\documentclass[10pt,a4paper]{article}

% Packages
\usepackage{fancyhdr}           % For header and footer
\usepackage{multicol}           % Allows multicols in tables
\usepackage{tabularx}           % Intelligent column widths
\usepackage{tabulary}           % Used in header and footer
\usepackage{hhline}             % Border under tables
\usepackage{graphicx}           % For images
\usepackage{xcolor}             % For hex colours
%\usepackage[utf8x]{inputenc}    % For unicode character support
\usepackage[T1]{fontenc}        % Without this we get weird character replacements
\usepackage{colortbl}           % For coloured tables
\usepackage{setspace}           % For line height
\usepackage{lastpage}           % Needed for total page number
\usepackage{seqsplit}           % Splits long words.
%\usepackage{opensans}          % Can't make this work so far. Shame. Would be lovely.
\usepackage[normalem]{ulem}     % For underlining links
% Most of the following are not required for the majority
% of cheat sheets but are needed for some symbol support.
\usepackage{amsmath}            % Symbols
\usepackage{MnSymbol}           % Symbols
\usepackage{wasysym}            % Symbols
%\usepackage[english,german,french,spanish,italian]{babel}              % Languages

% Document Info
\author{olkimmilo}
\pdfinfo{
  /Title (ch-25-travelers.pdf)
  /Creator (Cheatography)
  /Author (olkimmilo)
  /Subject (Ch 25 Travelers Cheat Sheet)
}

% Lengths and widths
\addtolength{\textwidth}{6cm}
\addtolength{\textheight}{-1cm}
\addtolength{\hoffset}{-3cm}
\addtolength{\voffset}{-2cm}
\setlength{\tabcolsep}{0.2cm} % Space between columns
\setlength{\headsep}{-12pt} % Reduce space between header and content
\setlength{\headheight}{85pt} % If less, LaTeX automatically increases it
\renewcommand{\footrulewidth}{0pt} % Remove footer line
\renewcommand{\headrulewidth}{0pt} % Remove header line
\renewcommand{\seqinsert}{\ifmmode\allowbreak\else\-\fi} % Hyphens in seqsplit
% This two commands together give roughly
% the right line height in the tables
\renewcommand{\arraystretch}{1.3}
\onehalfspacing

% Commands
\newcommand{\SetRowColor}[1]{\noalign{\gdef\RowColorName{#1}}\rowcolor{\RowColorName}} % Shortcut for row colour
\newcommand{\mymulticolumn}[3]{\multicolumn{#1}{>{\columncolor{\RowColorName}}#2}{#3}} % For coloured multi-cols
\newcolumntype{x}[1]{>{\raggedright}p{#1}} % New column types for ragged-right paragraph columns
\newcommand{\tn}{\tabularnewline} % Required as custom column type in use

% Font and Colours
\definecolor{HeadBackground}{HTML}{333333}
\definecolor{FootBackground}{HTML}{666666}
\definecolor{TextColor}{HTML}{333333}
\definecolor{DarkBackground}{HTML}{DECF2C}
\definecolor{LightBackground}{HTML}{FCFCF1}
\renewcommand{\familydefault}{\sfdefault}
\color{TextColor}

% Header and Footer
\pagestyle{fancy}
\fancyhead{} % Set header to blank
\fancyfoot{} % Set footer to blank
\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
    \SetRowColor{DarkBackground}
    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
    }
\end{tabulary}
\columnbreak
\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Ch 25 Travelers Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{olkimmilo} via \textcolor{DarkBackground}{\uline{cheatography.com/42456/cs/17042/}}}
\end{tabulary}
\end{multicols}}

\fancyfoot[L]{ \footnotesize
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
  \SetRowColor{FootBackground}
  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}olkimmilo \\
  \uline{cheatography.com/olkimmilo} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 14th September, 2018.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Sponsor}}  \\
  \SetRowColor{white}
  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
\end{tabulary}
\end{multicols}}




\begin{document}
\raggedright
\raggedcolumns

% Set font size to small. Switch to any value
% from this page to resize cheat sheet text:
% www.emerson.emory.edu/services/latex/latex_169.html
\footnotesize % Small font.


\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{PREPARING A PT FOR TRAVEL}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{1. Diseases spread through {\bf{food}} and {\bf{water}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{2. Diseases spread through {\bf{blood}} and {\bf{bodily fluids}}} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{3. Diseases transmitted by {\bf{insects}}} \tn 
% Row Count 4 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{DISEASE TRANSMITTED THROUGH FOOD AND WATER}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{DISEASE}} & {\bf{NOTES}} & {\bf{PX/TX}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\bf{TRAVELER'S DIARRHEA}}\{\{nl\}\}{\emph{E. coli}} (80-90\%)\{\{nl\}\}{\emph{Campylobacter jujuni}}\{\{nl\}\}{\emph{Shigella}}\{\{nl\}\}{\emph{Salmonella}} & - {\bf{Dysentry}} - if blood is in the stool (classified as severe).\{\{nl\}\}- Mild: tolerable, doesn't interfere with activities\{\{nl\}\}- Mod: distressing, interferes with planned activities\{\{nl\}\}- Severe: \seqsplit{incapacitating}, completely prevents activities\{\{nl\}\}- Onset of sx: 6-72 hrs\{\{nl\}\}- Untreated TD:3-7 days\{\{nl\}\}- Persistent TD = \textgreater{}14 days\{\{nl\}\} - TD can result in IBS & {\bf{RULE:}}" cook it, peel it, or forget it"\{\{nl\}\} {\bf{PX:}} \{\{nl\}\}- Bismuth \seqsplit{subsalicylate} (BBS), Pepto-Bismol\{\{nl\}\} - Abx is not usually rec., give to high risk pts\{\{nl\}\} - Recommended Abx: {\bf{Rifaximin}}\{\{nl\}\}\{\{nl\}\}{\bf{TX:}} Hydration (↑ fluid and salt)\{\{nl\}\}\{\{nl\}\}Mild: {\bf{Loperamide}}\{\{nl\}\}Mod: {\bf{*Loperamide}} +/- {\bf{antibiotics}}\{\{nl\}\}Severe: {\bf{Azithromycin}} 1g x 1 +/- {\bf{Loperamide}}\{\{nl\}\}{\bf{Note:}} Loperamide = 'IMODIUM A-D' \tn 
% Row Count 34 (+ 33)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{DISEASE TRANSMITTED THROUGH FOOD AND WATER (cont)}}  \tn
% Row 2
\SetRowColor{LightBackground}
{\bf{TYPHOID FEVER}}\{\{nl\}\}{\emph{Salmonella typhi}} & - Can be severe and life-threatening\{\{nl\}\}- Vaccines are 50-80\% effective\{\{nl\}\}- Wash hands and take food/water precautions even if vaccinated & {\bf{Vaccines:}}\{\{nl\}\}{\bf{Vivotif}}\{\{nl\}\}~~~- Oral, live, attenuated\{\{nl\}\}~~~- Dont use if on Abx or stomach's sensitive \{\{nl\}\}~~~- Q5yrs\{\{nl\}\}~~~- 1 week before traveling\{\{nl\}\}~~~- Don't use \textless{}6yo\{\{nl\}\}\{\{nl\}\}{\bf{Typhim Vi}} (inactivated, IM)\{\{nl\}\}~~~- Q2yrs\{\{nl\}\}~~~- ≥ 2 weeks before \{\{nl\}\}~~~- Don't use \textless{}2yo \tn 
% Row Count 33 (+ 33)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{DISEASE TRANSMITTED THROUGH FOOD AND WATER (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
{\bf{CHOLERA}}\{\{nl\}\}{\emph{Vibrio cholerae}} & - "Rice water stools" & {\bf{Vaccines:}}\{\{nl\}\}{\bf{Vaxchora}}\{\{nl\}\}~~~- Live-attenuated\{\{nl\}\}~~~- Single, oral\{\{nl\}\}~~~- Min: 10 days before\{\{nl\}\}~~~- Age: 18-64 \tn 
% Row Count 15 (+ 15)
% Row 4
\SetRowColor{white}
{\bf{POLIO}} & - Vaccine given in childhood\{\{nl\}\}- Single lifetime booster dose min 4 wks prior to travel is recommended for adults who are traveling to regions with it\{\{nl\}\} - May have to show proof of vaccination\{\{nl\}\} - Documented on Certificate of Vaccination or Prophylaxis (ICVP) &  \tn 
% Row Count 36 (+ 21)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{DISEASE TRANSMITTED THROUGH FOOD AND WATER (cont)}}  \tn
% Row 5
\SetRowColor{LightBackground}
{\bf{HEPATITIS A}} & - At highest risk: person traveling from developed country to developing countries\{\{nl\}\} - Can be asymptomatic\{\{nl\}\} - Symptoms: fever, malaise, jaundice, nausea, abdominal discomfort &  \tn 
% Row Count 15 (+ 15)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{DISEASES TRANSMITTED THROUGH BLOOD \& BODILY FLUIDS}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{HEPATITIS B}} & - Cause: blood and bodily fluids\{\{nl\}\} - Incubation of 90 days\{\{nl\}\} - Sx: malaise, jaundice, nausea, GI discomfort\{\{nl\}\} - Chronic infection can result in chronic liver disease or liver cancer\{\{nl\}\}- Vaccine is really important if travelers plan on:\{\{nl\}\}~~~~~- Receive medical care\{\{nl\}\}~~~~~- Provide medical work\{\{nl\}\}~~~~~- Have sex w/ new partners\{\{nl\}\}- Avoid \seqsplit{piercings/tattoos} & - 3-dose vaccine series\{\{nl\}\}- 6 mo to complete\{\{nl\}\}- Receive as many doses as possible before traveling\{\{nl\}\}~~~~~- Can complete upon return\{\{nl\}\}- High risk: May admin accelerated series\{\{nl\}\}~~~~~- Requires booster dose at 1 yr for long-term immunity \tn 
% Row Count 36 (+ 36)
% Row 1
\SetRowColor{white}
{\bf{MENINGOCOCCAL MENINGITIS}}\{\{nl\}\}{\emph{N. menigitidis}}\{\{nl\}\}\{\{nl\}\}- Belt of Africa \{\{nl\}\}(Dec-Jun) & - Cause: {\bf{respiratory secretions}}\{\{nl\}\}- High mortality rate\{\{nl\}\}- Medical emergency\{\{nl\}\}- Sx: fever, HA, nausea, stiff neck, mental changes\{\{nl\}\}~~~~~- Requires urgent tx & - Quadrivalent vacine containing 4 bacterial types: ACWY\{\{nl\}\}- Required by Saudia Arabia govt. during annual Hajj and Umrah pilgrimages \tn 
% Row Count 52 (+ 16)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{DISEASES TRANSMITTED BY INSECT BITES}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{17.67cm}}{{\bf{THESE ARE ALL TRANSMITTED BY MOSQUITOES}}\{\{ac\}\}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\bf{DENGUE}}\{\{nl\}\}{\emph{Aedes aegypti}}\{\{nl\}\}{\emph{Aedes albopictus}} & - Asymptomatic\{\{nl\}\}- Can develop \seqsplit{life-threatening} disease\{\{nl\}\}- Sx: shock, severe bleeding, organ failure & - No vaccine\{\{nl\}\}-{\bf{Tx:}} Supportive care \tn 
% Row Count 10 (+ 9)
% Row 2
\SetRowColor{LightBackground}
{\bf{MALARIA}}\{\{nl\}\}{\emph{Anopheles}} mosquito & - Multiplies in the liver and then moves into RBCs\{\{nl\}\}- Sx: shaking chills, high fever, flu-like illness\{\{nl\}\}\{\{nl\}\}Types:\{\{nl\}\}~~~- {\emph{Plasmodium vivax}} `(most common)`\{\{nl\}\}~~~- {\emph{P. falciparum}} `(most deadly)`\{\{nl\}\}~~~- {\emph{P. malariae}}\{\{nl\}\}~~~- {\emph{P. ovale}} & {\bf{Quick start PX:}}\{\{nl\}\}~~~- \seqsplit{Atovaquone/Proguanil} `(Malarone)`\{\{nl\}\}~~~- Doxycycline `(Doryx, Vibramycin)`\{\{nl\}\}~~~- Primaquine (most effective against P. vivax)\{\{nl\}\}\{\{nl\}\}{\bf{Advance start PX:}}\{\{nl\}\}~~~- Chloroquine\{\{nl\}\}~~~- Mefloquine `(Lariam)` \tn 
% Row Count 35 (+ 25)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{DISEASES TRANSMITTED BY INSECT BITES (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
{\bf{JAPANESES ENCEPHALITIS}} & - Sx: asymptomatic or\{\{nl\}\}Sx: encephalitis w/ rigors \& seizure risks, coma, and death\{\{nl\}\}- Mostlikley infected in rural agricultural areas & {\bf{PX}}: reduce exposure to mosquitoes\{\{nl\}\}\{\{nl\}\}{\bf{Vaccine:}}  {\emph{IIxiaro}}\{\{nl\}\}~~~- Age \textgreater{} 2 mo \{\{nl\}\}~~~~~~~- who's spending time outdoors or\{\{nl\}\}~~~~~~~- who's staying min 1 mo in endemic areas \tn 
% Row Count 22 (+ 22)
% Row 4
\SetRowColor{white}
{\bf{YELLOW FEVER}} & - Sx: most are asymptomatic, \seqsplit{influenza-like} sx, risk of shock and organic failure & {\bf{Vaccine:}}\{\{nl\}\}YF-VAX\{\{nl\}\}~~~- Live-attenuated\{\{nl\}\}~~~- Contra: \seqsplit{hypersensitivity} to eggs\{\{nl\}\}~~~- ICVP ("yellow card") provided after\{\{nl\}\}~~~- Card is only valid if completed 10 days before\{\{nl\}\}\{\{nl\}\}{\bf{TX:}} symptomatic relief with fluids, analgesics, and antipyretics\{\{nl\}\}- Aspirin and other NSAIDs {\bf{cannot}} be used (↑ risk of bleeding)\{\{nl\}\} \tn 
% Row Count 54 (+ 32)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{DISEASES TRANSMITTED BY INSECT BITES (cont)}}  \tn
% Row 5
\SetRowColor{LightBackground}
{\bf{ZIKA VIRUS}}\{\{nl\}\}{\emph{Aedes}} & - Sex or blood \seqsplit{transfusion-associated} transmission\{\{nl\}\}- Sx: fever, \seqsplit{maculopapular} rash, arthralgia, conjunctivitis\{\{nl\}\}- Caused babies to be born with microcephaly & - No vaccine\{\{nl\}\}- Use condom\{\{nl\}\}- Avoid mosquitoes\{\{nl\}\}- Do not travel to areas if pregnant \tn 
% Row Count 13 (+ 13)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{17.67cm}}{-  Insects that transmit disease are vectors \newline - Stay and sleep in screened or rooms w/ AC \newline - Use bed net (can be pre-treated w/ repellant) \newline - Cover exposed skin \newline - DEET: mosquito repellant \newline - Picaridin, oil of lemon, eucalyptus, or IR3535: mosquito repellant (not ticks) \newline - Permethrin to treat clothing, gear, bed nets \newline ~~~~~- Do {\bf{not}} apply directly to skin}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{ADDITIONAL CONCERNS FOR TRAVELING INDIVIDUALS}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{VENOUS THRMBOEMBOLISM PX}} & {\bf{PX:}}\{\{nl\}\}- Compression stockings\{\{nl\}\}- Walk\{\{nl\}\}- Lower leg exercises \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
{\bf{ALTITUDE SICKNESS AND MOTION SICKNESS}} & - Acute mountain sickness (AMS)\{\{nl\}\}~~~~~- Occurs when you climb rapidly to a high altitude\{\{nl\}\}\{\{nl\}\}{\bf{PX:}}\{\{nl\}\}- Acetazolamide `(Diamox)` 125 mg BID day before (preferred) or day of\{\{nl\}\}~~~~~- Contra: sulfa allergy\{\{nl\}\}~~~~~- AE: rash, taste alteration, dehydration, photosensitivity, urticaria \tn 
% Row Count 23 (+ 19)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}