Travel Unravelled

The World Health Organization (WHO) estimates that 5 million snakebites occur each year, with between 81,000 and 138,000 deaths. A fear of snakes is common. It doesn't help that snakes have long been cast as villains: In Raiders of the Lost Ark, a deadly cobra lurks in an ancient Egyptian temple. In Greek mythology, Medusa's snake mane is her ultimate weapon. And in real life, White Lotus star Walton Goggins recently revealed he was bitten by a snake while filming in Thailand. It's no surprise that travellers worry about snakebite. So in the 10th episode of Travel Unravelled, we're exploring how to minimize the risk of envenomation—and providing some tips for travellers and clinicians in the event that they do encounter a bite from a venomous serpent. Here, the Travel Unravelled team of Dr. Albie de Frey, Dr. Sarah McGuinness and Dr. Aisha Khatib benefit from the perspectives of renowned experts Professor David Warrell, the founding director of the Centre for Tropical Medicine at Oxford University, UK and Dr. Bart Currie, leader of the Tropical and Emerging Infectious Diseases team at the Menzies School of Health Research in Darwin, Australia. How do you determine snakebite risk at your travel destination? What can you do to minimize snakebite risk? What should you do if you get bitten by a snake? Takeaways that our experts explore include: The importance of immobilization and getting to medical care quickly The value of a photo of the snake, if safe to obtain The fact that not all snakebite victims require antivenom And that clinical assessment and observation are crucial in early hospital management LINKS Watch the World Health Organization's Science in 5 - Snakebites: Life saving facts This GeoSentinel analysis provides lots of information about travellers' exposures to animals around the world—including snakes. The WHO Factsheet on snakebite envenoming. Snake identification in Africa Guidelines on snake antivenom production Map showing snake species, data, and information Prevention and clinical management of snakebite in Africa Prevention and clinical management of snakebite in South and South East Asia Bandage types for snakebite first aid Global mapping of snakebite envenoming hotspots To follow us on your favourite podcast platform, go to our show feed on Apple Podcasts, Spotify or YouTube. Please remember to rate the show! Visit the International Association for Medical Assistance to Travellers (IAMAT), which provides extensive resources, like the Guide to Healthy Travel, and Guide to Travel Health Insurance. IAMAT is the exclusive sponsor of season 2 of ISTM's Travel Unravelled podcast. The ISTM's Travel Unravelled podcast is produced by Ghost Bureau, the Toronto content agency. DISCUSSION POINTS00:00 Introduction 01:42 Catching up with Travel Unravelled hosts 03:50 Introducing our guests​ 08:30 Is the fear of snakes an unreasonable concern for travellers? 12:50 Types of snakes: Cytotoxic, Neurotoxic, Hemotoxic 21:07 What to do if you've been bitten by a snake 34:23 Snakebite first aid: Everything you need to know 50:10 Signs and symptoms of snakebite 1:00:02 How to effectively treat a snakebite 1:08:00 Final remarks

ISTM podcast director Dr. Aisha Khatib and digital communications lead Dr. Sarah McGuinness discuss a strange medical case drawn from the pages of the Journal of Travel Medicine. Approximately two billion people around the world are afflicted with toxoplasmosis, a parasitic disease that typically results from exposure to cat feces. Most of those infected don't have any symptoms, but in some cases, the disease can cause muscle aches, fever and swollen glands. So is it possible that the Brazilian traveller contracted toxoplasmosis from the pink dolphins of the Amazon river? (A mini episode.) LINKS The Journal of Travel Medicine article: "Human toxoplasmosis as a result of swimming with pink dolphins in the Amazon river?" By Sylvia Lemos Hinrichsen, PhD, Tatiana Aguiar Santos Vilella, MSc, Reginaldo Gonçalves Lima Neto, PhD The episode web page at ISTM features supplementary pics of Drs. Aisha Khatib and Sarah McGuiness in the Amazon. Travel Unravelled is sponsored by IAMAT, the International Association for Medical Assistance to Travellers. KEY MOMENTS 00:00 Introduction 00:10 Dr. Aisha Khatib and Dr. Sarah McGuinness introduce the topic of toxoplasmosis. 02:01 Dr. Aisha Khatib and Dr. Sarah McGuinness discuss their own experiences swimming with pink dolphins in the Amazon River. 03:10 Explanation of what toxoplasmosis is—a zoonotic disease caused by a parasite that can infect warm-blooded animals, including humans. 04:31 Discussion of how toxoplasmosis is typically transmitted, including through contact with cat feces and eating undercooked meat. 05:57 Uncertainty around how the traveller in the case report contracted toxoplasmosis from swimming with pink dolphins in the Amazon. 08:04 Overview of the main transmission routes for toxoplasmosis that travellers should be aware of, including contact with cat feces, eating undercooked meat, and swimming in contaminated water. 11:21 Advice on testing and treatment for toxoplasmosis, particularly for pregnant women and those with weakened immune systems. 13:04 Key takeaways on the importance of good hygiene practices and being aware of potential disease risks when travelling.

Thought to be the inspiration behind legends like the vampire and the werewolf, the rabies virus poses a serious risk for travellers around the world. In the second episode of Travel Unravelled, hosts Dr. Anne McCarthy and Dr. Albie de Frey sink their teeth into all things rabies with podcast director Dr. Aisha Khatib. Discover the insidious nature of rabies, why it's considered one of the most fatal diseases in existence, how you can protect yourself before travelling to rabies-prone regions — and what to do if you get exposed to the virus from an animal bite. Featuring interviews with such rabies experts as the deputy director of South Africa's National Institute for Communicable Diseases, Dr. Lucille Blumberg, and the medical director of Belgium's Institute of Tropical Medicine, Dr. Patrick Soentjens, our second episode chronicles the evolution of rabies prevention recommendations, from vaccine developer Louis Pasteur to the state of the art today. LINKS Travel Unravelled is sponsored by IAMAT, the International Association for Medical Assistance to Travellers. Learn more about the upcoming CISTM19 in New Orleans this May 2025. Planning a trip? Consult with this CDC Rabies Assessment to see the risk level of your destination. See CDC's 2024 Rabies Yellow Book Read the WHO Guide for Rabies Pre and Post Exposure Prophylaxis in Humans, which guest Dr. Patrick Soentjens helped to develop. Learn more about the fascinating ancient history of rabies in this Tropical Medicine and Infectious Disease article. Read Dr. Lucille Blumberg's bio. Read Dr. Patrick Soentjens's bio. See the travel medicine website and app that Dr. Patrick Soentjens mentions, Wanda.be. CLINICAL PEARL Read the article that Dr. Olivier Aoun discussed in this episode's pearl: Multi-drug resistant gluteal abscesses due to Mycobacterium abscessus following medical tourism for cosmetic purposes to Mexico in the Journal of Travel Medicine

Travel Unravelled: an ISTM Podcast explores the latest developments, challenges and innovations in travel health and medicine. Join ISTM President-Elect Dr. Anne McCarthy, Travel Doctor Corporate CEO Dr. Albie De Frey and ISTM podcast director Dr. Aisha Khatib as they chat with experts around the world and give you practical tips for your next adventure. Whether you're a seasoned traveller or just starting to plan your first international trip, Travel Unravelled is your personal guide to staying healthy while exploring the world—without taking up any room in your suitcase.