Diseases potentially acquired by travel to Southeast Asia
- David Murdoch, MD, MSc, DTM&H, FRACP, FRCPA, FFSc(RCPA)
David Murdoch, MD, MSc, DTM&H, FRACP, FRCPA, FFSc(RCPA)
- Clinical Microbiologist and Infectious Diseases Physician
- University of Otago, Christchurch
Southeast Asia encompasses the region from southern China through the Indochina peninsula and islands bordering the South China Sea to the island of New Guinea. The countries within this region are Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar (Burma), the Philippines, Singapore, Thailand, and Vietnam. The region straddles the equator between latitudes of 30ºN and 10ºS and comprises rain forests, savanna, tropical beaches, and volcanic islands.
The health risks vary considerably between regions within Southeast Asia. There are a few places (eg, Singapore) where the food and waterborne risks do not differ appreciably from Western Europe, North America, and Australia.
The largest contemporary experience in travel-related disease in developing countries comes from GeoSentinel, the global surveillance network of the International Society of Travel Medicine and the United States Centers for Disease Control and Prevention [1,2]. A 2013 report from 53 GeoSentinel sites provided clinical-based surveillance information on more than 42,000 ill travelers who returned unwell from a trip between 2007 and 2011 . Among over 6800 diagnoses made in travelers who returned from Southeast Asia, over 90 percent of diagnoses fell into one of three categories: gastrointestinal (30 percent), febrile illness (26 percent), and dermatologic (35 percent):
●Among patients with a systemic febrile illness, dengue, P. falciparum and P. vivax malaria, and chikungunya virus were the top specific diagnoses.
●Among patients with diarrhea, Campylobacter, Giardia, and Salmonella were the three most common organisms isolated.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Freedman DO, Weld LH, Kozarsky PE, et al. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 2006; 354:119.
- Wilson ME, Weld LH, Boggild A, et al. Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clin Infect Dis 2007; 44:1560.
- Moyes CL, Henry AJ, Golding N, et al. Defining the geographical range of the Plasmodium knowlesi reservoir. PLoS Negl Trop Dis 2014; 8:e2780.
- Singh B, Daneshvar C. Human infections and detection of Plasmodium knowlesi. Clin Microbiol Rev 2013; 26:165.
- National Environment Agency. http://www.dengue.gov.sg/ (Accessed on November 20, 2014).
- Strickman D, Tanskul P, Eamsila C, Kelly DJ. Prevalence of antibodies to rickettsiae in the human population of suburban Bangkok. Am J Trop Med Hyg 1994; 51:149.
- Jensenius M, Han PV, Schlagenhauf P, et al. Acute and potentially life-threatening tropical diseases in western travelers--a GeoSentinel multicenter study, 1996-2011. Am J Trop Med Hyg 2013; 88:397.
- Parola P, Vogelaers D, Roure C, et al. Murine typhus in travelers returning from Indonesia. Emerg Infect Dis 1998; 4:677.
- World Health Organization. International Travel and Health. Geneva, WHO 2005.
- Steffen R. Epidemiologic studies of travelers' diarrhea, severe gastrointestinal infections, and cholera. Rev Infect Dis 1986; 8 Suppl 2:S122.
- Taylor DN, Echeverria P. Etiology and epidemiology of travelers' diarrhea in Asia. Rev Infect Dis 1986; 8 Suppl 2:S136.
- Hoge CW, Gambel JM, Srijan A, et al. Trends in antibiotic resistance among diarrheal pathogens isolated in Thailand over 15 years. Clin Infect Dis 1998; 26:341.
- Corwin AL, Khiem HB, Clayson ET, et al. A waterborne outbreak of hepatitis E virus transmission in southwestern Vietnam. Am J Trop Med Hyg 1996; 54:559.
- Corwin A, Jarot K, Lubis I, et al. Two years' investigation of epidemic hepatitis E virus transmission in West Kalimantan (Borneo), Indonesia. Trans R Soc Trop Med Hyg 1995; 89:262.
- Poovorawan Y, Theamboonlers A, Chumdermpadetsuk S, Komolmit P. Prevalence of hepatitis E virus infection in Thailand. Ann Trop Med Parasitol 1996; 90:189.
- Chow WC, Ng HS, Lim GK, Oon CJ. Hepatitis E in Singapore--a seroprevalence study. Singapore Med J 1996; 37:579.
- Antony SJ. Leptospirosis - An Emerging Pathogen in Travel Medicine: A Review of its Clinical Manifestations and Management. J Travel Med 1996; 3:113.
- Centers for Disease Control and Prevention (CDC). Update: outbreak of acute febrile illness among athletes participating in Eco-Challenge-Sabah 2000--Borneo, Malaysia, 2000. MMWR Morb Mortal Wkly Rep 2001; 50:21.
- UNAIDS/WHO epidemiological fact sheets on HIV/AIDS and sexually transmitted diseases. Geneva: UNAIDS/WHO 2002. Available at: www.who.int/emc-hiv/fact_sheets/index.html (Accessed on March 08, 2005).
- Hepatitis C: global prevalence. Wkly Epidemiol Rec 1997; 72:341.
- Beigel JH, Farrar J, Han AM, et al. Avian influenza A (H5N1) infection in humans. N Engl J Med 2005; 353:1374.
- Emerg Infect Dis 2004; 10.
- Sauerwein RW, Lammers JW, Horrevorts AM. Ceftazidime monotherapy for pulmonary melioidosis in a traveler returning from Thailand. Chest 1992; 101:555.
- Duong TA. Infection due to Penicillium marneffei, an emerging pathogen: review of 155 reported cases. Clin Infect Dis 1996; 23:125.
- Mitmoonpitak C, Tepsumethanon V, Wilde H. Rabies in Thailand. Epidemiol Infect 1998; 120:165.
- Centers for Disease Control and Prevention (CDC). Notes from the field: acute muscular sarcocystosis among returning travelers - Tioman Island, Malaysia, 2011. MMWR Morb Mortal Wkly Rep 2012; 61:37.
- Esposito DH, Stich A, Epelboin L, et al. Acute muscular sarcocystosis: an international investigation among ill travelers returning from Tioman Island, Malaysia, 2011-2012. Clin Infect Dis 2014; 59:1401.
- Uppal PK. Emergence of Nipah virus in Malaysia. Ann N Y Acad Sci 2000; 916:354.
- Luby SP. The pandemic potential of Nipah virus. Antiviral Res 2013; 100:38.
- Fenner PJ. Dangers in the ocean: the traveler and marine envenomation. I. jellyfish. J Travel Med 1998; 5:135.
- Fenner PJ. Dangers in the ocean: the traveler and marine envenomation. II. Marine vertebrates. J Travel Med 1998; 5:213.
- SURVEILLANCE DATA
- ARTHROPOD-BORNE DISEASES
- Dengue fever
- Japanese encephalitis
- Chikungunya fever
- Yellow fever
- FOODBORNE AND WATERBORNE DISEASES
- Travelers' diarrhea
- Hepatitis A and hepatitis E
- Schistosomiasis and other fluke infections
- OTHER INFECTIONS
- HIV infection
- Other sexually transmitted diseases
- Hepatitis B and hepatitis C
- Respiratory virus infections
- Penicillium marneffei infection
- Nipah virus infection
- OTHER HAZARDS
- Motor vehicle accidents
- Snake bites
- Marine hazards
- High-altitude disease
- INFORMATION FOR PATIENTS