Additional Important Aspects
The recent report on “viruses acquired abroad” (1) is very interesting. Schmidt-Chanasit et al. noted that “[t]he primary care physician should take a thorough history so that specifically targeted laboratory tests can be ordered as soon as possible (1).” Indeed, disease imported from distant endemic areas has become a major issue in traveler medicine. Many new emerging diseases in Europe and USA have been brought in by travelers, and the problem demands our attention. There are, however, some additional important considerations. First, it should be noted that multiple diseases are often endemic to the same area; thus, patients may be co-infected with two or more diseases, a possibility that is easily overlooked unless explicitly considered. Second, accurate and precise diagnostic testing is essential. The continuing underdiagnosis of some infections such as chikungunya virus infection (2) implies that clinical practice guidelines must be improved to keep up with the emergence of new diseases brought in by travelers in the present era of globalization.
Somsri Wiwanitkit, Prof. Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok, Thailand
|1.||Schmidt-Chanasit J, Schmiedel S, Fleischer B, Burchard GD: Viruses acquired abroad—what does the primary care physician need to know? Dtsch Arztebl Int 2012; 109(41): 681−92 VOLLTEXT|
|2.||Reusken CB, Bakker J, Reimerink JH, Zelena H, Koopmans MG: Underdiagnosis of chikungunya virus infections in symptomatic dutch travelers returning from the Indian ocean area. J Travel Med 2013; 20: 44–6 CrossRef MEDLINE|