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Derek Evans

Welcome to Evans Travel Health

NECTM May 2nd -4th 2018

Derek recently attended this Conference held in Stockholm this year. Here is his Report from Stockholm

Antibiotic resistance- Travelling around

This set of presentations looked at the increasing risk of antibiotic resistance coming from wild birds that are scavengers who seasonally migrate. Evidence was produced that suggested infections were often higher in wild guess than among the humans form the same area. The conclusion was that most birds mirror the resistance among humans in the close environment, migratory spread of the disease was probable but limited in scale. However wild birds can act as sentinels for dispersal of antibiotic resistance genes in the environment.

Travellers diarrhoea (TD) was again reviewed for its impact on the individual and noted that 21% had to change their daily plans, 13% were unable to leave their accommodation with the duration on incapacitation being 12-21 hours. The speaker focussed on the need to avoid colonisation by not using anti-microbials and increasing personal hygiene. The focus of this presentation was that taking loperamide instead of using anti microbial prevents overgrowth of infection and limiting longer term conditions such as IBS.

Under the heading of antibiotic resistant mobile communication devices were considered an increasing hazard with studies indicating that 9-25% of devices had pathogenic bacteria (up to 10% MRSA). In the UK 16% of mobile phones were contaminated with E.coli.

Malaria vaccines

Following a review of the Plasmodium life cycle the potential vaccine targets were within the sporozite, merozoites, infected erythrocytes and gametocyte stages. The challenges that were faced in manufacturing malaria vaccines included that the protective mechanisms were unclear; multiple stage-restricted antigens; antibody-dependent responses were often low; multi-antigen, multi-stage vaccines were required.

Symposium sessions

The risks for travellers for vaccine preventable travel health was highlighted in several presentations using the figure by Steffen et al (JTM, 2015. Vol 22; 1-12.

The risk of HepA had reduced from 1:2500-1:9000 since then which was reflected in the lowering of the risk in the UK by PHE in2016. This risk lowering was copied by other countries in Europe such as Holland.

Reviewing social media use showed that 84% is used to support a cause, 78% to interact and nurture relationships, 68% to build a personal image and to participate on a global level. However 94% use it pass on valuable information to others of which 49% influence action about products by sharing. The question therefore raised was how to ensure that travel health information exchanged is reliable and robust. The speaker then highlighted the falsehoods supplied by misinformation; fake news leading to exaggerations and distortion providing inaccuracies.