Incidence and Types of Illness When Traveling to the Tropics: A Prospective Controlled Study of Children and Their Parents

Catherine Newman-Klee Department of Pediatrics, University Hospital, Lausanne, Switzerland; Travel Clinic, Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland; Swiss Tropical Institute, Basel, Switzerland

Search for other papers by Catherine Newman-Klee in
Current site
Google Scholar
PubMed
Close
,
Valérie D’Acremont Department of Pediatrics, University Hospital, Lausanne, Switzerland; Travel Clinic, Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland; Swiss Tropical Institute, Basel, Switzerland

Search for other papers by Valérie D’Acremont in
Current site
Google Scholar
PubMed
Close
,
Christopher J. Newman Department of Pediatrics, University Hospital, Lausanne, Switzerland; Travel Clinic, Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland; Swiss Tropical Institute, Basel, Switzerland

Search for other papers by Christopher J. Newman in
Current site
Google Scholar
PubMed
Close
,
Mario Gehri Department of Pediatrics, University Hospital, Lausanne, Switzerland; Travel Clinic, Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland; Swiss Tropical Institute, Basel, Switzerland

Search for other papers by Mario Gehri in
Current site
Google Scholar
PubMed
Close
, and
Blaise Genton Department of Pediatrics, University Hospital, Lausanne, Switzerland; Travel Clinic, Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland; Swiss Tropical Institute, Basel, Switzerland

Search for other papers by Blaise Genton in
Current site
Google Scholar
PubMed
Close
Restricted access

Increasingly, families travel to tropical destinations exposing them to infectious agents and tropical diseases not encountered at home. We studied 157 children (0–16 years) and their adult relatives traveling to the tropics, who attended a pretravel clinic and were generally adherent to prescribed advice. Incidence rates of common illness in children and adults were respectively 16.9 (14.3–19.7) and 15.1 (12.7–17.8) episodes/100 person-weeks. Diarrhea, abdominal pain, and fever were the most frequent complaints. There was no significant difference in the incidence of morbid episodes between children and adults, except for fever (more frequent in children). Most episodes occurred in the first 10 days of travel. The similar incidence of morbidity in children and adults and the episodes’ mildness challenge the view that it is unwise to travel with small children.

Author Notes

Reprint requests: Blaise Genton, Swiss Tropical Institute, Socinstrasse 57, 4002 Basel, Switzerland, E-mail: Blaise.genton@unibas.ch.
  • 1

    Riordan FA, Tarlow MJ, 1998. Imported infections in east Birmingham children. Postgrad Med J 74 :36–37.

  • 2

    Brouwer ML, Tolboom JJ, Hardeman JH, 1999. Routine screening of children returning home from the tropics: retrospective study. BMJ 318 :568–569.

  • 3

    Genton B, Gehri M, 1999. Authors’ definition of asymptomatic children is not the one usually accepted. BMJ 319: 121 [letter, discussion of Brouwer ML, Tolboom JJ, Hardeman JH, 1999. Routine screening of children returning home from the tropics: retrospective study. BMJ 318: 568–569]; author reply. BMJ 319 :122.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Klein JL, Millman GC, 1998. Prospective, hospital based study of fever in children in the United Kingdom who had recently spent time in the tropics. BMJ 316 :1425–1426.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Brabin BJ, Ganley Y, 1997. Imported malaria in children in the UK. Arch Dis Child 77 :76–81.

  • 6

    West NS, Riordan FA, 2003. Fever in returned travellers: a prospective review of hospital admissions for a 2½ year period. Arch Dis Child 88 :432–434.

  • 7

    Steffen R, van der Linde F, Meyer HE, 1978. Risk of disease in 10,500 travelers to tropical countries and 1,300 tourists to North America [in German]. Schweiz Med Wochenschr 108 :1485–1495.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Steffen R, Rickenbach M, Wilhelm U, Helminger A, Schar M, 1987. Health problems after travel to developing countries. J Infect Dis 156 :84–91.

  • 9

    Hill DR, 2000. Health problems in a large cohort of Americans traveling to developing countries. J Travel Med 7 :259–266.

  • 10

    Martin DO, Austin H, 1996. Exact estimates for a rate ratio. Epidemiology 7 :29–33.

  • 11

    Mickey RM, Greenland S, 1989. The impact of confounder selection criteria on effect estimation. Am J Epidemiol 129 :125–137.

  • 12

    Bishop Y, Fienberg S, Holland P, 1975. Summary measures of goodness of fit. Discrete Multivariate Analysis: Theory and Practice. Cambridge: The MIT Press, 125–130.

    • PubMed
    • Export Citation
  • 13

    International Labour Organisation, 1998. International Standard Classification of Occupations (ISCO-88). Geneva: International Labour Organisation.

    • PubMed
    • Export Citation
  • 14

    Groupe Suisse de Travail pour les Conseils Médicaux aux Voyageurs, 2006. Medical recommendations for travelers [in French]. Available from: http://www.safetravel.ch. Accessed June 19, 2006.

    • PubMed
    • Export Citation
  • 15

    Cossar JH, Reid D, Fallon RJ, Bell EJ, Riding MH, Follett EA, Dow BC, Mitchell S, Grist NR, 1990. A cumulative review of studies on travellers, their experience of illness and the implications of these findings. J Infect 21 :27–42.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Bruni M, Steffen R, 1997. Impact of travel-related health impairments. J Travel Med 4 :61–64.

  • 17

    Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, Keystone JS, Pandey P, Cetron MS, 2006. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354 :119–130.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Hill DR, 2000. Occurrence and self-treatment of diarrhea in a large cohort of Americans traveling to developing countries. Am J Trop Med Hyg 62 :585–589.

  • 19

    Dudink J, Mearin L, Sukhai R, 2003. Ileus after the use of loperamide in a child with acute diarrhea. Ned Tijdsch Geneeskd 147 :670–672.

  • 20

    Cezard JP, Bingen E, Lambert-Zechovsky N, Marchand M, Marinier E, Navarro J, 1987. Effect of loperamide on fecal flora of children with severe prolonged diarrhea [in French]. Arch Fr Pediatr 44 :109–114.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Pitzinger B, Steffen R, Tschopp A, 1991. Incidence and clinical features of traveler’s diarrhea in infants and children. Pediatr Infect Dis J 10 :719–723.

  • 22

    Steffen R, Heusser R, Mächler R, Bruppacher R, Naef U, Chen D, Hofmann AM, Somaini B, 1990. Malaria chemoprophylaxis among European tourists in tropical Africa: use, adverse reactions, and efficacy. Bull World Health Organ 68 :313–322.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Steffen R, Fuchs E, Schildknecht J, Naef U, Funk M, Schlagenhauf P, Phillips-Howard P, Nevill C, Sturchler D, 1993. Mefloquine compared with other malaria- chemoprophylactic regimens in tourists visiting east Africa. Lancet 341 :1299–1303.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Phillips-Howard PA, Radalowicz A, Mitchell J, Bradley DJ, 1990. Risk of malaria in British residents returning from malarious areas. BMJ 300 :499–503.

  • 25

    Phillips-Howard PA, Bradley DJ, Blaze M, Hurn M, 1988. Malaria in Britain: 1977–86. Br Med J (Clin Res Ed) 296 :245–248.

  • 26

    Lobel HO, Phillips-Howard PA, Brandling-Bennett AD, Steffen R, Campbell CC, Huong AY, Were JB, Moser R, 1990. Malaria incidence and prevention among European and North American travellers to Kenya. Bull World Health Organ 68 :209–215.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Lackritz EM, Lobel HO, Howell BJ, Bloland P, Campbell CC, 1991. Imported Plasmodium falciparum malaria in American travelers to Africa. Implications for prevention strategies. JAMA 265 :383–385.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Hamer DH, Connor BA, 2004. Travel health knowledge, attitudes and practices among United States travelers. J Travel Med 11 :23–26.

  • 29

    Gisler S, Steffen R, Mutsch M, 2005. Knowledge, attitudes and practices among travellers to tropical and subtropical countries [in German]. Schweiz Rundsch Med Prax 94 :967–974.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 30 28 2
Full Text Views 88 3 0
PDF Downloads 15 3 0
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save