travel consultation case papua new guinea 35yr female

points:
a. personal: 35 yr female

b. destination: Papua New Guinea (nearby Austurilia)( risk of JE, Malaria, typhoid,dengue)

c. duration:3weeks. leaving time: in 3 weeks.

d. limited budget

e. allergy: doxycycline
f. vaccination: no vaccine for 10yrs.

g. disease: history of depression
h: medical mission

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information

the detail iternary

accommadation: hotel rural or other.
pregnent status

Vaccine:
allergy: no
routine: MMR, Tdap, chickenpox, polio?
recommendation: flu, Hepetitis A, typhoid(oral),  JE(less than 30days, may be dont need), HPV?
requirement: no
She also should get Hepatitis B vaccine because of her medical mission. As for her leaving with 30days, she could get monovalent shot follow the accelerated vaccine schedule(0, 7, 14days) and she should receive a booster dose at least 6 months after the start of the series to promote long- term immunity.
If TWINRIX, the schedule (doses at 0,7 and 21-30days) can be used. a booster dose should be given at 12 months to promote the long-term immunity.
Malaria:
according to the activity and areas.

resistant:chloroquine
prophylaxis: mefloquine cant use because of the history of depreesion
                  doxycycline cant use'
                  malarone is the best choice. begin 1-2days before travel and taken daily , at the same time each day, continue 1 week after leaving.
                  second choice is primaquine and need to test G6pd fisrt.

prevent method: insect repellent DEET
treatment:

Traveler's Diarrhea
area: no special
recommendation: ciprofloxacin

Others:
1.food and water. sun exposure.
2.special area: mountian
3. special activity: animal bites, rabies, snakes
4.jetlag
5. other disease: dengue fever.pay more attetion biting time: JE night time, malaria for between dawn and dusk. dengue fever:daylight



Distribution of dengue