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Case management of ill travelers with infectious diseases
Abstract:
Recent increase of international travelers raises awareness of travel-related infections. Travelers' diarrhea is the most common and caused by diarrheagenic E. coli and other patho- gens. Undifferentiated fever challenges physicians to correctly diagnose and includes ma- laria, dengue, and enteric fever. The pre-test probability for a disease which causes undiffer- entiated fever largely depends on the travel destination. Malaria is most common in travelers returning from sub-Saharan Africa while dengue is most common those returning from Southeast Asia and Latin America. Screening for asymptomatic travelers is not generally rec- ommended, but for long-term travelers and immigrants. Following outbreaks of highly infectious diseases in the past decades, hospital prepared- ness for travel-related infections focuses on infection prevention and control. Emerging viral pneumonias such as Middle East respiratory syndrome (MERS) and avian influenza H7N9 are major concerns. As seen in the largest outbreak of Ebola virus disease in West Africa, imported viral hemorrhagic fever such as Lassa fever is another concern. Since multidrug resistant bacteria silently spread globally by infected travelers, it would be of help to install appropriate isolation precaution for travelers with history of hospital admission abroad.
Insights
International travel increases the risk of infectious diseases like travelers' diarrhea, malaria, and dengue fever. Hospitals must prepare for these infections, focusing on prevention and control, especially with emerging threats like MERS and Ebola.
Area of Science:
- Infectious Diseases
- Public Health
- Travel Medicine
Background:
- Increased international travel correlates with a rise in travel-related infections.
- Common travel-related illnesses include travelers' diarrhea, malaria, dengue fever, and enteric fever.
- Physicians face diagnostic challenges with undifferentiated fevers, where pre-test probability depends on travel destination.
Purpose of the Study:
- To highlight the growing concern of travel-related infections due to increased international travel.
- To emphasize the importance of accurate diagnosis and hospital preparedness for infectious diseases.
- To discuss the implications of emerging infectious diseases and antimicrobial resistance in travelers.
Main Methods:
- Review of common travel-related infections and their etiological agents.
- Analysis of disease prevalence based on travel destinations (e.g., malaria in sub-Saharan Africa, dengue in Southeast Asia).
- Discussion of hospital preparedness strategies, including infection prevention and control measures.
Main Results:
- Travelers' diarrhea, caused by diarrheagenic E. coli and other pathogens, is the most frequent illness.
- Malaria and dengue fever are significant concerns, with geographical risk factors influencing their occurrence.
- Emerging viral threats like MERS, avian influenza H7N9, and viral hemorrhagic fevers (e.g., Ebola, Lassa) pose substantial risks.
- Multidrug-resistant bacteria spread globally via travelers, necessitating appropriate isolation precautions.
Conclusions:
- Effective diagnosis and management of travel-related infections are crucial.
- Hospital preparedness, focusing on infection control, is essential to mitigate outbreaks.
- Screening is generally not recommended for asymptomatic travelers, except for long-term travelers and immigrants.
- Isolation precautions for travelers with a history of overseas hospital admission are advised due to the silent spread of multidrug-resistant bacteria.
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