committee to advise on tropical medicine and travel (catmat)

Public Health Agency of Canada

Agence de santéPublique du Canada

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

April 2008

Pierre J. Plourde, M.D., FRCPCMedical Officer of Health, Winnipeg Regional Health Authority

Medical Director, Travel Health and Tropical Medicine Program, WRHA

Medical Consultant, Journeys Travel Health Clinic

Associate Professor, Medical Microbiology (Clinical Parasitology), University of Manitoba

Committee to Advise on Tropical Medicine and Travel(CATMAT)



CATMAT reports to...CATMAT reports to...

Public Health Agency of Canada,

Chief Public Health Officer of Canada,

Assistant Deputy Minister,

Migration and International Health,

Travel Health Program




MandateMandate

provides recommendations on prevention and treatment of infectious diseases and other health hazards for Canadian travellers;

suggests mechanisms for wide dissemination and use of recommendations and other travel medicine-related information; and

advises on priorities for epidemiological research and other activities related to travel or tropical medicine.




StructureStructure 10 members (4-year terms): Canadian

expertise in travel medicine, tropical medicine, parasitology, infectious diseases, public health, and epidemiology

liaison members: CPS, CPHA, CSIH, AMMI Canada (formerly CIDS), NACI, IDRC, CAEP

ex-officio members: HC, DND, CIC, DFA, US CDC




Summary:Summary:

Future statements/guidelines Yellow fever Update CDC Update Travel Health in the Canadian

Health Care System




Upcoming Published Statements:Upcoming Published Statements:

2007/2008 High altitude (April 2007)

Immunocompromised hosts (April 2007)

Hepatitis (in press)

Japanese encephalitis (final edits)

Malaria guidelines (final edits)




Future Updated Statements:Future Updated Statements:

2008/2009 Tuberculosis Typhoid Dengue fever Guidelines for TM practice Meningococcal meningitis Fever in the International Traveller




Future New Statements:Future New Statements:

2009 Yellow fever Long term traveller International adoption Elderly travellers Pregnancy and travel Pediatric traveller Accidents and injuries VFRs




Yellow fever Update:Yellow fever Update: Case Report (Calgary):

5 week old male born March 2007 (normal delivery) presented with 2 wk history of URTI and fever for 2 days, “seizure activity” for 1 day

Admitted and treated with antibiotics, acyclovir, and anti-seizure medications

Dx: encephalitis Normal CT head, CSF negative PCR Baby completely recovered Arboviral serology positive (Yf 1:5120 IgM!!)




Yellow fever Update:Yellow fever Update: Case Report (Calgary):

Arboviral serology positive (Yf 1:5120 IgM!!) Mother had travelled to Caracas, Venezuela for 7

days, when baby was 13 days old Mother had received yellow fever vaccine when

baby was 10 days old (no need for vaccine!) Baby was breastfed only; no rural travel Was baby infected with endemic yellow fever (no

evidence of current outbreak) or was baby infected with vaccine strain via breast milk (has never been documented)?




CDC Update:CDC Update:

Interactive “live” malaria maps online




Travel Health in the Canadian Travel Health in the Canadian Health Care System:Health Care System:




Travel Health in the Canadian Travel Health in the Canadian Health Care System:Health Care System: ~2,000,000 Canadian travellers to

developing countries 20% VFRs; “voluntourism” 75% travellers develop travel-related

illness (GI, dengue, malaria, typhoid) But true cost of travel-related illness

in Canada unknown




Travel Health in the Canadian Travel Health in the Canadian Health Care System:Health Care System: <15% travellers visit travel clinic Primary care practitioners often

provide incorrect advise*: 37% accuracy for immunizations (vs

76% THNs) 69% accuracy for antimalarials (vs 78%

for THNs)* Keystone JS, et al. J Travel Med 1994;1:72-78





“Why don’t provincial health care plans cover travel medicine?”

“if one can afford to travel, one can afford to pay”

?VFRs, students, missionaries, altruistic volunteers





Covering cost of pre-travel consultation fees – encourage travellers to seek advice from the right places

Correct the misconception that travel medicine is a “luxury item”




HaitiHaiti




Contacts…Contacts…

www.travelhealth.gc.ca

www.catmat.gc.ca



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

April 2008

Pierre J. Plourde, M.D., FRCPCMedical Officer of Health, Winnipeg Regional Health Authority

Medical Director, Travel Health and Tropical Medicine Program, WRHA

Medical Consultant, Journeys Travel Health Clinic

Associate Professor, Medical Microbiology and Community Health Sciences, University of Manitoba

committee to advise on tropical medicine and travel (catmat)

Documents

tropical medicine program

international health

travel health programcommittee

health hazards

frcpcmedical officer

public health agency

yellow fever vaccine

travel catmatapril