jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

26 World Travel Atlas Select Focus: Major Health Risks over the World Hepatitis E - ENDEMIC/INFECTED REGIONS:  The highest rates of infection: regions where low standards of sanitation promote the transmission of the virus.  Epidemics reported in Central and South-East Asia, North and West Africa, and in Mexico  Mortality rates ranging between 0.5% - 4.0%.  Hepatitis E is a self-limiting viral infection followed by recovery  VACCINE:, no commercially available vaccines exist for the prevention of Hepatitis E – BUT: in progress  PREVENTION: good personal hygiene, high quality standards for public water supplies, proper disposal of sanitary waste  For travelers to highly endemic areas: avoid drinking water and/or ice of unknown purity and eating uncooked shellfish, uncooked fruits or vegetables that are not peeled or prepared by the traveler

27 World Travel Atlas Select Focus: Major Health Risks over the World Hepatitis B:  is a serious global public health problem = majority of the worldwide hepatitis burden (1.2 Mio worldwide killed a year)  most serious type of viral hepatitis and the only type causing chronic hepatitis for which a vaccine is available.  TRANSMISSION: by contact with blood or body fluids of an infected person in the same way as human immunodeficiency virus (HIV), the virus that causes AIDS. However, H.B. is 50 to 100 times more infectious than HIV.  The main ways of getting infected are:  Perinatal (from mother to baby at the birth)  Child-to-child transmission  Unsafe injections and transfusions  Sexual contact  Endemic Areas: primarily in Africa and Asia : In much of the developing world, (sub-Saharan Africa, most of Asia, and the Pacific), most people become infected with H.B during childhood, 8% to 10% of people in the general population  chronically infected.  In these regions liver cancer caused by H.B. among first three causes death by cancer

28 World Travel Atlas Select Focus: Major Health Risks over the World Hepatitis B :  VACCINE: preventable with safe and effective vaccines (available since 1982 )  Although the vaccine will not cure chronic hepatitis, it is 95% effective in preventing chronic infections from developing, and is the first vaccine against a major human cancer  for all children to receive the hepatitis B vaccine, and 116 countries have added this vaccine to their routine immunization programmes.  Of the 2 billion people who have been infected with the hepatitis B virus more than 350 million have chronic (lifelong) infections.  chronically infected: high risk of death from cirrhosis of the liver and liver cancer

29 World Travel Atlas Select Focus: Major Health Risks over the World Hepatitis B :  TREATMENT:  Liver cancer is almost always fatal;  Chronic hepatitis B in some patients is treated with drugs called interferon or lamivudine  can help some patients. BUT: therapy costs thousands of dollars  Patients with cirrhosis are sometimes given liver transplants, with varying success. It is preferable to prevent this disease with vaccine than to try and cure it.

30 World Travel Atlas Select Focus: Major Health Risks over the World Hepatitis C :  is asymptomatic in 90% of cases  In contrast with viral hepatitis A or B, jaundice is relatively rare,  the disease becomes chronic: Chronic hepatitis C disease is the first cause of liver transplantation in developed countries  No vaccine is yet available


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