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  Subjects -> RECREATION, TRAVEL AND TOURISM (Total: 128 journals)
    - HOTELS AND RESTAURANTS (1 journals)
    - LEISURE AND RECREATION (20 journals)

RECREATION, TRAVEL AND TOURISM (107 journals)                  1 2     

40 [degrees] South     Full-text available via subscription   (Followers: 3)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 5)
Almatourism - Journal of Tourism, Culture and Territorial Development     Open Access   (Followers: 10)
American Journal of Tourism Management     Open Access   (Followers: 3)
American Journal of Tourism Research     Open Access   (Followers: 10)
Anatolia : An International Journal of Tourism and Hospitality Research     Hybrid Journal   (Followers: 5)
Annals of Tourism Research     Hybrid Journal   (Followers: 26)
Asia Pacific Journal of Tourism Research     Hybrid Journal   (Followers: 17)
Australian Antarctic Magazine     Free   (Followers: 4)
Caderno Virtual de Turismo     Open Access  
Cornell Hospitality Quarterly     Hybrid Journal   (Followers: 6)
Craft Research     Hybrid Journal   (Followers: 1)
Cuadernos de Turismo     Open Access  
Current Issues in Tourism     Hybrid Journal   (Followers: 15)
Czech Journal of Tourism     Open Access   (Followers: 2)
EchoGéo     Open Access   (Followers: 1)
Educación física y deporte     Open Access  
El Periplo Sustentable     Open Access  
Enlightening Tourism. A Pathmaking Journal     Open Access   (Followers: 3)
Estudios y Perspectivas en Turismo     Open Access  
Event Management     Full-text available via subscription   (Followers: 6)
Gestion Turistica     Open Access  
Globe, The     Full-text available via subscription   (Followers: 4)
Hospitality & Society     Hybrid Journal   (Followers: 2)
Hospitality Review     Full-text available via subscription   (Followers: 2)
Information Technology & Tourism     Full-text available via subscription   (Followers: 16)
Interaction     Full-text available via subscription   (Followers: 2)
International Journal of Contemporary Hospitality Management     Hybrid Journal   (Followers: 11)
International Journal of Culture Tourism and Hospitality Research     Hybrid Journal   (Followers: 13)
International Journal of Digital Culture and Electronic Tourism     Hybrid Journal   (Followers: 8)
International Journal of Event and Festival Management     Hybrid Journal   (Followers: 9)
International Journal of Hospitality & Tourism Administration     Hybrid Journal   (Followers: 6)
International Journal of Hospitality Management     Hybrid Journal   (Followers: 13)
International Journal of Religious Tourism and Pilgrimage     Open Access  
International Journal of Tourism Anthropology     Hybrid Journal   (Followers: 5)
International Journal of Tourism Policy     Hybrid Journal   (Followers: 5)
International Journal of Tourism Research     Hybrid Journal   (Followers: 12)
Journal of Business & Hotel Management     Partially Free  
Journal of China Tourism Research     Hybrid Journal   (Followers: 6)
Journal of Ecotourism     Hybrid Journal   (Followers: 3)
Journal of Environmental Management and Tourism     Open Access   (Followers: 2)
Journal of Franco-Irish Studies     Open Access  
Journal of Heritage Tourism     Hybrid Journal   (Followers: 7)
Journal of Hospitality & Tourism Education     Hybrid Journal   (Followers: 2)
Journal of Hospitality & Tourism Research     Hybrid Journal   (Followers: 11)
Journal of Hospitality and Tourism Management     Full-text available via subscription   (Followers: 9)
Journal of Hospitality and Tourism Technology     Hybrid Journal   (Followers: 3)
Journal of Hospitality Financial Management     Open Access   (Followers: 3)
Journal of Hospitality Marketing & Management     Hybrid Journal   (Followers: 12)
Journal of Indonesian Tourism and Development Studies     Open Access  
Journal of Outdoor Recreation and Tourism     Hybrid Journal   (Followers: 1)
Journal of Park and Recreation Administration     Full-text available via subscription   (Followers: 3)
Journal of Place Management and Development     Hybrid Journal   (Followers: 2)
Journal of Policy Research in Tourism, Leisure and Events     Hybrid Journal   (Followers: 8)
Journal of Quality Assurance in Hospitality & Tourism     Hybrid Journal   (Followers: 5)
Journal of Sport & Tourism     Hybrid Journal   (Followers: 8)
Journal of Sustainable Tourism     Hybrid Journal   (Followers: 11)
Journal of Tourism & Hospitality     Open Access   (Followers: 1)
Journal of Tourism and Cultural Change     Hybrid Journal   (Followers: 8)
Journal of Tourism and Recreation     Open Access   (Followers: 2)
Journal of Tourism Insights     Open Access   (Followers: 1)
Journal of Tourism Research & Hospitality     Hybrid Journal   (Followers: 2)
Journal of Travel & Tourism Marketing     Hybrid Journal   (Followers: 10)
Journal of Travel Medicine     Hybrid Journal  
Journal of Travel Research     Hybrid Journal   (Followers: 15)
Journal of Unconventional Parks, Tourism & Recreation Research     Open Access  
Journal of Vacation Marketing     Hybrid Journal   (Followers: 3)
Mobilities     Hybrid Journal   (Followers: 5)
Multiciencias     Open Access  
PASOS Revista de Turismo y Patrimonio Cultural     Open Access   (Followers: 1)
Podium Sport, Leisure and Tourism Review     Open Access   (Followers: 2)
Polish Journal of Sport and Tourism     Open Access   (Followers: 2)
Provincia     Open Access  
RACE - Revista de Administração, Contabilidade e Economia     Open Access  
Recreational Sport Journal     Hybrid Journal   (Followers: 6)
ReiseRecht aktuell : Zeitschrift für das Tourismusrecht     Hybrid Journal  
Research in Hospitality Management     Full-text available via subscription   (Followers: 2)
Revista de Gestão Ambiental e Sustentabilidade - GeAS     Open Access  
Revista de turism - studii si cercetari in turism     Open Access  
Revista Interamericana de Ambiente y Turismo     Open Access  
Revista Portuguesa e Brasileira de Gestão     Open Access  
Revista Rosa dos Ventos     Open Access   (Followers: 2)
Scandinavian Journal of Hospitality and Tourism     Hybrid Journal   (Followers: 4)
Space and Culture     Hybrid Journal   (Followers: 4)
Studies in Travel Writing     Hybrid Journal   (Followers: 5)
Téoros     Open Access  
The Rangeland Journal     Hybrid Journal   (Followers: 2)
Tourism     Open Access   (Followers: 3)
Tourism & Management Studies     Open Access   (Followers: 1)
Tourism Analysis     Full-text available via subscription   (Followers: 9)
Tourism and Hospitality Research     Hybrid Journal   (Followers: 6)
Tourism Culture & Communication     Full-text available via subscription   (Followers: 4)
Tourism Economics     Full-text available via subscription   (Followers: 5)
Tourism Geographies: An International Journal of Tourism Space, Place and Environment     Hybrid Journal   (Followers: 13)
Tourism in Marine Environments     Full-text available via subscription   (Followers: 2)
Tourism Management     Hybrid Journal   (Followers: 9)
Tourism Management Perspectives     Hybrid Journal   (Followers: 1)
Tourism Planning & Development     Hybrid Journal   (Followers: 10)
Tourism Recreation Research     Hybrid Journal  
Tourism Review     Hybrid Journal   (Followers: 2)

        1 2     

Journal Cover   Journal of Travel Medicine
  [SJR: 0.738]   [H-I: 40]   Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1195-1982 - ISSN (Online) 1708-8305
   Published by John Wiley and Sons Homepage  [1610 journals]
  • Profile of Travelers With Preexisting Medical Conditions Attending a
           Specialist Travel Medicine Clinic in Ireland
    • Authors: Calvin Teo Jia Han; Gerard Flaherty
      Abstract: Background Patients with complex medical comorbidities travel for protracted periods to remote destinations, often with limited access to medical care. Few descriptions are available of their preexisting health burden. This study aimed to characterize preexisting medical conditions and medications of travelers seeking pre‐travel health advice at a specialized travel medicine clinic. Methods Records of travelers attending the Galway Tropical Medical Bureau clinic between 2008 and 2014 were examined and information relating to past medical history was entered into a database. Data were recorded only where the traveler had a documented medical history and/or was taking medications. Results Of the 4,817 records available, 56% had a documented medical history and 24% listed medications. The majority of travelers with preexisting conditions were female. The mean age of the cohort was 31.68 years. The mean period remaining before the planned trip was 40 days. Southeast Asia was the most popular single destination, and 17% of travelers with medical conditions were traveling alone. The most frequently reported conditions were allergies (20%), insect bite sensitivity (15%), asthma (11%), psychiatric conditions (4%), and hypertension (3%). Of the 30 diabetic travelers, 14 required insulin; 4.5% of travelers were taking immunosuppressant drugs, including corticosteroids. Half of the female travelers were taking the oral contraceptive pill while 11 travelers were pregnant at the time of their pre‐travel consultation. Conclusions This study provides an insight into the medical profile of travelers attending a travel health clinic. The diverse range of diseases reported highlights the importance of educating physicians and nurses about the specific travel health risks associated with particular conditions. Knowledge of the effects of travel on underlying medical conditions will inform the pre‐travel health consultation.
      PubDate: 2015-06-22T02:02:55.90801-05:0
      DOI: 10.1111/jtm.12221
  • Risk Factors for Colonization With Multidrug‐Resistant Bacteria
           Among Patients Admitted to the Intensive Care Unit After Returning From
    • Authors: Marion Angue; Nicolas Allou, Olivier Belmonte, Yannick Lefort, Nathalie Lugagne, David Vandroux, Philippe Montravers, Jérôme Allyn
      Abstract: Background Few national recommendations exist on management of patients returning from abroad and all focus on hospitalized patients. Our purpose was to compare, in an intensive care unit (ICU), the admission prevalence and acquisition of multidrug‐resistant (MDR) bacteria carriage in patients with (“Abroad”) or without (“Local”) a recent stay abroad, and then identify the risk factors in “Abroad” patients. Methods In this retrospective study, we reviewed charts of all the patients hospitalized in the ICU unit from January 2011 through July 2013 with hygiene samplings performed. We identified all patients who had stayed abroad (“Abroad”) within 6 months prior to ICU admission. Results Of 1,842 ICU patients, 129 (7%) “Abroad” patients were reported. In the “Abroad” group, the rate of MDR strain carriage was higher at admission (33% vs 6.7%, p 
      PubDate: 2015-06-17T03:47:14.591385-05:
      DOI: 10.1111/jtm.12220
  • Travelers With Chikungunya Virus Infection Returning to Northwest Italy
           From the Caribbean and Central America During June–November 2014
    • Authors: Elisa Burdino; Tina Ruggiero, Maria Grazia Milia, Alex Proietti, Giuseppina Sergi, Ilaria Torta, Guido Calleri, Pietro Caramello, Donatella Tiberti, Valeria Ghisetti
      Abstract: Chikungunya virus (CHIKV) has recently emerged in the Caribbean. In Italy, CHIKV vector is documented in the Po river valley; therefore, a risk for autochthonous outbreaks is present. We report a case series of seven imported CHIKV infections in travelers returning from the Caribbean and Latin America occurring between June and November 2014, in the area of Turin, Northwest Italy, 3 years after the last imported cases were reported. These cases are a reminder of the need to always consider CHIKV infection in travelers from these epidemic areas as well as the importance of a prompt diagnosis.
      PubDate: 2015-06-17T03:04:16.186376-05:
      DOI: 10.1111/jtm.12219
  • Immunological Biomarkers in Postinfectious Irritable Bowel Syndrome
    • Authors: Brian L. Pike; Katie Ann Paden, Ashley N. Alcala, Kayla M. Jaep, Robert P. Gormley, Alexander C. Maue, Benjamin S. Christmann, Charles O. Elson, Mark S. Riddle, Chad K. Porter
      Abstract: Background There is a recognized need for biological markers to facilitate diagnoses of irritable bowel syndrome (IBS) and to distinguish it from other functional and organic disorders. As postinfectious IBS (PI‐IBS) is believed to account for as many as one third of all IBS cases, here we sought to identify differences in specific cytokines and serologic responses across patients with idiopathic IBS and PI‐IBS and healthy controls. Methods At total of 120 US military personnel were identified from the Defense Medical Surveillance System‐based International Classification of Diseases, 9th Revision, Clinical Modification (ICD9‐CM) codes recorded during medical encounters and were grouped based on infectious gastroenteritis (IGE) episode (Shigella, Campylobacter, Salmonella, or an unspecified pathogen) followed by IBS, IBS without antecedent IGE, or IGE without subsequent IBS within 2 years of the IGE exposure. Sera from subjects were assayed for cytokine levels and antibodies against a panel of microbiome antigens. Results In total, 10 of 118 markers considered were shown to differ between IBS patients and healthy controls, including cytokines interleukin‐6 (IL‐6), IL‐8, IL‐1β, and macrophage inflammatory protein‐1β (MIP‐1β), as well as antibody responses to microbial antigens. Antimicrobial antibody response profiles also differed between PI‐IBS cases compared with IBS cases without an antecedent episode of acute IGE. Comparisons also suggest that immunoglobulin A (IgA) and IgG profiles may point to pathogen‐specific origins among PI‐IBS cases. Conclusion Taken together, these results provide further evidence as to the molecular distinctness of classes of IBS cases and that serum biomarkers may prove useful in elucidating their pathobiological pathways.
      PubDate: 2015-06-08T07:15:02.970164-05:
      DOI: 10.1111/jtm.12218
  • Severe Sunburn After a Hot Air Balloon Ride: A Case Report and Literature
    • Authors: Sinan Ozturk; Huseyin Karagoz
      Abstract: Hot air balloon tours are very popular among travelers worldwide. Preventable burn injuries associated with hot air balloon rides have been reported during crashes into power lines, in propane burner explosions, and following contact with the propane burner tanks. We present a case of severe repeated sunburn, which poses another risk of preventable injury during hot air balloon rides, and briefly discuss the injury epidemiology of hot air balloon rides.
      PubDate: 2015-06-08T07:14:05.641046-05:
      DOI: 10.1111/jtm.12213
  • Travel Medicine Encounters of Australian General Practice Trainees—A
           Cross‐Sectional Study
    • Authors: Simon Morgan; Kim M. Henderson, Amanda Tapley, John Scott, Mieke L. van Driel, Neil A. Spike, Lawrie A. McArthur, Andrew R. Davey, Nigel F. Catzikiris, Parker J. Magin
      Abstract: Background Travel medicine is a common and challenging area of clinical practice and practitioners need up‐to‐date knowledge and experience in a range of areas. Australian general practitioners (GPs) play a significant role in the delivery of travel medicine advice. We aimed to describe the rate and nature of travel medicine consultations, including both the clinical and educational aspects of the consultations. Methods A cross‐sectional analysis from an ongoing cohort study of GP trainees' clinical consultations was performed. Trainees contemporaneously recorded demographic, clinical, and educational details of consecutive patient consultations. Proportions of all problems/diagnoses managed in these consultations that were coded “travel‐related” and “travel advice” were both calculated with 95% confidence intervals (CIs). Associations of a problem/diagnosis being “travel‐related” or “travel advice” were tested using simple logistic regression within the generalized estimating equations (GEE) framework. Results A total of 856 trainees contributed data on 169,307 problems from 108,759 consultations (2010–2014). Travel‐related and travel advice problems were managed at a rate of 1.1 and 0.5 problems per 100 encounters, respectively. Significant positive associations of travel‐related problems were younger trainee and patient age; new patient to the trainee and practice; privately billing, larger, urban, and higher socioeconomic status practices; and involvement of the practice nurse. Trainees sought in‐consultation information and generated learning goals in 34.7 and 20.8% of travel advice problems, respectively, significantly more than in non‐travel advice problems. Significant positive associations of travel advice problems were seeking in‐consultation information, generation of learning goals, longer consultation duration, and more problems managed. Conclusions Our findings reinforce the importance of focused training in travel medicine for GP trainees and adequate exposure to patients in the practice setting. In addition, our findings have implications more broadly for the delivery of travel medicine in general practice.
      PubDate: 2015-06-02T02:07:34.937118-05:
      DOI: 10.1111/jtm.12216
  • Tungiasis Outbreak in Travelers From Madagascar
    • Authors: Sorya Belaz; Eugénie Gay, Florence Robert‐Gangneux, Jean‐Claude Beaucournu, Claude Guiguen
      Abstract: Seven patients from a group of 16 travelers were diagnosed at our institution with one or more sand fleas on their toes, 1 day to 3 weeks after returning from Madagascar. A questionnaire was sent to the whole group to collect clinical and epidemiological information, which showed that 9 of 13 (69%) had received pre‐travel medical advice, but none were aware of sand flea; thus prevention measures were rarely applied. Five of seven (71%) patients wore open sandals throughout the trip. Overall, 10 sand fleas were extracted.
      PubDate: 2015-06-02T02:06:11.136902-05:
      DOI: 10.1111/jtm.12217
  • Influenza Outbreaks Among Passengers and Crew on Two Cruise Ships: A
           Recent Account of Preparedness and Response to an Ever‐Present
    • Authors: Alexander J. Millman; Krista Kornylo Duong, Kathryn Lafond, Nicole M. Green, Susan A. Lippold, Michael A. Jhung
      Abstract: Background During spring 2014, two large influenza outbreaks occurred among cruise ship passengers and crew on trans‐hemispheric itineraries. Methods Passenger and crew information for both ships was obtained from components of the ship medical records. Data included demographics, diagnosis of influenza‐like illness (ILI) or acute respiratory illness (ARI), illness onset date, passenger cabin number, crew occupation, influenza vaccination history, and rapid influenza diagnostic test (RIDT) result, if performed. Results In total, 3.7% of passengers and 3.1% of crew on Ship A had medically attended acute respiratory illness (MAARI). On Ship B, 6.2% of passengers and 4.7% of crew had MAARI. In both outbreaks, passengers reported illness prior to the ship's departure. Influenza activity was low in the places of origin of the majority of passengers and both ships' ports of call. The median age of affected passengers on both ships was 70 years. Diagnostic testing revealed three different co‐circulating influenza viruses [influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B] on Ship A and one circulating influenza virus (influenza B) on Ship B. Both ships voluntarily reported the outbreaks to the Centers for Disease Control and Prevention (CDC) and implemented outbreak response plans including isolation of sick individuals and antiviral treatment and prophylaxis. Conclusions Influenza activity can become widespread during cruise ship outbreaks and can occur outside of traditional influenza seasons. Comprehensive outbreak prevention and control plans, including prompt antiviral treatment and prophylaxis, may mitigate the impact of influenza outbreaks on cruise ships.
      PubDate: 2015-06-02T01:56:56.141959-05:
      DOI: 10.1111/jtm.12215
  • Expert Review of Evidence Bases for Managing Monkey Bites in Travelers
    • Authors: Nicholas J. Riesland; Henry Wilde
      PubDate: 2015-06-02T01:56:26.009192-05:
      DOI: 10.1111/jtm.12214
  • High Rate of Multidrug‐Resistant Gram‐Negative Bacilli
           Carriage and Infection in Hospitalized Returning Travelers: A
           Cross‐Sectional Cohort Study
    • Authors: Loïc Epelboin; Jérôme Robert, Ellina Tsyrina‐Kouyoumdjian, Sonia Laouira, Vanina Meyssonnier, Eric Caumes,
      Abstract: Background Carriage of and infection with multidrug‐resistant Gram‐negative bacilli (MDR‐GNB) are a potential cause of concern in travelers with no history of hospitalization abroad. Methods All consecutive returning travelers hospitalized in our department between February 2012 and January 2013 were prospectively screened for MDR‐GNB gastrointestinal tract carriage or infection. We compared the prevalence of MDR‐GNB in travelers to a non‐travelers nonexposed group. Then among the travelers, MDR‐GNB carriers were compared to noncarriers to determine risk factors of acquisition of MDR‐GNB. Results Overall, 359 patients (191 travelers, 168 non‐travelers) were included, and 25 (6.4%), including 23 travelers, harbored MDR‐GNB. Five travelers had an MDR‐GNB infection while 18 were asymptomatic enteric carriers. MDR‐GNB carriage or infection was significantly more frequent in travelers (11.0% vs 1.2% for non‐travelers, odds ratio (OR) = 11.3, p 
      PubDate: 2015-05-22T02:06:14.84014-05:0
      DOI: 10.1111/jtm.12211
  • Gnathostomiasis: An Emerging Infection of Raw Fish Consumers in
           Gnathostoma Nematode‐Endemic and Nonendemic Countries
    • Authors: James H. Diaz
      Abstract: Background Gnathostomiasis, a helminthic infection commonly reported in Southeast Asia and Latin America, may follow consumption of raw seafood infected with muscle‐encysted larvae of Gnathostoma species nematodes. As a result of increasingly exotic tastes for local ethnic dishes, including raw seafood, some regions outside of gnathostome‐endemic areas import live species for raw consumption. This may facilitate imported human gnathostomiasis or potentially the establishment of this zoonosis in formerly nonendemic regions. Traveling to a gnathostome‐endemic area is no longer a criterion for diagnosis. The objectives of this review are to enhance clinician awareness of this infection by describing the behavioral risk factors for its acquisition, life‐cycle, clinical manifestations, diagnosis, management, and prevention. Methods Internet search engines were queried with the key medical subject heading words. Case reports, case series, epidemiological investigations, and laboratory studies were reviewed; high risk behaviors for gnathostomiasis were identified; and human cases were stratified as cutaneous gnathostomiasis, visceral gnathostomiasis, neurognathostomiasis, and ocular gnathostomiasis. Results The greatest risk factors for gnathostomiasis included the consumption of raw freshwater seafood dishes in endemic regions and the consumption of raw imported or domestic seafood dishes in households and ethnic restaurants in many nonendemic regions. Conclusions Gnathostomiasis is no longer a disease of returning travelers, and autochthonous cases may be anticipated to increase as a result of the importation of live Gnathostoma‐infected species and the potential establishment of regional zoonoses of Gnathostoma‐infected wild species. Since the eradication of gnathostomiasis is unlikely given the global distribution of Gnathostoma nematodes, the only effective preventive strategy is to educate persons in endemic and nonendemic areas that fish, eels, frogs, snakes, and birds must be cooked thoroughly first before eating and not eaten raw or marinated. The onset of migratory subcutaneous swellings with hyper‐eosinophilia weeks to months after consuming raw seafood should provoke suspicion of gnathostomiasis.
      PubDate: 2015-05-22T02:05:59.403378-05:
      DOI: 10.1111/jtm.12212
  • Short‐Term Immunogenicity and Safety of an Accelerated
           Pre‐Exposure Prophylaxis Regimen With Japanese Encephalitis Vaccine
           in Combination With a Rabies Vaccine: A Phase III, Multicenter,
           Observer‐Blind Study
    • Authors: Tomas Jelinek; Gerd D. Burchard, Sebastian Dieckmann, Silja Bühler, Maria Paulke‐Korinek, Hans D. Nothdurft, Emil Reisinger, Khaleel Ahmed, Dietrich Bosse, Seetha Meyer, Marco Costantini, Michele Pellegrini
      Abstract: Background The current Japanese encephalitis (JE) vaccination regimen requires two doses and 4 weeks to complete, which may not always be feasible for travelers on short notice. One of the primary endpoints of this phase III study was to demonstrate noninferiority of immune responses to a JE vaccine following an accelerated 1‐week JE vaccination regimen administered concomitantly with a rabies vaccine as compared to a standard 4‐week JE regimen alone. In addition, the immunogenicity of concomitant administration of JE and rabies vaccines following standard regimens was evaluated, as well as the tolerability and safety profile of each regimen under study. Methods Healthy adults aged 18 to ≤65 years were randomized to regimens with an accelerated or standard schedule: JE+rabies‐standard (n = 167), JE+rabies‐accelerated (n = 217) or JE‐standard (n = 56). Immunogenicity against JE antigen was assessed by a 50% plaque reduction neutralization test (PRNT50) titer of ≥1 : 10, measured 28 days after last active vaccine (LAV) administration. Solicited reactions were collected 7 days after each vaccination; spontaneously reported adverse events (AEs) and serious AEs were monitored up to day 57. This paper reports results until day 57. Results Noninferiority of immune responses was established for JE+rabies‐accelerated compared to the JE‐standard regimen 28 days after LAV administration. Overall, 99% and 100% of subjects in the JE+rabies‐accelerated and JE‐standard groups, respectively, achieved PRNT50 titers of ≥1 : 10 at 28 days after LAV administration. No impact of concomitant rabies vaccination was observed either on immune responses or on the safety profile of the JE vaccine. Conclusions This was the first randomized, controlled trial that demonstrated the strong short‐term immunogenicity of a new, accelerated, 1‐week JE‐regimen, which was noninferior to that of the standard regimen, with a satisfactory tolerability and safety profile and no impact of concomitant rabies vaccination. This accelerated regimen, if licensed, could potentially be a valid alternative for individuals requiring a primary series of JE vaccination and rabies pre‐exposure prophylaxis on short notice.
      PubDate: 2015-05-22T01:55:31.774843-05:
      DOI: 10.1111/jtm.12210
  • Zika Virus in an American Recreational Traveler
    • Authors: Dyan J. Summers; Rebecca Wolfe Acosta, Alberto M. Acosta
      Abstract: We report the case of a 48‐year‐old American traveler who presented to our clinic with diffuse rash, malaise, fatigue, fever, arthralgia, low back pain, and bilateral exudative conjunctivitis. The patient had an extensive vaccination and travel history: most notable for prior receipt of yellow fever vaccine; extensive travel or residence in areas endemic for dengue, chikungunya, and West Nile virus; and recent travel to French Polynesia. Clinical and laboratory findings were consistent with Zika virus (ZIKV) infection. Our report highlights the need to include ZIKV in the differential diagnosis, especially in febrile patients with a rash returning from endemic areas.
      PubDate: 2015-05-21T07:02:51.572295-05:
      DOI: 10.1111/jtm.12208
  • Yellow Fever Vaccination of a Primary Vaccinee During Adalimumab Therapy
    • Authors: Esther R. Nash; Myron Brand, Spyridon Chalkias
      Abstract: In this case report, we describe a 63‐year‐old female with Crohn's disease since age 16 years, and on adalimumab therapy, who inadvertently received a yellow fever vaccine (YFV) 4 days before her next dose of adalimumab. She had never received YFV. Her next dose of tumor necrosis factor (TNF) antagonist was held. She did not report any adverse effects referable to the vaccine. Reverse transcriptase‐polymerase chain reaction (RT‐PCR) for yellow fever (YF) viral RNA on days 12 and 18 postvaccination was negative. Neutralizing antibody to YF virus vaccine was immunoprotective on day 18 following vaccination, which further increased by day 26. A neutralizing antibody obtained 2 years following vaccination also remained immunoprotective.
      PubDate: 2015-04-29T02:01:15.672925-05:
      DOI: 10.1111/jtm.12209
  • A Case of Rickettsia felis Infection Imported From Nepal
    • Authors: Giorgia Sulis; Paola Rodari, Silvio Caligaris, Lina R. Tomasoni, Francesco Castelli, Maurizio Gulletta
      Abstract: Rickettsia felis is an emerging spotted fever group pathogen that may be responsible for potentially life‐threatening infections. A cosmopolitan distribution has been postulated though most human cases were observed in Africa and the Americas. We report an imported case from Nepal that occurred in an Italian tourist who presented with a 1‐week history of fever, headache, nausea, vomiting, and a mild maculopapular rash 14 days after return.
      PubDate: 2015-04-17T06:05:27.400816-05:
      DOI: 10.1111/jtm.12207
  • Marine Scorpaenidae Envenomation in Travelers: Epidemiology, Management,
           and Prevention
    • Authors: James H. Diaz
      Abstract: Background The Scorpaenidae are a large family of venomous marine fish that include scorpionfish, lionfish, and stonefish. Although most stonefish are confined to the Indo‐Pacific, scorpionfish are distributed in the tropics worldwide, and two species of Indo‐Pacific lionfish were inadvertently introduced into the Eastern Atlantic in the 1990s. Since then, lionfish have invaded shallow reef systems in the Eastern Atlantic, Gulf of Mexico, and Caribbean Sea. All of these regions are popular travel destinations for beachcombing, fishing, swimming, and scuba diving—recreational activities that increase risks of Scorpaenidae envenomation. Methods To meet the objectives of describing species‐specific presenting clinical manifestations, diagnostic and treatment strategies, and outcomes of Scorpaenidae envenomation in travelers, Internet search engines were queried with the key words. Results Well‐conducted, retrospective epidemiological investigations of Scorpaenidae envenomation case series concluded: (1) most cases occurred in young adult male vacationers visiting endemic regions; (2) victims sought medical attention for pain control within 2 hours of injury and presented with intense pain, edema, and erythema in affected extremities; (3) systemic manifestations and surgical interventions were relatively uncommon following initial management with hot water soaks and parenteral analgesics; (4) all cases required tetanus prophylaxis; deeply penetrating, lacerated, and necrotic wounds required antibiotic prophylaxis; and (5) equine Fab stonefish antivenom does have antigen‐neutralizing cross‐reactivities with both Indo‐Pacific and Atlantic Scorpaenidae species and is indicated in severe scorpionfish and stonefish envenomation worldwide. Conclusions Travel medicine practitioners should counsel their patients about Scorpaenidae envenomation risks in endemic regions and maintain a high index of suspicion regarding Scorpaenidae envenomation in all travelers returning from tropical beach and ocean holidays and reporting painful fish sting injuries.
      PubDate: 2015-04-17T05:55:59.386949-05:
      DOI: 10.1111/jtm.12206
  • A Bubble Turtle: Bullous Contact Dermatitis After a Black Henna Tattoo in
           a Backpacker in Thailand
    • Authors: Vorada Choovichian; Lapakorn Chatapat, Watcharapong Piyaphanee
      PubDate: 2015-04-09T07:17:22.824958-05:
      DOI: 10.1111/jtm.12202
  • Fasciola hepatica in a German Traveler Returning From Thailand
    • Authors: Helmut J.F. Salzer; Stefan Schmiedel
      PubDate: 2015-04-09T07:17:10.48929-05:0
      DOI: 10.1111/jtm.12205
  • Lymphadenopathy in Patients With Chikungunya Virus Infection Imported From
           Hispaniola: Case Reports
    • Authors: Francesca F. Norman; Begoña Monge‐Maillo, Jose‐Antonio Perez‐Molina, Fernando de Ory, Leticia Franco, María‐Paz Sánchez‐Seco, Rogelio López‐Vélez
      Abstract: Chikungunya virus (CHIKV) is currently spreading in the Caribbean and America. Lymphadenopathy, described in infections with other alphaviruses, is not commonly reported in CHIKV infections. Painful lymphadenopathy was found in three of the first six CHIKV infections from the current outbreak diagnosed at a reference center in Madrid, Spain.
      PubDate: 2015-04-01T01:44:17.40182-05:0
      DOI: 10.1111/jtm.12204
  • Establishment of Health Utility Indices for Post‐Infectious
           Functional Gastrointestinal Disorders in Active Duty US Military
    • Authors: Chad K. Porter; Nadia Thura, Carey D. Schlett, John W. Sanders, David R. Tribble, Marshall R. Monteville, Mark S. Riddle
      Abstract: Introduction Knowledge of disease burden attributable to functional gastrointestinal disorders (FGD) in travelers is lacking, despite the high incidence of travelers' diarrhea (TD) associated with increased FGD risk. One tool for assessing the impact of disease on health‐related quality of life is the health utility index (HUI), which values health states based on preferential health outcomes. Health utilities can be used as preference weights in the estimation of quality‐adjusted life‐years (QALYs). Methods Six months following travel to Egypt or Turkey, 120 US military personnel completed a survey on TD during deployment, health‐related quality of life (SF‐36), and the onset of functional bowel disorders (Rome II). Elements from the SF‐36 were used to develop SF‐6D values, which were combined with health state valuations to enable calculation of HUI scores for each subject. Mean index scores were compared across functional outcomes, specific symptoms, and demographic profiles. Results The presence of FGD significantly reduced index scores, with irritable bowel syndrome (IBS) and dyspepsia showing the greatest impact (−0.17 and −0.19, respectively) compared with those with no FGD (p 
      PubDate: 2015-04-01T01:42:53.443363-05:
      DOI: 10.1111/jtm.12200
  • Myiasis in Travelers
    • Authors: Tamar Lachish; Enbal Marhoom, Kosta Y. Mumcuoglu, Moshik Tandlich, Eli Schwartz
      Abstract: Background Cutaneous myiasis is a well‐established diagnosis in returning travelers from tropical countries. The most common form of myiasis seen in this population is localized furuncular myiasis caused by Dermatobia hominis and Cordylobia anthropophaga. There are limited data on the disease course and outcome in travelers to tropical countries. Methods A retrospective observational study of patients who presented with myiasis was conducted between 1999 and July 2014 in the post‐travel clinics in Israel. Data regarding exposure history, travel duration, clinical presentation, treatment, and parasitological identification were collected and analyzed. Results Among 6,867 ill returning Israeli travelers, 1,419 (21%) had a dermatologic complaint, 90 (6.3%) of them were diagnosed with myiasis. Myiasis was acquired in Latin America by 72 (80%) patients, mainly (54%) in the Madidi National Park, Amazonas Basin, Bolivia; 18 cases (20%) were acquired in Africa. In 76% of cases, manual extraction was sufficient to remove the larva; 24% required surgical intervention. Despite the fact that most patients did not receive antibiotic treatment, only one developed secondary infection, upon partial removal of the larva. Conclusions This is the largest myiasis case series in ill returning travelers. Myiasis is not a rare dermatologic complaint with most Israeli cases imported from Latin America and specifically the Madidi National Park in Bolivia. Treatment is based on full extraction of the larva after which no antibiotic treatment is needed. Myiasis is a preventable disease and travelers should be informed of the different preventive measures according to their travel destination.
      PubDate: 2015-04-01T01:42:51.051098-05:
      DOI: 10.1111/jtm.12203
  • The Risk of Sexual Assault and Rape During International Travel:
           Implications for the Practice of Travel Medicine
    • Authors: Kieran M. Kennedy; Gerard T. Flaherty
      PubDate: 2015-04-01T01:42:32.217967-05:
      DOI: 10.1111/jtm.12201
  • Dengue Vaccines for Travelers: Has the Time Come?
    • Authors: Annelies Wilder‐Smith
      PubDate: 2015-04-01T01:35:56.793063-05:
      DOI: 10.1111/jtm.12198
  • Looking Over the Fence—How Travel Medicine Can Benefit From Tourism
    • Authors: Irmgard L. Bauer
      PubDate: 2015-03-19T01:21:16.474243-05:
      DOI: 10.1111/jtm.12197
  • Frequency and Characteristics of Infectious Diseases in Internationally
           Adopted Children: A Retrospective Study in Nantes From 2010 to 2012
    • Authors: Fanny Hénaff; Isabelle Hazart, Georges Picherot, Françoise Baqué, Christèle Gras‐Le Guen, Elise Launay
      Abstract: Background and Aims Internationally adopted children are more susceptible to developing and carrying acute or chronic infectious diseases. Specialized consultations exist in the main French cities; however, specialized consultation with a pediatrician is not mandatory. The main objective of this study was to determine the frequency and characteristics of infections (bacterial, viral, and parasitic) among a group of international adoptees in Nantes over a 3‐year period. Methods A retrospective chart review was conducted of internationally adopted children who went through the Medical Guidance for Adopted Children Consultation between 2010 and 2012. Results A total of 133 children were included in the study. Of these, 55% had an infectious disease; 8% were severe infections. We found a frequency of 38% [confidence interval (CI) 95% 30–46] for parasitic intestinal and 35% (CI 95% 27–43) for dermatologic infections. African children were more likely to have infections that required hospitalization [odds ratio (OR) = 12, p = 0.004, CI 95% 1.3–113.7] and more likely to carry extended‐spectrum β‐lactamase‐producing bacteria. Conclusion The frequency of infectious diseases, and sometimes severe diseases, found among our cohort of internationally adopted children highlights the need for systematic, specialized medical care.
      PubDate: 2015-03-17T01:28:57.109231-05:
      DOI: 10.1111/jtm.12196
  • Estimating Air Travel–Associated Importations of Dengue Virus Into
    • Authors: Mikkel B. Quam; Kamran Khan, Jennifer Sears, Wei Hu, Joacim Rocklöv, Annelies Wilder‐Smith
      Abstract: Background Southern Europe is increasingly at risk for dengue emergence, given the seasonal presence of relevant mosquito vectors and suitable climatic conditions. For example, Aedes mosquitoes, the main vector for both dengue and chikungunya, are abundant in Italy, and Italy experienced the first ever outbreak of chikungunya in Europe in 2007. We set out to estimate the extent of dengue virus importations into Italy via air travelers. Methods We attempted to quantify the number of dengue virus importations based on modeling of published estimates on dengue incidence in the countries of disembarkation and analysis of data on comprehensive air travel from these countries into Italy's largest international airport in Rome. Results From 2005 to 2012, more than 7.3 million air passengers departing from 100 dengue‐endemic countries arrived in Rome. Our Importation Model, which included air traveler volume, estimated the incidence of dengue infections in the countries of disembarkation, and the probability of infection coinciding with travel accounted for an average of 2,320 (1,621–3,255) imported dengue virus infections per year, of which 572 (381–858) were “apparent” dengue infections and 1,747 (1,240–2,397) “inapparent.” Conclusions Between 2005 and 2012, we found an increasing trend of dengue virus infections imported into Rome via air travel, which may pose a potential threat for future emergence of dengue in Italy, given that the reoccurring pattern of peak importations corresponds seasonally with periods of relevant mosquito vector activity. The observed increasing annual trends of dengue importation and the consistent peaks in late summer underpin the urgency in determining the threshold levels for the vector and infected human populations that could facilitate novel autochthonous transmission of dengue in Europe.
      PubDate: 2015-03-10T03:59:32.747507-05:
      DOI: 10.1111/jtm.12192
  • Delayed Diagnosis of High Drug‐Resistant Microorganisms Carriage in
           Repatriated Patients: Three Cases in a French Intensive Care Unit
    • Authors: Jérôme Allyn; Marion Angue, Olivier Belmonte, Nathalie Lugagne, Nicolas Traversier, David Vandroux, Yannick Lefort, Nicolas Allou
      Abstract: We report three cases of high drug‐resistant microorganisms (HDRMO) carriage by patients repatriated from a foreign country. National recommendations suggest systematic screening and contact isolation pending results of admission screening of all patients recently hospitalized abroad. HDRMO carriage (carbapenem‐resistant Acinetobacter baumanii and carbapenemase‐producing Enterobacteriaceae) was not isolated on admission screening swabs, but later between 3 and 8 days after admission. In absence of cross‐transmission, two hypotheses seem possible: a false‐negative test on admission, or a late onset favored by antibiotic pressure. Prolonged isolation may be discussed even in case of negative screening on admission from high‐risk patients.
      PubDate: 2015-02-28T03:46:15.381153-05:
      DOI: 10.1111/jtm.12194
  • The Estimation of Imported Dengue Virus From Thailand
    • Authors: Sittisede Polwiang
      Abstract: Background Dengue fever is one of the important causes of illness among travelers returning from Thailand. The risk of infection depends on the length of stay, activities, and arrival time. Due to globalization, there is a concern that infected travelers may carry dengue virus (DENV) to their country of residence and cause an outbreak. Methods To estimate the infective person‐days of travelers returning from Thailand, we developed a model with the following parameters: the probability of travelers being infected, number of arrivals, length of stay of travelers, incubation period, and duration of the infective period. The data used in this study were the dengue incidences in Thailand during 2004–2013 and foreign traveler arrivals in 2013. Results We estimated the highest infective person‐days for each country group. The highest value was from June to August during the rainy season in Thailand for all groups. Infective person‐days ranged from 87 to 112 per 100,000 travelers each year. Conclusion Our results provided a fundamental step toward estimation of the risk of the secondary transmission of DENV in non‐epidemic countries via travelers, which can serve as an early warning of a dengue outbreak. The highest infective person‐day is associated with the rainy season in Thailand. The increasing number of overseas travelers may increase the risk of global transmission of the DENV. Better understanding of the virus transmission dynamics will enable further quantitative predictions of epidemic risk.
      PubDate: 2015-02-28T02:02:51.188032-05:
      DOI: 10.1111/jtm.12193
  • The Raised Potential for Vector‐Borne Diseases in European Travelers
           Following the EU's Biocide Directive on DEET Dosing
    • Authors: Ron H. Behrens
      PubDate: 2015-02-28T01:52:13.628549-05:
      DOI: 10.1111/jtm.12191
  • Massive Intra‐Alveolar Hemorrhage Caused by Leptospira Serovar
           Djasiman in a Traveler Returning From Laos
    • Authors: Guillaume Héry; Julien Letheulle, Erwan Flécher, Charlotte Quentin, Caroline Piau, Yves Le Tulzo, Pierre Tattevin
      Abstract: Leptospirosis is one of the most common pathogens responsible for life‐threatening tropical disease in travelers. We report a case of massive intra‐alveolar hemorrhage caused by Leptospira serovar Djasiman in a 38‐year‐old man returning from Laos, who was cured with antibiotics and salvage treatment with extra‐corporeal membrane oxygenation.
      PubDate: 2015-02-28T01:31:35.309969-05:
      DOI: 10.1111/jtm.12189
  • Patient Awareness of Need for Hepatitis A Vaccination (Prophylaxis) Before
           International Travel
    • Authors: Stephen J. Liu; Umid Sharapov, Monina Klevens
      Abstract: Introduction Although hepatitis A virus (HAV) infection is preventable through vaccination, cases associated with international travel continue to occur. The purpose of this study was to examine the frequency of international travel and countries visited among persons infected with HAV and assess reasons why travelers had not received hepatitis A vaccine before traveling. Methods Using data from sentinel surveillance for HAV infection in seven US counties during 1996 to 2006, we examined the role of international travel in hepatitis A incidence and the reasons for patients not being vaccinated. Results Of 2,002 hepatitis A patients for whom travel history was available, 300 (15%) reported traveling outside of the United States. Compared to non‐travelers, travelers were more likely to be female [odds ratio (OR) = 1.74 (95% confidence interval [95% CI], 1.35, 2.24)], aged 0 to 17 years [OR = 3.30 (1.83, 5.94)], Hispanic [OR = 3.69 (2.81, 4.86)], Asian [OR = 2.00 (1.06, 3.77)], and were less likely to be black non‐Hispanic [OR = 0.30 (0.11, 0.82)]. The majority, 189 (61.6%), had traveled to Mexico. The most common reason for not getting pre‐travel vaccination was “Didn't know I could [or should] get shots” [100/154 (65%)]. Conclusion Low awareness of HAV vaccination was the predominant reason for not being protected before travel. Different modes of traveler education could improve prevention of hepatitis A. To highlight the risk of infection before traveling to endemic countries including Mexico, travel and consulate websites could list reminders of vaccine recommendations.
      PubDate: 2015-01-24T09:36:03.9437-05:00
      DOI: 10.1111/jtm.12186
  • Acute Schistosomiasis: A Risk Underestimated by Travelers and a Diagnosis
           Frequently Missed by General Practitioners—A Cluster Analysis of 42
    • Authors: Laurence Rochat; Alain Bizzini, Nicolas Senn, Pierre‐Yves Bochud, Blaise Genton, Serge de Vallière
      Abstract: Background In 2011, a patient was admitted to our hospital with acute schistosomiasis after having returned from Madagascar and having bathed at the Lily waterfalls. On the basis of this patient's indication, infection was suspected in 41 other subjects. This study investigated (1) the knowledge of the travelers about the risks of schistosomiasis and their related behavior to evaluate the appropriateness of prevention messages and (2) the diagnostic workup of symptomatic travelers by general practitioners to evaluate medical care of travelers with a history of freshwater exposure in tropical areas. Methods A questionnaire was sent to the 42 travelers with potential exposure to schistosomiasis. It focused on pre‐travel knowledge of the disease, bathing conditions, clinical presentation, first suspected diagnosis, and treatment. Results Of the 42 questionnaires, 40 (95%) were returned, among which 37 travelers (92%) reported an exposure to freshwater, and 18 (45%) were aware of the risk of schistosomiasis. Among these latter subjects, 16 (89%) still reported an exposure to freshwater. Serology was positive in 28 (78%) of 36 exposed subjects at least 3 months after exposure. Of the 28 infected travelers, 23 (82%) exhibited symptoms and 16 (70%) consulted their general practitioner before the information about the outbreak had spread, but none of these patients had a serology for schistosomiasis done during the first consultation. Conclusions The usual prevention message of avoiding freshwater contact when traveling in tropical regions had no impact on the behavior of these travelers, who still went swimming at the Lily waterfalls. This prevention message should, therefore, be either modified or abandoned. The clinical presentation of acute schistosomiasis is often misleading. General practitioners should at least request an eosinophil count, when confronted with a returning traveler with fever. If eosinophilia is detected, it should prompt the search for a parasitic disease.
      PubDate: 2015-01-21T04:18:59.920383-05:
      DOI: 10.1111/jtm.12187
  • Immediate Recall of Health Issues Discussed During a Pre‐Travel
    • Authors: Sarah L. McGuinness; Tim Spelman, Douglas F. Johnson, Karin Leder
      Abstract: Background An important role of pre‐travel consultations is to improve travelers' understanding of travel‐related diseases, but the efficacy of education provided is unknown. This study sought to assess recall and knowledge immediately following a pre‐travel consultation. Methods The study was conducted at a hospital‐based pre‐travel clinic in Melbourne, Australia. Travelers aged ≥16 years seen between September 2010 and March 2012 were invited to complete an anonymous self‐administered questionnaire immediately following their consultation to assess knowledge of appropriate preventive measures and presumptive self‐treatment strategies for common travel risks. The doctor of each participating traveler also completed a survey regarding issues discussed. Results A total of 300 participants were recruited (34% male, median age 31 years). Most were traveling for vacation (77%) and reported previous travel (95%). Main travel destinations were Asia (43%), Americas (21%), and Africa (17%). Doctors' and travelers' surveys showed variable levels of concordance: 94% of patients recalled discussion of malaria, 84% rabies, and 76% dengue. For malaria, 95% remembered discussions regarding insect repellents, and 92% recalled that medical advice should be sought if fever developed. For travelers with whom rabies was discussed, 94% recalled that medical advice must be urgently sought following a bite/scratch. For travelers' diarrhea (TD), 99% knew to drink only boiled/bottled water, but 13% did not recall avoiding unpeeled fruit/vegetables as a prevention strategy. There was 20% discordance between doctors and travelers regarding antibiotics for TD self‐treatment, but only 4% discordance regarding prescription of malaria prophylaxis. Factors associated with improved recall were doctor discussion, previous travel, and a university education. Conclusions Key travel health messages are well assimilated after pre‐travel consultation. However, large amounts of information are discussed and immediate recollection of all information is not possible. This study reinforces the importance of providing supplementary information (eg, written and/or electronic resources) to accompany pre‐travel consultations.
      PubDate: 2015-01-16T01:10:56.08216-05:0
      DOI: 10.1111/jtm.12183
  • The Pre‐Travel Health Consultation
    • Authors: Iain B. McIntosh
      Pages: 143 - 144
      PubDate: 2015-04-23T02:18:05.891783-05:
      DOI: 10.1111/jtm.12182
  • Medical Tourism
    • Authors: Lin H. Chen; Mary E. Wilson
      Pages: 218 - 218
      PubDate: 2015-04-23T02:18:02.608282-05:
      DOI: 10.1111/jtm.12190
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