Turkiye Klinikleri Infectious Diseases - Special Topics

Seyahat Sagligi Ozel Sayisi
.: EDITORIALS
Sayı Editöründen
Editorials
Prof. Dr. Üner KAYABAŞa
aEnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji AD, Niğde Ömer Halisdemir Üniversitesi Tıp Fakültesi, NİĞDE
Article Language: TR
Günümüzde küreselleşme, sanayileşmenin artması, nüfus artışı ve ekonominin güçlenmesi ile ülkeler arası ilişkiler gelişmiş, kişilerin hem ticari hem de turistik amaçlı seyahatleri yaygınlaşmıştır. Zamanın değerli olması nedeniyle de seyahatlarda uçaklar daha çok tercih edilmeye başlamıştır. Amerika Birleşik Devletleri'nden yurtdışına seyahat edenlerin sayısı 1995 yılında 52 milyonken, 2011 yılında 58.7 milyona yükselmiştir.(1) Dünya genelinde 2013 yılında %5 oranında büyüyen uluslararası turist sayısı 1.087 milyara ulaşmış ve gün geçtikçe de artmaya devam edeceği gözlenmektedir.(2) Bu seyahatler ile yolcular seyahat ettikleri yerlerdeki enfeksiyon hastalıklarını kendi ülkelerine taşıyabilmektedir. Özellikle sıtma, influenza ve sarıhumma gibi hastalıkların yayılımı seyahatlerle daha da artmaktadır. 2010 yılında yaklaşık 216 milyon insanın sıtmaya yakalandığı ve 655.000 kişinin ölümüne neden olduğu bildirilmiştir.(3) Amerika Birleşik Devletleri'nde endemik bölgelerden uçakla seyahat edenlerde ve hatta uçuş ekibinde bile her yıl sıtma vakalarının görüldüğü bildirilmiştir.(4) Benzer şekilde uçak yolculuğu sırasında influenza ve diğer solunum yolu virüsleri bulaşabilmekte ve salgınlara neden olabilmektedir. (5) Kuzey Amerika'da 2009 yılında 2009 pandemik influenza (H1N1) vakaları tespit edilmiş ve birkaç hafta içinde tüm dünyada yeni vakalar tespit edilmesi üzerine Dünya Sağlık Örgütü (WHO) influenza için pandemi alarm düzeyini faz 4'e yükseltmiştir.(6,7) Yine dünya çapında her yıl milyonlarca insan Hindistan, Hint Okyanusu adaları ve komşu ülkelere seyahat etmektedir. Hindistan'da üç yıl yaşadıktan sonra ülkemize dönen bir olguda Türkiye'de ilk kez Chikungunya enfeksiyonu tanımlanmıştır.(8) Son Ebola virüs hastalığı salgını 2014 yılında Batı Afrika'da başlayıp birçok Afrika ülkesine yayılmış, buralardan kendi ülkelerine dönen seyyahlarda ve bunlara ülkelerinde sağlık hizmeti veren sağlık çalışanlarında da saptanmıştır.(9)

Bununla birlikte seyahat edenlerin çoğunluğunun bu risklerden habersiz olduğu ve gerekli önlemleri almadığı fark edilmiştir.(10-12) Tüm bunlardan dolayı, son iki dekattan beri seyahat sağlığı ve seyahat tıbbı konsepti gelişmiştir. Seyahat sağlığı konsepti ile enfeksiyon hastalıklarının ve antibiyotik direncinin dünya çapındaki epidemiyolojisi ve enfeksiyon dışı sağlık riskleri (iklimin ve yükseltilerin etkisi gibi) bölgelere göre izlenmekte, seyyahın kronik hastalıklarına seyahatin etkisi ve kötü sonuçlarının önlenmesi, seyahat edilecek bölgenin özelliklerine göre immünoproflaksi veya kemoproflaksi önerileri seyahat edeceklere bu konuların uzmanları tarafından sunulmaktadır.(13-17)

Türkiye'den hava yolu ile yurt dışına çıkan yolcu sayısı 2013 yılında 36.731.037 iken, bunların 17.148.018 (%46,7)'i İstanbul Uluslararası Atatürk havaalanından gerçekleşmiştir.(18) Türkiye Kalkınma Bankası verilerine göre 2007 yılında Türkiye'den 8.937.660 Türk vatandaşı yurt dışına seyahat etmiştir.(19)

Hazırlanan bu özel sayıda seyahat sağlığı konusu, farklı alanlardan 16 yazarın katkısı ile 11 bölümde ele alınmış olup; seyahat sağlığı uygulamaları hakkında bilgilendirme ve farkındalığın arttırılması amaçlanmıştır.

Prof. Dr. Üner KAYABAŞ
Sayı Editörü

KAYNAKLAR
1. Kogelman L, Barnett ED, Chen LH, Quinn E, Yanni E, Wilson ME, et al. Knowledge, Attitudes, and Practices of US Practitioners WHO Provide Pre-Travel Advice. J Travel Med 2014;21(2):104-14.
2. World Tourism Organization (UNWTO) 2014. International tourism exceeds expectations with arrivals up by 52 million in 2013. PR No.: PR14004, Madrid, 20 Jan 14. http://media.unwto.org/press-release/2014-01-20/international-tourism-exceeds-expectations-arrivals- 52-million-2013 (Erişim tarihi: 22.01.2015).
3. World Health Organization. World malaria report 2011. Geneva:WHO Press; 2012.
4. Selent M, Beau de Rochars VM, Stanek D, Bensyl D, Martin B, Cohen NJ, et al. Malaria Prevention Knowledge, Attitudes, and Practices (KAP) Among International Flying Pilots and Flight Attendants of a US Commercial Airline. J Travel Med 2012;19(6):366-72.
5. Centers for Disease Control and Prevention. CDC Health Information for Internal Travel 2014. New York: Oxford University Press;2014.
6. Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team, Dawood FS, Jain S, et al. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009;360(25):2605-15.
7. World Health Organization. Pandemic (H1N1) 2009-update 60. Available at: http://www.who.int/csr/don/ 2009_08_04/ en/ index.html.(Erişim tarihi: 18.08.2014).
8. Yağcı Çağlayık D, Uyar Y, Korukluoğlu G, Ertek M, Unal S. An imported Chikungunya fever case from New Delhi, India to Ankara, Turkey: the first imported case of Turkey and review of the literature. Mikrobiyol Bul 2012;46(1):122-8.
9. Centers for Disease Control and Prevention. 2014 Ebola Outbreak in West Africa-Outbreak Distribution Map.
http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html (Erişim tarihi: 22.11.2014)
10. van Genderen PJ, van Thiel PP, Mulder PG, Overbosch D; Dutch Schiphol Airport Study Group. Trends in knowledge, attitudes, and practices of travel risk groups toward prevention of hepatitis A: results from the Dutch Schiphol Airport survey 2002 to 2009. J Travel Med 2012;19(1):35-43.
11. Larocque RC, Rao SR, Tsibris A, Lawton T, Barry MA, Marano N, et al. Pre-travel health advice-seeking behavior among US international travelers departing from Boston Logan International AirportJ Travel Med 2010;17(6):387-91.
12. Dahlgren AL, Deroo L, Avril J, Bise G, Loutan L. Health risks and risk-taking behaviors among International Committee of the Red Cross (ICRC) expatriates returning from humanitarian missions. J Travel Med 2009; 16(6): 382-90.
13. Aw B, Boraston S, Botten D, Cherniwchan D, Fazal H, Kelton T, et al. Travel medicine: What's involved? When to refer? Can Fam Physician 2014;60(12):1091-103.
14. World Health Organization. Health risks and precautions: general considerations. In: World Health Organization, ed. International travel and health. Geneva:WHO Press; 2011. p.1-13.
15. Zimmermann R, Hattendorf J, Blum J, Nuesch R, Hatz C. Risk Perception of Travelers to Tropical and Subtropical Countries Visiting a Swiss Travel Health Center. J Travel Med 2013;20(1):3-10.
16. Chiodini JH, Anderson E, Driver C, Field VK, Flaherty GT, Grieve AM, et al. Recommendations for the practice of travel medicine. Travel Med Infect Dis 2012;10(3): 109-28.
17. Selcuk EB, Kayabas U, Binbasioglu H, Otlu B, Bayindir Y, Bozdogan B, et al. Travel health attitudes among Turkish business travellers to African countries. Travel Med Infect Dis 2016;14(6):614-20.
18. Türkiye İstatistik Kurumu. Ulaştırma İstatistikleri: İstatistiki Bölge Birimleri Sınıflamasına Göre Hava Meydanlarında İniş-Kalkış Yapan Uçak Sayısı ile İç ve Dış Hatlarda Taşıma,1,2,3.Düzey. http://www.tuik.gov.tr/PreTablo.do?alt_id=1051 (Erişim tarihi: 22.01.2015)
19. Önen MO. Dünyada ve Türkiye'de turizm. Ekonomik ve Sosyal Araştırmalar Müdürlüğü, Temmuz 2008, Ankara.
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30.03.2014

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