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Survey highlights health risks of overseas travel
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    All large hospitals in the United Kingdom should have clinical staff specialising in infectious diseases to cope with the rise in overseas travel and the emergence of new diseases, says a new report.

    Researchers who carried out an audit at Addenbrooke's Hospital, Cambridge, of cases of imported infections also call for more education about the prevention of malaria.

    Malaria accounted for the largest number of cases in the survey—85 out of a total of 301—and the authors found that only 19 of these patients had received a full course of prophylaxis and that 34 did not receive any prophylaxis.

    "The lack of prophylactic measures against malaria is very worrying. This suggests inadequate availability of advice or lack of knowledge by general practitioners and physicians or a lack of advice seeking by the general public," say the authors of the study, which will be published in Travel Medicine and Infectious Disease and is available online to subscribers at www.elsevierhealth.com/journals/tmid

    "Over the past decade there have been 100 deaths from malaria in the UK, hence this is the most important area to target preventative efforts. This merits a Department of Health driven education effort to encourage more use and better use of prophylaxis."

    One of the authors of the report, Mark Roberts, a registrar in infectious diseases at Addenbrooke's, said, "Most people with malaria were UK nationals returning from foreign travel. A few cases occurred in overseas students following travel to their country of origin during the holidays.

    "The main group to target education efforts at are the UK nationals who have no preexisting immunity to malaria. Travel is so easy today and yet malaria is just as nasty as it has ever been."

    The authors analysed cases treated at the hospital over five years. Thirty three different disease classifications were represented among the 301 cases, including malaria, tuberculosis, hepatitis, typhoid, dengue fever, tapeworm, tick bites, and HIV.

    The authors say that the figures probably underestimate the actual number of cases of imported infection, because many cases will have been treated by GPs or non-specialist hospital physicians.

    The number of people travelling overseas from the United Kingdom is estimated to be increasing at a rate of around 8% a year. In 2002 more than 59 million visits abroad were made.(Roger Dobson)