Travel medicine interventions and neurological disease

An overview of travel-associated central nervous system infectious diseases: risk assessment, general considerations and future directions

Nervous system infections are among the most important diseases in travellers. Healthy travellers might be exposed to infectious agents of central nervous system, which may require in-patient care. Progressive course is not uncommon in this family of disorders and requires swift diagnosis. An overview of the available evidence in the field is, therefore, urgent to pave the way to increase the awareness of travel-medicine practitioners and highlights dark areas for future research. In November 2013, data were collected from PubMed, Scopus, and Web of Knowledge (1980 to 2013) including books, reviews, and peer-reviewed literature. Works pertained to pre-travel care, interventions, vaccinations related neurological infections were retrieved. Here we provide information on pre-travel care, vaccination, chronic nervous system disorders, and post-travel complications. Recommendations with regard to knowledge gaps, and state-of-the-art research are made. Given an increasing number of international travellers, novel dynamic ways are available for physicians to monitor spread of central nervous system infections. Newer research has made great progresses in developing newer medications, detecting the spread of infections and the public awareness. Despite an ongoing scientific discussion in the field of travel medicine, further research is required for vaccine development, state-of-the-art laboratory tests, and genetic engineering of vectors.

Influenza and pneumococcal vaccinations in the emergency department

Influenza and pneumococcal pneumonia remain among the most significant causes of morbidity and mortality of any of the infectious disease emergencies presenting to emergency departments (EDs). Because the ED has become a recommended location at which immunizations have been administered to prevent several infections, pneumococcal and influenza vaccinations can have an impact on the care of ED patients. ED personnel are uniquely positioned to vaccinate a substantial number of patients who would not otherwise be vaccinated, including many high-risk populations. In addition to decreasing vaccine-preventable mortality and morbidity from influenza and pneumococcal diseases, EDs that implement and monitor a systematic approach to these vaccinations can attenuate ED overcrowding and facilitate patient flow. ED vaccination strategies have been proved to be successful and reimbursable and are advocated by several major clinical practice advisory groups.