Holiday-makers are at risk of picking up and bringing home superbugs, according to a study looking at the spread of antimicrobial resistance (AMR) worldwide.
Drug-resistant infections are already responsible for some 700,000 deaths globally each year, but it is estimated that this figure could rise to 10 million annually by 2050 if left unchecked.
The report, published by the Center for Disease Dynamics, Economics & Policy (CDDEP), found that tourists are contributing to the spread of AMR across international borders – with as many as 88 per cent of unwell tourists returning to the UK from India infected with drug resistant bacteria.
Although AMR has been found on every continent – including the most pristine places on earth – the prevalence of drug resistant bacteria varies dramatically.
Tourists who visit areas with high levels of AMR, such as South and Southeast Asia and the Middle East, are likely to be exposed to highly resistant strains of bacteria and can then take the infection home.
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Self-medicating travellers using over-the-counter antibiotics to treat infections whilst on holiday can also inadvertently accelerate the process of drug-resistance.
The report said that tourists must be better educated about the risks of spreading AMR before they travel – for instance being aware of alternative treatments for diarrhea or taking preventative measures.
“Doctors and governments have a role to play in ensuring travelers are informed of the health risks associated with international travel, through public information campaigns, social media, posters, web-pages, and pre-travel consultations,” said Dr Isabel Frost, a fellow at CDDEP.
“Travellers can lower their risk by ensuring vaccines are up to date, taking care to eat cooked food that has been hygienically prepared, washing hands before eating and after toilet use, drinking clean water, and practicing safe sex,” she added.
It is particularly common to pick up a superbug from developing countries, where rates of bacterial illnesses are high but healthcare provision is generally lower.
Of UK patients with typhoid returning from India, almost 90 per cent tested positive for drug resistant enterobacteriaceae – a microorganism that causes gastroenteritis, meningitis and pneumonia.
CDDEP found one in ten then infected another household member when back in the UK.
Historic social and family links between the UK and India mean thousands of people travel between the two countries daily. It is also a popular holiday hot-spot for Brits, who, along with Americans, make up around 40 per cent of the 8.9 million tourists visiting the country each year.
But a major shortage of doctors in the vast country means patients are often given incorrect antibiotics by unqualified professionals, accelerating the pace at which pathogens develop resistance. Holiday-makers can easily carry these resistant pathogens home.
Public health facilities also regularly run out of essential medicines, so unlicensed vendors sell less effective products instead.
But medical tourism, an industry which will be worth roughly $8 billion in India alone by 2020, is also contributing to AMR. Patients are increasingly travelling internationally to seek cheaper surgical procedures such as transplants, cosmetic surgery and dental care.
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