Características clínicas y epidemiológicas de las enfermedades infecciosas importadas por viajeros españoles a los Trópicos

Résumé

Introduction: Spain could be a potential area in Europe for the development and spread of emerging diseases from the tropics due to its geoclimatic characteristics, but there is little information on infectious diseases imported by travellers. The aim of this study was to analyze clinical-epidemiological characteristics of infectious diseases imported by Spanish travellers from the tropics. Methods: A retrospective descriptive study of 2982 travellers seeking medical advise who return ill from the tropics was conducted. Demographic data, details of travel (destination, type and duration) preventive measures, clinical syndromes and diagnoses were analysed. Results: The three main syndromes in travellers to the Caribbean–Central America, Indian subcontinent–South-East Asia, and other areas were diarrhoea, fever, and cutaneous syndrome (p < 0.05); in sub-Saharan Africa were fever, cutaneous syndrome, and diarrhoea (p < 0.05); and in South America were cutaneous syndrome, diarrhoea, and fever (p <0.05). Fever and cutaneous syndrome was more frequent in high risk tourism, eosinophilia in low risk professional travellers. Fever, cutaneous syndrome and diarrhoea were more frequent in short term travellers. Low risk tourists show higher risk of larva cutanea migrans, other ectoparasites, rickettsioses, schistosomiasis, respiratory infections, viral acute hepatitis and enteric fever. Traveller ´s diarrhoea, cutaneous larva migrans, rickettsiosis and bacterial respiratory infections were more frequent in short term travelers and filariases in long term travellers (p<0.05). Travellers to sub-Saharan Africa showed a higher frequency of malaria, rickettsiosis, filariases, and schistosomiasis (p < 0.05); those to South America showed cutaneous larva migrants, other ectoparasitoses, and cutaneous/mucocutaneous leishmaniasis; and those to the Indian subcontinent–Southeast Asia showed intestinal parasitoses, arboviriasis, and enteric fever (p <0.05). Conclusions: Increased international travel is a key factor for the development and spread of emerging pathogens. Information on these diseases is essential to establish early warning mechanisms and action plans. Spain represents a unique setting for this.