Displaying publications 41 - 51 of 51 in total

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  1. Lally L, McCabe E, Flaherty GT
    J Travel Med, 2019 Jan 01;26(1).
    PMID: 30476182 DOI: 10.1093/jtm/tay135
  2. Chang L, Lim BCW, Flaherty GT, Torresi J
    J Travel Med, 2019 Sep 02;26(6).
    PMID: 31066446 DOI: 10.1093/jtm/taz034
    BACKGROUND: With the advent of highly active antiretroviral drugs for the treatment of human immunodeficiency virus (HIV) it has become possible for people with HIV to travel to destinations that may place them at risk of a number of infectious diseases. Prevention of infections by vaccination is therefore of paramount importance for these travellers. However, vaccine responsiveness in HIV-positive individuals is not infrequently reduced compared to HIV-negative individuals. An understanding of the expected immune responses to vaccines in HIV-positive travellers is therefore important in planning the best approach to a pretravel consultation.

    METHODS: A PubMed search was performed on HIV or acquired immune deficiency syndrome together with a search for specific vaccines. Review of the literature was performed to develop recommendations on vaccinations for HIV-positive travellers to high-risk destinations.

    RESULTS: The immune responses to several vaccines are reduced in HIV-positive people. In the case of vaccines for hepatitis A, hepatitis B, influenza, pneumococcus, meningococcus and yellow fever there is a good body of data in the literature showing reduced immune responsiveness and also to help guide appropriate vaccination strategies. For other vaccines like Japanese encephalitis, rabies, typhoid fever, polio and cholera the data are not as robust; however, it is still possible to gain some understanding of the reduced responses seen with these vaccines.

    CONCLUSION: This review provides a summary of the immunological responses to commonly used vaccines for the HIV-positive travellers. This information will help guide travel medicine practitioners in making decisions about vaccination and boosting of travellers with HIV.

  3. Flaherty GT, Geoghegan R, Brown IG, Finucane FM
    J Travel Med, 2019 05 10;26(3).
    PMID: 30855079 DOI: 10.1093/jtm/taz018
    BACKGROUND: It is unknown whether obesity is a barrier to international travel. The purpose of this qualitative study was to describe the travel experiences of a cohort of severely obese individuals attending a hospital-based bariatric service, to identify their perceived barriers to travel and to generate recommendations that address the needs of severely obese individuals.

    METHODS: Semi-structured interviews were conducted with severely obese patients attending a regional, structured, multidisciplinary lifestyle modification programme. Coding and thematic analysis of the transcripts were completed by three independent researchers. A thematic analysis was performed based on examination of the transcribed interviews. Demographic and clinical data such as gender, age and body mass index were also recorded.

    RESULTS: Twelve patients (six males), with a mean age of 54 ± 5.98 years and a mean body mass index of 46.2 ± 8.2 kg/m2, agreed to semi-structured interviews (14-52-minute duration). The principal themes emerging from the interviews included obese air traveller embarrassment, physical discomfort on commercial flights, perceived weight bias, challenges in accessing hotel rooms, heat intolerance in warm climates, restricted leisure travel activities and medical co-morbidities. Most of the interviewees perceived a health benefit to travel but regarded obesity as a significant barrier to international travel.

    CONCLUSION: These findings highlight the limitations experienced by obese travellers when engaging in international travel. Our results may inform the pre-travel health advice given to obese travellers. They might also serve to raise awareness among operators within the travel industry of the difficulties travellers with severe obesity face.

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