More and more people are traveling around the world and between several countries, sometimes bringing diseases home with them, which poses a considerable challenge to the family doctor. He must not only be informed about the different entities in our latitudes, but also bring with him a broad knowledge of, for example, tropical ailments. This is particularly important in potentially lethal courses such as malaria, meningitis, or viral hemorrhagic fevers (most commonly dengue).
Prof. Dr. med. Peter Schmid-Grendelmeier of the University Hospital Zurich shows which dermatological clinical pictures the general practitioner should be familiar with and when a referral or an advisory board of a physician trained in tropical medicine is necessary. In a practice-relevant checklist, he addresses the wide variety of skin changes that can sometimes be triggered by the sun, animals, microbes (bacteria, fungi, viruses), toxins, and plants. Of course, epidemiologically above all the sun-related dermatoses (dermatitis solaris, polymorphous light dermatosis) are frequently encountered, but rarely does such a condition actually lead patients to the practice.
Similarly often associated with a travel vacation to the tropics is diarrhea, due in no small part to the fact that the useful advice “cook it, boil it, peel it or forget it” is quickly jettisoned on the part of tourists upon arrival in the sunny destination. Increased educational work by primary care physicians is certainly desirable and recommended here. In our article, we also address the four main pillars of sensible travel advice: Arthropod bites; Food, drink and diarrhea; Personal contact incl. Sex; accidents, animal bites and special risks. An up-to-date overview of immunizations for adult travel abroad is also provided. In addition, and this is increasingly a health issue, the number of people visiting friends and relatives in their former home countries (‘visiting friends and relatives” VFR) is increasing. In many studies, they are the travel group with the highest morbidity. This becomes a problem especially when such people also do not feel encouraged to go to travel counseling (after all, they think they know all the dangers in their former home country). This is also something that the treating family doctor in Switzerland must pay more attention to and ask directly in a normal consultation whether such trips are planned.
I wish you an interesting reading of the current issue of HAUSARZT PRAXIS and hope you can extract some relevant information for your concrete daily work.
Cornelia Staehelin, M.D.
HAUSARZT PRAXIS 2014; 9(6): 10
