Medical Tourist Risks with SSI
The CDC Report
In their Notes from the Field report dated March 2015, the CDC provided information regarding two cases of rapidly growing nontuberculous mycobacterial surgical-site infections. Both patients had cosmetic surgery done at a private surgical clinic in the Dominican Republic one month before seeking treatment for a wound infection in the U.S.
In early 2014, there was a total of 19 cases reported in five different states, all female patients that had been to the Dominican Republic to have surgical procedures done. Twelve of the patients had surgery at the same clinic and the remaining seven had been to other practices.
Risks for Medical Tourists
The outbreak of rapidly growing nontuberculous mycobacterial underscores the infection risks associated with medical tourism. Studies indicate that hundreds of thousands of people travel abroad for medical treatment for various procedures such as:
- Orthopedic surgery
- Cosmetic surgery
- Cardiology care and surgery
- Oncology care
Medical tourists frequent destinations like Thailand and Mexico because the procedures tend to cost less, but it comes at a price. Many patients traveling abroad for treatment use medical concierge services to find health care facilities. These companies are not accredited and may not have all the information available to make sound recommendations. They don’t track patient outcomes or research infection control, for example.
Medical tourism is a known risk for antibiotic-resistant strains of bacteria not previously seen in the U.S. The CDC recommends that healthcare providers take extra precautions such as switching to single-use medical devices when treating patients that have traveled to other countries for surgery. There have been several outbreaks of infectious disease documented among medical tourists. Physicians who encounter wound infections should get a complete travel history from the patient to determine if they are medical tourists, as well.
Caregivers aware of a patient that is planning to travel to foreign destinations for treatment should warn patients about the risks, which go beyond just surgical site infections. Doctors in small clinics like the one in the Dominican Republics may not practice good infection control and may have unsafe injection practices putting medical tourists are at risk for hepatitis and HIV, as well. Blood supplies in many countries are not screened, either, increasing the risk of complications.