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Malaria is a common cause of death among returning travellers

This is based on the findings of 100,000 sick travellers evaluated in 25 European specialist clinics between 1998 and 2018.


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Arboviruses like chikungunya and dengue is becoming more frequent among travellers who fall ill during or after their journey. Although the number of deaths due to travellers’ disease is limited, overseas travellers succumb most commonly to malaria, as shown in a study by EuroTravNet published in The Lancet Regional Health – Europe. EuroTravNet, which is part of the worldwide GeoSentinel Infectious Diseases Sentinel Surveillance Network, collected the findings of 100,000 sick travellers that were evaluated in specialised European clinics between 1998 and 2018.  EuroTravNet is an international network of 25 European travel clinics, many linked to university hospitals. The travel clinic of the Institute of Tropical Medicine (ITM) in Antwerp is one of the most important centres in this network.

Except for last year, people are travelling more frequently and farther away. Accordingly, the number of returning travellers with medical complaints within the European network is steadily rising.. Especially the so-called arboviruses, where infections like dengue, chikungunya and Zika are transmitted by mosquitoes, have increased among returning travellers in recent years. Between 1998 and 2002, infections caused by arboviruses accounted for only 1.7% of those travellers with complaints. That number rose to 6.2% between 2012 and 2018. Due to the global increase of mosquitoes spreading these diseases, dengue, chikungunya and the Zika virus are becoming more common. In addition, the possibility of testing for these infections has also improved.

Acute and chronic diarrhoea are the most common reasons for seeing a doctor after the return trip. The risk of dying from a travel-related infectious disease is generally limited if there is prompt diagnosis and treatment – the study counted 44 cases of death out of a total of 100,000 cases over a period of 20 years. Malaria remains the most common cause of death, as well as the most common parasitic disease among travellers. Malaria  is entirely preventable if one takes preventive malaria pills, and if diagnosed in time, it is completely curable. Thanks to greater awareness of rabies, travellers are increasingly seeking treatment after being bitten by an animal during their trip. Travellers were bitten mainly by dogs, monkeys, cats and bats, mainly in Asia and North Africa.

”It is the first time that such an extensive dataset on imported diseases in European travellers has been published. This unique study is extremely valuable because it provides insight into the changing epidemiology of infectious diseases worldwide. It allows us to give better and more tailored travel advice to departing travellers; better assist physicians in preventing, diagnosing and treating patients; and provide better information to public health authorities about the epidemiology trends of imported infectious diseases”, says Prof Emmanuel Bottieau of ITM.

EuroTravNet is part of GeoSentinel, an international network of 68 travel clinics. Within this network, ITM has built strong bonds with these travel clinics worldwide. The travel clinics share recommendations and experiences with each other. Thanks to this network, doctors from the ITM travel clinic can also refer travellers who become unwell during their trip, to reliable hospitals abroad. It increases the service that ITM can offer to travellers.

The travel clinic is the best-known activity of ITM among the Belgian public. Every year, ITM doctors give travel advice to over 21,000 travellers and administer around 48,000 vaccinations. About 5800 travellers come back from their overseas trip with medical complaints and consult with ITM. It is ITM’s ambition to offer first-class medical care to its patients in Belgium in the field of tropical infectious diseases through its medical services.

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