Young travellers need health advice

Most children and teens who travel overseas to visit friends and families risk getting deadly rabies and other preventable diseases because their parents don't seek medical advice for them before packing the luggage, a new study suggests.

Animal bites and malaria are the two most common diagnoses that are preventable, Dr. Stefan Hagmann, of the pediatric infectious diseases division at Bronx-Lebanon Hospital Center in New York, and his colleagues say in Monday's issue of the journal Pediatrics.

Of the 1,591 international pediatric patients aged 17 and under who visited medical clinics after returning home after travelling, 96 cases or six per cent were for animal bites. Fifty-two per cent were domestic dog bites, 20 per cent were cat bites and 19 per cent were monkey bites, the researchers found.

Animal bites are a real problem, says Dr. Jay Keystone, a staff physician in the Centre for Travel and Tropical Medicine at Toronto General Hospital, who contributed data for the study.

"Not only do parents have to talk to their children about animals, but they also have to encourage [children] to tell them if they've been bitten," Keystone said.

While babies can't speak, older children may conceal a nip or bite from their parents out of guilt that they gave in to the temptation to approach an animal even though they knew they shouldn't, he said.

Children are also more prone to suffer greater rates of illness and death from exposure to animals than adults, the study noted.

Those bitten by an animal need several doses of rabies vaccine, but needles may not be sterilized properly in developing countries and treatment might not be available, Keystone said.

There are three preventative doses of rabies vaccine that can be taken before leaving Canada, which cost $600.

Also, many of the children in the study who fell ill were travelling to visit friends and relatives. Previous research has suggested those who visit some countries for longer than a month are at higher risk of contracting malaria and typhoid fever.

"It is alarming that only approximately one-half of all children … in this study received pre-travel care," the study's authors wrote. "Access to competent preventive pretravel health care for children should be improved."

The study's authors advised travellers to get:

•  Routine travel vaccines, and preventive antimalarials. 
• Recommendations on skin care, sun and arthropod protection, as well as protective shoe wear.
•  Caregivers for children should be prepared to treat diarrhea and respiratory infections by packing antibiotics.

Since the database does not include all international travellers and the total number of travellers is not known, the researchers were unable to estimate incidence rates for different parts of the world.