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Europeans represent the majority of international travelers and clinicians encountering returned patients have an essential role in recognizing, and communicating travel-associated public health risks. Field, et al. (2010) sought to investigate the morbidity of travel-associated infectious diseases in European travelers, and analyzed diagnoses with demographic, clinical and travel-related predictors of disease, in 6,957 ill returned travellers who presented in 2008 to EuroTravNet centers with a presumed travel associated condition. eir research was published in BMC Infectious Diseases.
The researchers report that gastro-intestinal (GI) diseases accounted for 33 percent of illnesses, followed by febrile systemic illnesses (20 percent), dermatological conditions (12 percent) and respiratory illnesses (8 percent). There were three deaths recorded; a sepsis caused by Escherichia coli pyelonephritis, a dengue shock syndrome and a Plasmodium falciparum malaria. GI conditions included bacterial acute diarrhea (6.9 percent), as well as giardiasis and amebasis (2.3 percent). Among febrile systemic illnesses with identified pathogens, malaria (5.4 percent) accounted for most cases followed by dengue (1.9 percent) and others including chikungunya, rickettsial diseases, leptospirosis, brucellosis, Epstein Barr virus infections, tick-borne encephalitis (TBE) and viral hepatitis.
Dermatological conditions were dominated by bacterial infections, arthropod bites, cutaneous larva migrans and animal bites requiring rabies post-exposure prophylaxis and also leishmaniasis, myasis, tungiasis and one case of leprosy. Respiratory illness included 112 cases of tuberculosis including cases of multi-drug resistant or extensively drug resistant tuberculosis, 104 cases of influenza-like illness, and five cases of Legionnaires disease. Sexually transmitted infections (STI) accounted for 0.6 percent of total diagnoses and included HIV infection and syphilis. A total of 165 cases of potentially vaccine preventable diseases were reported. Purpose of travel and destination specific risk factors was identified for several diagnoses such as Chagas disease in immigrant travellers from South America and P. falciparum malaria in immigrants from sub-Saharan Africa. Travel within Europe was also associated with health risks with distinctive profiles for Eastern and Western Europe.
Field, et al. (2010) conclude that in 2008, a broad spectrum of travel associated diseases were diagnosed at EuroTravNet core sites. Diagnoses varied according to regions visited by ill travelers. The spectrum of travel associated morbidity also shows that there is a need to dispel the misconception that travel, close to home in Europe, is without significant health risk.
Reference: Field V, Gautret P, Schlagenhauf P, Burchard GD, Caumes E, Jensenius M, Castelli F, Gkrania-Klotsas E, Weld L, Lopez-Velez R, de Vries P, von Sonnenburg F, Loutan L, Parola P. Travel and migration associated infectious diseases morbidity in Europe, 2008. BMC Infectious Diseases 2010, 10:330doi:10.1186/1471-2334-10-330