Clinical reminder: travel history assessments

With the warmer months of summer and associated increases in tourism and events in Michigan approaching, the MDHHS wants to remind the healthcare community of the importance of including evaluations of travel history and coordination with local public health, in the assessment of patients. Historically, public health has provided essential coordination services that have been directed to address several potential disease introductions to Michigan including patient screening for Zika virus, response to identified cases of active tuberculosis, monitoring of returning travelers from Ebola outbreak countries, supporting assessment of possible Middle East Respiratory Syndrome patients, and more recently, evaluation and response around travelers from areas experiencing measles outbreaks.

Of significant interest currently is the dramatic increase in measles cases not only locally but worldwide. Clinicians need to consider measles in their differential diagnosis when caring for individuals who have either recently traveled abroad or have traveled to Michigan from domestic areas experiencing measles outbreaks.

While international travel unites us as a global community it also comes with certain risks. Areas of the world continue to struggle with outbreaks of infectious diseases that are largely not present in Michigan. As part of our global society, Michigan often welcomes visitors, students and employees from across the world. Many of these travelers enter Michigan from areas that may still be experiencing endemic illness and outbreaks of illness from endemic, novel and antibiotic resistant infections. In order to contain new outbreaks of illness here, Michigan’s healthcare community plays a critical role.

Travel history is an essential part of patient assessment. All patient assessments should include an evaluation of international and domestic travel. If that history includes international travel or domestic travel from areas with current outbreaks, it should be included in an evaluation of possible cause. Further, when cases of infectious disease are identified in recent travelers, timely consultation with your local public health agency is important. Local public health can work to assess the risk of infection to other members of the community and provide rapid response to curtail spread of disease.

Please include an assessment of travel history in your patient evaluations and, when warranted, share your findings with your local public health department.

For your reference, current information describing outbreaks of national and international concern can be found at the CDC Current Outbreak List website  and the World Health Organization’s Emergencies Preparedness, Response webpage .

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