Kato Yasuyuki
Nihon Rinsho. 2016 Dec;74(12):2052-2056.
Recent increase of international travelers raises awareness of travel-related infections. Travelers' diarrhea is the most common and caused by diarrheagenic E. coli and other patho- gens. Undifferentiated fever challenges physicians to correctly diagnose and includes ma- laria, dengue, and enteric fever. The pre-test probability for a disease which causes undiffer- entiated fever largely depends on the travel destination. Malaria is most common in travelers returning from sub-Saharan Africa while dengue is most common those returning from Southeast Asia and Latin America. Screening for asymptomatic travelers is not generally rec- ommended, but for long-term travelers and immigrants. Following outbreaks of highly infectious diseases in the past decades, hospital prepared- ness for travel-related infections focuses on infection prevention and control. Emerging viral pneumonias such as Middle East respiratory syndrome (MERS) and avian influenza H7N9 are major concerns. As seen in the largest outbreak of Ebola virus disease in West Africa, imported viral hemorrhagic fever such as Lassa fever is another concern. Since multidrug resistant bacteria silently spread globally by infected travelers, it would be of help to install appropriate isolation precaution for travelers with history of hospital admission abroad.
国际旅行者数量最近的增加提高了对与旅行相关感染的认识。旅行者腹泻是最常见的,由致泻性大肠杆菌和其他病原体引起。不明原因发热给医生正确诊断带来挑战,包括疟疾、登革热和伤寒热。导致不明原因发热的疾病的预检概率很大程度上取决于旅行目的地。疟疾在从撒哈拉以南非洲返回的旅行者中最常见,而登革热在从东南亚和拉丁美洲返回的旅行者中最常见。一般不建议对无症状旅行者进行筛查,但长期旅行者和移民除外。在过去几十年发生高传染性疾病疫情后,医院对与旅行相关感染的准备工作侧重于感染预防和控制。中东呼吸综合征(MERS)和甲型H7N9禽流感等新型病毒性肺炎是主要关注点。如在西非最大规模的埃博拉病毒病疫情中所见,输入性病毒性出血热如拉沙热是另一个关注点。由于多重耐药菌通过受感染的旅行者在全球悄然传播,为有国外住院史的旅行者采取适当的隔离预防措施会有所帮助。