A case series of infectious complications in medical tourists requiring hospital admission or outpatient home parenteral therapy

Author:

Robinson Paul D1,Vaughan Stephen12,Missaghi Bayan1,Meatherall Bonnie1,Pattullo Andrew1,Kuhn Susan3,Conly John13425

Affiliation:

1. Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada

2. Synder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada

3. Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada

4. Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada

5. O’Brien Institute for Public Health, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada

Abstract

BACKGROUND: Travelling for medical care is increasing, and this medical tourism (MT) may have complications, notably infectious diseases (ID). We sought to identify MT-related infections (MTRIs) in a large Canadian health region and estimate resulting costs. METHODS: Retrospective and prospective capture of post-MT cases requiring hospital admission or outpatient parenteral antimicrobial therapy was completed by canvassing ID physicians practicing in Calgary, Alberta, from January 2017 to July 2019. Cost estimates for management were made with the Canadian Institute for Health Information’s (CIHI’s) patient cost estimator database tool applied to estimated rates of Canadians engaging in MT from a 2017 Fraser Institute report. RESULTS: We identified 12 cases of MT-related infectious syndromes. Eight had microbial aetiologies identified. MTs were young (mean = 40.3 y, SD = 12.2) and female ( n = 11) and pursued surgical treatment ( n = 11). Destination countries and surgical procedures varied but were largely cosmetic ( n = 5) and orthopaedic ( n = 3). Duration to organism identification (mean = 5.3 wk) and treatment courses (mean = 19 wk) appeared lengthy. CIHI cost estimates for management of relevant infectious complications of our cases ranged from $6,288 to $20,741, with total cost for cases with matching codes ( n = 8) totalling $94,290. CONCLUSIONS: In our series of MTRIs, etiologic organisms often found in Canadian-performed post-procedural infections were identified, and prolonged treatment durations were noted. Young women pursuing cosmetic surgery may be a population to target with public health measures to reduce the incidence of MTRIs and burden of disease.

Publisher

University of Toronto Press Inc. (UTPress)

Subject

Infectious Diseases,Microbiology (medical)

Reference51 articles.

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