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Guatemala,[object Object],Preparing For Your Trip,[object Object]
Where is Las Conchas, Guatemala?,[object Object],http://www.geographyiq.com/countries/gt/Guatemala_map_flag_geography.htm,[object Object],Las Conchas,[object Object]
Packing Essentials ,[object Object],Adequate supply of prescription medications,[object Object],Medication for diarrhea,[object Object],Pepto Bismol, Loperamide, and antibiotics for traveler’s diarrhea ,[object Object],Medication for other common illnesses ,[object Object],Headache – Acetaminophen,  Aspirin,[object Object],Upset stomach – Pepto Bismol,[object Object],Motion sickness  - Meclizine,  Dimenhydrinate, Promethazine,[object Object],Sunglasses and hat,[object Object],Loose fitting clothing for tropical weather,[object Object],Antibacterial liquid/wipes,[object Object],Sleeping net for bed,[object Object],Protection from mosquitoes ,[object Object],Insect repellant ,[object Object],DEET for skin ,[object Object],Permethrin for clothes, sheets, sleeping nets ,[object Object],Sunblock ,[object Object],SPF of 15 or greater ,[object Object]
Before Your Trip ,[object Object],Vaccinations,[object Object],The following vaccinations are recommended:,[object Object],Be up-to-date on all vaccines required in U.S.,[object Object],Hepatitis A,[object Object],Hepatitis B,[object Object],Typhoid ,[object Object],Rabies,[object Object],Malaria Prophylaxis is strongly recommended.,[object Object]
Before Your Trip—Routine Vaccines,[object Object],Influenza,[object Object],You need one dose every fall (or winter),[object Object],Pneumococcal,[object Object],You need 1 or 2 doses if you smoke cigarettes or have certain chronic medical conditions,[object Object],Varicella (chickenpox),[object Object],Consider this vaccine if you have never had chicken pox  OR if vaccinated and you only received  one dose,[object Object],Tetanus, Diphtheria, pertussis (whooping cough),[object Object],Be sure to get a 1-time dose of “Tdap” (adult whooping cough vaccine),[object Object],You need a Td booster shot every 10 years,[object Object],Measles, Mumps, Rubella ,[object Object],You need at least 1 dose of MMR if you were born in 1957 or later ,[object Object],more information available at:  http://www.immunize.org/catg.d/p4030.pdf,[object Object]
Before Your Trip—Hepatitis A,[object Object],One of the most common vaccine-preventable infections acquired during travel ,[object Object],Spread person-to-person, or contaminated water/food,[object Object],HepA is asymptomatic, but flu-like symptoms are not uncommon;,[object Object], lasts 3 to 6 months,[object Object],Vaccinations available,[object Object],HAVRIX—2 doses, 2nd dose 6 to 12 months after initial dose,[object Object],VAQTA—2 doses, 2nd dose 6 to 18 months after initial dose,[object Object],TWINRIX—protects against both HepA and HepB; 4 doses ,[object Object],Other preventable measures,[object Object],Boil/cook all foods for at least 1 minute,[object Object],Do not drink tap water or brush teeth with tap water,[object Object],Do not consume raw vegetables, or fruits that cannot be peeled.,[object Object],Avoid food and drinks from street vendors ,[object Object],Eat only foods that have been thoroughly cooked or still steaming hot,[object Object],“Boil it, cook it, peel it, or forget it”,[object Object],Treatment,[object Object],None; only symptoms are treatable,[object Object]
Before Your Trip—Hepatitis B,[object Object],Transmission,[object Object],Bodily fluids,[object Object],Early signs and symptoms,[object Object],Nausea, vomiting, abdominal pain, jaundice, skin rashes, joint pain, arthritis ,[object Object],Incubation period ,[object Object],90 days ,[object Object],Two categories ,[object Object],Acute:  usually goes away after 2 or 3 weeks.  Liver function returns to normal in 4 to 6 months ,[object Object],Chronic:  may lead to cirrhosis and death ,[object Object],Vaccinations,[object Object],Recombivax HB,[object Object],Energix-B,[object Object],Both vaccines are inactivated and dosing periods are at 0, 1, and 6 month intervals ,[object Object],Treatment ,[object Object],Acute:  none,[object Object],Chronic:  antiviral medications ,[object Object]
Before Your Trip—Typhoid ,[object Object],Transmission,[object Object],Consumption of water or food contaminated with infected human feces,[object Object],Signs and Symptoms,[object Object],Fever that gradually increases daily from low-grade to high, macular rash on trunk, headache, malaise, anorexia, enlargement of liver and spleen ,[object Object],Preventative Measures ,[object Object],“Boil it, cook it, peel it, or forget it”,[object Object],Vaccinations ,[object Object],Vivotif:  oral, live attenuated vaccine, must be refrigerated, dosage is 1 capsule every other day - 4 dosages ,[object Object],Typhim Vi:  Vi capsular polysaccharide vaccine, IM injection every 2 years ,[object Object],Both are given 2 weeks prior to exposure ,[object Object],Treatment ,[object Object],Empiric treatment:  Ciprofloxacin for duration of 3 to 5 days ,[object Object],Alternative:  3rd generation cephalosporin  (Cefixime, Cefdinir),[object Object]
Before Your Trip—Rabies ,[object Object],Rabies can be found on all continents except Antarctica ,[object Object],In certain areas of the world, including Central and South America, rabies in dogs is still a major problem ,[object Object],Preventative measures,[object Object],Best accomplished by avoiding bites from mammals ,[object Object],Wound cleansing and disinfection ,[object Object],Vaccination ,[object Object],Vaccinations,[object Object],HDCV:  human diploid cell vaccine; given IM at pre-exposure or post-exposure,[object Object],PCEC:  embryo cell vaccine; given IM at pre-exposure or post-exposure,[object Object],Human Rabies Immune Globulin:  local infusion at wound site + IM distal site; post-exposure,[object Object]
Before Your Trip—Malaria ,[object Object],Location,[object Object],Rural areas only at altitudes below 4,921 feet,[object Object],No malaria in Guatemala City, Antigua, or Lake Antitlan,[object Object],Drug Resistance ,[object Object],None ,[object Object],Malaria Type ,[object Object],P. vivax; 97%,[object Object],P. falciparum; 3%,[object Object],Prophylaxis for areas with malaria ,[object Object],Atovaquone/proguanil (Malarone),[object Object],Doxycycline,[object Object],Mefloquine,[object Object],Primaquine,[object Object],Must be tested and documented to have normal glucose-6-phosphate dehydrogenase activity ,[object Object]
How Do I Stay Healthy?,[object Object],Avoid mosquito bites ,[object Object],Avoid outbreaks,[object Object],Be aware of peak exposure times and places ,[object Object],Wear appropriate clothing ,[object Object],Check for ticks ,[object Object],Use Bed nets ,[object Object],Spray Insecticides ,[object Object],Treat clothes with Permethrin,[object Object],Apply DEET containing insecticide to skin,[object Object],Avoid areas of standing water,[object Object],Reside in well air-conditioned, enclosed areas,[object Object]
How Do I Stay Healthy?,[object Object],Prevent animal bites and scratches ,[object Object],Travelers to rabies-endemic countries should be warned about the risk of acquiring rabies and educated on avoiding bites (see “rabies” for additional information),[object Object],Street dogs represent the most frequent risk for bite exposure to travelers, followed by monkeys,[object Object],Children are considered high risk because their small stature makes extensive bites more likely, they are attracted to animals, and there is the remote possibility that they may not report a possible exposure,[object Object]
How Do I Stay Healthy?,[object Object],Avoid contaminated food and water,[object Object],Drink only bottled water or use water sanitizing techniques,[object Object],Boil water,[object Object],Do not use ice cubes ,[object Object],Avoid undercooked meat and fish,[object Object],All fruits and vegetables should be cleaned and peeled; if not, avoid it,[object Object],Do not consume food from street vendors ,[object Object],Do not consume unpasteurized dairy products ,[object Object]
How Do I Stay Healthy?,[object Object],Other Important Tips,[object Object],Be aware of possible natural disasters ,[object Object],Avoid injuries,[object Object],Wear helmets, no drinking and driving, avoid overcrowded transportation, avoid night driving, consider hiring a driver, follow all traffic laws, wear a seatbelt,[object Object],Keep feet clean and dry, and never go barefoot,[object Object],Reduces the risk of fungal and parasitic infections ,[object Object]
How to Stay Safe,[object Object],Always travel with your group,[object Object],Stay on main roads,[object Object],Be cautious of ANY stranger who approaches you,[object Object],Avoid having devices such as cell phones, laptops, and iPods visible (never use them in public),[object Object],Never hail taxis – only use reputable tour organizations,[object Object],Taxi Seguro – “safe taxi”,[object Object],Travelling after dark is strongly discouraged,[object Object],If by chance, you are victimized, do not resist,[object Object],Avoid large gatherings of people – protests are common & may become violent,[object Object],Crime and Safety,[object Object]
Crime and Safety,[object Object],Kidnapping,[object Object],Keep a close eye on any children in the group,[object Object],Don’t make any unnecessary contact with children,[object Object],people are often accused of stealing children if they are seen talking or taking pictures with  children,[object Object]
U.S. Embassy,[object Object],Guatemalan American Citizen Services,[object Object],(502) 2326-4501 – normal business hours,[object Object],Normal business hours ,[object Object],Monday – Thursday - 7:30 a.m. – 12 p.m. and 1 p.m. – 3 p.m.,[object Object],Friday – 7:30 – 11:30 a.m.,[object Object],(502) 2331-2354 – after normal business hours,[object Object],Guatemalan Police number – equivalent to “911”,[object Object],120,[object Object],122,[object Object],123,[object Object],The Embassy is located at AvenidaReforma 7-01,  Zona 10, Guatemala City, Guatemala. The American Citizen Services Unit in the Embassy is accessed through the door on 7thCalle.,[object Object],ASISTUR – Assistance to Tourists,[object Object],1500 2421-2810,[object Object],1500 5578-9836,[object Object],Fax,[object Object],1500 2421-2891,[object Object]
References,[object Object],We hope you enjoy your stay in Guatemala!,[object Object],If you need additional information, please do not hesitate to use these resources:,[object Object],Centers for Disease Control and Prevention: http://wwwnc.cdc.gov/travel/,[object Object],World Health Organization: http://www.who.int/en/,[object Object],US Department of State: http://travel.state.gov/travel/travel_1744.html,[object Object],The Shalom Foundation: http://theshalomfoundation.org,[object Object]
http://theshalomfoundation.org,[object Object]

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