Travel Medicine Resources for Canadian Practitioners

Canada Communicable Disease Report
Volume 32 • ACS-6 - 1 June 2006

An Advisory Committee Statement (ACS)

Committee to Advise on Tropical Medicine and Travel (CATMAT)*†

Preamble

The Committee to Advise on Tropical Medicine and Travel (CATMAT) provides the Public Health Agency of Canada (PHAC) with ongoing and timely medical, scientific, and public health advice relating to tropical infectious disease and health risks associated with international travel. PHAC acknowledges that the advice and recommendations set out in this statement are based upon the best current available scientific knowledge and medical practices, and is disseminating this document for information purposes to both travellers and the medical community caring for travellers.

Persons administering or using drugs, vaccines, or other products should also be aware of the contents of the product monograph(s) or other similarly approved standards or instructions for use. Recommendations for use and other information set out herein may differ from that set out in the product monograph(s) or other similarly approved standards or instructions for use by the licensed manufacturer(s). Manufacturers have sought approval and provided evidence as to the safety and efficacy of their products only when used in accordance with the product monographs or other similarly approved standards or instructions for use.

Introduction

The goal of this document is to provide both the novice and the experienced travel medicine practitioner with a comprehensive, though not exhaustive, list of resources. Resources that appear to be most used by health professionals currently practising this specialty have been included. The collection has been divided into sections based mainly on the type of medium.

A survey was used as one determinant of inclusion of the many books, journals, Web sites, and conferences. The question was presented to the members of TRAVELMED and TRAVMED. These are, respectively, an international and a Canadian e-mail discussion forum for travel medicine practitioners. In addition, the opinions of experts in travel medicine were solicited, and Internet searches were performed to identify resources.

The resources listed are international. However, we have paid particular attention to Canadian sources of information. These will often be more accessible to Canadian practitioners and will reflect common practice in this country.

Travel and tropical medicine frequently overlap. The intent of this document is to focus on travel medicine. Tropical medicine resources are cited mainly when they regularly include travel medicine material. In addition, the final section of the paper provides an annotated bibliography of tropical medicine resources for health practitioners planning to work in the developing world.

The reader will find a number of references to Web sites. These URL addresses should be correct at the time of writing, though invariably some will change or be removed. CATMAT welcomes reports of such outdated links and will endeavour to update them on the Web version of this document.

Categories of resource

1. Courses and conferences
2. Books
3. Periodicals and handbooks updated regularly
4. Journals
5. Internet forums
6. Subscription CDs and on-line subscription services
7. Outbreak reports
8. Web sites
9. Travel medicine clinics in Canada and abroad
10. Travel medicine groups in Canada
11. Certification
12. Resources for use by medical practitioners traveling to resource-poor settings

I. Courses and conferences

Canada

Alberta, Canmore

The Alberta Association of Travel Health Professionals Conference is held annually in the late spring, continuing for 1.5 days. Nationally and internationally known speakers.

www.aathp.com

British Columbia, Victoria

The NOVA Travel Medicine Conference is held annually on the first weekend in November. International medicine and tropical diseases.

Cindy Lundy, RN 250-658-6056
www.novaclinical.com
info@novaclinical.com

Manitoba, Winnipeg

The Manitoba Travel Health Network Annual Conference is held annually in April. Held over 1.5 days, this is a good review of current topics. The intended audience is physicians, nurses, and pharmacists. Continuing medical education (CME) credits are offered to physician specialists, general practitioners, and pharmacists.

http://www.wrha.mb.ca/community/travel/conference.php

Ontario, Toronto

Travel Medicine Update at the Toronto General Hospital. Includes recent advances in the field of travel medicine as well as practical advice on the counselling of international travellers, including special needs groups. Usually held every 2 years.

Quebec, Montreal

Conference on the Health of International Travellers. Held in the fall of each year, usually 2 days' duration. Canadian and international speakers, good review of current topics. Because of its relatively small size, presenters are often more accessible for questions. French is an asset but not essential.

1-800-499-1394
info@medisys.ca

McGill University Tropical Medicine course. Usually 3days in duration, focusing on tropical medicine but with travel medicine content as well. Held in the spring of even years. Particularly useful for those who are also seeing travellers after their return.

Kelly Glover - (514) 934-1934
kelly.glover@muhc.mcgill.ca
http://ww2.mcgill.ca/mgh_pgb/

The above list includes regularly scheduled meetings only. For a current list of upcoming Canadian conferences, both regularly held and otherwise, consult the Public Health Agency of Canada's Travel Medicine Program.

www.travelhealth.gc.ca

International

International Society of Travel Medicine (ISTM) Conference. Thisis the largest of the travel medicine meetings, generally lasting 5 days. It is held in the spring of odd years. The location varies. Plenary sessions and a wide choice of concurrent meetings cover the gamut of travel medicine topics.

http://www.istm.org/

Travel and International Medicine Course. Held biannually in Seattle, Washington. This has been described as a thorough conference for those newer to travel medicine.

http://uwcme.org

Asia Pacific Travel Health Society Congress. Held on even years.

Annual meeting of the American Society of Tropical Medicine and Hygiene. Primarily tropical medicine with some travel medicine content.

http://www.astmh.org

A comprehensive listing of upcoming international travel medicine conferences can be found at the ISTM Web site.

II. Books

Travel medicine

• Travel Medicine, Keystone et al, 2004
• Manual of Travel Medicine, Steffen, Dupont, Wilder-Smith, 2003
• Principles and Practice of Travel Medicine, Zuckerman, 2003
• Travel and Tropical Medicine Handbook, Jong, 2004
• The Travel Doctor, Wise, 2002, oriented more to the traveller than the practitioner, though useful to both; Canadian
• Textbook of Travel Medicine and Health, Dupont, Steffen, 2004

Vaccines

• Traveler’s Vaccines, Jong, 2004
• Vaccines, Plotkin & Orenstein, 2003
• Travel and Routine Immunizations: A Practical guide for the Medical Office, Richard F. Thompson, MD, published annually

Malaria

• Travelers’ Malaria, Patricia Schlagenhauf-Lawlor, useful, country-specific information, 2001

Traveller’s diarrhea

• Traveller’s Diarrhea, 2003

Tropical disease

• Strickland’s Hunter’s Tropical Medicine, 2000
• Manson’s Tropical Diseases, 2003
• Tropical Dermatology, Tyring, Lupi, Hengge, 2005

Other

• Control of Communicable Diseases Manual, 17th ed., James Chin, handy reference for the essentials of most infectious diseases, 2000
• Wilderness Medicine, 4th ed., Auerbach, 2001
• Goode’s World Atlas, Rand and McNally
• Hammond Ambassador World Atlas

Ideally, the atlas will show the states/provinces in most countries, since many malaria recommendations name these specifically. Topography should also be shown, so that a general idea of altitude is obtainable.

III. Periodicals and handbooks updated regularly

Note: Recommendations from the following sources, particularly regarding malaria prophylaxis, do not always completely agree with each other.

Canadian Immunization Guide, 2002. Produced by the National Advisory Committee on Immunization (NACI), this book provides Canadian recommendations and guidelines for all vaccines licensed for use in this country. It deals comprehensively with problematic situations such as immunizing immunosuppressed travellers. Available from the Canadian Public Health Association (new edition pending).

http://www.phac-aspc.gc.ca/publicat/cig-gci/

Canadian Recommendations for the Prevention and Treatment of Malaria among International Travellers, 2004. Produced by the Committee to Advise on Tropical Medicine and Travel (CATMAT).

http://www.phac-aspc.gc.ca/tmp-pmv/catmat-ccmtmv/index-eng.php

Health Information for International Travel . Also known as the "yellow book", from the Centers for Disease Control and Prevention (CDC) in the United States. Generally regarded as a very useful resource to have on hand. Included are US malaria prophylaxis recommendations, international yellow fever requirements and recommendations, and information on vaccine use from a US perspective.

http://www.cdc.gov/travel/yb/index.htm

International Travel and Health, WHO. Particularly useful for its malaria recommendations and international requirements for yellow fever vaccine. Published yearly.

http://www.who.int/ith/en/

Guide d'intervention en santé-voyage, 1994. Produced by the Ministère de la Santé et des Services sociaux, Quebec. A very useful feature is the collection of malaria maps showing the endemic areas within countries, for which a knowledge of French is not needed.

Guide d'intervention en santé-voyage (PDF Document)

World Malaria Risk Chart . Produced by the International Association for Medical Assistance to Travellers (IAMAT). Part of a package that includes a booklet of physicians around the world. This chart is particularly detailed regarding malaria distribution within countries, by season and by altitude.

http://www.iamat.org

Redbook . Produced by the American Academy of Pediatrics. The Redbook has chapters on international travel and adoption.

http://aapredbook.aappublications.org

Travel Medicine Advisor . Travel medicine articles and country-specific handouts.

1-800-688-2421
http://www.travelmedicineadvisor.com

International Travel Health Guide, by Stuart Rose, is updated annually.

IV. Journals

Journals devoted to travel medicine

Journal of Travel Medicine . The official journal of the International Society of Travel Medicine. Members automatically receive this publication, devoted mainly to travel medicine with some tropical medicine.

www.istm.org

Travel Medicine and Infectious Disease

http://www.elsevier.com/wps/find/journaldescription.cws_home/643125/description#description

Journals with frequent travel medicine content

Clinical Infectious Diseases

http://www.journals.uchicago.edu/toc/cid/current

Emerging Infectious Diseases

http://www.cdc.gov/ncidod/EID/index.htm

Vaccine

http://www.elsevier.com/locate/vaccine

Lancet

www.lancet.com

Lancet Infectious Diseases

http://www.thelancet.com/journals/laninf/issue/current

British Medical Journal

www.bmj.com

Canadian Medical Association Journal occasionally has travel medicine material of interest to Canadian practitioners.

www.cmaj.ca

Journal of the American Society of Tropical Medicine and Hygiene, primarily tropical medicine but with some travel medicine content.

www.ajtmh.org

Morbidity and Mortality Weekly Report (MMWR), articles relevant to travel medicine sometimes appear.

http://www.cdc.gov/mmwr

Canada Communicable Disease Report (CCDR), travel medicine articles appear fairly often, and will usually include any Canadian aspects.

http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/

V. Internet forums

Travmed, a Canadian travel medicine e-mail discussion forum - open to Canadian travel medicine practitioners

travelclinic@rogers.com

Travelmed, international travel medicine e-mail discussion forum - open to members of the International Society of Travel Medicine

http://www.istm.org

Tropmed, American Society of Tropical Medicine and Hygiene

VI. Subscription CDs and on-line subscription services

These programs provide detailed assistance for any itinerary. The user inputs the requested travel information. The program displays its recommendations regarding immunizations, malaria prophylaxis, and advice for the traveller. Generally, these programs can be very helpful for the novice in the field. The expert will already know much of this and will be more interested in fine-tuning recommendations, something for which these products may be less helpful.

Travax EnCompass SL Shoreland, a popular source of travel medicine information. US $895 single clinic license

www.shoreland.com

Tropimed, US $175

www.tropimed.com

Additional

Gideon - Primarily a tropical and infectious disease diagnostic program but includes detailed epidemiologic information on travel-related diseases. US $695/yr (Web), US $720 CD with quarterly updates, per subscriber

http://www.gideononline.com/

Travel Medicine Advisor, on line. US $449/yr

http://www.ahcpub.com

VII. Outbreak reports

It is highly recommended that the practitioner stay current regarding disease outbreaks of importance to travellers. We reccmmend that the reader subscribe to the following two e-mail services and regularly log on to the third, which is Web-based.

Promed, at this time perhaps the most frequently used disease outbreak e-mail service. Past outbreak reports are available on the Promed Web site. These reports are timely but generally not confirmed.

www.promedmail.org

Weekly Epidemiological Record, World Health Organization, outbreak reports.

http://www.who.int/wer/en/

Public Health Agency of Canada, Travel Medicine Program

http://www.phac-aspc.gc.ca/tmp-pmv/

VIII. Web sites

Note: Because of the very large number of travel medicine Web sites, this section emphasizes Canadian sites of interest. The links sections of several of the listed sites provide access to the broad range of international Web pages.

Canadian

Committee to Advise on Tropical Medicine and Travel (CATMAT), Government of Canada recommendations and position papers from CATMAT

http://www.phac-aspc.gc.ca/tmp-pmv/catmat-ccmtmv/index-eng.php

Public Health Agency of Canada Travel Medicine Program

http://www.phac-aspc.gc.ca/tmp-pmv/

Canada Communicable Disease Report (CCDR), travel medicine articles appear fairly often and will usually include any Canadian aspects.

http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/

Comité consultatif québecois sur la santé des voyageurs ,useful malaria atlas is available as a PDF file.

http://www.msss.gouv.qc.ca/sujets/santepub/preventioncontrole/voyageurs/fs_voyageur.html

Canadian Malaria Network, timely medical access to quinine for the treatment of malaria

http://www.phac-aspc.gc.ca/tmp-pmv/quinine/index-eng.php/

Canadian guidelines for vaccine storage and transportation

http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/95pdf/cdr2111e.pdf

Health Canada's ship inspection program, provides inspection scores for cruise ships

http://www.hc-sc.gc.ca/hl-vs/travel-voyage/general/ship-navire-eng.php

National Reference Centre for Parasitology, reference diagnostic service in serology for parasitic diseases

http://www.medicine.mcgill.ca/tropmed/txt/national.htm

Foreign Affairs Canada, travel advisories

http://www.voyage.gc.ca/

International

International Society of Travel Medicine, international links to travel medicine recommendations, travel advisories, vaccine resources, surveillance, and country information

www.istm.org

World Health Organization

www.who.int

Pan-American Health Organization, country profiles and core health data; malaria maps for Latin America

www.paho.org
http://www.paho.org/English/AD/DPC/CD/mal-2005.htm

US cruise ship inspection ratings, provides inspection scores

http://usgovinfo.about.com/gi/dynamic/offsite.htm?site=http://www.cdc.gov/nceh/vsp/default.htm

Centers for Disease Control and Prevention Travelers' Health

http://www.cdc.gov/travel/

IX. Travel medicine clinics in Canada and abroad

Canada

http://www.phac-aspc.gc.ca/tmp-pmv/yf-fj/index-eng.php

Abroad

www.istm.org
www.astmh.org

X. Travel medicine groups in Canada

The West Coast Travel Medicine Society, holds meetings and informal get-togethers.

info@wctms.ca or
ray@tmvc.com (Ray Christopherson)

Alberta Association of Travel Health Professionals, holds an annual conference.

www.aathp.com/

Manitoba Travel Health Network, managed by the Winnipeg Regional Health Authority, Travel Health and Tropical Medicine Services. Holds annual conferences and 1-2 yearly telemedicine meetings on travel medicine between rural and urban practitioners in Manitoba.

http://www.wrha.mb.ca/community/travel/mthn.php

Central West Public Health Departments (Ontario), meets every 3 months, and the three public health departments that run travel clinics (Halton, Kitchener-Waterloo, and Niagara) often get together after those meetings to discuss issues/concerns.

Halton: Mary Anne Carson (905) 825-6060 x7863
Waterloo: Naideen Bailey (519) 883-2000
Niagara: Heather Hague (905) 688-3762 x7329

Ottawa Travel Medicine Group, meets intermittently.

Dr. Bob Birnbaum (613) 722-8010

XI. Certification

The International Society of Travel Medicine holds a Certificate of Knowledge examination, usually in conjunction with the biannual conference. Successful candidates are awarded a certificate attesting to proficiency in travel medicine.

www.istm.org/

American Society of Tropical Medicine and Hygiene holds an examination for the Certificate of Knowledge in Clinical Tropical Medicine and Traveler's Health.

www.astmh.org

XII. Resources for use by medical practitioners traveling to resource-poor settings

Books - reference texts

Principles of Medicine in Africa ,3^rd ed. (2004)
Edited by Eldryd Perry, Richard Godfrey, David Mabey, Geoffrey Gill
1462 pages, Cambridge University Press

• An excellent, advanced level resource for medical practitioners in Africa. Especially for solo practitioners or those working without internal medicine and specialist back-up, this book is well worth the cost. (Not practical for short-term workers because of its weight!)

Mansons Tropical Diseases ,21^st ed. (2003)
Edited by Gordon C. Cook
1847 pages, W.B. Saunders

• Standard tropical medicine text

Clinical Tuberculosis ,2^nd ed. (1998)
J. Crofton, N Horne, F Miller
MacMillan

• Practical resource for health care workers with minimal prior experience in TB

Tuberculosis, 4th ed. (1998)
Edited by David Schlossberg
Springer-Verlag

• A more detailed/advanced text that covers clinical tuberculosis. Provides more detail on the broad range of extrapulmonary disease and non-tuberculous mycobacteria.

Essential Malariology, 4th ed.(2002)
D A Warell, H M Gilles and contributors
Pages: 348 Colour plates: 39. Also many black and white plates and figures.
Tropical Health Technology

http://www.tht.ndirect.co.uk

• Reference text covering all aspects of malaria

Books - quick reference texts

Handbook of Medicine in Developing Countries ,2^nd ed. (2002)
Dennis Palmer and Catherine Wolf
Paul Tournier Institute

http://www.cmf.org.uk/bookstore/?context=book&id=69

• A quick reference designed for physicians working in resource-limited settings. Inexpensive and suitable for travelers with limited luggage space!

Oxford Handbook of Tropical Medicine ,2^nd ed. (2004)
M Eddleson, S Pierini, R Wilkinson, R Davidson and contributors
Pages: 768

Books - manuals and practical texts

Management of Severe Malaria: A Practical Handbook ,2^nd ed. (2000)
World Health Organization
http://www.who.int/malaria/docs/hbsm_toc.htm

• An essential resource for people working in malaria endemic areas.

Human Labour and Birth (Oxorn and Foote), 5^th ed. (1986)
Harry Oxorn
McGraw Hill, 918 pages

• An excellent resource on labour and childbirth, rich in detailed instructions and diagrams demonstrating the mechanisms of birth for all presentations and positions of the fetus. Useful as a refresher for those without recent obstetric experience and for new learners.

Primary Surgery, Volume 1: Non Trauma (1990)
Primary Surgery, Volume 2: Trauma (1987)
Maurice King
Oxford University Press

• A practical guide to surgical procedures designed for physicians with limited training in surgery. Indications, limitations, complications and procedures are thoroughly described with many helpful diagrams. A "must have" for physicians who will be called upon to perform surgical procedures in areas where referral options are limited.

Primary Anaesthesia (1996)
Maurice King
Oxford University Press

• Basic guide to anaesthetic care, appropriate for people with minimal training and resources

District Laboratory Practice in Tropical Countries. Part 1: QC, Health and Safety, Parasitology, Clinical Chemistry, Management, Equipment (1998)
Pages: 454. Colour plates: 92 and black and white plates and figures.

District Laboratory Practice in Tropical Countries: Part 2: Microbiology, Haematology, Blood Transfusion (2000)
Pages : 434. Colour plates : 116. Black and white plates and figures.
Monica Cheesbrough
Tropical Health Technology.

http://www.tht.ndirect.co.uk/

• An immensely practical bench manual for use in basic level laboratories.

Microscopical Diagnosis of Tropical Diseases THT Learning bench aid series No 1-9 Tropical Health Technology

http://www.tht.ndirect.co.uk/

• Laminated colour guides to diagnosis of blood and stool par-asites, examination of blood, urine, CSF infections associ-ated with HIV disease and AIDS.

Caring for Severely Malnourished Children (2003)
A. Ashworth, A. Burgess
Macmillan (Book and CD ROM)
Available from TALC

• Guide to management of malnutrition in resource-limited settings. Based on WHO guidelines. CD ROM contains resources for a 5-day training course targeted at nurses.

Books - basic texts

Where There Is No Doctor, revised edition
David Werner
Hesperian Foundation: http://www.hesperian.org
Multiple languages available

• Useful as a guide book for basic level community health workers or non-medical individuals living in areas without access to reliable medical care

Where There Is No Dentist
Murray Dickson
Hesperian Foundation: http://www.hesperian.org

• Useful for medical practitioners who may be called upon to provide emergency dental care.

Helping Health Workers Learn: A Book of Methods, Aids and Ideas for Instructors at the Village Level
David Werner and Bill Bower
Hesperian Foundation
http://www.hesperian.org

• Useful for those who have a significant role in teaching – especially in cross cultural settings and where students have had minimal basic schooling.

CD ROMs and other resources

Topics in International Health CD-ROM series Wellcome Trust: available from CABI Publishing North America

cabi-nao@cabi.org

Titles available:

Acute Respiratory Infection
Dengue
Diarrhoeal Diseases
HIV/AIDS (revised edition)
Leishmaniasis
Leprosy
Malaria (2^nd ed.)
Nutrition
Schistosomiasis
Sexually Transmitted Infections (2^nd ed.)
Sickle Cell Disease
Trachoma (2^nd ed.)
Tuberculosis

• Interactive tutorials with extensive image sets, graphics, and animations. Useful for independent study or teaching. Special student and developing country rates.

TALC: Teaching Aids at Low Cost

• A wide variety of books, CDs, videos, slide sets, and other resources on all aspects of health, for use in resource-limited settings. Resources range from in-depth reference works to training and practical manuals and basic teaching aids. Many of the resources listed here are available from TALC. A full catalogue of materials is available on line at www.talcuk.org

Tropical Medicine Central Resource: International Registry of Tropical Imaging

• On line resource for radiologic imaging of tropical diseases. Includes text describing epidemiology, geographic distribution, clinical features, and diagnosis of a wide range of tropical diseases
  
  http://tmcr.usuhs.mil/

Expiration

This document will be updated every 2 years.

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* Members: Dr. P.J. Plourde (Chair); Dr. C. Beallor; M. Bodie-Collins (Executive Secretary); Dr. K. Gamble; Ms. A. Henteleff; Dr. S. Houston; Dr. S. Kuhn; Dr. A. McCarthy; Dr. K.L. McClean; Dr. J.R. Salzman.

Liason Representatives: Dr. C. Greenaway; Mrs. A. Hanrahan; Dr. C. Hui; Dr. R. Saginur; Dr. P. Teitelbaum; Dr. M. Woo.

Ex-Officio Representatives: Dr. J. Given, Dr. F. Hindieh; Dr. J.P. Legault; Dr. P. McDonald; Dr. R. Paradis; Dr. C. Reed; Dr. M. Smith; Dr. M. Tepper

Member Emeritus: Dr. C.W.L. Jeanes.

†This statement was prepared by Dr. P. Teitelbaum and approved by CATMAT.

[Canada Communicable Disease Report]