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Abstract Ref Number = APCP61
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Approach of Sick Children after Traveling from Endemic Countries
Pornthep Chanthavanich
Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University
Bangkok, Thailand
Every year, millions of children travel internationally with their families. Of 1186 million arrivals worldwide in 2015, approximately 10% were children. Therefore, they may be exposed to a large number of infectious agents, many of which are not endemic to their home countries. Although the vast majority experience uneventful travel, it is not uncommon for children to present with illness during or after travel. Most travel-associated illness is mild and self-limited; serious conditions regularly occur. Most post-travel infections become apparent soon after travel, but incubation periods vary, and some syndromes can present months to years after initial infection. However, most ill travelers will seek medical care within 1 month after traveling.
Approach of sick children after traveling from endemic countries
1. screen for serious illnesses or infections that can easily spread
2. initial management for serious illnesses
3. history taking and physical examination
4. consider underlying medical illness
5. detail travel history (itinerary, duration of travel, immunizations, activities, exposure, incubation period, current disease outbreaks, etc.)
6. laboratory investigations and differential diagnosis (travel-related and not travel-related)
7. diagnosis, treatment and /or referral
8. investigate the same illness among travelers on the same trip
Common presentations are gastrointestinal symptoms (mostly travelers’ diarrhea), dermatologic symptoms, fever, and respiratory symptoms. In the evaluation and treatment of a child presenting with illness, clinicians must entertain diagnostic possibilities of travel-related illness or illness acquired at home.
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