Travel health preparation and travel-related morbidity of splenectomised individuals

• Published in: Travel medicine and infectious disease Vol. 10; no. 4; pp. 197 - 200
• Main Authors: Boeddha, Christien, de Graaf, Wilmar, Overbosch, David, van Genderen, Perry J.J
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.07.2012; Elsevier Limited
• Subjects: Adult; Aged; Ailments; Americans abroad; Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis; Antibiotics; Case-Control Studies; Encapsulated bacteria; Female; Guidelines as Topic; Health care; Health risks; Humans; Immunization; Immunocompromised Host; Infection; Infectious Disease; Malaria; Malaria - prevention & control; Malaria Vaccines - administration & dosage; Male; Middle Aged; Morbidity; Patient Acceptance of Health Care - statistics & numerical data; Prophylaxis; Prospective Studies; Splenectomy; Splenectomy - adverse effects; Surveys and Questionnaires; Travel; Travel - statistics & numerical data; Travel medicine; Travelling; Vaccination - statistics & numerical data; Vaccines; Vector-borne diseases; Netherlands; Splenectomy; Infection; Travelling; Ailments; Encapsulated bacteria
• ISSN: 1477-8939; 1873-0442
• DOI: 10.1016/j.tmaid.2012.06.005

Summary Asplenic or hyposplenic patients are at an increased risk of encapsulated bacterial and intraerythrocytic parasitic infections, which are endemic at many travel destinations. With proper travel health advice and preparation splenectomised individuals could have comparable travel-related morbidity as healthy control subjects. We conducted a prospective case–control study with 21 travel pairs. Each pair consisted of a splenectomised patient (case) and a healthy, non-splenectomised travel companion (control) in order to match for travel destination, duration and potential exposures to travel-related health risks. All participants filled out a questionnaire detailing travel health preparation including vaccination and malaria prophylaxis as well as travel-related morbidity. Cases and controls were comparable for age and gender. Cases received significantly more information about on demand use of antibiotics in case of fever. Immunisation coverage against encapsulated bacteria and adherence to malaria prophylaxis guidelines was suboptimal. There were no significant differences in the occurrence of travel-related ailments nor differences in severity of ailments. The immunisation coverage against encapsulated bacteria and adherence to malaria prophylaxis guidelines was suboptimal in some splenectomised patients and should be improved. Strict adherence to national travel health advice guidelines and specific guidelines for asplenic patients is advisable. However, with regard to travel-related morbidity there are no significant differences in morbidity between splenectomised patients and healthy controls, at least in the setting of short-term travel.