Vol 27 No 2 December - The Indian Society for Parasitology

Journal of Parasitic Diseases
Vol. 27 (2) Dec. 2003, pp. 76-84
Parasitic infections in travelers visiting
tropical countries
Review
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SUBHASH CHANDRA PARIJA*, SURESH CHANDRA PRADHAN , SANJAY BHATTACHARYA
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Departments of Microbiology & Pharmacology , Jawaharlal Institute of Postgraduate Medical Education
and Research, Pondicherry-605 006, India
International travel for tourism, military operations, exploration and adventure is on the increase. About
20% of the world population harbors parasites and the resulting morbidity and mortality from such diseases
are most prevalent in tropical and subtropical countries, which are visited every year by millions from the
developed nations. A non-immune traveler from a non-endemic region is thus exposed to a multitude of
infections including parasitic diseases, from enhanced contact in a changed ecological milieu. The travel
related major parasitic infections in the Indian subcontinent could be classified as food and water borne
(amoebiasis, giardiasis, intestinal coccidiosis), vector borne (malaria, filariasis, visceral leishmaniasis), and
soil transmitted (geohelminthic infections like ascariasis, hookworm infestation, trichuriasis,
strongyloidiasis). Lack of hygiene and sanitation in large parts of the tropical world, increased vector
density and man-vector interaction in exotic environmental niches, and lack of adequate personal protective
measures from ignorance or complacency have contributed to increased cases of parasitic infection among
travelers, visiting the tropical countries. The resistance of parasites and vectors to chemotherapy and
insecticides respectively has compounded the problem. As effective vaccines have not yet been developed in
parasitic diseases, personal protective measures in the form of health education, pre-travel counseling, and
chemotherapy remains the only effective approach to prevent and treat parasitic infections among travelers.
Prophylaxis, diagnosis, and therapy of these infections represent an opportunity and challenge to the health
care professionals in developed nations.
Key Words : Parasitic diseases, tropical countries, travel medicine, chemotherapy
to jet planes and underwater tunnels has
revolutionized the way we move between countries
and continents. However, the globalization of man has
had its own side effects. One of them is the plethora of
infections to which a non-immune traveler from a non-
endemic zone is exposed while visiting an endemic
one. Tourists, seamen, business entrepreneurs,
military personnel, the adventurer, and the explorer
from developed nations visiting the tropics are
subjected to a wide variety of infectious agents during
the course of their travel. The disease that they acquire
is either manifested during their travel, or remains
asymptomatic initially, and get overt later on after the
incubation period is over. In both instances however,
the visiting traveler or the returning travelers' health is
at stake.
Parasitic infections are one of the commonest causes
INTRODUCTION
"For with long travel I am stiff and weary."
-William Shakespeare
eople travel to many different places, for many
Pdifferent reasons, with many different interests, in
many different ways. Man's movement from place to
place either as a struggle for existence or as a source of
psychological sustenance has paralleled his evolution
from a primitive creature to a modern human. Today
man travels for many reasons. A search for the
unknown, a destination for leisure, a tour for business,
and a voyage for a war, are some reasons, which make
man move from one place to another. The evolution of
the transport systems from sailing ships and caravans
* Corresponding Author