Pre-Planning, Travel Histories Important for Children

September 29, 2015

Children travelling abroad are potentially exposed to a wide spectrum of illnesses, and a detailed travel history is important in those presenting to emergency rooms with symptoms suggesting infectious disease, according to a new study co-authored by a School of Public Health researcher.

Writing in the Pediatric Infectious Disease Journal, a research team that includes David Hamer, professor of global health and of medicine at the School of Medicine, recommended that pre-travel health clinicians tailor advice to children and families to focus on the prevention of frequently occurring illnesses such as travelers’ diarrhea and less common but severe infections such as malaria, hepatitis A, and typhoid fever. Hamer is the principal investigator on GeoSentinel, a multi-country network studying travel-related illnesses.

“This study shows that it is not always an exotic diagnosis, such as dengue or tuberculosis, which may lead to hospitalization of a child returning from international travel,” the authors wrote. “Often, in a child, it is travelers’ diarrhea that may require hospitalization, and this can be contracted at all travel destinations.”

The research team analyzed records of 801 children with travel-related diseases who were treated in the emergency room of University of Zurich Children’s Hospital between July 2007 and December 2012. Overall, the ill children had mainly acute diarrhea or respiratory infections and presented with gastrointestinal symptoms and fever.

Compared to outpatients, inpatients were significantly more likely to be male and to have travelled to Southern Asia. Those hospitalized also were more likely to have febrile/systemic illnesses (such as malaria and typhoid fever), neurologic diseases, or to present with non-specific findings such as dehydration.

As with adult travelers, the study found children who are visiting relatives or friends are at higher risk to acquire certain travel-related diseases than are tourist travelers.

The authors said pre-travel health advice “can play an important role in the prevention of dehydration due to travelers’ diarrhea. Parents traveling with children should be informed about common food and water precautions” and should carry oral rehydration sachets.

“Travel history is essential,” they wrote. “Physicians should be knowledgeable about the probabilities of the occurrence of travel-related pathogens according to geographic areas and recommend diagnostic methods and empiric therapies accordingly.”

The study was led by Patricia Schlagenhauf of the WHO Collaborating Centre for Travellers’ Heath, Epidemiology, Biostatistics and Prevention Institute at the University of Zürich and director of the Zurich GeoSentinel site. Co-authors are from: the Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital, Zürich; the Children’s Research Centre, University Children’s Hospital; and the Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich.

Lisa Chedekel