Scientific Program Committee Awards for the Best Presentations at CISTM8

The Scientific Program Committee reviewed the numerous excellent presentations at CISTM8 and decided to make two awards: best oral free communication and best poster presentation. The abstracts of these two presentations are printed here:

Best oral free communication:

High incidence of pertussis in non-immune Hajj pilgrims

Authors: A. Wilder-Smith, Travelers' Health & Vaccination Centre, Tan Tock Seng Hospital; S. Ravindran, Clinical Research Unit, Tan Tock Seng Hospital; A. Earnest, Infectious Disease Research Centre, Tan Tock Seng Hospital and N. I. Paton, Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.

Objectives: Prolonged cough occurs in a large proportion of the two million pilgrims attending the annual Hajj in Saudi Arabia. Pertussis is a frequent, but often underestimated cause of prolonged cough illness in adults. We conducted a prospective seroepidemiological study to determine the incidence of pertussis in adult Hajj pilgrims.

Method: We measured IgG antibodies to pertussis toxin in pre and post Hajj serum samples taken from 358 Singaporeans attending the year 2002 Hajj pilgrimage and questioned pilgrims about occurrence and duration of cough.

Results: Five out of 358 (1.4%) pilgrims acquired pertussis (as defined as a > 4 fold increase in IgG to pertussis toxin and prolonged cough). Of the 40 pilgrims who had no pre Hajj immunity against pertussis, three (7.5%) acquired pertussis.

Conclusions: The overall incidence rate during this one month event is higher than that of many other vaccine-preventable travel-related diseases (except influenza). The incidence of pertussis in non-immune pilgrims was even as high as 7.5%. This is not only of concern for the pilgrims, but may also lead to initiation of pertussis outbreaks upon return to their countries of origin. Administration of acellular pertussis vaccine (or DTaP) should be considered for departing Hajj pilgrims to address is problem.

Best poster presentation at CISTM8:

Pharmacists and Travel Advice for Tropics

Authors: R. Teodósio, L. Gonçalves and J. Atouguia, Institute of Hygiene and Tropical Medicine, Lisbon, Portugal, and E. Imperatori, National School of Public Health, Lisbon, Portugal:

Objectives: To identify which topics pharmacists in the Lisbon area discuss with travelers and the advice given about transmission and prevention of malaria, yellow fever vaccination, and prevention and treatment of diarrhea.

Methods: A cross-sectional survey was undertaken. A self-administered questionnaire was given to pharmacists (one for each pharmacy in the random sample) during the period of November-December 2001. Questions were asked about advice given to an adult traveler traveling to tropical Africa.

Results: 251 pharmacists agreed to participate in the study; 20.1 % were male and 79.9% female; the average age was 43.55 years (SD 13.75).

Travel advice was not given in 5.6% of the pharmacies; 82.2% of the pharmacies gave advice to up to 3 travelers per month, only 2.5% of the pharmacies gave advice to more than 10 travelers per month. Of all the the studied pharmacies, 89.8% advised about malaria, 64.4% about vaccines and 97% about diarrhea.

In the group that gave advice about malaria, only 59% talked about transmission by mosquito bite and 90.8% gave no advice regarding bites at nightfall. A large number (90.6%) indicated "use of repellent" to protect against mosquito bite, but 53.3% didn't indicate to "protect with clothes"; 96.7% did not indicate "air conditioning"; 66.7% did not indicate "use of bed mosquito nets".

In a sample of 170 pharmacists 43.5% advised chemoprophylaxis with mefloquine and 44.1% with chloroquine; 25.29% advised both mefloquine and chloroquine. In this group there was association between "advise mefloquine" and "advise chloroquine" (p = 0.001).

In the group that gave advice about vaccines, 21.2% did not inform about yellow fever vaccine.

In the group that gave advice about diarrhoea, no information was given about: the need to consume bottled water, 38.8%; the need to avoid ice cubes, 65.8%; the need to increase consumption of potable water during episodes of diarrhea, 62.3°'0; the use of oral rehydration sachets, 74.3°o. In this group of pharmacists there was no association between the last two variables (p=0.3).

Conclusions: In spite of the large number of pharmacies giving travel advice, this advice is incomplete and incorrect, and must be improved.

Submitted by:

Prof. Dr. Hans Dieter Nothdurft, Chair,
Scientific Program Committee