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. 2014 Dec;31(6):678-87.
doi: 10.1093/fampra/cmu063. Epub 2014 Sep 26.

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel

Stefan H F Hagmann  1 , Pauline V Han  2 , William M Stauffer  3 , Andy O Miller  4 , Bradley A Connor  5 , DeVon C Hale  6 , Christina M Coyle  7 , John D Cahill  8 , Cinzia Marano  9 , Douglas H Esposito  2 , Phyllis E Kozarsky  10 ; GeoSentinel Surveillance Network
Affiliations

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel

Stefan H F Hagmann et al. Fam Pract. 2014 Dec.

Abstract

Background: US residents make 60 million international trips annually. Family practice providers need to be aware of travel-associated diseases affecting this growing mobile population.

Objective: To describe demographics, travel characteristics and clinical diagnoses of US residents who present ill after international travel.

Methods: Descriptive analysis of travel-associated morbidity and mortality among US travellers seeking care at 1 of the 22 US practices and clinics participating in the GeoSentinel Global Surveillance Network from January 2000 to December 2012.

Results: Of the 9624 ill US travellers included in the analysis, 3656 (38%) were tourist travellers, 2379 (25%) missionary/volunteer/research/aid workers (MVRA), 1580 (16%) travellers visiting friends and relatives (VFRs), 1394 (15%) business travellers and 593 (6%) student travellers. Median (interquartile range) travel duration was 20 days (10-60 days). Pre-travel advice was sought by 45%. Hospitalization was required by 7%. Compared with other groups of travellers, ill MVRA travellers returned from longer trips (median duration 61 days), while VFR travellers disproportionately required higher rates of inpatient care (24%) and less frequently had received pre-travel medical advice (20%). Illnesses of the gastrointestinal tract were the most common (58%), followed by systemic febrile illnesses (18%) and dermatologic disorders (17%). Three deaths were reported. Diagnoses varied according to the purpose of travel and region of exposure.

Conclusions: Returning ill US international travellers present with a broad spectrum of travel-associated diseases. Destination and reason for travel may help primary health care providers to generate an accurate differential diagnosis for the most common disorders and for those that may be life-threatening.

Keywords: Diagnosis; epidemiology; morbidity; prevention; surveillance; travel..

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Conflict of interest statement

Conflict of interest: Dr. Connor reported receiving royalties from Elsevier for ‘Travel Medicine, 3rd Edition’. Dr. Marano reported that she is an employee of GlaxoSmithKline Vaccines and that she is a GlaxoSmithKline stock option owner. No other author reported conflict of interest.

Figures

Figure 1
Figure 1
Top 10 diagnoses by world geographic regions visited among ill US travellers after return from international travel, GeoSentinel Surveillance Network, 2000–12.
Figure 2
Figure 2
Broad diagnostic categories according to purpose of travel and region of exposure in US residents after return from international travel, US GeoSentinel Clinics, 2000–12. Patients can have ≥1 diagnosis in different categories. Latin America includes Mexico, and countries in the Caribbean, Central and South America. MVRA, missionary, volunteer, research, aid work; VFR, visitng friends and relatives.
See this image and copyright information in PMC

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