Vol 27 No 2 December - The Indian Society for Parasitology
Vol 27 No 2 December - The Indian Society for Parasitology
Vol 27 No 2 December - The Indian Society for Parasitology
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JPD : <strong>Vol</strong>. <strong>27</strong> (2), 2003<br />
Parasitic infections in travelers<br />
77<br />
of morbidity and mortality among visiting and documented that of 1000 travelers to developing<br />
returning travelers around the wortd. History is countries, 15% traveled <strong>for</strong> business, 12% <strong>for</strong> teaching<br />
witness to the numerous outbreaks of parasitic or study and 3% <strong>for</strong> missionary activity. <strong>The</strong> most<br />
diseases like malaria and sleeping sickness among popular countries visited were Kenya (<strong>27</strong>%), India<br />
laborers and soldiers. Ancient caravanners recognized (19%), Nepal (13%), Thailand (10%), Hong Kong,<br />
the signs of sleeping sickness that had often been Tanzania or Peru (9%) and the people's republic of<br />
observed in travels to southern kingdoms of Africa. In China (7%). <strong>The</strong> median duration of travel was 21 days<br />
the summer of 1828 "swamp fever" (or malaria) broke while 5% had longer than 1-year travel period (Hill,<br />
out along the construction route of the Rideau Canal in 1988).<br />
Canada. <strong>The</strong> "malaria", according to most experts was<br />
In a study of 171 cases at the tropical disease unit in<br />
not native to <strong>No</strong>rth America but had been introduced<br />
Spain it was found that the commonest diagnoses were<br />
by infected British soldiers who had returned from<br />
malaria (34 cases), amoebiasis (8 cases), giardiasis (6<br />
India. During the American Civil War (1861-65), one<br />
cases), and cutaneous larva migrans (5 cases). <strong>The</strong><br />
half of the white troops and 80% of the black soldiers<br />
origin areas were Africa (84 cases), Central America<br />
of the Union Army got malaria annually. <strong>The</strong>re<strong>for</strong>e, it<br />
(49 cases), South America (23 cases) and Asia (15<br />
is clear from the lessons of history that the hazards of<br />
cases). Among the patients, 72 were tourists and 49<br />
traveling have taken its toll from early times. Newer<br />
were immigrants (Zubero Sulibarria et al, 2000).<strong>The</strong><br />
innovations in mass transport system, changes in<br />
steady growth of intercontinental travel has caused an<br />
humanity's way of life have altered the dynamics of<br />
increasing incidence of tropical diseases in many parts<br />
man's interaction with the environment leading to an<br />
of Europe, including continental Europe. Malaria and<br />
enhanced exposure of various diseases, including<br />
amebiasis deserve special attention, due to their<br />
parasitic diseases (Desowitz, 1996).<br />
frequency and potential fatality (Hassig, 1999).<br />
Travelers visiting tropical countries: facts and<br />
Travelers' diarrhea is the most frequent health problem<br />
figures<br />
encountered by travelers in the tropics (Nettleman,<br />
In recent years, international travel has increased 1996). Twenty to 50% of the 35 million people who<br />
enormously. With greater movement of people, there travel from industrialized countries each year are<br />
has been an increased encounter with a wide variety of affected by traveler's diarrhea (Lima, 2001). Travelers<br />
parasitic diseases. <strong>The</strong> jet age travel, globalization of experience a high rate of diarrhea caused by a wide<br />
food and agricultural market, and the incubation variety of enteric pathogens acquired by ingestton of<br />
period being longer than the travel period, the diseases contaminated food or water. A single or a combination<br />
may not be identified as travel-related ones. <strong>The</strong>re is a of palhogen(s) can be found in the stool of a majority<br />
greater need of in<strong>for</strong>mation <strong>for</strong> travel related medical of ill individuals. Important risk factors regarding<br />
care to meet the challenges of travel-associated tropical diarrhea in travelers include the point of origin<br />
sickness. Worldwide statistics on travelers indicate and destination of the traveler, host factors, and<br />
that 1.4 million people cross international borders exposure to contaminated food and water. <strong>The</strong> most<br />
everyday (Freedman, 1999). Each year 12 million-35 common parasitic causes of traveler's diarrhea in<br />
million persons travel from an industrialized country adults in developing countries include infection with<br />
to a developing country in the tropics or subtropics Entamoeba histolytica, Giardia lamblia,<br />
(Black, 1990; Lima, 2001). In a study of almost 8000 Cryptosporidium parvum and Cyclospora<br />
travelers to developing countries, Steffen and cayetanensis (Black, 1990; Lima, 2001). Although<br />
colleagues have reported that 15% of them had health intestinal protozoa account <strong>for</strong> a minority of cases of<br />
problems, 8% consulted a doctor and 3% were unable acute traveler's diarrhea, but they are the common<br />
to work <strong>for</strong> an average of 15 days. (Steffen, 1987) <strong>The</strong>y pathogens in travelers who experience protracted<br />
also reported that the problems were more common in diarrhea during or after travel (Okhuysen' 2001). It<br />
younger individuals, those who had significant was observed that diarrhea is not only the most<br />
contact with people especially in rural areas and those common health hazard during travel in the tropics but<br />
who had a prolonged stay. In another study, it has been also the most frequent condition which prompts