Is an adequate travel history being documented in adult patients presenting with fever to the Emergency Department at Mater Dei Hospital?

Abstract

Background: Travelling has increased exponentially, especially to destinations with tropical and sub-tropical climates. The importance of obtaining a travel history was first coined by Maegraith in his publication entitled 'Unde Venis'. Emergency Physicians often fail to inquire for a travel history for a multitude of reasons. Such absence can have serious implications on both the clinical and the public health aspect.

Method: A retrospective analysis of patients' holder of Identification number ending with 'F' who have returned from abroad (21 days) and presented to the Emergency Department with a fever between the period of December 2017 and June 2018, were included. The emergency clerking sheet from the Emergency Department reception (for patients who were discharged) or the medical file from medical records (for patients who were admitted), were analysed for the presence or absence of an adequate travel history against the travel history proforma created.

Results: A total of 234 case notes were analysed. 1.3% were asked about the diurnal variation of fever and 85.9% inquired about the duration of fever in days. With regards to symptomatology, only 36% were inquired about respiratory symptoms and 48% about gastrointestinal ones. 0.4% were asked about the possibility of casual sex abroad and 1.7% about the risk of exposure to contaminated food and water.

Conclusion: Results obtained show that there is a significant lack of awareness. Researchers are therefore proposing the use of a ready-made proforma which should be used at all times for patients who present to the Emergency Department with fever and a recent history of travel.