Infectious Disease Acquisition in Pediatric International Travelers: A ۱۰-Year Review at a Canadian Tertiary Care Hospital

Introduction: Children are frequent international travelers and may acquire serious infectious diseases during travel. We undertook a retrospective ۱۰-year review examining children admitted to hospital with infectious diseases associated with international travel at a Canadian tertiary care pediatric hospital. Methods: Retrospective chart review was performed on select travel-related infectious diseases in children ranging in age from birth to <۱۸ years who were admitted at the Hospital for Sick Children in Toronto between January ۱st, ۲۰۰۹ and December ۳۱st, ۲۰۱۸. Cases were identified using ICD-۱۰ discharge codes. Patient demographics, travel history, epidemiological data, disease, and prophylaxis history were documented. Results: A total of ۱۵۴ children were hospitalized with a travel-related infection over a ۱۰-year period. The most common diagnoses were typhoid or paratyphoid fever (n = ۵۸, ۳۸%), malaria (n = ۵۷, ۳۷%), and hepatitis A (n = ۱۴, ۸%). The median age of those infected was ۸ years (IQR ۳-۱۲). There were ۱۲۰ (۷۸%) children who were Canadian born, ۳۱ (۲۰%) immigrants and ۳ (۲%) who were visiting Canada. Of those who lived in Canada, ۱۱۲ (۹۰%) travelled for the purpose of visiting friends and relatives (VFR), ۶ (۵%) for tourism and ۲ (۲%) for humanitarian work. India was typically known for the acquisition of infection for typhoid or paratyphoid fever, and Nigeria for malaria. Hepatitis A was most commonly acquired in Pakistan. Conclusion: Imported infectious diseases continue to be a significant issue in travelers returning from trips suggesting improved preventative pre-travel care. VFR children are a group that should, in particular, be targeted for appropriate pre-travel advice and care.

Keywords:

Child , Travel , Communicable diseases , Travel-Related Illness , Canada