BACKGROUND: Between 1995 and 1997, stool samples of 322 Austrian tourists returning from abroad with diarrhea were examined for bacteria, parasites and viruses. METHODS: Epidemiologic data were collected from information furnished by physicians and hospitals and from questionnaires. Moreover, testing expenses and additional cost for treated cases were evaluated. RESULTS: In 97 of 322 patients examined (30%), one or more pathogens were detected in the stool. Bacteria were found in 38 patients (39%), parasites in 33 patients (34%) and viruses in 26 patients (27%). In 6 patients, mixed infections with parasites and viruses were detected and in 5 patients with bacteria and viruses. Among bacteria, Campylobacter jejuni was most frequent; among parasitic infections, Giardia lamblia. Significant correlations were established between the country of destination, age, travel style and length of stay. Forty-four percent of all patients visited Asia (including Turkey), 27% Africa, 18% Latin America, and only 10% southern Europe. The group between 20 and 29 years of age was most frequently affected (p<.001), the group between 0 and 19 years of age least. Fifty-seven percent stayed in a hotel without frequent changes of location; 43% undertook a trekking trip; and of those, 75% belonged to the group aged between 20 and 39. In terms of the correlation between travel style and pathogen, it was found that 74% of patients with bacterial infections stayed in a hotel (avg. 57.9%; p<.05) whereas 64% of all patients with parasitic infections undertook a trekking trip (avg. 42%; p<.001). Thirty-six percent of all patients with parasitic infections spent their vacation in India (avg. 13%; p<.001). The length of stay of patients with bacterial infections was shorter than average (72% spent between 1 and 2 weeks abroad, avg. 49.8%). Patients with parasitic infections spent significantly more time abroad than average (42% more than 2 months; avg. 17.7%; p<.001). Average cost of specific antimicrobial therapy was U.S.$31 whereas the average cost of identifying a patient needing such treatment was almost U.S.$580. CONCLUSION: Optimal detection rate and cost reduction for the diagnosis require precise history, adequate collection of samples using adequate transport media, and rapid transfer to the laboratory.
BACKGROUND: Between 1995 and 1997, stool samples of 322 Austrian tourists returning from abroad with diarrhea were examined for bacteria, parasites and viruses. METHODS: Epidemiologic data were collected from information furnished by physicians and hospitals and from questionnaires. Moreover, testing expenses and additional cost for treated cases were evaluated. RESULTS: In 97 of 322 patients examined (30%), one or more pathogens were detected in the stool. Bacteria were found in 38 patients (39%), parasites in 33 patients (34%) and viruses in 26 patients (27%). In 6 patients, mixed infections with parasites and viruses were detected and in 5 patients with bacteria and viruses. Among bacteria, Campylobacter jejuni was most frequent; among parasitic infections, Giardia lamblia. Significant correlations were established between the country of destination, age, travel style and length of stay. Forty-four percent of all patients visited Asia (including Turkey), 27% Africa, 18% Latin America, and only 10% southern Europe. The group between 20 and 29 years of age was most frequently affected (p<.001), the group between 0 and 19 years of age least. Fifty-seven percent stayed in a hotel without frequent changes of location; 43% undertook a trekking trip; and of those, 75% belonged to the group aged between 20 and 39. In terms of the correlation between travel style and pathogen, it was found that 74% of patients with bacterial infections stayed in a hotel (avg. 57.9%; p<.05) whereas 64% of all patients with parasitic infections undertook a trekking trip (avg. 42%; p<.001). Thirty-six percent of all patients with parasitic infections spent their vacation in India (avg. 13%; p<.001). The length of stay of patients with bacterial infections was shorter than average (72% spent between 1 and 2 weeks abroad, avg. 49.8%). Patients with parasitic infections spent significantly more time abroad than average (42% more than 2 months; avg. 17.7%; p<.001). Average cost of specific antimicrobial therapy was U.S.$31 whereas the average cost of identifying a patient needing such treatment was almost U.S.$580. CONCLUSION: Optimal detection rate and cost reduction for the diagnosis require precise history, adequate collection of samples using adequate transport media, and rapid transfer to the laboratory.
Authors: Thomas R Gillespie; David Morgan; J Charlie Deutsch; Mark S Kuhlenschmidt; Johanna S Salzer; Kenneth Cameron; Trish Reed; Crickette Sanz Journal: Ecohealth Date: 2010-03-18 Impact factor: 3.184