International Medical Concerns

Aka: International Medical Concerns, Travel Related Morbidity and Mortality

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II. Precautions

  1. Visiting Friends and Relatives (VFR) account for up to 40% of trips from industrialized nations to tropical destinations

III. Causes: Travel Related Morbidity and Mortality

  1. See Vector Borne Disease
  2. Most common illnesses in non-migrant travelers returning to the U.S.
    1. Acute Diarrhea (17%)
      1. Exacerbation of Irritable Bowel Syndrome and Chronic Diarrhea is also common
    2. Viral syndromes including Influenza like illness
    3. Malaria (3%)
    4. Campylobacter jejuni (3%)
    5. Giardiasis (2%)
    6. Dengue Fever (2%)
  3. Most common serious medical conditions while traveling internationally
    1. Cardiovascular events (approaches 50% of adverse events)
    2. Injuries (25%, esp. MVA)
      1. Motor Vehicle Accidents are the highest risk for mortality in international travelers
    3. Infectious disease (1%)
  4. References
    1. Brown (2023) MMWR Surveill Summ 72(7):1-22 +PMID: 37368820 [PubMed]
    2. Rupert (2025) Am Fam Physician 111(3): 245-53 [PubMed]

IV. Causes: Latin America

  1. Malaria
  2. Zika Virus
  3. Intestinal Parasites
    1. Helminths
    2. Amebiasis
    3. Giardia
  4. Chagas Disease (South American Trypanosomiasis)
  5. Leishmaniasis
  6. Cysticercosis
  7. Schistosomiasis
  8. Onchocerciasis
  9. Lymphatic Filariasis
  10. Echinococcus

V. Causes: Africa

  1. Malaria
  2. Sickle Cell
  3. Intestinal Parasites
    1. Helminths
    2. Amebiasis
    3. Giardia lamblia
  4. Diarrheal illnesses
  5. Human Immunodeficiency Virus (HIV)
  6. Viral Hemorrhagic Fevers
  7. Borreliosis
  8. Leprosy
  9. Leishmaniasis
  10. Cysticercosis
  11. Schistosomiasis
  12. Onchocerciasis
  13. Filariasis
  14. Echinococcus

VI. Causes: Middle East

  1. Thalassemia
  2. G6PD Deficiency
  3. Schistosomiasis
  4. Parasites
    1. Hookworm
    2. Amoebae
    3. Hydatid cyst

VII. Causes: Asia

  1. Leprosy
  2. Intestinal Parasites
    1. Roundworm
    2. Hookworm
    3. Filaria
    4. Flukes
    5. Amoebae
    6. Giardia lamblia
  3. Human Immunodeficiency Virus (HIV)
  4. Malaria (in southeast Asia)

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