A Patient’s Itinerary Helps Doctor Determine Disease
By Barbara Anderson, The Fresno Bee, Calif.
May 12–Destination matters when it comes to illness brought home after a trip.
A worldwide study of travelers, including information collected from people in the central San Joaquin Valley, found physicians could predict the cause of an illness based on the person’s travel itinerary.
Public health officials say information like this is useful in disease surveillance, including keeping alert to new emerging diseases or a pandemic.
The GeoSentinel study, published in the Jan. 12 issue of The New England Journal of Medicine, used information from more than 17,000 travelers ill enough to see a doctor after their travels between June 1996 and August 2004.
Among the findings: Fevers with only generalized symptoms occurred disproportionately among those returning from sub-Saharan Africa or Southeast Asia. Acute diarrhea was a common occurrence for those returning from south central Asia; and skin problems were disproportionately seen among those returning from the Caribbean or Central or South America.
Malaria was one of the three most common causes of fever among travelers from every region, but travelers from sub-Saharan Africa and Central America had confirmed or probable dengue more frequently than malaria.
And travelers from all regions except Southeast Asia appeared at doctors’ offices with parasite-induced diarrhea more often than with bacterial diarrhea.
The study illustrates how collecting information about travelers can help doctors in their treatment of patients, said Dr. Michael W. Lynch, a travel medicine specialist and site director of the Central Valley GeoSentinel Project.
“The more data you collect, the more chances you can put a higher priority as far as what disease you think the person may have … and how rapidly you find what to do properly for the patient,” Lynch said.
The Central Valley GeoSentinel Project collects information from hospitals and other medical providers in the Valley about travel-related illnesses. The project is a part of the GeoSentinel Surveillance Network, a cooperative agreement between the International Society of Travel and the federal Centers for Disease Control and Prevention.
Dr. Edward Moreno, health officer for Fresno County, said the project can help alert health providers about increases in the incidence of diseases in particular countries.
Doctors would then be more apt to ask appropriate questions of someone who has recently traveled to one of those countries, he said.
Lynch said travel medicine is a relatively new field, but its importance is beginning to be understood.
One of the goals of the Central Valley GeoSentinel Project is to increase participation by hospitals and clinics. Information collected about travel-related illnesses can help with an understanding of how diseases are transported across borders, Lynch said.
Members of the worldwide travel medicine project will meet this weekend in Los Angeles to compare notes. One of the topics of discussion: The vulnerability to travel-related illnesses for people who travel abroad to visit friends and relatives.
This group is at particular risk, Lynch said, because they often stay in private homes instead of hotels during visits. And, he said: “They don’t have the resistance [to native diseases] they once had.”
The reporter can be reached at banderson@fresnobee.com or (559) 441-6310.
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Copyright (c) 2006, The Fresno Bee, Calif.
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