Travel Medicine Exam Questions with
Correct Answers
Risk vs benefit of vaccines - Answer-Safety of vaccine vs catastrophic result of
infection
Two vaccines that are often required for travel - Answer-1. Meningococcal
2. Yellow fever (now it is a once in a lifetime vaccine)
Some recommended vaccines for travellers (depending on the time/place of travel) -
Answer-HepA
Influenza
JE
Meningococcal
Rabies
Tick-borne encephalitis
BCG
Cholera and traveller's diarrhea - Dukoral
Routine vaccines - Answer-- Tetanus
- Diptheria
- Measles
- Mumps
- Rubella
- Polio
- Pneumococcal
- Varicella
- Meningitis
- HepB
- Flu shot
- Rotavirus
- HiB
- Pertussis
What type of vaccine do you avoid in pregnancy? Name one - Answer-Live vaccines
(general rule)
Ex. MMR
Older traveller's response to immunization may be (incr/dec) and they may be
(more/less) susceptible to A/E of vaccines? - Answer-Decreased (less robust
response to vaccines)
More susceptible (i.e. fever, malaise)
*Might want more time to prepare them before they go travelling
Children are at greater risk of certain travel-related infections (4) - Answer-Rabies
, Typhoid
Meningococcal
HepA
What is the most common illness in travellers to resource-poor regions? - Answer-
Traveller's diarrhea
What is traveller's diarrhea (TD)? - Answer-Greater than or equal to 3 loose stools
over a 24 hour period
What are the enteric symptoms of TD? - Answer-Fever
Nausea
Vomiting
Abdominal cramping
TD is self-limiting - how many days?
However --> 2 consequences - Answer-3-5 days
1. 25% of travellers change their plans bc of it
2. some left with post-infectious IBS (quite debilitating)
Rates of diarrhea - Answer-40-60% over 2-3 week vacation
What are the causes of TD?
- bacterial (4)
- viral (2)
- parasites - Answer-Bacterial enteropathogens:
E.coli, Salmonella, Campylobacter, Shigella species
*E.coli (ETEC - enterotoxigenic) = most common = up to 1/3 etiologies
*less common= cholera, aeromonas species
Viral - rotavirus, norovirus (cruise ships/resorts)
Parasites - usually in LT travellers
Vaccine to prevent TD - Answer-Dukoral - inactivated cholera vaccine
Who can get dukoral (age) - Answer->2 y/o
Killed whole cell Vibrio cholera and non-toxic recombinant
cholera toxin B-subunit (BS) - what part gives protection, against what organism and
how much? - Answer-The BS subunit provides moderate, ST protection against
ETEC (~50% protection)
What is the overall expected protection against TD with dukoral? - Answer-25%
*May give travellers false sense of protection (don't want them to lose the v. imp food
and water precautions)
Dukoral is good if using it for what? - Answer-Cholera protection
Correct Answers
Risk vs benefit of vaccines - Answer-Safety of vaccine vs catastrophic result of
infection
Two vaccines that are often required for travel - Answer-1. Meningococcal
2. Yellow fever (now it is a once in a lifetime vaccine)
Some recommended vaccines for travellers (depending on the time/place of travel) -
Answer-HepA
Influenza
JE
Meningococcal
Rabies
Tick-borne encephalitis
BCG
Cholera and traveller's diarrhea - Dukoral
Routine vaccines - Answer-- Tetanus
- Diptheria
- Measles
- Mumps
- Rubella
- Polio
- Pneumococcal
- Varicella
- Meningitis
- HepB
- Flu shot
- Rotavirus
- HiB
- Pertussis
What type of vaccine do you avoid in pregnancy? Name one - Answer-Live vaccines
(general rule)
Ex. MMR
Older traveller's response to immunization may be (incr/dec) and they may be
(more/less) susceptible to A/E of vaccines? - Answer-Decreased (less robust
response to vaccines)
More susceptible (i.e. fever, malaise)
*Might want more time to prepare them before they go travelling
Children are at greater risk of certain travel-related infections (4) - Answer-Rabies
, Typhoid
Meningococcal
HepA
What is the most common illness in travellers to resource-poor regions? - Answer-
Traveller's diarrhea
What is traveller's diarrhea (TD)? - Answer-Greater than or equal to 3 loose stools
over a 24 hour period
What are the enteric symptoms of TD? - Answer-Fever
Nausea
Vomiting
Abdominal cramping
TD is self-limiting - how many days?
However --> 2 consequences - Answer-3-5 days
1. 25% of travellers change their plans bc of it
2. some left with post-infectious IBS (quite debilitating)
Rates of diarrhea - Answer-40-60% over 2-3 week vacation
What are the causes of TD?
- bacterial (4)
- viral (2)
- parasites - Answer-Bacterial enteropathogens:
E.coli, Salmonella, Campylobacter, Shigella species
*E.coli (ETEC - enterotoxigenic) = most common = up to 1/3 etiologies
*less common= cholera, aeromonas species
Viral - rotavirus, norovirus (cruise ships/resorts)
Parasites - usually in LT travellers
Vaccine to prevent TD - Answer-Dukoral - inactivated cholera vaccine
Who can get dukoral (age) - Answer->2 y/o
Killed whole cell Vibrio cholera and non-toxic recombinant
cholera toxin B-subunit (BS) - what part gives protection, against what organism and
how much? - Answer-The BS subunit provides moderate, ST protection against
ETEC (~50% protection)
What is the overall expected protection against TD with dukoral? - Answer-25%
*May give travellers false sense of protection (don't want them to lose the v. imp food
and water precautions)
Dukoral is good if using it for what? - Answer-Cholera protection
