Kids differ from adults in travel-related ills

Children who travel the globe are susceptible to a number of infections and injuries, but they appear less likely than adults to have a pre-travel doctor visit, a new study finds.

In a study of more than 34,000 international travelers who sought medical care for travel-related ills, researchers found that children most often suffered bouts of diarrhea, skin injuries—most commonly animal bites or parasite-induced rashes—fevers and respiratory infections.

A number of those problems were more common among children compared with adult travelers, and children were also more likely than adults to be hospitalized for their conditions.

Children were less likely than adults, however, to have gotten any medical advice before their trip, the study found. While 59 percent of adults had gotten pre-travel medical care, only 49 percent of children had.

The findings, reported in the journal Pediatrics, underscore the importance of taking kids to the doctor before any international excursions, the researchers say.

Parents should discuss their travel plans with their child’s pediatrician about four to six weeks in advance, said lead researcher Dr. Stefan Hagmann, of the Bronx-Lebanon Hospital Center in New York. That will leave enough time for any necessary vaccinations, he told Reuters Health.

Besides vaccines, children may need medications, such as drugs used to prevent malaria. Parents can also get advice on how to self-treat common problems like diarrhea and respiratory infections—and how to recognize when a child’s symptoms are serious enough to warrant medical care, Hagmann said.

Travel to tropical regions presents the greatest risks, but problems like diarrhea and respiratory infections can happen anywhere, Hagmann pointed out. So it’s best for parents to talk with their pediatricians regardless of their travel destination, he said.

The findings are based on patients who visited one of a network of travel-medicine clinics in 19 countries between 1997 and 2007. The clinics were all part of a surveillance network designed to track travel-related ills and injuries.

Overall, there were 1,591 children and teenagers and 32,668 adults among the patients. The majority sought treatment after trips to Asia, Sub-Saharan African or Latin America.

Of the children, 28 percent were treated for a diarrheal illness, while one-quarter were treated for skin conditions—most often bites from dogs or other animals, insect bites and a skin rash called cutaneous larva migrans (CLM), which is caused by hookworm larvae that get under the outer layers of the skin.

Another 23 percent of children contracted fever-inducing infections, most commonly malaria. Respiratory tract illnesses, including colds and middle-ear infections, were seen in 11 percent.

A number of illnesses and injuries were more common in children than adults. Children were at greater risk of animal bites, CLM, respiratory infections and certain causes of diarrhea—like bacterial infection and acute gastroenteritis, a stomach infection often caused by food poisoning.

Children were also more likely to end up in the hospital—14 percent, versus 10 percent of adults. The reasons are not clear, Hagmann said, but it may partly reflect children’s greater risk of severe dehydration from diarrhea.

Parents can take some measures to reduce their children’s travel-related risks.

To help prevent animal bites, for instance, parents should be sure to tell their children to stay away from strange animals. Hagmann pointed out that while most cases of rabies in the U.S. are found in wild animals, in some other countries the infection is common in domestic animals. Some travelers may be advised to get rabies vaccination, depending on their destination.

Making sure children eat only well-cooked foods and avoid tap water can lower the odds of diarrheal illnesses, according to Hagmann. He added, however, that travelers’ diarrhea can be difficult to prevent, and the best thing parents can do is to talk with their doctors about how to manage the problem.

SOURCE: Pediatrics, May 2010.

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