Assessment in travelers coming from Latin America

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In recent years has been an important increase in international travel including Latin America.

Travelling involves a series of risk depending of the travel destination, the standards of accommodation as well as the lifestyle and host characteristic (healthy versus pre existing condition, pregnancy, infants). Most illnesses reported by ill travelers are mild but some are serious enough to seek medical attention.

A systematic approach to the assessment of the ill returned traveler with knowledge of the most common, region-specific pathogens and recent outbreaks of infection will aid diagnosis and treatment.

The detailed travel history is the cornerstone of the post travel screening process, including travel destination, the particular area within a country, urban or rural areas were visited, season (dry or rainfall), purpose of travel, hygiene standard (food and water exposures), duration of stay, accommodation, pre-travel vaccination, prophylaxis adherence and personal protection measures, illness of any travel companions, history of unprotected sexual contacts with new partners or casual sex, date of return in relation to onset of symptoms and type of symptoms. The physical examination may yield useful information.

According GeoSentinel surveillance, the most common syndromes in returned travelers from Latin America are chronic and acute diarrhea especially parasitic causes (Giardiasis), dermatological problems (larva migrans, myasis and leishmania), respiratory tract illness and fever (dengue and malaria).

Diarrhea remains the most frequent illness among travelers visiting Latin America. Dengue is a reemerging illness in the region as well and is the main cause of viral fever in returned travelers. Malaria should be considered if exposures and clinical findings are consistent with the diagnosis. Initial laboratory investigation should be performed depending upon exposure and other factors that prompt consideration of a particular disease.