Motto: The goal of our workplace is to connect applied clinical research, innovative teaching together with the provision of quality health care based on the use of the most modern knowledge of medical science and well-coordinated teamwork of satisfied employees.

The Department of Infectious Diseases and Travel Medicine 2. LF UK and FN Motol provides comprehensive treatment and preventive care in infectious medicine and travel medicine from the age of 15. The professional focus of the workplace and the care provided is based on a modern concept of the field and is inspired by the position of infectious medicine abroad with an emphasis on ambulatory care and consultation services for other clinics and departments within the FN Motol. The clinic provides acute and specialized outpatient care in the entire range of infectious medicine (except for HIV infection) and has bed capacity for the hospitalization of adult patients whose health condition requires it.

Among the most common diagnoses that we consult and treat at our clinic are febrile and inflammatory conditions, diarrheal diseases, respiratory and urinary tract infections, exanthema infections (infections that manifest as rashes), neuroinfections, liver infections, and skin and soft tissue infections. The clinic specializes in the diagnosis and treatment of febrile conditions of unclear etiology, imported tropical infections, opportunistic infections in immunodeficient patients, infections associated with the provision of health care and infections in risk groups of patients (seniors, patients with serious chronic diseases, etc.).

The clinic is set up Vaccination center, also providing vaccination against covid-19, and Travel medicine center. The Travel Medicine Center provides comprehensive pre-departure counseling as well as diagnosis and treatment of health problems for travelers after returning from a risk area. It is completely unique among Prague hospitals Center for the Treatment of Infections in Intravenous Drug Users, which provides outpatient and inpatient care for drug-addicted patients. It provides psychiatric and psychological care to hospitalized patients, helps arrange treatment for motivated patients, provides substitution treatment during hospitalization and provides internal examinations before starting substitution treatment with methadone. Care for patients with chronic hepatitis B or C is provided in Center for the treatment of viral hepatitis.

The clinic participates in teaching students of bachelor's and master's study programs at the 2nd Faculty of Medicine of the UK and serves as a teaching workplace of the Institute for Postgraduate Education in Healthcare. The clinic's scientific and research activities are based on cooperation with related laboratory and clinical disciplines at the Motol National Research Institute. Main research topics include antibiotic therapy and prescription, travel medicine, infections in high-risk patient groups and epidemiology of infectious diseases.

Inpatient department

The clinic's bed department has a total of 23 beds. The department is built in a box system with double rooms and one single room. Each room is equipped with its own bathroom, TV and telephone, which the patient can use to communicate with the nurse, but also with his relatives and friends, if they call the nurses' office (22443 6928/6929).

Hospital stay

When admitted to the hospital, please bring with you:

• Health insurance card and identity card
• Recommendations for hospitalization (if you have one), reports and results from previous examinations
• Medicines that you take regularly (in original packaging) or at least a list of them
• Basic toiletries, bathrobe, pyjamas, slippers with non-slip soles
• Mobile phone and charger

If it is an acute admission, it is advisable to bring the necessary things to the patient in the shortest possible time after agreement with the medical staff. Please do not bring large amounts of money, valuables (expensive jewelry, watches...), weapons to the hospital. We recommend storing valuables, jewellery, large sums of money and important documents in the institutional safe.

Part of the administrative procedures for admission to hospitalization is the signing of consent to hospitalization and subsequent diagnostic and treatment procedures. Don't be afraid to ask anything that is unclear to you and that you are worried about. The treating doctors will be happy to explain everything. During hospitalization, please inform the treating doctor or nurse about all your problems and what is troubling you. Try to give the medical professionals all the necessary information, as this will facilitate and speed up the treatment and shorten the time of hospitalization in the hospital.

In the case of hospitalization, it is necessary to comply with the internal regulations of the department and the hospital, which the doctors and nurses of the clinic will introduce you to.

Rules for visits to the inpatient ward

Visits to the inpatient ward are permitted daily from 14:00 p.m. to 17:00 p.m., but it is necessary to respect the regime established by the nursing staff. In exceptional cases, visits may be permitted outside of the specified visiting hours after consultation with the clinic staff. We recommend that a maximum of 2 people stay in the room with one patient during the visit. Children under 15 and pregnant women are not allowed access to wards and patient rooms. The attending physician is authorized to prohibit visits to selected rooms for epidemiological reasons. Visits must respect the instructions of healthcare workers, including the use of recommended personal protective equipment (coats, mouthpieces, gloves), washing and hand disinfection.

Rules for communicating information about health status

Information is communicated only to persons listed in the medical records who know the password for communication. Information is provided by the attending physician on working days from 11:00 a.m. to 12:00 p.m. on phone number 22443 6928/6929. On the weekend, you can request up-to-date information about your health status from the doctor's office between 15:00 p.m. and 16:00 p.m. An exception to the above-mentioned rule is the situation when the patient is admitted for hospitalization on duty (15:30-7:45), after which information on the current state of health can be requested in the morning hours of the following day.

Management and staff

Head of the clinic:
MD Milan Trojánek, Ph.D.
tel.: 22443 6900/6901

Deputy head for health activities:
MD Martin Tulach
tel .: 22443 6903

Deputy Principal for Teaching:
MD Aneta Nyčová

Deputy Head for Science and Clinical Research:
MD Vyacheslav Grebenyuk

Head of inpatient department:
MD Grigory Mesezhnikov
tel.: 22443 6948/6928/6929

Chief Consular Doctor:
MD Marek Štefan, MBA
tel .: 22443 6911

Secondary doctors (acute and specialist ambulances):
MD Jan Kubik
MD Vyacheslav Grebenyuk
MD Veronika Yegorova

Secondary doctors (inpatient department):
MD Lukáš Kohout
MD Aneta Nyčová
MD Barbora Pišová
MD Teresa Ernestová
MD Sarah Schwott
MD Kateřina Kupská

Head nurse:
M.Sc. Milena Chybová
tel .: 22443 6905

Station nurse:
Hana Black
tel .: 22443 6907

Vaccination Center:
Bc. Denisa Ličáková
tel .: 22443 2330
mobile: 775 939 710

Secretariat:
Bc. Martin Mecerod
tel.: 22443 6900/6901
mobile: 720 932 246

Jarmila Marešová
tel .: 22443 6910

News for patients

We are currently vaccinating

• Vaccination against tick-borne meningoencephalitis

We travel safely

MD Veronika Yegorova
Department of Infectious Diseases and Travel Medicine 2nd Faculty of Medicine, UK and Motol Medical University

Whether your dream destination is Europe, the Mediterranean or exotic tropical regions, don't forget, in addition to buying flights and accommodation, also to prepare in terms of health. Anyway, don't be afraid to travel, as we say: "There are no dangerous countries, only risky travelers."

Health, and specifically infectious, risks differ greatly not only depending on which destination we are going to, but also when and how long we will stay in the given destination, how we will be accommodated or how we will eat. Along with this, the recommendations for vaccination of travelers also differ. There is an abundance of vaccines on the market, and aside from mandatory vaccinations (e.g. yellow fever when traveling to sub-Saharan Africa or Latin America), every traveler should at least have a valid tetanus vaccination. It doesn't matter whether you go to lie on the beach of a five-star hotel or hitchhike across the country, even the most careful person can get hurt. Without knowing the latest "tetanus" application, your vacation can not only be complicated, but also more expensive. If more than 10 years have passed since the last application, it is advisable to get re-vaccinated before the trip, with a combined vaccine that also provides protection against whooping cough and diphtheria being optimal.

Another vaccination that is suitable for any traveler is the vaccination against type A jaundice, which is sometimes referred to in layman's terms as dirty hands disease. However, you can get infected even if you follow the rules of personal hygiene very closely, because in some areas you are not able, for example, to monitor the staff of catering establishments, their hygiene and state of health. This vaccination can also be used in our conditions, we can see local outbreaks of type A jaundice in more isolated communities or, for example, during floods.

Vaccination against rabies is definitely worth considering when traveling to nature or staying in risk areas for longer periods. Even when actively trying to avoid animals, you never know when a local animal will look out for you. For example, monkeys tend to be quite aggressive in exotic destinations and are not afraid, a moment of inattention is enough. Rabies is always a fatal disease, and after risky contact with an animal, an unvaccinated person must receive 5 doses of vaccine together with animal/human serum. This is not only expensive, but above all it may not be available in all destinations. Other vaccinations that are considered according to the risk in a given destination include, for example, vaccination against typhoid, hepatitis B, meningococci, poliomyelitis or Japanese encephalitis.

Even after completing the vaccination, however, it is necessary to be careful about how you will behave while eating at the destination. It is not for nothing that it is said that whoever did not have digestive problems during the trip, it is as if he had not even traveled. Diarrheal diseases are among the most common health problems of travelers. These are mostly self-healing conditions, which can, however, make vacations very unpleasant.

The basis of prevention is the consumption of original bottled water, not only for drinking, but also for brushing teeth or rinsing the mouth. While it's tempting to do so while on vacation, you should try to avoid ice in your drinks. Although eating in markets and streets is certainly part of learning about local culture, it cannot be considered safe. Choose fruit/vegetables with skin, food in original packaging and avoid unpasteurized dairy products or insufficiently heat-treated meat. In general, remember the rule: "Peel it, boil it or forget it". And most importantly, observe increased hand hygiene before each meal.

If diarrhea develops, the basis of treatment is to maintain hydration (it is advisable to purchase so-called rehydration solutions at the pharmacy before the trip, which will also supply the body with minerals). Other recommended drugs include adsorbents (diosmectite, black coal) or racecadotril. Loperamide, which slows down peristalsis, is also very effective, but should not be used in patients who have fever, intense abdominal pain, or stools containing blood or mucus. We do not recommend the routine use of antibiotics or intestinal disinfectants due to the possible influence of the intestinal microflora and the risk of longer-term digestive problems. In patients who take medications for diabetes or high blood pressure, it may be necessary to temporarily discontinue these medications in the event of an acute diarrheal illness with dehydration.

In addition to vaccinations and dietary habits, it is also a good idea to evaluate the risk of malaria before the trip, which occurs mainly in sub-Saharan Africa, although the risk also exists in other tropical regions. It is a serious febrile disease transmitted by female Anopheles mosquitoes. These insects are active from dusk to dawn. As part of prevention, there is effective chemoprophylaxis using antimalarials, which a specialist in the travel medicine center will prescribe for you depending on the risk. Among the antimalarials, atovaquone/proguanil is most often used, which is effective and very well tolerated by travelers. Malaria can take a more dramatic course in travelers than in locals, with death occurring within days. Traveling to a malarious region without antimalarials is neither adventure nor heroism, but a downright unnecessary and ill-advised risk.

Since malaria is not the only mosquito-borne disease in many destinations, it is a good idea to protect yourself from insect bites. Mosquitoes also transmit some of the most common tropical infections, such as dengue fever, chikungunya, Zika, West Nile fever and Japanese encephalitis. Even in the Mediterranean region, a mosquito bite can be risky, because the tiny mosquitoes can transmit papatachi fever (similar to our tick-borne meningoencephalitis), West Nile fever or leishmaniasis. At the time of the highest mosquito activity, limit skin exposure: wear long pants and sleeves, prefer loose cuts and light-colored clothes, on which you can see mosquitoes better. Use repellents with sufficient effectiveness on the skin (50% DEET or 20% (p)icaridin). Always buy repellent at a pharmacy or sporting goods store before your flight. Do not buy them in the tropics, because less effective preparations are often sold abroad. Products with permethrin can be applied directly to clothing. Due to the predominance of mosquito activity at night, it is appropriate to limit the opening of windows when the light is on, unless insect nets are installed in them. As a supplement, it is possible to choose electric insecticides in the socket, have the fan/air conditioning on and a mosquito net placed above the bed.

Precisely because of the risk of malaria and other tropical infections, it is always important that a traveler who falls ill with fever during a stay in the tropics or shortly (up to 2 months) after returning immediately seeks medical treatment and informs that he has stayed in the tropics. Although most cases of fever after returning from the tropics are not caused by tropical diseases, if they are, they require different procedures in diagnosis and therapy. If you have any health problems after returning from the tropics, you can use the services of the Clinic for Infectious Diseases and Travel Medicine of the 2nd Faculty of Medicine of the UK and the Motol Medical Center.

The basis before the trip is also a good preparation of the travel first aid kit. Medicines for temperature and pain, medicines for diarrhea, sore throat and cough, as well as medicines for allergies, after insect bites and basic needs for first aid in case of injury should not be missing. Before traveling, it is also important to ensure that you have a sufficient amount of chronically used medication, even in case your vacation is unexpectedly extended. Do not forget to check with the following specialists for chronic diseases and if they are not well compensated, postpone the trip until a time when it is safe for you to travel. If you have to travel, always require additional insurance for your chronic diseases as part of your travel insurance.

During long flights, be prepared for the possible occurrence of jet lag. Jet lag most often affects travelers when quickly crossing 3 or more time zones. Symptoms include fatigue, headaches, trouble sleeping, concentration and irritability. Symptoms usually disappear within a few days with a more restful regime. As part of prevention, you should travel with physical and mental rest, wear comfortable clothes for the flight, take care of a sufficient drinking regime and limit the consumption of alcohol on board or at the airport. When traveling east, try to fall asleep 1-2 hours earlier a few days before departure and prefer a night flight with the possibility of sleeping on the plane. On the other hand, when traveling to the west, sleep 1-2 hours later and prioritize a flight during the day with sleep settings according to the destination.

Last but not least, the risk of sexually transmitted diseases, especially gonorrhea, is worth mentioning. Resistant strains of Nesseria are increasing worldwide, and treatment can then be quite complicated. Everyone likes to get to know a culture in a different way, so don't forget to pack condoms and try to behave responsibly to avoid an unpleasant souvenir from your travels.

Cultural or religious customs cannot be included in this topic, but it is appropriate to find out the basic rules of the given country before the trip and respect them. Keep in mind that you are the one visiting the country and treat yourself with the respect you would want tourists to treat us with. When traveling to less developed countries, prepare for a possible culture shock, and despite the incomprehensible facts, try to see the beauty in these differences, after all, that is one of the reasons why you travel.

So, in summary, how can you best prepare for travel and what should you do to ensure that your vacation goes according to your wishes? Always respect the culture and customs of the country in question, do not put yourself at unnecessary risk, be it in terms of people, animals, food or insects. Take out high-quality additional travel insurance (including additional insurance for possible chronic diseases) and, above all, visit an expert in the field of travel medicine before your trip, with whom you can discuss your travel plans together. Finally, sign up for DROZD from the Ministry of Foreign Affairs and enjoy a well-deserved vacation in your dream destination. In case of any questions or problems, do not be afraid to contact us, we are here for you before, during and after your trip.

• Travel first aid kit
• Prevention of mosquito bites
• Fever during stay and after return from tropics
• Traveler's diarrhea
• Animal injuries and risks in the wild
• Jet lag
• Sunburn and scald
• Altitude sickness
• Travel insurance and the DROZD system
• What to do in case of health problems after returning from trips?

We travel safely

MD Veronika Yegorova
Department of Infectious Diseases and Travel Medicine 2nd Faculty of Medicine, UK and Motol Medical University

Whether your dream destination is Europe, the Mediterranean or exotic tropical regions, don't forget, in addition to buying flights and accommodation, also to prepare in terms of health. Anyway, don't be afraid to travel, as we say: "There are no dangerous countries, only risky travelers."

Health, and specifically infectious, risks differ greatly not only depending on which destination we are going to, but also when and how long we will stay in the given destination, how we will be accommodated or how we will eat. Along with this, the recommendations for vaccination of travelers also differ. There is an abundance of vaccines on the market, and aside from mandatory vaccinations (e.g. yellow fever when traveling to sub-Saharan Africa or Latin America), every traveler should at least have a valid tetanus vaccination. It doesn't matter whether you go to lie on the beach of a five-star hotel or hitchhike across the country, even the most careful person can get hurt. Without knowing the latest "tetanus" application, your vacation can not only be complicated, but also more expensive. If more than 10 years have passed since the last application, it is advisable to get re-vaccinated before the trip, with a combined vaccine that also provides protection against whooping cough and diphtheria being optimal.

Another vaccination that is suitable for any traveler is the vaccination against type A jaundice, which is sometimes referred to in layman's terms as dirty hands disease. However, you can get infected even if you follow the rules of personal hygiene very closely, because in some areas you are not able, for example, to monitor the staff of catering establishments, their hygiene and state of health. This vaccination can also be used in our conditions, we can see local outbreaks of type A jaundice in more isolated communities or, for example, during floods.

Vaccination against rabies is definitely worth considering when traveling to nature or staying in risk areas for longer periods. Even when actively trying to avoid animals, you never know when a local animal will look out for you. For example, monkeys tend to be quite aggressive in exotic destinations and are not afraid, a moment of inattention is enough. Rabies is always a fatal disease, and after risky contact with an animal, an unvaccinated person must receive 5 doses of vaccine together with animal/human serum. This is not only expensive, but above all it may not be available in all destinations. Other vaccinations that are considered according to the risk in a given destination include, for example, vaccination against typhoid, hepatitis B, meningococci, poliomyelitis or Japanese encephalitis.

Even after completing the vaccination, however, it is necessary to be careful about how you will behave while eating at the destination. It is not for nothing that it is said that whoever did not have digestive problems during the trip, it is as if he had not even traveled. Diarrheal diseases are among the most common health problems of travelers. These are mostly self-healing conditions, which can, however, make vacations very unpleasant.

The basis of prevention is the consumption of original bottled water, not only for drinking, but also for brushing teeth or rinsing the mouth. While it's tempting to do so while on vacation, you should try to avoid ice in your drinks. Although eating in markets and streets is certainly part of learning about local culture, it cannot be considered safe. Choose fruit/vegetables with skin, food in original packaging and avoid unpasteurized dairy products or insufficiently heat-treated meat. In general, remember the rule: "Peel it, boil it or forget it". And most importantly, observe increased hand hygiene before each meal.

If diarrhea develops, the basis of treatment is to maintain hydration (it is advisable to purchase so-called rehydration solutions at the pharmacy before the trip, which will also supply the body with minerals). Other recommended drugs include adsorbents (diosmectite, black coal) or racecadotril. Loperamide, which slows down peristalsis, is also very effective, but should not be used in patients who have fever, intense abdominal pain, or stools containing blood or mucus. We do not recommend the routine use of antibiotics or intestinal disinfectants due to the possible influence of the intestinal microflora and the risk of longer-term digestive problems. In patients who take medications for diabetes or high blood pressure, it may be necessary to temporarily discontinue these medications in the event of an acute diarrheal illness with dehydration.

In addition to vaccinations and dietary habits, it is also a good idea to evaluate the risk of malaria before the trip, which occurs mainly in sub-Saharan Africa, although the risk also exists in other tropical regions. It is a serious febrile disease transmitted by female Anopheles mosquitoes. These insects are active from dusk to dawn. As part of prevention, there is effective chemoprophylaxis using antimalarials, which a specialist in the travel medicine center will prescribe for you depending on the risk. Among the antimalarials, atovaquone/proguanil is most often used, which is effective and very well tolerated by travelers. Malaria can take a more dramatic course in travelers than in locals, with death occurring within days. Traveling to a malarious region without antimalarials is neither adventure nor heroism, but a downright unnecessary and ill-advised risk.

Since malaria is not the only mosquito-borne disease in many destinations, it is a good idea to protect yourself from insect bites. Mosquitoes also transmit some of the most common tropical infections, such as dengue fever, chikungunya, Zika, West Nile fever and Japanese encephalitis. Even in the Mediterranean region, a mosquito bite can be risky, because the tiny mosquitoes can transmit papatachi fever (similar to our tick-borne meningoencephalitis), West Nile fever or leishmaniasis. At the time of the highest mosquito activity, limit skin exposure: wear long pants and sleeves, prefer loose cuts and light-colored clothes, on which you can see mosquitoes better. Use repellents with sufficient effectiveness on the skin (50% DEET or 20% (p)icaridin). Always buy repellent at a pharmacy or sporting goods store before your flight. Do not buy them in the tropics, because less effective preparations are often sold abroad. Products with permethrin can be applied directly to clothing. Due to the predominance of mosquito activity at night, it is appropriate to limit the opening of windows when the light is on, unless insect nets are installed in them. As a supplement, it is possible to choose electric insecticides in the socket, have the fan/air conditioning on and a mosquito net placed above the bed.

Precisely because of the risk of malaria and other tropical infections, it is always important that a traveler who falls ill with fever during a stay in the tropics or shortly (up to 2 months) after returning immediately seeks medical treatment and informs that he has stayed in the tropics. Although most cases of fever after returning from the tropics are not caused by tropical diseases, if they are, they require different procedures in diagnosis and therapy. If you have any health problems after returning from the tropics, you can use the services of the Clinic for Infectious Diseases and Travel Medicine of the 2nd Faculty of Medicine of the UK and the Motol Medical Center.

The basis before the trip is also a good preparation of the travel first aid kit. Medicines for temperature and pain, medicines for diarrhea, sore throat and cough, as well as medicines for allergies, after insect bites and basic needs for first aid in case of injury should not be missing. Before traveling, it is also important to ensure that you have a sufficient amount of chronically used medication, even in case your vacation is unexpectedly extended. Do not forget to check with the following specialists for chronic diseases and if they are not well compensated, postpone the trip until a time when it is safe for you to travel. If you have to travel, always require additional insurance for your chronic diseases as part of your travel insurance.

During long flights, be prepared for the possible occurrence of jet lag. Jet lag most often affects travelers when quickly crossing 3 or more time zones. Symptoms include fatigue, headaches, trouble sleeping, concentration and irritability. Symptoms usually disappear within a few days with a more restful regime. As part of prevention, you should travel with physical and mental rest, wear comfortable clothes for the flight, take care of a sufficient drinking regime and limit the consumption of alcohol on board or at the airport. When traveling east, try to fall asleep 1-2 hours earlier a few days before departure and prefer a night flight with the possibility of sleeping on the plane. On the other hand, when traveling to the west, sleep 1-2 hours later and prioritize a flight during the day with sleep settings according to the destination.

Last but not least, the risk of sexually transmitted diseases, especially gonorrhea, is worth mentioning. Resistant strains of Nesseria are increasing worldwide, and treatment can then be quite complicated. Everyone likes to get to know a culture in a different way, so don't forget to pack condoms and try to behave responsibly to avoid an unpleasant souvenir from your travels.

Cultural or religious customs cannot be included in this topic, but it is appropriate to find out the basic rules of the given country before the trip and respect them. Keep in mind that you are the one visiting the country and treat yourself with the respect you would want tourists to treat us with. When traveling to less developed countries, prepare for a possible culture shock, and despite the incomprehensible facts, try to see the beauty in these differences, after all, that is one of the reasons why you travel.

So, in summary, how can you best prepare for travel and what should you do to ensure that your vacation goes according to your wishes? Always respect the culture and customs of the country in question, do not put yourself at unnecessary risk, be it in terms of people, animals, food or insects. Take out high-quality additional travel insurance (including additional insurance for possible chronic diseases) and, above all, visit an expert in the field of travel medicine before your trip, with whom you can discuss your travel plans together. Finally, sign up for DROZD from the Ministry of Foreign Affairs and enjoy a well-deserved vacation in your dream destination. In case of any questions or problems, do not be afraid to contact us, we are here for you before, during and after your trip.

Travel first aid kit

General information:

• Medicines that you take for a long time and that are necessary for you, always take them in your cabin (not checked-in) luggage (it is necessary to follow the rules regarding liquids and sprays on board), ask your doctor for a prescription for the amount that will be sufficient even in case of an unplanned extension of time stay
• Never expose the medication to direct sunlight or heat
• Follow the expiration date marked on the packaging
• Before taking the medicine, read the package leaflet of the medicine
• Observe increased caution when using medicines during pregnancy or breastfeeding, check whether the medicines can be used
• Keep medicines out of the reach of children
• If you use opiates or injectable drugs, request a certificate from the prescribing doctor in English, check the applicable regulations on the import of drugs to the given destination

Medicines and travel first aid kit equipment:

1. Chronically used medicines: medicines that you take permanently/occasionally, in sufficient quantities (even in case of an unexpected extension of stay)
2. Medicines that might be needed when your chronic disease worsens
3. Medicines for pain and temperature: paracetamol (do not use ibuprofen or acetylsalicylic acid, which can affect the function of blood platelets and blood clotting)
4. Basic needs for first aid in case of injury or accident:
   1. Pressure bandage, sterile squares, elastic bandage, patch, plaster
   2. Steri-strips for small wounds (band-aid stitches)
   3. Scissors, tweezers, gloves
   4. Antiseptic, disinfection
5. Medicines against diarrhea and indigestion:
   1. Oral rehydration solutions
   2. Diosmectite
   3. Medicines containing bismuth
   4. racecadotril
   5. Loperamide (do not use with febrile diarrhoea, diarrhea with significant abdominal pain or if there is blood or mucus in the stool)
   6. Antiemetics (ondansetron…)
   7. We do not recommend the routine use of intestinal disinfectants or antibiotics
6. Medicines against allergies or skin reactions
   1. Antihistamines
7. Topical medicines on the skin
   1. Antibiotic ointment for purulent skin infection
   2. Antifungal drugs
   3. Local corticoid or local antihistamine for insect bites or skin reactions
8. Spasmolytics (preferably in tablet form)
9. Medicines for respiratory problems:
   1. Against colds
   2. Against cough
   3. Against pain in the throat (preparations containing a local anesthetic are suitable)
10. Eye drops
11. Medicines for motion sickness (dimenhydrinate, moxastin)
12. Sunscreens, sun creams, sunglasses
13. Repellents: optimally with the active ingredient DEET (20-50%) or (p)icaridin 20%
    Attention: apply the repellant only on skin not covered by clothing, do not apply around the mucous membranes, when using sunscreens at the same time, apply the cream first, then the repellant; the duration of action of the preparation depends on the concentration of the active substance
14. Antimalarials (if indicated)
15. Thermometer

Antimalarial

• The most commonly recommended antimalarial is atovaquone/proguanil (available in packs of 12 tablets)
• Depending on the risk of malaria in the place of stay, we recommend:

1. Full chemoprophylaxis - the traveler takes antimalarial regularly, in the case of atovaquine/proguanil, prophylaxis is started 1 day before entering the risk area, antimalarial is taken every day during the stay and 5 to 7 days after return. It is important that the traveler takes the tablets regularly at the same time. Fats increase the absorption of the active substance, so it is advisable to take the tablets with food (e.g. after breakfast).
2. Stand-by chemoprophylaxis - the traveler will take antimalarial medicine in case he develops a fever. A therapeutic dose is administered, in the case of atovaquone/proguanil, the patient immediately takes 4 tablets, another 4 tablets. in 24 hours and the last 4 tbl. from the package again in 24 hours. Therapy is always started if it is not malaria, but other diseases are not expected to have an adverse effect on the course of the antimalarial. On the contrary, if the therapy of possible malaria is not started in time, the patient is at risk of a number of serious complications. At the same time, we always recommend seeking immediate medical treatment at the place of stay.

The use of antibiotics during a stay in risk areas/tropics is associated with the risk of subsequent colonization (settlement) by multi-resistant bacteria, for which the subsequent therapy can be quite complicated even in our conditions. Therefore, we do not recommend unindicated use of antibiotics without consulting a doctor.

Prevention of mosquito bites

Mosquitoes found in tropical areas pose a potential risk to travelers because they can transmit a variety of serious infectious diseases. Diseases that are spread by mosquitoes include, for example, malaria, dengue or chikungunya or Japanese encephalitis. Mosquitoes that transmit malaria (genus Anopheles) are active mainly in the evening and at night, while mosquitoes that transmit selected viral infections (e.g. dengue or Japanese encephalitis) are active during the day (genera Aedes and Culex), therefore, for example, in the prevention of these infections partially different procedures are used (sleeping under a mosquito net to prevent the transmission of malaria).

Principles of protection against mosquitoes:

• limit skin exposure during peak insect activity (dusk to dawn for malaria-carrying mosquitoes)
  • wear loose cuts, long sleeves and trousers
  • prefer light colors of clothing
• do not use perfumed soaps or cosmetics
• apply sufficiently effective repellents to exposed skin, we recommend e.g. 50% DEET or 20% (p)icaridin; the duration of effectiveness depends on the concentration of the active substance (repeated administration is necessary), do not apply repellents in the immediate vicinity of the mucous membranes or on clothing
• buy repellent already at home (pharmacies, sporting goods), don't buy it in the tropics (often less effective preparations are offered)
• if necessary, products with permethrin can be applied to clothing
• in malarious areas, sleep only under a mosquito net, prefer rooms with air conditioning, ventilate only if insect nets are installed in the windows

Fever during stay and after return from tropics

Febrile illnesses are a relatively common cause of health problems for travelers. It is reported that approximately 1/3 of cases of fever in travelers are caused by tropical infections (e.g. malaria, dengue or chikungunya), while 2/3 of all cases of fever are caused by common infections found in our domestic conditions (e.g. respiratory infections, urinary tract infections, diarrheal diseases, etc.). Although most cases of febrile infections are uncomplicated, in some cases fever can be the first symptom of serious or life-threatening conditions, so it requires early examination by a doctor. Travelers should seek medical treatment immediately if they develop a fever during their stay in the tropics or within 3 months of their return. After your return, you can contact our clinic with health problems.

Treatment of fever

• bed rest with plenty of fluids
• alternating use of individual antipyretics in a sufficient dose
  • Paracetamol 500-1000 mg (according to weight) after 6-8 hours (more suitable than ibuprofen or acetylsalicylic acid, because it does not affect the function of blood platelets)
  • metamizole in a dose of 500 mg up to 4 times a day every 6 hours
  • Ibuprofen choose only when previous antipyretics are ineffective
  • Taking kyselin acetylsalicylic acid avoid

Selected tropical febrile infections

Malaria

Malaria is a parasitic disease transmitted by mosquitoes (genus Anopheles) with nocturnal activity. Malaria occurs primarily in sub-Saharan Africa, the Amazon, and selected areas of South and Southeast Asia. The incubation period for tropical malaria is usually 8 to 15 days, but can be significantly longer for other types of malaria. The disease is manifested by fever with accompanying episodes of chills and headaches. Malaria is one of the most serious tropical infections with a wide range of serious and life-threatening complications. A vaccine for travelers is not available, but infection in high-risk areas can be prevented by taking antimalarials. The risk of infection is further partially reduced by the use of repellants and mosquito nets. If this infection is suspected, it is necessary to see a doctor immediately (during your stay in the tropics and up to 3 months after your return). In the event that medical treatment is not possible and the traveler is staying in a malarious area without provision of antimalarial drugs, it is advisable to immediately start so-called stand-by antimalarial therapy in case of fever (e.g. atovachone/proguanil - the patient immediately takes 4 tablets, another 4 tablets in 24 hours and the last 4 tablets from the package again in 24 hours). More information on antimalarial prophylaxis can be found in the section "Travel first aid kit".

Dengue fever

Viral infection transmitted by mosquitoes of the genus Aedes (daily activity). It is a relatively common disease that occurs mainly in South and Southeast Asia, Oceania and Latin America. It is characterized by a short incubation period (4-10 days), after which flu-like symptoms develop with a predominant fever, headaches (typically behind the eyes), muscle and joint pains, or a rash. Some patients also report typical itching of the palms and soles or a metallic taste in the mouth. The disease can be complicated, therefore, if this infection is suspected, medical treatment and regular monitoring of blood parameters are necessary. Treatment is only symptomatic, in complicated cases hospitalization and infusion therapy may be necessary.

Chikungunya fever

A viral febrile disease transmitted by mosquitoes of the genus Aedes. The incubation period of infection is usually 4 to 8 days. The infection is manifested by fever with an accompanying rash, muscle and joint pain. Complications of this infection are long-lasting pain and swelling of the joints, which can last for several months. Treatment is only symptomatic.

Traveler's diarrhea

Diarrheal diseases are among the most common health problems of travelers. Although these are usually self-healing conditions, they can greatly complicate a stay abroad. Adhering to the principles of safe eating is a possible prevention, but this is quite difficult. It is therefore especially important to know how to treat the disease and when to seek medical treatment. In general, the basis of therapy is rehydration and symptomatic treatment. In uncomplicated conditions, it is not advisable to use general or local antibiotics in view of the possible risks (influence of the microflora, colonization with multi-resistant bacteria, long-term digestive problems...). In the case of probiotics, no convincing effectiveness has been demonstrated in high-quality clinical studies, so we do not recommend their routine use in the prevention or therapy of traveler's diarrhea. If you have been taking selected medications for a long time, it may be necessary to temporarily discontinue them after consultation with your doctor (e.g. selected medications used in the treatment of high blood pressure or diabetes).

What to do to avoid diarrhea while traveling?

• Pay attention to increased hand hygiene, always wash or disinfect your hands before each meal (disinfectant gels)
• Drink only bottled water and beverages (including brushing your teeth or mouthwash), avoid ice
• Eat only packaged foods or sufficiently heat-treated fresh foods, avoid risky foods that have been stored at room temperature (buffet meals...), "dry" foods (bakery) are safe
• Fruits and vegetables can only be consumed if they can be peeled (bananas, citrus), avoid salads, sliced ​​or mixed fruits/vegetables completely
• Do not consume dairy products or insufficiently heat-treated meat products
• The simple rule is "Peel it, boil it or forget it".

What to do if bottled water is not available?

In exceptional situations, it is possible to make water from an unknown source potable. Some of the methods listed below can be used to ensure maximum protection, and it is advisable to combine the individual methods. Allow the cloudy water to settle first, filter it through a clean cloth/coffee filter and then treat it. Treated water must be stored in clean containers to avoid recontamination.

• Boiling: for 1 min, longer at higher altitudes
• Chemical disinfection: chlorine-based preparations (dosage and time of action according to the manufacturer), the method may not be sufficiently effective against the selected agents
• Water filters: choose the smallest possible pore size of the filter membrane, the method may not be sufficiently effective against the selected agents
• UV light: only for smaller amounts of non-turbid liquid

How to treat traveler's diarrhea?

• Adequate fluid intake
  • An oral rehydration solution is especially suitable, if necessary it can also be prepared (1 liter of water, 1 teaspoon of sugar, 1 teaspoon of salt)
  • Prefer mineral water, avoid lemonades, juices or milk drinks
  • In case of vomiting, it is advisable to drink liquids in small sips
• Intestinal adsorbent
  • Basis of symptomatic therapy
  • They are not absorbed from the gastrointestinal tract, they bind to harmful substances, bacteria, toxins, gases and various chemical compounds that inactivate them (do not use together with medicines - it is necessary to ensure a time gap)
  • Safe, they do not affect the intestinal microflora
• loperamide
  • It slows down intestinal peristalsis and thus the frequency of diarrhea
  • Use only if necessary (overflight/crossing with impossibility to use the toilet)
  • Do not use for longer than 48 hours, we do not recommend use in children
  • The product cannot be used in case of febrile diarrhea or diarrhea with blood or mucus admixture (risk of complications)
• racecadotril
  • It reduces the excretion of water into the intestinal lumen and thereby reduces the volume of stool
  • Safe preparation, does not affect intestinal microflora
• ondansetron
  • First-line antiemetic drug

When to seek medical treatment in case of diarrhea?

• When you have a fever or chills or chills
• If you have significant or persistent abdominal pain
• If you repeatedly vomit and cannot take enough fluids
• If you observe a mixture of blood or a large amount of mucus in the stool
• If you have numerous bulky watery stools (more than 10/day) and if there is a risk of dehydration
• If symptoms persist for more than 14 days
• If you suffer from any significant internal or other chronic disease

Animal injuries and risks in the wild

Animals can transmit a number of serious and life-threatening diseases. In risk areas, avoid close contact with domestic and wild animals.

If there is a bite, scratch or other risk injury from an animal (dog, cat, monkey...) in areas where rabies may occur, it is always necessary to immediately start so-called anti-rabies prophylaxis. After the injury itself, properly clean and disinfect the wound. Since it is not possible to provide a veterinary examination of the animal in tropical or developing areas, and at the same time it cannot be assumed that the animals would be properly and regularly vaccinated against rabies, it is necessary to immediately seek medical treatment in order to apply anti-rabies serum and start vaccination against rabies. Considering that rabies is a disease that cannot be cured and always ends in the death of the infected person, it is necessary to start anti-rabies prophylaxis without delay. As animal injuries occur relatively often, we recommend travelers who go to the tropics repeatedly to be vaccinated against rabies before the trip. Preventive vaccination significantly reduces the risk of infection in the event of injury by an animal, at the same time it is not necessary to apply anti-rabies serum after the injury, only two preventive doses of the vaccine are sufficient. As with other injuries, it is also necessary to check the validity of the tetanus vaccination, or apply a booster dose of the vaccine.

Avoid swimming in natural freshwater sources while in the tropics. The reason is the possible occurrence of developmental stages of schistosomiasis, which can penetrate intact skin and cause a rash (so-called cercarial dermatitis) or even the systemic disease of schistosomiasis. The infection occurs mainly in sub-Saharan Africa and Asia, but infection can also occur in other tropical regions.

When swimming in the sea, do not go barefoot on the beach and do not lie directly on open ground or sand. When the skin comes into contact with sand or soil contaminated with animal faeces, the larvae of marsupials can be transferred, which can cause the skin disease "larva migrans cutanea", which is manifested by the development of "corridors" on the skin and intense itching. Larvae can also be transmitted through wet clothes (towel, swimsuit).

Jet lag

Jet lag most often affects travelers when quickly crossing 3 or more time zones. The most common symptoms include increased fatigue, headaches, sleep disorders (difficulty falling asleep when flying east, waking up early when flying west), concentration disorders or irritability.

Prevention of shingles

• sufficient physical and mental rest before departure
• comfortable clothes and shoes for the trip
• sufficient drinking regime during the trip (unsweetened drinks, mineral water)
• limit alcohol consumption
• on board, use earplugs, an eye mask or listen to white noise to sleep peacefully
• the way east
  • fall asleep 1-2 hours earlier a few days before departure
  • prefer a night flight and sleep on the plane
• way west
  • fall asleep 1-2 hours later a few days before departure
  • prioritize a daytime flight, plan your sleep according to the time at the destination

Self-treatment of shingles

• avoid mental stress and increased physical exertion
• quality food in smaller portions, prevent a higher intake of carbohydrates
• take a short rest when tired during the day (20-30 min)
• avoid long naps during the day
• do not consume caffeine in the afternoon and evening
• use of hypnotics only in extreme situations

Sunburn and scald

If you stay in the sun for a long time, there is a risk of heatstroke or sunburn. These diseases are easily confused - they sound similar, are caused by overheating and show similar symptoms. So what is the difference between them?

A sunburn is caused by the direct action of sunlight on the uncovered scalp and thus leads to its overheating and irritation of the meninges. It is manifested by headaches, nausea, vomiting, weakness and rapid breathing. The person is enraptured, the face is warm and red. The patient may feel pain and stiffness in the neck.

Heatstroke is a condition that leads to a failure of the ability to regulate internal temperature, resulting in overheating of the body. It does not necessarily have to be the effect of sunlight, for example, a longer stay in an overheated, poorly ventilated area is enough. Young children, the elderly and people with chronic diseases are particularly at risk. It manifests itself similarly to a burn, but with more pronounced general symptoms and a more serious course. After the initial excessive sweating, there will be reddening of the skin, drying of the skin and failure of thermoregulation. The temperature rises to 40 °C, convulsions can develop, sometimes even a disturbance of consciousness with organ failure.

First aid consists in moving the victim to the shade or a cool, well-ventilated area. It is necessary to take off tight clothing and apply cold compresses to the whole body (in case of burns, especially to the head and neck). If the patient is able to swallow, it is good to give cold drinks. If you suspect heatstroke or burns, it is always advisable to contact a doctor.

Both sunburn and sunburn are easily preventable: When staying in the sun, it is necessary to protect the head with a cover, avoid the midday sun, and wear loose and airy clothes. It is very important to drink plenty of water and avoid strenuous physical activity during hot weather.

Altitude sickness

Every stay in a high mountain environment carries certain risks. At higher altitudes (usually above 2500 m), the amount of oxygen in the air decreases and so-called acute mountain sickness can occur.

The first symptoms tend to be very non-specific – headaches, dizziness, nausea or vomiting, sleep problems or weakness appear. Even with mild symptoms of altitude sickness, it is not recommended to continue the ascent and wait until the symptoms subside or descend to lower positions.

A mild form can then develop into more serious conditions - swelling of the lungs or swelling of the brain. These conditions usually occur at altitudes from 4000 m above sea level. Lung swelling is manifested by shortness of breath, rapid breathing and coughing; brain swelling followed by headache, behavioral changes and impaired walking coordination (typically heel-toe walking disorder).

The ideal first aid is to descend to lower altitudes and limit physical activity as much as possible. In order to avoid altitude sickness, it is necessary to climb the mountains gradually (ideally 300-400 m/day), it is necessary to follow the drinking regime, to avoid alcohol and smoking. If brain swelling is suspected, dexamethasone 8 mg can be taken in bursts in the field (and continue with 4 mg after 6 hours), but it is always necessary to consult a doctor about the state of health.

Travel insurance and the DROZD system

Travelers traveling to risk areas are advised to take out high-quality additional travel insurance. Don't forget to familiarize yourself with the insurance conditions and exclusions from the insurance, or take out additional insurance for risky activities and sports or possible deterioration of your health due to a chronic illness.

We also recommend clients to register in the DROZD system (Voluntary registration of citizens of the Czech Republic when traveling abroad) of the Ministry of Foreign Affairs of the Czech Republic. The system makes it possible to provide up-to-date notifications about travel and stay abroad and to organize help for Czech citizens more efficiently in the event of emergencies. More information can be found on the website Ministry of Foreign Affairs of the Czech Republic.

What to do in case of health problems after returning from trips?

If you have acute health problems after returning from the tropics, contact the Department of Infectious Diseases and Travel Medicine of the 2nd Faculty of Medicine of the UK and the Motol Medical Center.

In the case of non-acute conditions, you can make an appointment for an examination:
phone no.: 22443 6930 (working days 8:00-15:00)
e-mail: infektion@fnmotol.cz

In case of acute and urgent conditions, we will treat you at any time in the emergency clinic of our clinic.
You will find us in the premises of FN Motol, building no. 22 (east end of the premises towards Na Homolce Hospital)

Contact:

Ambulance for ordered and non-acute conditions: 22443 6930 (working days 8:00-15:00)

Acute ambulance: 22443 6945 (working days 7:00-15:30, outside working hours care for urgent/acute conditions is provided by a doctor on duty in the inpatient department)

Contact number for emergencies (fever after returning from the tropics): 724 967 016 (anytime)

e-mail: infektion@fnmotol.cz

Vaccination Center and Travel Medicine Center

Vaccination center FN Motol

The Vaccination Center of FN Motol offers its clients high-quality advice in the area commercial vaccination. We are able to provide all available vaccinations that are appropriate in domestic conditions (e.g. vaccination against influenza, tick-borne meningoencephalitis, hepatitis A/B, meningococcal and pneumococcal infections, chicken pox, measles, rubella, mumps, tetanus, diphtheria, whooping cough, shingles herpes or infections caused by human papillomaviruses...).

Our center also provides vaccination against covid-19 and vaccination of risk groups of patients, for whom vaccination is indicated for health reasons (e.g. older patients, patients with weakened immunity, after spleen removal...) and is possibly also covered by public health insurance.

Center of Travel Medicine of the FN Motol

The Travel Medicine Center of the FN Motol provides not only comprehensive and high-quality pre-departure counseling, vaccinations, but also provides diagnosis and treatment of health problems in patients after returning from the tropics or risk areas. Pre-departure counseling includes an assessment of health status, assessment of possible health risks, compilation of a vaccination plan, provision of antimalarial chemoprophylaxis, provision of information on the most common potential risks and possibilities for their prevention or therapy. The services provided as part of pre-departure counseling are not covered by public health insurance and are governed by the currently valid price list, which is published on the clinic's website.

When acute health problems after returning from the tropics or other risk areas the patient can search for acute and emergency ambulance of our clinic (e.g. in case of febrile conditions), in case of longer-term difficulties may order for examination at the phone number below. Treatment in case of health problems after returning from the tropics is fully covered by public health insurance.

We provide our commercial services for favorable prices, while clients with us does not apply charge for the consultation itself or the application of the vaccine. All and students they have in our center 10% discount for the services provided. You can find the current price offer in the attached price list. Payment is only possible by credit card.

Why use the services of the Vaccination Center and the Travel Medicine Center of FN Motol?

• We offer not only the vaccination itself, but comprehensive and high-quality consulting services
• You can easily order through the electronic reservation system
• We offer short ordering periods
• We have appointments for ordering not only in the morning, but also in the afternoon and early evening
• For travel advice, we base ourselves only on high-quality and verified international recommendations, we use the resources of the American Center for Disease Control and Prevention (CDC) and the German Center for Travel Medicine (CRM)
• When recommending individual vaccinations, we also carefully consider cost effectiveness for the client
• We have favorable vaccine prices and offer a 10% discount for students and contract partners
• If you get vaccinated with us, you do not pay a fee for the consultation or for the application of the vaccine
• You can also communicate with our doctors in English
• For risk groups of patients or older people, we can supplement vaccinations paid for by public health insurance
• Antimalarials, repellants and other necessities for a travel first aid kit can be conveniently purchased directly at the FN Motol premises
• We take care of our clients at any time, even in case of health problems after returning from the tropics or risk areas

Where to find us:

The Vaccination Center (including covid-19 vaccinations) and the Travel Medicine Center will be located in Building G on the lower ground floor from February 1, 2023 (connecting corridor between the children's and adult parts).

Electronic reservation system: https://objednavky.fnmotol.cz

Electronic reservation system covid-19: https://registrace.mzcr.cz/

Contact phone: 224 43 2336 (working hours: weekdays 8:00 a.m. – 16:00 p.m.)

Opening hours:

valid from 4 March 9
Where to find us:

The Vaccination Center and the Travel Medicine Center of the Infectious Diseases and Travel Medicine Clinic of the 2nd Faculty of Medicine of the UK and the Motol General Hospital have been located since February 1 in building G on the lower ground floor (connecting corridor between the children's and adult parts of the hospital). From the Nemocnice Motol subway stop on line A, go through the atrium to the directorate building, to the end of the corridor and then up the stairs to the lower ground floor. Alternatively, by elevator one floor below, and from the elevator to the right.

Contact phone: 224 43 2336

Reservation system: https://registrace.mzcr.cz

The MZČR brochure with information on vaccination against covid-19 can be found here: We vaccinate ourselves for a life without fear.

Vaccination covid-19

In our vaccination center, we use the Comirnaty vaccine (manufactured by Pfizer/Biontech). We vaccinate adults and children from the age of five in the basic scheme and also apply booster doses.

More information about vaccination against covid-19 and possibility of registration (order) for vaccination can be found on the website of the Ministry of Health of the Czech Republic: https://koronavirus.mzcr.cz/ockovani-proti-covid-19/.

From June 12, 6, the Vaccination Center will provide vaccinations against covid-2023 (children from 19 years old, adults and self-payers) only for booked patients.

We also vaccinate self-payers in all the mentioned age groups. Bring with you: insurance card, vaccination card (distance from the last vaccination), or legal representative's identity card.

Vaccination against tick-borne meningoencephalitis

WHEN?
Now is the best time to get vaccinated?
It is advisable to prefer the period before the start of seasonal tick activity, i.e. rather the winter months, but you can vaccinate against tick-borne meningoencephalitis all year round.
Protection begins 14 days after the second dose of the vaccine.

WHERE?
FN Vaccination Center in Motola, we will order you on tel.: 224 432 336 or you can register online at the link: https://objednavky.fnmotol.cz/

WHY?
Tick-borne meningoencephalitis:

• a serious viral disease affecting the central nervous system
• transmission to humans by sucking on an infected tick = difficult prevention, not normally transmissible from person to person
• rarely transmitted by unpasteurized dairy products
• The Czech Republic is one of the countries with the highest number of CME cases in the entire EU (we are an endemic area)
• the number of diseases in the Czech Republic accounts for up to ¼ of all cases in the EU
• In recent years, an increase in the number of diseases, thanks to climate change, has also spread to areas of higher altitudes
• it often affects active and healthy individuals
• generally worse course in older individuals, can have lifelong consequences (impaired mobility, concentration,...)
• seasonal nature of the disease, 95% of cases from May to November, most in July (up to approx. 30% of cases)
• there is no specific therapy

The only effective prevention against the disease is vaccination, the effectiveness of vaccination is up to 99%

HOW OFTEN?
The basic scheme generally consists of 3 doses of the vaccine, with the 2nd dose being vaccinated in 1-3 months, the 3rd dose following in 5-12 months. The first revaccination is in 3 years, then every 5 years. Over the age of 60, revaccination is again three years old.
If the vaccination is already started during the seasonal activity of ticks and it is desirable to induce rapid protection, it is possible to apply the 2nd dose after 14 days.
Schemes may vary by vaccine manufacturer.

FOR HOW MUCH?
One dose of the vaccine for an adult costs CZK 850, from the age of 50 the vaccination is covered by the health insurance company, it is possible to use a financial contribution from the preventive programs of the health insurance companies.

Vaccination of patients on immunosuppressive and biological therapy

MD Veronika Yegorova

Patients using immunosuppressive or biological therapy (i.e. immunomodulating) treatment may be at increased risk of developing or having a severe course of a number of infections. The reason is not only the immunomodulation therapy itself, but in some cases also the disease itself, for which the patient is taking the treatment. Infectious complications can endanger patients on immunomodulation therapy by worsening the underlying disease itself. A suitable prevention is vaccination, which can either completely prevent the disease or significantly reduce its course.  

Vaccination of patients using immunomodulatory treatment is completely safe in the case of inanimate vaccines, although the effectiveness of the vaccines may be lower than in healthy individuals. Vaccination with live vaccines (measles, rubella, mumps, chicken pox, yellow fever...) must be consulted with a specialist.

Before starting immunomodulating therapy, it is advisable to make sure that the patient has undergone or been vaccinated against chicken pox, further that it is protected against viral hepatitis B and has a valid vaccination against tetanus (or whooping cough and diphtheria). Patients using immunosuppressive or biological therapy should be regularly vaccinated against the flu a Covid-19. In addition to the patients themselves, individuals living in the same household should also undergo this vaccination. In terms of both risk and frequency, vaccination against pneumococcal infections, which cause pneumonia, but can also cause purulent inflammation of the meninges or blood poisoning (sepsis). Vaccination against is also to be considered in selected patients shingles, because as a result of reduced immunity, the risk of development and severity of the course is higher, including the risk of so-called postherpetic neuralgia (intense, bothersome long-term pain during the course of the affected nerve). In certain age groups, it is also advisable to supplement vaccination against human papillomaviruses, which can cause certain cancers (cancer of the cervix, rectum, etc.).

For advice on vaccinations suitable for you, it is possible to make an appointment at a specialized counseling center for at-risk patients within the Vaccination Center of the Clinic for Infectious Diseases and Travel Medicine 2.LF UK and FN Motol. Vaccination should be carried out at the time of stabilization of the autoimmune disease and ideally before starting immunosuppressive therapy.

Price list

• Price list of the Travel Medicine Center and Vaccination Center FN Motol valid from 1 July 7

Contributions of health insurance companies for vaccinations

Types of vaccines

Live attenuated (= weakened) vaccines

The vaccine contains a weakened virus or bacteria that are not able to cause disease, but can multiply in the body and thus trigger an immune response. High efficacy and usually long-term protection are typical for these vaccines. It is usually sufficient to administer one or two doses of the vaccine without the need for a booster dose. However, these vaccines cannot be given to pregnant women or people with a weakened immune system.

Examples: vaccination against measles, rubella, mumps, chicken pox, yellow fever

Inactivated (= non-living) vaccines, cleaved vaccines, subunit vaccines, toxoids

These vaccines contain the entire killed microorganism, or its parts, which cannot cause disease or otherwise damage the human organism, but provoke an immune response. Vaccines can also be safely used in pregnant women or people with weakened immunity (while the immune response may be weakened). Vaccines usually need to be given in multi-dose schedules with revaccination required. With repeated application, the so-called booster effect applies (higher immune response to the same dose of vaccine than with the first application).

Examples: vaccination against tetanus, diphtheria, whooping cough, tick-borne meningoencephalitis, viral hepatitis A/B or influenza

Polysaccharide vaccines

The vaccine contains the capsule polysaccharide of the selected bacterium, which induces an immune response independent of T cells. These vaccines cannot be used in children under 2 years of age, as their immune system is not able to respond to these vaccines. Vaccines provide relatively short-term protection, there is no booster effect when revaccinating. Repeated administration of the vaccine may lead to a reduction in its effectiveness. Vaccines are safe even in people with weakened immune systems, but the immune response in the elderly or immunocompromised patients may be worse than with other vaccines (which use T lymphocytes). These vaccines are being replaced by more suitable polysaccharide conjugate vaccines.

Examples: vaccination against typhoid or pneumococci (23-valent vaccine)

Polysaccharide conjugate vaccines

Vaccines contain capsular polysaccharides of bacteria to which protein structures (usually toxoids) are attached. Although the basic structure to which the immune system reacts is a polysaccharide, the vaccine induces an immune response dependent on T-lymphocytes, i.e. similar to, for example, inactivated or cleaved vaccines. This is a more suitable alternative to the polysaccharide vaccines themselves, as they can also be used in infants and toddlers up to 2 years of age, they induce a better immune response, provide longer protection, and a so-called booster effect is observed when revaccinating them.

Examples: vaccination against ACWY meningococci or pneumococci (13-, 15- and 20-valent vaccine)

Vaccinable diseases and individual vaccines

• Tetanus, diphtheria, whooping cough
• Measles, rubella, mumps
• chickenpox
• Poliomyelitis
• Jaundice (viral hepatitis) type A
• Jaundice (viral hepatitis) type B
• Flu
• Tick-borne meningoencephalitis
• Infections caused by human papillomaviruses (HPV)
• Meningococcal disease
• Pneumococcal disease
• Hemophilic diseases
• Shingles
• Typhoid
• Rabies
• Yellow Fever
• Dengue
• Japanese encephalitis
• Valais
• Monkey pox

Used and other sources of information

• Centers for Disease Control and Prevention (US) www.cdc.gov
• European Center for Disease Control and Prevention ecdc.europa.eu
• European vaccination portal vaccination-info.eu/cs
• World Health Organization www.who.int
• National health information portal www.nzip.cz
• Czech Vaccinology Society ČLS JEP www.vakcinace.eu
• State Institute of Public Health www.szu.cz
• Information system of infectious diseases https://szu.cz/publikace/data/infekce-v-cr/
• Vacciny.net www.vakciny.net
• Avenue www.avenier.cz

Center for the treatment of viral hepatitis

We deal with the prevention, diagnosis and treatment of all types of viral hepatitis, both acute and chronic. We are among the guaranteed centers for the treatment of chronic viral hepatitis (Society of Infectious Medicine and Czech Hepatological Society ČLS JEP). We guarantee patients interdisciplinary treatment by a team of experienced doctors according to current medical knowledge.

Center for the Treatment of Infections in Intravenous Drug Users

We treat infectious diseases across the entire spectrum (except HIV infection), we examine or hospitalize patients with febrile conditions on an outpatient basis to establish a diagnosis, patients with infectious endocarditis (inflammation of the heart valves), spondylodiscitis or sacroiliitis (inflammation of the vertebrae, intervertebral discs or joints of the pelvic bones and spine) , liver inflammation (hepatitis) or skin and soft tissue infections. In cooperation with dermatovenerologists, we also provide care for patients with sexually transmitted infections. We treat and monitor patients with chronic viral hepatitis (inflammation of the liver) on an outpatient basis. Short-term detoxification is also possible for hospitalized patients. We do not provide an outpatient substitution program or detoxification itself. We provide free vaccinations against viral hepatitis type A and B to patients treated at our center. We cooperate with low-threshold facilities and a number of addiction and contact centers and communities.

Infectious diseases and infectious medicine

Infectious diseases have influenced the development of the entire human civilization, while they were still the most common cause of death at the end of the 19th century. In the course of the 20th century, mainly thanks to the improvement of hygienic conditions, the introduction of vaccination programs and the discovery of new treatment options, there was a dramatic decrease in the incidence and number of deaths from infectious diseases, thereby significantly reducing their societal impact in developed countries. However, the originally optimistic ideas about a solved problem with infectious diseases appear to be completely unrealistic from today's point of view. Thanks to significant demographic, ecological and climatic changes, in recent decades humanity has increasingly encountered epidemic occurrences of completely new or emerging diseases, such as e.g. covid-19, SARS, MERS, or hemorrhagic fevers (e.g. Ebola), which in in today's globalized world, they can pose a potential risk to the human population. In developed countries, epidemics of diseases that can be prevented by vaccination are reappearing, which is related, among other things, to the trend of refusing recommended and mandatory vaccination. Another significant problem is the growing resistance of microorganisms to available anti-infectives, which greatly limits our treatment options.

However, a fundamental change for the field of infectious medicine is represented by the increasing life expectancy and the increasing representation of patients with serious chronic diseases or immune disorders, because it is infections that represent significant and often serious complications for these patients. That is why professional circles are increasingly talking about the need to ensure easily accessible and high-quality ambulatory and consultative infectious disease care.

Infectious disease medicine is currently a modern and dynamically developing field that is dedicated to the rational diagnosis, treatment, prevention and research of infectious diseases, while, contrary to the common notion, it is no longer true that infectious disease workplaces serve mainly to isolate people with transmissible infections. On the contrary, most of the disease cases that an infectious disease specialist encounters and deals with are not transmissible between people. The most common diagnoses that infectious disease specialists deal with include febrile and inflammatory conditions, respiratory and urinary tract infections, diarrheal diseases, liver infections, neuroinfections, skin and soft tissue infections, zoonoses (infections transmitted by animals) or healthcare-associated infections.

History of the clinic

The 30s
The building of the current clinic was built according to the project of the architect Rudolf Kvěch and was opened in February 1937 as the Masaryk Institute for the Treatment of Lupus of the Czech Regional Society against Tuberculosis. The building was attached to the Motol hospital on August 5, 1948.

The 50s
The department was founded in 1951 in the premises of SANOPSZ (Sanatorium of the District Insurance Company of Private Employees) in the later building of the State Sanatorium in Prague 5 (Na Cihlářce).
The increasing number of cases of infectious hepatitis led in 1953 to the relocation of the department to the current building in the Motol hospital. The priority was MUDr. Otakar Souček, a gastroenterologist, who originally worked at the internal clinic of the Motol hospital under the guidance of prof. MD Miloš Netousek, DrSc.

The 70s
In 1971, MD took over the management of the department. V. Hazuka - internist, gastroenterologist. The department performed endoscopic examinations and non-invasive and invasive liver examinations in the field of gastroenterology for Prague and the Central Bohemian region.

The 90s
Since 1992, the department was headed by MUDr. Jana Železna, at that time the treatment of chronic viral hepatitis with interferon was introduced. In 1998, the reconstruction of the ground floor of the pavilion was completed and a care program for drug-dependent patients with hepatitis began. In 1999, MUDr. Iron retired.

2000
In 2000, MUDr. Jiřina Hobstová CSc., who originally worked at the Bulovka University of Applied Sciences. Under the leadership of dr. Hobst's department continued to care for drug-addicted patients, but the program was expanded to cover all infectious diseases that occur in drug-addicted patients. The department participated in teaching students of the 3rd Faculty of Arts of the UK and the 1st Faculty of Arts of the UK.

2013
In 2013, as part of the reorganization, the status of the department was changed, and the Infectious Department of FN Motol became the 6th station of the Internal Clinic of the 2nd LFUK and FN Motol. MUDr was appointed head of the station. Jan Dvořák. The scope of work of the department has not changed, it has expanded towards the care of internally ill patients.

2016
MUDr left the position of head of the department. Jan Dvořák and he was replaced in the position by MUDr. Martin Tulach.

2022
On September 1.9.2022, 2, a new Department of Infectious Diseases and Travel Medicine was established at the 2nd Faculty of Medicine of the UK and the Motol Faculty of Medicine. The first head of the clinic was appointed MUDr. Milan Trojánek, Ph.D., who originally worked at the Clinic of Infectious Diseases of the XNUMXnd Faculty of Medicine of the UK and the Bulovka Medical University. The head of the clinic is MUDr. Martin Tulach.

Teaching

The workplace provides teaching in bachelor's, master's and doctoral studies at the 2nd Faculty of Medicine of the Charles University. The clinic is also a training workplace of the Department of Infectious Medicine of the IPVZ.

Master's degree

general medicine

The workplace participates in the teaching of the subject Infectious Medicine together with the partner workplace at FN Bulovka. Teaching at the Clinic of Infectious Medicine and Travel Medicine of the 2nd Faculty of Medicine of the UK and Motol Medical University takes place in a three-day block (Tuesday to Thursday) in the first week of the internship. The clinic is located on the premises of the Motol Medical Center in building No. 22. The main topics taught include febrile conditions (including fever of unclear origin), inflammatory indicators and their importance in the diagnosis of infections, infections associated with the provision of health care, infections in immunodeficient patients, viral hepatitis, HIV (epidemiology, pre- and post-exposure prophylaxis) and travel medicine. More detailed information about teaching and teaching materials can be found in SIS.

The clinic participates in interdisciplinary teaching in related subjects and organizes optional subjects focusing on the professional profile of the workplace. The department is also involved in providing internships for students in the tropics.

The clinic staff welcomes students' interest in individual internships within the subject K10 or any extracurricular activities.

Bachelor's degree 

Nursing and Pediatric Nursing

The workplace provides teaching of the subject Nursing care in infectious medicinea Nursing care of children in infectious medicine in the 3rd year of study.

Doctoral studies

Clinic staff are trainers of students in the study program Preventive medicine and epidemiology (2. LF UK) a Mikrobiologie (LF in Pilsen, UK). The study topics correspond to the specialist focus of the clinic and are mainly about the issues of travel and tropical medicine, epidemiology of infectious diseases or antibiotic therapy and prescription.

Science and clinical research

The clinic's scientific and research activities are based on cooperation with related laboratory and clinical disciplines at the Motol National Research Institute. Main research topics include antibiotic therapy and prescription, travel medicine, infections in high-risk patient groups and epidemiology of infectious diseases.

Contact

Clinic secretariat 
22443 6900/6901

Ambulance

emergency clinic (7:00-19:00): 22443 6945
specialist ambulance (for orders): 22443 6930

doctor on duty (19pm-00am): 7 00

Electronic reservation system: objednavky.fnmotol.cz

Electronic reservation system covid-19: https://registrace.mzcr.cz

Inpatient department
22443 6928/6929

Contact to the doctor (translations, admission to hospital)
22443 7777