Preparing young travellers for low resource destinations

BMJ 2012; 345 doi: (Published 6 November 2012)
Cite this as: BMJ 2012;345:e7179

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I noted the article relating to the overview of preparing young travellers for low resource destinations with interest.

In the section pertaining to “extra advice available for medical students and volunteers” had the authors considered including education regarding locally appropriate public health escalation measures in the context of infectious out-breaks. It is often those working in direct service provision that will first encounter patients presenting with symptoms suggestive of an infectious outbreak.

In many resource poor settings the relative luxuries of full personal protective equipment (PPE) which are disposable after single use are not routinely available. It is recognised that in previous outbreaks the remote settings may have contributed to diagnostic delay (1). During this period full PPE and optimal infection control measures may be unattainable due to resource limitations. Awareness of local public health infrastructure, GOARN and documents providing practical infection control advice for resource poor settings (2) can be empowering, informative and expedite optimal management. In Sheffield we have recently designed an educational program incorporating this aspect for elective students which is due to be implemented in the next year.

Dr J Cunningham Specialty trainee Sheffield (former VSO Volunteer Mbarara, Uganda 2008)

1) Proportion of Deaths and Clinical Features in Bundibugyo Ebola Virus Infection, Uganda - - Emerging Infectious Disease journal - CDC
2) Interim Infection Control Recommendations for Care of Patients with Suspected or Confirmed Filovirus (Ebola, Marburg) Haemorrhagic Fever, March 2008. WHO

Competing interests: None declared

Jane E Cunningham, Specialty Registar in Infectious Diseases and Microbiology

Royal Hallamshire Hospital, Sheffield, Glossop Road Sheffield, South Yorkshire S10 2JF

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What a pity that there was no advice about contraception or (often as important in ares with minimal washing facilities) menstrual control. This needs to be organised early to give time to adjust and manage side-effects. Implants are popular, and have the advantage that they cannot be stolen, lost or affected by diarrhoea and vomiting, but irregular bleeding may take some months to settle

Competing interests: None declared

Lesley Elizabeth Bacon, consultant in sexual health

Lewisham healthcare nhs trust, Lewisham High Street, London SE13 6LH

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