Travel to Haiti Julia Jewett, RN, BScN Carol Lynn Raithby, RN, BScN

Port au Prince, Haiti

Travel Assessment Destination Detailed Itinerary Accommodations Activities

Malaria A disease caused by a parasite that is spread by the bite of an infected female mosquito These mosquitoes bite at night: dusk-dawn Symptoms from 6 days later to several months Symptoms include fever, chills, headache, muscle aches, fatigue, V & D, jaundice

Malaria in Asia

World Health Organization Malaria: Malaria risk due exclusively to P. falciparum exists throughout the year in the whole country. No P. falciparum resistance to chloroquine reported. Recommended prevention: Mosquito bite prevention plus chloroquine prophylaxis or Mosquito bite prevention plus atovaquone– proguanil, doxycycline or mefloquine.

Malaria Prevention Travelers to malaria-endemic areas need to be: – Aware of risk of malaria and understand it is a serious potentially fatal illness – Know how to best prevent it with insect precautions and oral prophylaxis – Seek medical attention urgently should they develop a fever during or after travel

Prevent Mosquito Bites Insect Repellant with 30% DEET Reapply at least every 4-6 hours Appropriate clothing – light colors, long pants & sleeves Screens & Bed Nets Avoid Scented Products

Dengue Viral Infection from Aedes Mosquito More than 100 Million cases annually Urban & Rural risk in 100 countries Mosquito Precautions

Routine Immunizations Tdap MMR Influenza

Travel Vaccines for Haiti Hepatitis A & B Typhoid Dukoral Rabies - for prolonged visits

Hepatitis A A viral illness that infects your Liver least 2 weeks later Causes fever, fatigue, weight loss, N & V, abdominal pain, jaundice Spread by fecal-oral route from direct contact or from contaminated food & water Recommended for all Travelers 1 dose of vaccine before travel

Hepatitis B A viral illness that infects your Liver Spread through exposure to Blood & Body Fluids Spread through unscreened Blood and contaminated Medical & Dental Equipment

Typhoid A type of Salmonella bacteria Acquired through poor sanitation, contaminated food and water supplies, and direct contact with an infectious person Causes fever, headache, weakness, muscle & joint pain, may have a rash with pink spots Vaccine - protection develops in 2 weeks and lasts for 2-3 years

“Travel expands the mind…..but loosens the bowels”

Travelers’ Diarrhea Most common travel-related health problem; affects about 50% Bacteria are most common cause of TD E. coli is the most common Bacteria Viruses and Parasites can also cause TD

Dukoral Oral, Inactivated Travelers’ Diarrhea and Cholera Vaccine Provides protection against E. coli(ETEC) & V. cholera 2 doses of liquid vaccine - 1 week apart

Cholera in Mexico, Cuba, Dominican Republic and Haiti Updated: September 27, 2013 Travel Health Notice Since the beginning of the cholera epidemic in October 2010, the Dominican Republic and Haiti have reported thousands of cholera cases and related deaths. Cases of cholera decreased in 2013 compared to 2012, although they continue to be reported throughout both countries. There have been increases in the number of cases during seasonal heavy rainfall in the months of May to July and September to October. PHAC

Prevention of Travelers’ Diarrhea “Boil it, Cook it, Peel it, or Forget it!” Treated Water or Bottled Water Well-cooked meals, served hot Pasteurized dairy products Avoid salads and uncooked foods Avoid Street Vendors Careful Brushing Teeth

Prevention of Travelers’ Diarrhea Hand Washing - Alcohol Hand Sanitizers Managing Travelers’ Diarrhea Drink lots of fluids to stay hydrated Medications to slow diarrhea Prescription – review pharmacy information

Injury and Crime Avoidance Road Safety Seat belts Crime activity Money/Valuables Scan & Copy Documents

Other Travel Tips…. Sun Safety Medical Kit Excellent Footwear Appropriate Clothing Travel Light

“If you look like your passport picture, you’re too ill to travel.” Author Unknown

Thank-you!!