Interim Guidance for Healthcare Professionals Evaluating Travelers Returning from Tsunami-Affected Areas
Travelers to tsunami-affected areas may return with a variety of physical problems, including fever, respiratory illness, dehydration, diarrhea or other gastrointestinal disturbance, rash, injuries, exacerbations of underlying chronic medical conditions, and/or mental health issues. Jet lag, exhaustion, and slight disorientation are commonly seen post-travel and must be distinguished from more severe emotional problems such as post traumatic stress syndrome. Most returning travelers who are ill will not have an exotic illness, but one which is typical of the many seen in returning travelers from the tropics.
Fever in anyone who has traveled to a malaria endemic area (all tsunami-affected regions except the Maldives) is a medical emergency, requiring an emergent malaria blood film. These should be performed immediately with results called to the physician. If the initial smear is negative, another should be performed if malaria remains a possibility. Persons who develop a fever up to one year following travel to an endemic area should be evaluated for malaria. Thailand has been considered a low risk area for acquiring malaria, except along the borders with Burma (Myanmar), Laos, and Cambodia. However, because conditions for malaria transmission are present (flooding, heavy rains, potential migration of malaria-infected persons into affected areas, and breakdown in mosquito control), malaria chemoprophylaxis is being recommended for travelers to tsunami affected regions of Thailand, and malaria should be considered in travelers returning from these regions who have fever.
All returning travelers who are ill, or who become ill, should be evaluated by a physician. As many physicians have not had experience in the management of returnees from developing areas, particularly where disasters have occurred, it is recommended that those initially seeing these patients strongly consider referring them to an infectious diseases or tropical medicine specialist.
A list of providers who specialize in clinical tropical medicine is available through the American Society of Tropical Medicine and Hygiene website. The International Society of Travel Medicine also has a directory of ISTM member travel clinics available at its website. Although many of these clinics only provide pre-travel services, a number do provide post-travel care, or they may be able to refer someone to an appropriate facility.
See also Interim Guidance for Health-Care Professionals Advising Travelers to Tsunami-Affected Areas.
- Page last updated January 14, 2005
- Content source: CDC Emergency Communication System (ECS), Division of Health Communication and Marketing (DHCM), National Center for Health Marketing (NCHM)
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