Tropical travel medicine

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Jason Toth is an emergency medicine and urgent‐care physician at Providence Saint Joseph Medical Center in Burbank, CA, USA. From time to time, Toth gives medication, vaccinations and advice to patients who intend to travel to exotic—and not‐so‐exotic—places around the world. Increasingly, however, he also finds himself treating patients who have contracted tropical diseases in the jungles of Africa, South America and Asia. “If you're a doctor in any large medical center ER department, such as Los Angeles or New York, especially those that are portside, in a given day you see people who speak a half dozen different languages from all parts of the globe,” he said. “They bring with them tropical and infectious diseases; dengue fever, malaria.” > …primary‐care physicians, not just infectious disease specialists, should sharpen their skills to identify tropical diseases… Toth' patients should actually consider themselves lucky that he is able to correctly diagnose and treat tropical diseases. Many others suffer unnecessarily, simply because their primary‐care physician has never seen a case of malaria or dengue and is unable to diagnose it. As Gerd‐Dieter Burchard, head of the clinical department and head of clinical research at the Bernhard Nocht Institute for tropical medicine in Hamburg, Germany, commented: “Although you would suspect that every physician in Germany now knows something about malaria, we still have patients who come too late to our hospital because the general physician has not thought of malaria as the reason for the fever as the patient has just come back from Africa. This still happens.” There is a growing awareness among health‐care professionals that, as people travel more frequently to remote places and as global commerce increases, more people will return home with infectious diseases that, so far, have only seriously plagued the developing world. European and American physicians, medical students and …