Amicizia D, Micale R T, Pennati B M, Zangrillo F, Iovine M, Lecini E, Marchini F, Lai P L, Panatto D
Department of Health Sciences, University of Genoa, Italy.
J Prev Med Hyg. 2019 Dec 20;60(4):E271-E285. doi: 10.15167/2421-4248/jpmh2019.60.4.1333. eCollection 2019 Dec.
The burden of diarrheal diseases is very high, accounting for 1.7 to 5 billion cases per year worldwide. Typhoid fever (TF) and cholera are potentially life-threatening infectious diseases, and are mainly transmitted through the consumption of food, drink or water that have been contaminated by the feces or urine of subjects excreting the pathogen. TF is mainly caused by Salmonella typhi, whereas cholera is caused by intestinal infection by the toxin-producing bacterium Vibrio cholerae. These diseases typically affect low- and middle-income countries where housing is overcrowded and water and sanitation are poor, or where conflicts or natural disasters have led to the collapse of the water, sanitation and healthcare systems. Mortality is higher in children under 5 years of age. Regarding their geographical distribution, TF has a high incidence in sub-Saharan Africa, India and south-east Asia, while cholera has a high incidence in a few African countries, particularly in the Horn of Africa and the Arabian Peninsula. In the fight against these diseases, preventive measures are fundamental. With modern air travel, transmissible diseases can spread across continents and oceans in a few days, constituting a threat to global public health. Nowadays, people travel for many reasons, such as tourism and business. Several surveys have shown that a high proportion of travelers lack adequate information on safety issues, such as timely vaccination and prophylactic medications. The main objective of this overview is to provide information to help European travelers to stay healthy while abroad, and thus also to reduce the potential importation of these diseases and their consequent implications for public health and society. The preventive measures to be implemented in the case of travel to countries where these diseases are still endemic are well known: the adoption of safe practices and vaccinations. It is important to stress that an effective preventive strategy should be based both on vaccinations and on hygiene travel guidelines. Furthermore, the emergence of multidrug-resistant strains is becoming a serious problem in the clinical treatment of these diseases. For this reason, vaccination is the main solution.
腹泻病负担非常高，全球每年有17亿至50亿病例。伤寒热（TF）和霍乱是潜在的危及生命的传染病，主要通过食用被排出病原体的受试者粪便或尿液污染的食物、饮料或水传播。TF主要由伤寒沙门氏菌引起，而霍乱由产毒素的霍乱弧菌肠道感染所致。这些疾病通常影响低收入和中等收入国家，这些国家住房拥挤，水和卫生条件差，或者冲突或自然灾害导致水、卫生和医疗系统崩溃。5岁以下儿童死亡率更高。就其地理分布而言，TF在撒哈拉以南非洲、印度和东南亚发病率较高，而霍乱在一些非洲国家发病率较高，特别是在非洲之角和阿拉伯半岛。在抗击这些疾病方面，预防措施至关重要。随着现代航空旅行的发展，传染病可在数天内跨越各大洲和海洋传播，对全球公共卫生构成威胁。如今，人们因多种原因出行，如旅游和商务。多项调查显示，很大一部分旅行者缺乏关于安全问题的充分信息，如及时接种疫苗和预防性用药。本综述的主要目的是提供信息，帮助欧洲旅行者在国外保持健康，从而减少这些疾病的潜在输入及其对公共卫生和社会的影响。前往这些疾病仍为地方病的国家旅行时应采取的预防措施众所周知：采取安全做法和接种疫苗。必须强调的是，有效的预防策略应基于接种疫苗和卫生旅行指南。此外，多重耐药菌株的出现正成为这些疾病临床治疗中的一个严重问题。因此，接种疫苗是主要解决办法。
