Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
International travelers should make sure that these
vaccinations are up to date and that no boosters are required, since many
conditions which are rare in the U.S. due to immunity in the general population
may be more common in other countries.
"Recommended" vaccinations are given to protect travelers from illnesses that
occur routinely in other parts of the world. Doctors determine which vaccines
are recommended for international travel on an individual basis, taking into
consideration your destination, whether you will be spending time in rural
areas, the season of the year you are traveling, your age, your overall health
status, and your immunization history.
Some examples of vaccines that may be recommended for international travelers
(remember you may need more, fewer, or different vaccinations, depending on your
individual circumstances) include the following:
Hepatitis A: This
condition is spread by person-to-person contact, through contaminated water,
shellfish harvested in contaminated water, or other food products contaminated
during preparation or handling. Hepatitis A may be contracted where sanitation
conditions may be lacking.
Rabies: Rabies virus is
endemic in dogs in many countries throughout the world, including, but not
limited to, parts of Thailand, Vietnam, Brazil, China, the Philippines, Sri
Lanka, and Indonesia.
Typhoid fever: This
condition may be contracted in many areas of the world through contaminated
drinking water or food or by consuming food or beverages that have been
handled by an infected person.
Rabies is a disease caused by a virus that enters the body through the bite
from infected animals and causes brain swelling and, if not quickly treated,
results in convulsions,
respiratory failure, and death in almost every person
infected. Very rarely, rabies has been transmitted
by saliva droplets from an infected animal that contacts a skin break (abrasion
or cut). Aerosols of saliva droplets or bat guano may also rarely cause rabies.
Rabies is worldwide (except for Australia and New Zealand currently);
developing countries have dogs as the most common source of
bites that lead to
rabies. However, many wild animals (especially foxes, skunks, raccoons, and bats)
in both developed and developing countries can be infected with rabies virus so
their bites (and saliva) can transmit the disease to other animals and humans.
Most developed countries have animal vaccination programs that effectively
reduce or eliminate the source of rabies in domestic animals (especially dogs and
cats);
some even have programs to reduce or eliminate the virus in some wild animals.
For example, vaccine materials are set out in the wild for coyotes to ingest to
reduce or eliminate rabies in their population in Texas. Until recently, when
rabies-infected bats were found in Scotland, all of England was rabies-free due
to its vaccine program. Rabies is termed a
zoonosis, which means the disease is
usually transmitted from animals to humans. The terms rabies and rabies virus
(Lyssavirus rabies) are currently interchanged in most of the medical literature
although technically "rabies" is the disease process and "rabies virus" is the
species of Lyssavirus that causes the disease. However, the dual meaning is so
pervasive in the medical and lay literature that "rabies" will be used in this
article to mean both the disease and the viral cause of the disease.
About 55,000 deaths per year worldwide are due to rabies, and the majority of
these deaths occur in children.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
Tetanus is an often-fatal disease caused by nerve toxins produced by the common bacteria Clostridium tetani. In a seven-day period after infection, a person experiences muscle spasms, restlessness, headache, irritability, then lockjaw, and the lungs stop functioning. Tetanus is treatable with antibiotics and drainage. Sedation is often give to stop muscle spasms.
There are millions of dogs living in the United States, and thus many cases of dog bites. Annually, hundreds of people seek emergency medical care for dog bites. Treatment for a dog bite depends on how deep the injury is and the amount of tissue damage. Dog bites can be prevented by employing preventative measures.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Dysphagia is the medical term for the symptom of difficulty
swallowing, derived from the Latin and Greek words meaning difficulty eating.
Mechanism of swallowing
Swallowing is a complex action.
Food is first chewed
well in the mouth and mixed with saliva.
The tongue then propels the chewed food
into the throat (pharynx).
The soft palate elevates to prevent the food from
entering the posterior end of the nasal passages, and the upper pharynx
contracts, pushing the food (referred to as a bolus) into the lower pharynx. At
the same time, the voice box (larynx) is pulled upwards by muscles in the neck,
and, as a result, the epiglottis bends downwards. This dual action closes off
the opening to the larynx and windpipe (trachea) and prevents passing food from
entering the larynx and trachea.
The contraction of the muscular pharynx
continues as a progressing, circumfe...