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Query: UMLS:C0024530 (malaria)
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Nearly 40 million journeys abroad were recorded from the Federal Republic of Germany last year. 60-70% of travellers going to southern countries seek medical advice for preventive measures, particularly in Public Health centres. Inquiries for vaccinations are prevalent. Current aspects of immunization against yellow fever, cholera, tetanus, polio, typhoid fever, hepatitis A, hepatitis B, rabies meningococcal meningitis, European tick-borne encephalitis, measles and tuberculosis are discussed. Finally, some remarks on malaria prevention, hygiene, health insurance and information services are given in brief.
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PMID:[Preventive health care in travel, especially vaccinations]. 253 28

Rapid air travel has increased the potential for international transmission of infectious diseases. Important aspects of this problem include the transmission of foodborne and waterborne illnesses, the translocation of insect vectors, the rapid transport of individuals with incubating illnesses, the direct transmission of diseases inside aircraft and the transmission of zoonoses through animal transport. Infectious outbreaks on aircraft and in the vicinity of airports have included influenza, staphylococcal gastroenteritis, salmonellosis, cholera and malaria.
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PMID:International spread of disease by air travel. 268 87

The itinerary of international travelers will largely determine the amount of pretravel counseling number of immunizations and type of malaria prophylaxis they will need. The countries visited are also the best predictor of traveler's diarrhea. Only yellow fever and cholera vaccines are required for entry into certain countries; the latter generally given only to satisfy entry requirements. Polio vaccine is important for some areas and is frequently neglected. For most malarious areas, chloroquine once per week is recommended. Fansidar should be prescribed weekly for very few travelers. Traveler's diarrhea is best prevented by avoiding high risk foods and beverages. Antibiotics, generally not recommended for prophylaxis, are very effective in treatment. Travelers should be reminded to advise physicians of their travel history during future medical encounters so that diseases, possibly contracted during travel, may be considered in diagnoses.
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PMID:Counseling the international traveler. 279 6

Home visitors annually administered questionnaires in 1977, 1978 and 1979 to 1091 heads of households in 687 compounds distributed among 8 villages in the Kainji Lake Area of Nigeria. They wanted to establish baseline data on vital and health statistics in the area and evaluate the existing birth and death registration system. 41.6% of all deaths during the 3 year period happened in children 10 years old and 34% happened in the 0-5 year age group. 21% occurred in the of = 60 year age group. The 3 leading causes of death in the area included gastroenteritis (33.7%), malaria (32.9%), and measles (7.6%). In 1977 a cholera epidemic struck Karabande in the southern end of the Kainji Lake Area. In 1978 Karabande had an epidemic of measles which accounted for measles being the 3rd most common cause of death in this study. Deaths due to the 3 leading afflictions declined considerably in the 3rd year, e.g., measles cases 5-17-0. 66.3% of the women have been married once, while 33.7% have been married more than once. 70% of all divorces occurred due to lack of affection, cruelty, and desertion. Vital statistics registration began in 1965, but registrars only recorded births (1965-1980: 6504) and not deaths. They did not understand the importance of registration of births and deaths for national and local planning. In New Bussa, the National Electric Power Authority hospital and the General Hospital recorded 9830 live births between 1969-1980, which considerably exceeded the 4972 registered births in New Bussa alone and the 6504 births in all the registration centers in the same period. There were a higher number of registered births among the nonindigenous population who migrated to the region than among the local people.
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PMID:A study of vital and health statistics of the Kainji Lake Area of Nigeria. 284 54

Travel to the developing world by U.S. citizens has been increasing. Exposure to illnesses such as travelers' diarrhea, malaria, and vaccine-preventable diseases challenges the internist to provide pre-travel advice. Each traveler's itinerary, duration of stay and medical history, including previous immunizations, should be reviewed. Immunizations that may be required by individual countries, such as yellow fever and cholera, may then be administered. Immunizations for diseases such as hepatitis, typhoid fever, and meningococcal disease can be given according to the type of exposure within each country. Restricting a traveler's diet to cooked foods and purified, carbonated, or heated beverages may prevent travelers' diarrhea and other enteric infections. Most travelers will want to carry medications to treat diarrhea promptly. Malaria is prevented by avoiding mosquitos, taking safe and appropriate anti-malarials and treating malaria if it occurs. Preparation before travel may prevent medical complications.
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PMID:Health advice for international travel. 261 18

Two antigens, cholera toxin (CT) and a synthetic albumin-conjugated 16-residue peptide derived from the circumsporozoite (CS) protein of Plasmodium falciparum sporozoites, were tested as immunogens in rabbits. The malaria peptide-albumin conjugate by itself was completely nonimmunogenic, and although cholera toxin was immunogenic it also expressed considerable native toxicity. After attachment of CT to liposomes containing ganglioside GM1, toxicity of CT was completely eliminated and antigenicity was enhanced. Therefore liposomes may be capable of reducing toxicity of certain potentially dangerous antigens such as toxins. After incorporation of the malaria peptide-albumin conjugate into liposomes a high titre of specific antibodies was induced against the malaria peptide but not against albumin. These antibodies also reacted with native CS protein. Three adjuvants, including lipid A and two types of lipophilic muramyl dipeptide, were compared and found to be effective in liposomes. Based on the conversion of synthetic P. falciparum CS peptide from a nonimmunogenic to an immunogenic form and on the 'toxoiding' effect of liposomes for CT, it is concluded that liposomes should be considered as being a useful carrier for antigens and adjuvants for vaccines for poorly antigenic or toxic substances.
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PMID:Effectiveness of liposomes as potential carriers of vaccines: applications to cholera toxin and human malaria sporozoite antigen. 353 3

Travelers to developing countries participated in a follow-up study of the health risks associated with short (less than three months) visits to these nations. Travelers to the Greek or Canary Islands served as a control cohort. Participants completed a questionnaire to elicit information regarding pretravel vaccinations, malaria prophylaxis, and health problems during and after their journey. Relevant infections were confirmed by the respondent's personal physician. The questionnaire was completed by 10,524 travelers; the answer rate was 73.8%. After a visit to developing countries, 15% of the travelers reported health problems, 8% consulted a doctor, and 3% were unable to work for an average of 15 days. The incidence of infection per month abroad was as follows: giardiasis, 7/1,000; amebiasis, 4/1,000; hepatitis, 4/1,000; gonorrhea, 3/1,000; and malaria, helminthiases, or syphilis, less than 1/1,000. There were no cases of typhoid fever or cholera.
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PMID:Health problems after travel to developing countries. 359 28

At the invitation of the Chinese government a New Zealand delegation visited the People's Republic of China to observe medical administration and public health. The use of "barefoot doctors" and the integration of western and traditional medicine has led to a revision of the organization of medical care. Acupuncture has been implemented for anesthesia, diagnosis, treatment and drug addiction. Herbal medicine, treatment of fractures and burns and cupping and mixibustion are additional methods of treatment employed with success by the Chinese. The emphasis on preventive medicine has led to education of the people and "barefoot doctors" and to the elimination of various pests such as flies, mosquitoes, rats, bedbugs the semination of a wide range of endemic bacterial and viral diseases such as plague, cholera and leprosy and the elimination of diseases such as malaria, hookworm and venereal diseases. Population control is emphasized in schools (premarital sex is strongly disapproved of) and through the revolutionary philosophy that women can only gain equality when they are freed from endless childbearing. Birth rates have been reduced to 6.5 per 1000 in urban Shanghai. Medical training has been shortened to 3 1/2 years and is taught with the philosophy that it will be used to serve the people.
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PMID:Where health is patriotism. Visit of New Zealand medical delegation to China: 20 August-9 September 1974. 453 4

Most communicable diseases in Singapore have been brought under control and some eliminated. In recent years, an increasing proportion of the reported cases turned out to be imported. Between the period 1977 and 1982, 96% of malaria, 44% of paratyphoid, 32% of typhoid, 20% of leprosy, 11% of acute viral hepatitis, 7% of dengue fever/dengue haemorrhagic fever and 7% of cholera were imported. About 10% of the notified tuberculosis cases were non-residents while all the sporadic cases of poliomyelitis (except in 1977) and diphtheria (except in 1982) were contracted outside Singapore. The majority of the infections originated from Southeast Asia and the Indian subcontinent. The main groups of population with imported infections were local residents who travelled to the endemic areas without taking adequate preventive measures, foreign contract workers, and foreign seeking medical treatment in Singapore. Whether or not these imported cases would spread the infection to others in the community and cause epidemics depend on the virulence of the pathogen introduced, the susceptibility of the population and the environmental conditions which favour transmission of infection. Measures taken to reduce the risk of transmission include provision of a high standard of environmental sanitation, epidemiological surveillance to detect and eliminate the focus of infection; maintenance of a high level of herd immunity through immunisation; health education of the medical practitioners and of the public on the need for personal prophylaxis when travelling overseas; and screening of foreign contract workers and returning residents in special situations.
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PMID:Imported communicable diseases in Singapore. 609 73

This lecture, a memorial to Joseph E. Smadel, reviews the involvement of the military in the development and use of immunizing materials. Smallpox and smallpox immunization in the military and the development and present status of immunization against typhoid, cholera, yellow fever, typhus, tetanus, diphtheria, plague, influenza, adenovirus, meningitis, rubella, and malaria are reviewed. Dr. Smadel's personal contributions to the significant achievements of the military program to civilian practice are emphasized.
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PMID:Immunization and military medicine. 636 77


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