Recognition of Imported Tropical Infectious Disease in Returned Travelers in a University Hospital Emergency Department

Authors

  • Gerard Flaherty School of Medicine, National University of Ireland, Galway, Ireland; School of Medicine, International Medical University, Kuala Lumpur, Malaysia
  • Andrew Scott School of Medicine, National University of Ireland, Galway, Ireland
  • Michael Malak School of Medicine, National University of Ireland, Galway, Ireland
  • Gloria Avalos School of Medicine, National University of Ireland, Galway, Ireland
  • Timothy O’Brien School of Medicine, National University of Ireland, Galway, Ireland

DOI:

https://doi.org/10.17140/EMOJ-1-109

Keywords:

Recognition, Tropical, Infectious disease, Emergency department

Abstract

Objective: Healthcare workers practising in Ireland may encounter tropical illness in the returned traveler. This study aimed to establish the awareness of tropical diseases in front-line healthcare professionals working in an Irish hospital.
Methods: A questionnaire was administered to doctors and nurses working in an Irish university teaching hospital. The respondents’ ability to obtain a travel history, to recognize tropical illness in returned travelers and to demonstrate awareness of the geographical distribution of tropical diseases was evaluated.
Results: Fifty clinicians completed the survey (29 doctors and 21 nurses), most of whom had not previously worked in the tropics and had not received formal training in tropical or travel medicine. The following items were not routinely included in their travel histories: illness in traveling companions, water and food consumption, insect and animal bites. Tropical illness was infrequently considered in patients presenting with a variety of common symptoms. There was a poor level of familiarity of several tropical infectious diseases. There was a tendency for doctors to underestimate the prevalence of dengue infection. A substantial proportion of doctors were not confident in their ability to manage a patient with malaria. The educational activities preferred by the majority of respondents were tropical disease manuals, workshops and wall charts.
Conclusion: This study highlights a low level of knowledge of tropical medicine among a sample of healthcare workers who may be called upon to assess the returned tropical traveler. Opportunities for training in tropical medicine should be provided to emergency department clinicians.

References

World Tourism Organization. UNWTO World Tourism Ba-rometer. Available at http://dtxtq4w60xqpw.cloudfront.net/sites/ all/files/pdf/unwto_barom14_06_dec_excerpt.pdf 2014; Ac-cessed January 10, 2015.

Freedman DO, Weld LH, Kozarsky PE, et al. Spectrum of disease and relation to place of exposure among ill returned trav-elers. New England Journal of Medicine. 2006; 354(2): 119-130. doi: 10.1056/NEJMoa051331

Hill DR. Health problems in a large cohort of Americans trav-eling to developing countries. Journal of Travel Medicine. 2000; 7: 259-266. doi: 10.2310/7060.2000.00075

Steffen R, deBernardis C, Banos A. Travel epidemiology -a global perspective. International Journal of Antimicrobial Agents. 2003; 21: 89-95. doi: 10.1016/S0924-8579(02)00293-5

Steffen R, Rickenbach M, Wilhelm U, Helminger A, Schar M. Health problems after travel to developing countries. Journal of Infectious Diseases. 1987; 7: 259-266.

Boggild AK, Castelli F, Gautret P, et al. Vaccine preventable diseases in returned international travelers: results from the Ge-oSentinel Surveillance Network. Vaccine. 2010; 28(46): 7389- 7395. doi: 10.1016/j.vaccine.2010.09.009

Leder K, Torresi J, Libman MD, et al. GeoSentinel surveil-lance of illness in returned travelers, 2007-2011. Annals of Inter-nal Medicine. 2013; 158(6): 456-468. doi: 10.7326/0003-4819- 158-6-201303190-00005

London School of Hygiene and Tropical Medicine. Diploma in Tropical Medicine and Hygiene. Available at http://www.lshtm. ac.uk/study/cpd/stmh.html 2015; Accessed January 3, 2015.

Liverpool School of Tropical Medicine. Diploma in Tropical Medicine and Hygiene. Available at http://www.lstmed.ac.uk/ learning--teaching/lstm-courses/professional-diplomas/dtmh 2015; Accessed January 3, 2015.

Fairley JK. General approach to the returned traveler. In: Brunette GW, Kozarsky PE, eds. CDC Health Information for International Travel. Atlanta, Georgia: Oxford University Press. 2014; 470-474.

Chen LH, Wilson ME, Davis X, et al. Illness in long-term travelers visiting GeoSentinel clinics. Emerging Infectious Dis-eases. 2009; 15(11): 1773-1782. doi: 10.3201/eid1511.090945

Wilson ME, Weld LH, Boggild A, et al. Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clinical Infectious Diseases. 2007; 44(12): 1560-1568. doi: 10.1086/518173

Schulte C, Krebs B, Jelinek T, Nothdurft HD, von Sonnen-burg F, Löscher T. Diagnostic significance of blood eosinophilia in returning travelers. Clinical Infectious Diseases. 2002; 34(3): 407-411. doi: 10.1086/338026

Health Protection Surveillance Centre. Burden of imported malaria in Ireland: recommendations for surveillance and pre-vention. Available at http://www.hpsc.ie/AboutHPSC/Scienti-ficCommittees/Publications/File,4680,en.pdf 2010; Accessed January 10, 2015.

Downloads

Published

2015-06-09

How to Cite

Gerard Flaherty, Andrew Scott, Michael Malak, Gloria Avalos, & Timothy O’Brien. (2015). Recognition of Imported Tropical Infectious Disease in Returned Travelers in a University Hospital Emergency Department. Emergency Medicine, 1(2), 39–45. https://doi.org/10.17140/EMOJ-1-109