Illness in Returned Travelers and Immigrants/Refugees: The 6-Year Experience of Two Australian Infectious Diseases Units.

Hdl Handle:
http://hdl.handle.net/10144/18921
Title:
Illness in Returned Travelers and Immigrants/Refugees: The 6-Year Experience of Two Australian Infectious Diseases Units.
Authors:
O'Brien, D P; Leder, K; Matchett, E; Brown, G V; Torresi, J
Journal:
Journal of Travel Medicine : Official Publication of the International Society of Travel Medicine and the Asia Pacific Travel Health Association
Abstract:
BACKGROUND: Data comparing returned travelers and immigrants/refugees managed in a hospital setting is lacking. METHODS: We prospectively collected data on 1,106 patients with an illness likely acquired overseas who presented to two hospital-based Australian infectious diseases units over a 6-year period. RESULTS: Eighty-three percent of patients were travelers and 17% immigrants/refugees. In travelers, malaria (19%), gastroenteritis/diarrhea (15%), and upper respiratory tract infection (URTI) (7%) were the most common diagnoses. When compared with immigrants/refugees, travelers were significantly more likely to be diagnosed with gastroenteritis/diarrhea [odds ratio (OR) 8], malaria (OR 7), pneumonia (OR 6), URTI (OR 3), skin infection, dengue fever, typhoid/paratyphoid fever, influenza, and rickettsial disease. They were significantly less likely to be diagnosed with leprosy (OR 0.03), chronic hepatitis (OR 0.04), tuberculosis (OR 0.05), schistosomiasis (OR 0.3), and helminthic infection (OR 0.3). In addition, travelers were more likely to present within 1 month of entry into Australia (OR 96), and have fever (OR 8), skin (OR 6), gastrointestinal (OR 5), or neurological symptoms (OR 5) but were less likely to be asymptomatic (OR 0.1) or have anaemia (OR 0.4) or eosinophilia (OR 0.3). Diseases in travelers were more likely to have been acquired via a vector (OR 13) or food and water (OR 4), and less likely to have been acquired via the respiratory (OR 0.2) or skin (OR 0.6) routes. We also found that travel destination and classification of traveler can significantly influence the likelihood of a specific diagnosis in travelers. Six percent of travelers developed a potentially vaccine-preventable disease, with failure to vaccinate occurring in 31% of these cases in the pretravel medical consultation. CONCLUSIONS: There are important differences in the spectrum of illness, clinical features, and mode of disease transmission between returned travelers and immigrants/refugees presenting to hospital-based Australian infectious diseases units with an illness acquired overseas.
Affiliation:
Victorian Infectious Diseases Service, Centre for Clinical Research Excellence, Royal Melbourne Hospital, Victoria, Australia. obrien@amsterdam.msf.org
Issue Date:
21-Feb-2008
URI:
http://hdl.handle.net/10144/18921
DOI:
10.1111/j.1708-8305.2006.00033.x
PubMed ID:
16706945
Language:
en
ISSN:
1195-1982
Appears in Collections:
Other Diseases

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Brien, D P-
dc.contributor.authorLeder, K-
dc.contributor.authorMatchett, E-
dc.contributor.authorBrown, G V-
dc.contributor.authorTorresi, J-
dc.date.accessioned2008-02-21T16:37:09Z-
dc.date.available2008-02-21T16:37:09Z-
dc.date.issued2008-02-21T16:37:09Z-
dc.identifier.citationIllness in Returned Travelers and Immigrants/Refugees: The 6-Year Experience of Two Australian Infectious Diseases Units., 13 (3):145-52notJ Travel Meden
dc.identifier.issn1195-1982-
dc.identifier.pmid16706945-
dc.identifier.doi10.1111/j.1708-8305.2006.00033.x-
dc.identifier.urihttp://hdl.handle.net/10144/18921-
dc.description.abstractBACKGROUND: Data comparing returned travelers and immigrants/refugees managed in a hospital setting is lacking. METHODS: We prospectively collected data on 1,106 patients with an illness likely acquired overseas who presented to two hospital-based Australian infectious diseases units over a 6-year period. RESULTS: Eighty-three percent of patients were travelers and 17% immigrants/refugees. In travelers, malaria (19%), gastroenteritis/diarrhea (15%), and upper respiratory tract infection (URTI) (7%) were the most common diagnoses. When compared with immigrants/refugees, travelers were significantly more likely to be diagnosed with gastroenteritis/diarrhea [odds ratio (OR) 8], malaria (OR 7), pneumonia (OR 6), URTI (OR 3), skin infection, dengue fever, typhoid/paratyphoid fever, influenza, and rickettsial disease. They were significantly less likely to be diagnosed with leprosy (OR 0.03), chronic hepatitis (OR 0.04), tuberculosis (OR 0.05), schistosomiasis (OR 0.3), and helminthic infection (OR 0.3). In addition, travelers were more likely to present within 1 month of entry into Australia (OR 96), and have fever (OR 8), skin (OR 6), gastrointestinal (OR 5), or neurological symptoms (OR 5) but were less likely to be asymptomatic (OR 0.1) or have anaemia (OR 0.4) or eosinophilia (OR 0.3). Diseases in travelers were more likely to have been acquired via a vector (OR 13) or food and water (OR 4), and less likely to have been acquired via the respiratory (OR 0.2) or skin (OR 0.6) routes. We also found that travel destination and classification of traveler can significantly influence the likelihood of a specific diagnosis in travelers. Six percent of travelers developed a potentially vaccine-preventable disease, with failure to vaccinate occurring in 31% of these cases in the pretravel medical consultation. CONCLUSIONS: There are important differences in the spectrum of illness, clinical features, and mode of disease transmission between returned travelers and immigrants/refugees presenting to hospital-based Australian infectious diseases units with an illness acquired overseas.en
dc.language.isoenen
dc.rightsArchived with thanks to Journal of Travel Medicine : Official Publication of the International Society of Travel Medicine and the Asia Pacific Travel Health Associationen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshAustraliaen
dc.subject.meshBacterial Infectionsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshCommunicable Diseasesen
dc.subject.meshConfidence Intervalsen
dc.subject.meshEmigration and Immigrationen
dc.subject.meshHumansen
dc.subject.meshInfection Controlen
dc.subject.meshMiddle Ageden
dc.subject.meshOdds Ratioen
dc.subject.meshPatient Acceptance of Health Careen
dc.subject.meshPopulation Surveillanceen
dc.subject.meshPreventive Health Servicesen
dc.subject.meshRefugeesen
dc.subject.meshRetrospective Studiesen
dc.subject.meshStatistics, Nonparametricen
dc.subject.meshTravelen
dc.subject.meshTropical Medicineen
dc.titleIllness in Returned Travelers and Immigrants/Refugees: The 6-Year Experience of Two Australian Infectious Diseases Units.en
dc.contributor.departmentVictorian Infectious Diseases Service, Centre for Clinical Research Excellence, Royal Melbourne Hospital, Victoria, Australia. obrien@amsterdam.msf.orgen
dc.identifier.journalJournal of Travel Medicine : Official Publication of the International Society of Travel Medicine and the Asia Pacific Travel Health Associationen

Related articles on PubMed

All Items in MSF are protected by copyright, with all rights reserved, unless otherwise indicated.