title: Management of Children with Travel-related Illness Evaluated in a Pediatric Emergency Room.
abstract: BACKGROUND
  Children travelling are potentially exposed to a wide spectrum of illness, which includes not only mild self-limiting disease but also severe illness requiring hospitalization. Risk factors for hospitalization need to be analyzed to inform prevention and treatment strategies for travel-related disease, to make travelling for children-from a medical perspective-more secure.
  
  
  METHODS
  We performed a cross-sectional analysis on children with travel-related disease presenting at the Emergency Room of University of Zurich Children's Hospital between July 2007 and December 2012. The profile of children being hospitalized was compared with that of children treated as outpatients.
  
  
  RESULTS
  Eight hundred and one children (57.4% male) were included in the study. Eighty-three children (10.4%) were treated as inpatients. Compared with outpatients, inpatients were significantly more likely to be male, to have travelled to Southern Asia, to have a diagnosis of Salmonella typhi or Salmonella paratyphi (3.6 % vs. 0.1%, P < 0.0001), pyogenic abscess (3.6% vs. 0.1 %, P < 0.0001) or malaria (1.4 % vs. 0.2%, P = 0.0384). Neurologic diagnoses (such as seizure disorder: 3.6% vs. 0.4%, P < 0.0001) were diagnosed more often among inpatients. Furthermore, inpatients presented more often with nonspecific findings such as dehydration (8.5% vs. 0.6%, P < 0.0001). No correlation with inpatient care was seen for visiting friends and relatives/immigrant travel.
  
  
  CONCLUSIONS
  Children acquire a wide spectrum of travel-related illness. A careful, detailed travel history is important in children presenting in the emergency room with symptoms suggesting infectious disease.
authors.affiliation: From the *WHO Collaborating Centre for Travellers' Heath, Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Switzerland; †Division of Infectious Diseases and Hospital Epidemiology, ‡Children's Research Centre, University Children's Hospital Zürich, Zürich, Switzerland; §Center for Global Health and Development, ¶Department of Global Health, Boston University School of Public Health, Boston, Massachusetts; ‖Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, Massachusetts; and **Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Deborah
authors.initials: D
authors.lastname: Leuthard
authors.forename: Christoph
authors.initials: C
authors.lastname: Berger
authors.forename: Georg
authors.initials: G
authors.lastname: Staubli
authors.forename: David
authors.initials: D
authors.lastname: Nadal
authors.forename: Sabine
authors.initials: S
authors.lastname: Schmid
authors.forename: David
authors.initials: D
authors.lastname: Hamer
authors.forename: Rainer
authors.initials: R
authors.lastname: Weber
authors.forename: Patricia
authors.initials: P
authors.lastname: Schlagenhauf
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013557:Switzerland / Q000453:epidemiology; D014195:Travel