Illness in long-term travelers visiting GeoSentinel clinics

Abstract

Length of travel appears to be associated with health risks. GeoSentinel Surveillance Network data for 4,039 long-term travelers (trip duration >6 months) seen after travel during June 1, 1996, through December 31, 2008, were compared with data for 24,807 short-term travelers (trip duration <1 month). Long-term travelers traveled more often than short-term travelers for volunteer activities (39.7% vs. 7.0%) and business (25.2% vs. 13.8%). More long-term travelers were men (57.2% vs. 50.1%) and expatriates (54.0% vs. 8.9%); most had pretravel medical advice (70.3% vs. 48.9%). Per 1,000 travelers, long-term travelers more often experienced chronic diarrhea, giardiasis, Plasmodium falciparum and P. vivax malaria, irritable bowel syndrome (postinfectious), fatigue >1 month, eosinophilia, cutaneous leishmaniasis, schistosomiasis, and Entamoeba histolytica diarrhea. Areas of concern for long-term travelers were vector-borne diseases, contact-transmitted diseases, and psychological problems. Our results can help prioritize screening for and diagnosis of illness in long-term travelers and provide evidence-based pretravel advice.

Figure 1

Flow chart for analysis of illness and injury in long-term travelers, GeoSentinel Surveillance Network, June 1996–December 2008.

Figure 2

Proportionate illness (per 1,000 ill travelers) for the most frequent diagnoses in long-term travelers, by world geographic region visited, GeoSentinel Surveillance Network, June 1996–December 2008. PEP, postexposure prophylaxis; IBS, irritable bowel syndrome; TB, tuberculosis; LTBI, latent TB infection; CLM, cutaneous larva migrans; P., Plasmodium.