Check with your healthcare provider or pharmacist to be sure you begin them early enough. They must be continued throughout your trip and for a specific number of days after you return. The amount of time depends on which medicine you are prescribed. Put together a traveler's first aid kit with specific items geared to your destinations. Add enough extra medicines and supplies to last a few days past the duration of your trip.
Your healthcare provider can help you identify what should be included in your kit. Research emergency medical care during your trip and what medical evacuation services are available in case of serious illness. Contact your health insurance plan to find out what is covered in other countries. Take 2 copies of your medical insurance information with you and keep them in separate areas. If you are traveling as part of an organized tour, contact the agency regarding medical services available and any additional insurance that might be available.
If you have any infectious disease symptoms when you return home, contact your healthcare provider and describe where you have traveled. Symptoms can include fever, rash, joint pain, diarrhea, belly pain, and red eyes. However, each person is unique and your symptoms may be different. The culprit was a deer mouse discovered near the home of one of the initial patients. Hantavirus was discovered by Ho-Wang Lee in Korea in as the etiological agent responsible for the Korean hemorrhagic fever outbreak which occurred among American and Korean soldiers during the Korean War.
Patients with hantavirus pulmonary syndrome HPS had mild flu-like symptoms such as malaise, headache, cough, fever, with a sudden onset of pulmonary edema, and finally death. SNV infection occurs wherever its reservoir rodent carrier the deer mouse is found. This includes the entire populated area of North America except for the far southeastern region. SNV can be contracted through the inhalation of virus-contaminated deer mouse excretion. However, since that time the fatality rate has steadily declined as more mild cases have come to be recognized.
A deer mouse, the natural reservoir of SNV, is shown in insert. The Nipah 9 virus was first identified in April on a pig farm in peninsular Malaysia when it caused an outbreak of neurological and respiratory disease. The outbreak resulted in human cases, human deaths, and the culling of 1 million pigs Fig.
Symptoms of infection from the Malaysian outbreak were primarily encephalitic in humans and respiratory in pigs. Respiratory illness in humans has been seen in later outbreaks, increasing the likelihood of human-to-human transmission and indicating the existence of more dangerous strains of the virus.
Based on seroprevalence data and the data from viral isolations, the primary reservoir for Nipah virus was identified as Pteropid fruit bats.
The transmission of Nipah virus from bats to pigs is thought to be due to an increasing overlap between bat habitats and piggeries in peninsular Malaysia. A Geographic distribution of Henipah virus outbreaks. The regions affected by Nipah virus violet and Hendra virus red are denoted. B Bats large flying fox , the natural reservoirs of Nipah virus.
A related Hendra virus was discovered in September when it caused the deaths of 13 horses and a trainer at a training complex in Hendra, a suburb of Brisbane in Queensland Australia. Nipah virus, along with Hendra virus, belongs to the genus Henipavirus belonging in the family Paramyxoviridae see Table The majority of cases were in Hong Kong 9.
It was eradicated by January of the following year. Phylogenetic analysis of these viruses indicated a high probability SARS-CoV originated in bats and spread to humans either directly or indirectly through animals held in Chinese markets. The map illustrates the areas around the world that were affected by the SARS outbreak of — It is speculated the virus spreads from bats to human via dromedary camel Fig. Almost all cases have been linked to Saudi Arabia. Although human-to-human transmission seems to be inefficient, it has been shown to spread between people who are in close contact.
Virions contain characteristic club-like projections emanating from the viral membrane. It is transmitted from cave bats to humans via dromedary camel. Why are new human pathogenic viruses continually emerging? In most cases, outbreaks have been known to occur in tropical regions in which there were no human inhabitants. An increase in contact with wild animals, due to the expansion of the human habitat, is believed to be the main cause for the emergence of new viruses.
Changes in the environment such as rainforest developments have led to an increase in contact between wild animals and humans. As a result, viruses which only existed in rainforests are able to be transmitted to a new human host. Climate changes such as global warming are another cause for the emergence of new viruses.
Many of these newly emerging viruses are zoonotic viruses. In particular, bats serve as reservoirs to many newly emerging viruses. What makes bats so special? Bats are unique because they are mammals that can fly. As mammals, they are a closer relation to humans than to birds. In addition, it is speculated that the immunity of bats is conspicuously tolerable to viruses. Many types of viruses found in bats ie, virome 10 are currently being analyzed with the implementation of next generation sequencing technology.
The bat virome is expected to provide insight on newly emerging viruses that have yet been discovered. Besides newly emerging viruses, the variants of existing viruses also cause serious epidemics. These viruses have infected humans in the past. However, they continue to appear in drug-resistant forms or reappear after apparent control or elimination.
Three distinct kinds of influenza virus variants are responsible for flu epidemics: the seasonal flu , the pandemic flu , and the avian flu. On the other hand, the avian influenza virus will be described with an emphasis on the mechanism of zoonotic infection. Seasonal Flu : The seasonal flu, as its name implies, is a flu epidemic that occurs yearly. Why are influenza viruses able to infect people who have previously been infected in the past?
Multiple reinfection capabilities represent a salient feature of influenza virus infection. The reason for this is because variants with distinct antigenicity emerge each year. The antibodies circulating in the person previously infected are unable to neutralize a new seasonal strain. Pandemic Flu : The pandemic flu which occurred in the 20th century has already been described see Box Here, specific features of the H1N1 influenza pandemic are described. The epidemic started in Mexico in April of It rapidly spread globally, resulting in up to million infections and over 16, deaths.
During the pandemic, many international meetings were canceled because many people were afraid to travel abroad without proper protection.
The culprit was quickly identified to be a swine influenza virus which first infected a boy living near a pig farm in Mexico. Table 1 Mosquito-borne viral emerging infectious diseases. People infected with yellow fever virus are viremic shortly before the onset of fever and up to 5 d after onset Yellow fever virus has 3 transmission cycles: jungle sylvatic , intermediate savannah , and urban The urban cycle involves transmission of the virus between humans and mosquitoes, primarily.
Virus brought to the urban setting by a viremic human who was infected in the jungle or savannah Incubation 3—6 d. Wide spectrum including asymptomatic. Early flulike symptoms: fever, malaise, myalgia, headache, vomiting. Majority will have bimodal disease. Fever returns within 24 h: hepatitis, jaundice, renal failure. Issue is not enough vaccine. Incubation 3—7 d. Abrupt onset high fever for up to 2 wk, severe polyarthralgia, transient skin rash maculopapular on trunk and extremities.
Relapse may occur 2—3 mo after onset. Rely on detection of the virus No specific antiviral treatment Supportive management. In , large outbreaks worldwide affecting children and adults. Epidemics in the United States in eighteenth and early twentieth centuries. Fluid therapy Tetravalent vaccine approved in some countries, for example, Mexico WHO recommends: Remove all sources of stagnant water to prevent mosquito breeding Prevent mosquito bites: wear appropriate clothing, use of insecticides see yellow fever Use of mosquito nets and coils around people sick with dengue fever to prevent mosquitoes biting and transmitting Vector surveillance and control are important.
Data from Refs. Factors contributing to emergence of outbreaks Three hundred thirty-five EID events were identified between and National institute of allergy and infectious diseases emerging infectious diseases categories Not to confuse the reader, but recognizing a resource in the prioritization of emerging pathogen threats to the United States, the author refers to the National Institute of Allergy and Infectious Diseases NIAID categorization.
Accessed July 26, Emerging infections from fungus to zoonotic flu viruses What do C auris , Elizabethkingia anopheles , the Lone Star tick, and avian influenza H7N2 have in common? Elizabethkingia anopheles This common gram-negative bacillus was discovered in by Elizabeth King, an American bacteriologist, while working on a bacterium attributed to meningitis in infants.
Lone Star Tick This aggressive tick, Amblyomma americanum , is found in the southeastern, south central, and eastern United States. MCR Genes Although there is no immediate public threat, mcr- 1 brings to the forefront the global challenges in addressing antibiotic resistance and best practices for antibiotic use. Summary Emerging and reemerging infectious diseases are difficult to predict, let alone manage.
Footnotes Disclosure statement: There are no commercial or financial conflicts of interest. References 1. Petersen E. Clin Microbiol Infect. Baylor College of Medicine Emerging infectious diseases. Fauci A. The perpetual challenge of infectious diseases. N Engl J Med. Morens D. Emerging infectious diseases: threats to human health and global stability. PLOS Pathog.
Ryu S. One health perspectives on emerging public health threats. J Prev Med Public Health. Wolfe N. One Health Initiative. Rosenberg R. Vital signs: trends in reported vectorborne disease cases- United States and territories, Rathore M. Emerging infectious diseases. Adv Pediatr. CDC Yellow fever. Ramachandran V. Chikungunya: a reemerging infection spreading during dengue fever outbreak in National Capital Region of India.
Centers for Disease Control and Prevention Dengue. Jones K. Global trends in emerging infectious diseases. Van Doom H. Bunnell K. Contagion Live-Infectious Diseases Today. MacNair C. Overcoming mcr-1 mediated colistin resistance with colistin in combination with other antibiotics. Nat Commun. Adams E. Emerg Infect Dis. Sears D. Candida auris : an emerging multidrug-resistant pathogen. Int J Infect Dis. CDC Candida auris. Yung C. Elizabethkingia anopheles and association with tap water and handwashing, Singapore.
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