Society News

Ron H. Behrens, MD

Cooperation between the travel industry and travel health professionals in the UK.

Beginning in late October the service team admitting malaria patients to The Hospital for Tropical Diseases (HTD), noticed an unusual number of travelers who had recently traveled to The Gambia presenting with falciparum malaria This pattern was also reflected in the number of telephone enquiries from hospitals across the UK to our clinical staff requesting advice on the management of malaria. During the same period of 1999, a single case of malaria contracted in The Gambia was treated at HTD. A posting to TropNetEurop, a clinical surveillance network of 33 European members (www.tropnet.net), bought immediate reports of similar increases in cases of the disease from The Gambia. Members in Sweden, Denmark, Austria, Germany and Spain also reported an unusual number of malaria cases, many requiring treatment in intensive care units. Surveillance figures of the malaria reference laboratory confirmed an increase of 34% compared with the previous year (1999), which was double that reported in 1998. Four deaths had been notified.

Tourists planning to travel to The Gambia need to be alerted to the increased risk of malaria. A press release to the media led to some articles in the national newspapers. The largest independent tour operator to The Gambia, The Gambia Experience, approached the London School of Hygiene and Tropical Medicine (LSHTM) for support and advice. A meeting between representatives of three travel operators servicing The Gambia, ABTA (the Association of British Travel Agents), and malaria experts of the LSHTM was organized. The tour operators agreed to provide more detailed malaria advice to future clients in promotional material and to include malaria warnings and advice within accommodations in their Gambian resorts. The Gambia Experience has also supported the implementation of a case control study into the outbreak, by mailing questionnaires to its clients identified as controls.

This collaboration between travel medicine personnel and the tourist industry is providing a valuable opportunity for health professionals to target health advice to travelers. It has also enabled research into the risk factors that are leading to increased risks of malaria in package tourists to The Gambia which remains a popular destination for many European travelers.

Ron is a Senior Lecturer at the London School of Hygiene & Tropical Medicine, and a Consultant at the Hospital for Tropical Diseases.