SCREENING THE RETURNED TRAVELER

Large numbers of people return to the UK each year (estimated at 2 mil lion in 1990) from tropical areas where they may have been exposed to a variety of tropical infections. Some will seek medical help because of specific symptoms, whilst others who are asymptomatic will request screening investigations to reveal latent infections which might give rise to symptoms later in life. A third group will ask for help with r etrospective diagnosis of illnesses suffered whilst abroad. People fro m all three groups may express concern about the risk of passing on in fections to close contacts or may be worried about their fitness to re turn to the tropics. The precise value of screening for tropical illne ss is hard to quantify, as the chance of finding an important treatabl e illness in any one individual will depend on the level of risk of in fection to which that individual has been exposed. In some groups of t ravellers such as refugees, screening is clearly worthwhile, whilst in others whose risk of serious infection is low, the benefit is likely to be small. Nevertheless a demand for screening after tropical travel exists, and it is important to be aware of how to investigate for asy mptomatic disease in returned travellers who request screening.