Diseases know no borders, and as international business and personal travel continues to become more common, the borderlines become even more blurred. Physicians who specialize in travel and tropical medicine, like Phyllis E. Kozarsky, MD, professor of medicine, Emory University School of Medicine, now have new data that will help guide their treatment of international travelers.
Data on more than 17,000 ill returning travelers collected through the GeoSentinel Surveillance Network, an established network of International Society of Travel Medicine clinics, show, for the first time, that travelers to different parts of the developing world face varying but significant risks. The study appears in the Jan. 12 issue of "The New England Journal of Medicine."
The Emory TravelWell Clinic, located at Emory Crawford Long Hospital, is part of the GeoSentinel Surveillance Network, and Dr. Kozarsky, the clinic director, is a co-author of the study and a founder of the network.
"This data will not only guide me and my colleagues in travel and tropical medicine, but it will help internal medicine specialists and emergency physicians who may be faced with treating patients who present with unusual or exotic diseases," says Dr. Kozarsky.
"This information gives us a blueprint of what to look for when it comes to diagnosing sick travelers, based on where they have been," says lead author David O. Freedman, MD, director of the University of Alabama at Birmingham Travel Medicine Clinic. "Doctors -- travel medicine specialists in particular -- can use the destination-specific differences we've found to guide the diagnosis and treatment of ill travelers, meaning they can order the correct tests and begin the correct therapy while waiting for confirmation."
Co-author Martin Cetron, MD, director of the Division of Global Migration and Quarantine at the Centers for Disease Control and Prevention (CDC), explains that the data also will be used to enhance information available to travelers on the CDC's Travelers Health Web site, one of the most widely used resources on the CDC's Web site.
"In a world where global travel is increasingly more common and tens of millions of people from industrialized nations travel to the developing world each year for commerce, research, education, missionary and military purposes, it is more obvious than ever that travelers should seek pre-travel consultation at a specialized travel clinic before travel and especially after they travel, if they become ill," says Dr. Kozarsky.
GeoSentinel, co-founded by Dr. Freedman, Dr. Kozarsky, and Dr. Cetron, is a collaboration between the International Society for Travel Medicine and the CDC. It is a communications and data-collection network of 30 travel/tropical medicine clinics and 120 associated network members operating on six continents.
Building on the international response to the 2003 SARS outbreaks, GeoSentinel has identified new sites in Asia to prepare for avian influenza. The electronic communications infrastructure established through GeoSentinel recently helped identify imported traveler-related cases and outbreaks of SARS from multiple locations, leptospirosis from Borneo, Hantavirus from Chile, Hajj meningitis from Singapore and the first-ever dengue from Easter Island.