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Illness in returned travelers and immigrants/refugees: the 6-year experience of two Australian infectious diseases units.
J Travel Med. 2006 May-Jun; 13(3):145-52.JT

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.

Authors+Show Affiliations

Victorian Infectious Diseases Service, Centre for Clinical Research Excellence, Royal Melbourne Hospital, Victoria, Australia. obrien@amsterdam.msf.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16706945

Citation

O'Brien, Daniel P., et al. "Illness in Returned Travelers and Immigrants/refugees: the 6-year Experience of Two Australian Infectious Diseases Units." Journal of Travel Medicine, vol. 13, no. 3, 2006, pp. 145-52.
O'Brien DP, Leder K, Matchett E, et al. Illness in returned travelers and immigrants/refugees: the 6-year experience of two Australian infectious diseases units. J Travel Med. 2006;13(3):145-52.
O'Brien, D. P., Leder, K., Matchett, E., Brown, G. V., & Torresi, J. (2006). Illness in returned travelers and immigrants/refugees: the 6-year experience of two Australian infectious diseases units. Journal of Travel Medicine, 13(3), 145-52.
O'Brien DP, et al. Illness in Returned Travelers and Immigrants/refugees: the 6-year Experience of Two Australian Infectious Diseases Units. J Travel Med. 2006;13(3):145-52. PubMed PMID: 16706945.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Illness in returned travelers and immigrants/refugees: the 6-year experience of two Australian infectious diseases units. AU - O'Brien,Daniel P, AU - Leder,Karin, AU - Matchett,Elizabeth, AU - Brown,Graham V, AU - Torresi,Joseph, PY - 2006/5/19/pubmed PY - 2006/8/3/medline PY - 2006/5/19/entrez SP - 145 EP - 52 JF - Journal of travel medicine JO - J Travel Med VL - 13 IS - 3 N2 - 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. SN - 1195-1982 UR - https://www.unboundmedicine.com/medline/citation/16706945/Illness_in_returned_travelers_and_immigrants/refugees:_the_6_year_experience_of_two_Australian_infectious_diseases_units_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/j.1708-8305.2006.00033.x DB - PRIME DP - Unbound Medicine ER -