Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-76fb5796d-vvkck Total loading time: 0 Render date: 2024-04-30T03:46:22.042Z Has data issue: false hasContentIssue false

Chapter 6 - Travelers from Overseas

Published online by Cambridge University Press:  20 July 2023

By
Arha Cho ,
Erena Weathers  and
Geoffrey W. Jara-Almonte
Edited by
Mark Curato ,
Kaushal Shah  and
Christopher Reisig
Mark Curato
Affiliation:
Weill Cornell Medicine, New York
Kaushal Shah
Affiliation:
Weill Cornell Medicine, New York
Christopher Reisig
Affiliation:
Weill Cornell Medicine, New York
Get access

Summary

About 40 million people travel from abroad to the United States per annum; many international travelers arrive in urban centers, and those who are ill will seek care there. Clinicians working in urban hospitals or near points of international arrival must be familiar with diseases commonly acquired abroad as well as uncommon but potentially serious conditions such as emerging and re-emerging infectious diseases. The assessment of the ill international traveler begins with a thorough history including the patient’s itinerary, activities, and risk factors. A familiarity with conditions endemic to the region of travel, timing of exposure, and knowledge of incubation period will allow the clinician to form a focused differential diagnosis. Knowledge of the specific diseases for which the patient is at risk, their potential complications, and the patient’s clinical status will determine need for diagnostic testing, empiric treatment, and ultimate disposition.

Keywords

International TravelerTraveler’s DiarrheaHemorrhagic FeverEnteric FeverEbolaMedical TourismMalariaDengue
Type
Chapter
Information
Urban Emergency Medicine , pp. 67 - 86
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Freedman, DO, Weld, LH, Kozarsky, PE, Fisk, T, Robins, R, Von Sonnenburg, F, Keystone, JS, Pandey, P, Cetron, MS, GeoSentinel Surveillance Network. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med. 2006;354(2):119–130.Google Scholar
Upadhyay, DK, Sittig, DF, Singh, H. Ebola US Patient Zero: lessons on misdiagnosis and effective use of electronic health records. Diagnosis. 2014;1(4):283–287.Google Scholar
Wilson, ME, Weld, LH, Boggild, A, Keystone, JS, Kain, KC, von Sonnenburg, F, Schwartz, E, GeoSentinel Surveillance Network. Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clin Infect Dis. 2007;44(12):1560–1568.Google Scholar
Nilles, EJ, Arguin, PM. Imported malaria: an update. Am J Emerg Med. 2012;30(6):972–980.Google Scholar
World Health Organization, Special Programme for Research and Training in Tropical Diseases. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. World Health Organization, 2009.Google Scholar
CDC. Treatment of Malaria: Guidelines for Clinicians (United States). 2020. Available from: www.cdc.gov/malaria/resources/pdf/Malaria_Treatment_Guidelines.pdf.Google Scholar
Simkhada, PP, Sharma, A, van Teijlingen, ER, Beanland, RL. Factors influencing sexual behaviour between tourists and tourism employees: a systematic review. Nepal J Epidemiol. 2016;6(1):530.Google Scholar
Lu, TS, Holmes, A, Noone, C, Flaherty, GT. Sun, sea and sex: a review of the sex tourism literature. Trop Dis, Travel Med Vacc. 2020;6(1).Google Scholar
Braun, DL, Kouyos, RD, Balmer, B, Grube, C, Weber, R, Günthard, HF. Frequency and spectrum of unexpected clinical manifestations of primary HIV-1 infection. Clin Infect Dis. 2015;61(6):1013–1021.Google Scholar
Gupta, S, Gupta, M, Bhardwaj, S, Chugh, T. Current clinical patterns of typhoid fever: a prospective study. J Trop Med Hygiene. 1985;88(6):377–381.Google Scholar
Mogasale, V, Desai, SN, Mogasale, VV, Park, JK, Ochiai, RL, Wierzba, TF. Case fatality rate and length of hospital stay among patients with typhoid intestinal perforation in developing countries: a systematic literature review. PLoS One. 2014;9(4):e93784.Google Scholar
Jensenius, M, Schlagenhauf, P, Loutan, L, Parola, P, Schwartz, E, Leder, K, Freedman, DO, GeoSentinel Surveillance Network. Acute and potentially life-threatening tropical diseases in western travelers – a GeoSentinel Multicenter Study, 1996–2011. Am J Trop Med Hygiene. 2013;88(2):397–404.Google Scholar
CDC. Extensively Drug-Resistant Typhoid Fever in Pakistan. 2019. Available from: wwwnc.cdc.gov/travel/notices/watch/xdr-typhoid-fever-pakistan.Google Scholar
CDC. Testing Guidance New Zika and Dengue Testing Guidance (Updated November 2019). 2019. Available from: www.cdc.gov/zika/hc-clinicians/testing-guidance.html.Google Scholar
Harvey, K, Esposito, DH, Han, P, Kozarsky, P, Freedman, DO, Plier, DA, Sotir, MJ, Centers for Disease Control and Prevention. Surveillance for travel-related disease – GeoSentinel surveillance system, United States, 1997–2011. MMWR Surveill Summ. 2013;62(3):1–23.Google Scholar
Hill, DR. Health problems in a large cohort of Americans traveling to developing countries. J Travel Med. 2000;7(5):259–266.Google Scholar
Siddique, A, Akram, K, Zaman, K, Laston, S, Salam, A, Majumdar, R, Zaman, K, Fronczak, N, Laston, S. Why treatment centres failed to prevent cholera deaths among Rwandan refugees in Goma, Zaire. Lancet. 1995;345(8946):359–361.Google Scholar
Shane, AL, Mody, RK, Crump, JA, Tarr, PI, Steiner, TS, Kotloff, K, Langley, JM, Wanke, C, Warren, CA, Cheng, AC, Cantey, J, Pickering, LK. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017;65(12):e45–e80.Google Scholar
de Bruyn, G, Hahn, S, Borwick, A. Antibiotic treatment for travellers’ diarrhoea. Cochrane Database of Syst Rev. 2000;2000(3):CD002242.Google Scholar
Kantele, A, Lääveri, T. Extended-spectrum beta-lactamase-producing strains among diarrhoeagenic Escherichia coli – prospective traveller study with literature review. J Travel Med. 2022;29(1):taab042.CrossRefGoogle ScholarPubMed
Borders, PB. Quick Facts About Medical Tourism 2022. Available from: www.patientsbeyondborders.com/media.Google Scholar
Pereira, RT, Malone, CM, Flaherty, GT. Aesthetic journeys: a review of cosmetic surgery tourism. J Travel Med. 2018;25(1):tay042.Google Scholar
Gale, J. How Thailand Became a Global Gender-Change Destination. Bloomberg. 2015.Google Scholar
Moore, W. Delray Beach woman warns of dangers of medical tourism after suffering from complications. WPTV 5: NBC; 2019. Available from: www.wptv.com/news/local-news/investigations/delray-beach-woman-warns-of-dangers-of-medical-tourism-after-suffering-from-complications.Google Scholar
Adido, TO. Transplant Tourism: An International and National Law Model to Prohibit Travelling Abroad for Illegal Organ Transplants. Nijhoff, 2018.Google Scholar
Stoney, RJ, Kozarsky, PE, Walker, AT, Gaines, JL. Population-based surveillance of medical tourism among US residents from 11 states and territories: findings from the Behavioral Risk Factor Surveillance System. Infect Control Hosp Epidemiol. 2022; 43(7):870–875.Google Scholar
Chambers, A. Trends in US health travel services trade. United States International Trade Commission Executive Briefing on Trade. 2015.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×