Screening patients for travel related infections is an important way to identify cases early and prevent the spread of infections in healthcare. This webpage provides several resources to help healthcare implement screening and infection prevention practices for travel related infections.
Topics
Importance of Travel History | Screening and Triage | Screening and Infection Control | Clinical Evaluation | Healthcare Readiness | Resources | Contact Us |
Importance of Travel History
A travel history is a key part of assessing sick patients, especially during entry to a healthcare facility.
Understanding a patient's travel history allows healthcare providers to identify individuals who may have encountered or been exposed to unique pathogens during their travels, including but not limited to:
Beyond these specific pathogens, a comprehensive travel history is instrumental in recognizing a spectrum of travel-related infections. These may encompass well-known diseases like Zika virus, Malaria, Dengue, as well as vaccine-preventable diseases like Measles.
Taking a travel history is an important part of:
- Providing rapid triage
- Prompt isolation of patients
- Initiating infection control measures to minimize disease spread
Screening and Triage
According to the CDC, as many as 43%–79% of travelers to low- and middle-income countries become ill with a travel-associated health problem. Although most of these illnesses are mild, some travelers become sick enough to seek care from a health care provider. Furthermore, potentially severe, transmissible infections (e.g., COVID-19, Ebola, MERS) require enhanced infection control measures and often, higher levels of care.
Assessment Questions
When evaluating patients for acute illness, you can ask:
- "Have you traveled internationally within the past month?"
MyPACT | Identify, Isolate, and Inform Approach Risk Assessment
Acute Symptoms
Symptoms indicating infection include:
- New respiratory symptoms
- Fever (≥100.4◦F or 38.0◦C)
- Rash
Response to "Yes" Answers
Patients who answer "yes" to recent travel and acute illness questions should be placed in a private room until evaluated by a health professional. Follow infection prevention precautions based on their symptoms and your facility's protocol.
For Patients that Report Recent Travel and Acute Symptoms
To ensure a comprehensive understanding of the situation, a more in-depth assessment is necessary, including the patient’s
- Travel itinerary
- Underlying illnesses
- Severity of illness
- Recent exposure to potential infections
By following this systematic approach to screening and triage, healthcare providers can gather crucial information, enabling them to make informed decisions and provide targeted care for patients.
Screening and Infection Control
These are examples of best practices for robust and informed screening, triage, and infection control for travel related infections.
- Perspectives: Screening Asymptomatic Returned Travelers
- Minnesota Department of Public Health HCID Screening Guide
- CDC Clinical Screening and Diagnosis for Viral Hemorrhagic Fevers (VHFs)
Clinical Evaluation
Effective clinical evaluation involves a thorough examination of patient symptoms, medical history, travel history, exposure history and diagnostic data, ensuring a comprehensive understanding that forms the foundation for informed decision making and personalized treatment plans.
Utilize resources such as the CDC’s Yellow Book and CDC Traveler’s Health below for more information.
- CDC Traveler's Health- Search by traveler destination, find travel health notices, recommended vaccines, and updates.
- CDC Yellow Book: Health Information for International Travel - Published every two years as a reference for health professionals providing care to international travelers and is a useful resource for anyone interested in staying healthy abroad.
- CDC General Approach to the Returned Traveler - Contains tables of common travel associated infections by incubation periods and elements of post-travel evaluation, general management, and common syndromes.
- CDC Fever in the Returned Traveler - Resource for evaluating a febrile returned traveler
Healthcare Readiness
During the 2014-16 Western Africa Ebola Virus Disease outbreak, the Centers for Disease Control and Prevention (CDC) created a tiered healthcare model to identify and manage patients with suspect and confirmed special pathogens.
In Washington, Providence Sacred Heart Medical Center in Spokane was designated by the US Department of Health & Human Services (HHS) as one of 1the Region 10 Emerging Special Pathogen Treatment Centers serving Washington, Idaho, Oregon, and Alaska.
Community Resources and Support
For a robust response to travel-related health concerns, collaboration and support from community resources are vital. Engage with local health jurisdictions, healthcare coalitions, and other community links to strengthen the collective response. These entities play a crucial role in information dissemination, coordination, and ensuring a cohesive approach to managing health issues related to travel.
Resources
Beyond the specific focus areas, additional resources contribute to a well-rounded understanding of travel-related health considerations. These resources serve as valuable additions to your toolkit for addressing a spectrum of travel-related health scenarios.
-
National Emerging Special Pathogens Training & Education Center (netec.org)
- CDC Current Outbreaks List
- CDC After Travel Tips – Advice if feeling sick after travel.
- Health Map - World outbreak tracker and map (Boston Children's Hospital)
- World Health Organization COVID-19 Travel Advice for the General Public
- APIC Emerging Infectious Diseases Task Force
- Association for Professionals in Infection Control and Epidemiology (APIC) Emerging Infectious Diseases Playbooks
Contact Us
For more information, please contact HAI@doh.wa.gov.