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. 2018 Jan 1;25(1):10.1093/jtm/tay074.
doi: 10.1093/jtm/tay074.

Illness among US resident student travellers after return to the USA: a GeoSentinel analysis, 2007-17

Kristina M Angelo  1 , N Jean Haulman  2 , Anne C Terry  2 , Daniel T Leung  3 , Lin H Chen  4   5 , Elizabeth D Barnett  6 , Stefan H F Hagmann  7   8 , Noreen A Hynes  9 , Bradley A Connor  10   11 , Susan Anderson  12 , Anne McCarthy  13 , Marc Shaw  14   15 , Perry J J Van Genderen  16 , Davidson H Hamer  17   18
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Illness among US resident student travellers after return to the USA: a GeoSentinel analysis, 2007-17

Kristina M Angelo et al. J Travel Med. .

Abstract

Background: The number of US students studying abroad more than tripled during the past 20 years. As study abroad programmes' destinations diversify, students increasingly travel to resource-limited countries, placing them at risk for infectious diseases. Data describing infections acquired by US students while travelling internationally are limited. We describe illnesses among students who returned from international travel and suggest how to prevent illness among these travellers.

Methods: GeoSentinel is a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. This study included the records of US resident student international travellers, 17-24 years old, who returned to the USA, had a confirmed travel-related illness at one of 15 US GeoSentinel sites during 2007-17 and had a documented exposure region. Records were analysed to describe demographic and travel characteristics and diagnoses.

Results: The study included 432 students. The median age was 21 years; 69% were female. More than 70% had a pre-travel consultation with a healthcare provider. The most common exposure region was sub-Saharan Africa (112; 26%). Students were most commonly exposed in India (44; 11%), Ecuador (28; 7%), Ghana (25; 6%) and China (24; 6%). The median duration of travel abroad was 40 days (range: 1-469) and presented to a GeoSentinel site a median of 8 days (range: 0-181) after travel; 98% were outpatients. Of 581 confirmed diagnoses, the most common diagnosis category was gastrointestinal (45%). Acute diarrhoea was the most common gastrointestinal diagnosis (113 of 261; 43%). Thirty-one (7%) students had vector-borne diseases [14 (41%) malaria and 11 (32%) dengue]. Three had vaccine-preventable diseases (two typhoid; one hepatitis A); two had acute human immunodeficiency virus infection.

Conclusions: Students experienced travel-related infections, despite the majority having a pre-travel consultation. US students should receive pre-travel advice, vaccinations and chemoprophylaxis to prevent gastrointestinal, vector-borne, sexually transmitted and vaccine-preventable infections.

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Conflict of interest statement

Conflict of interest: NJH: Speaker list for Sanofi Pasteur, DTL: Author royalties from UpToDate, Inc., DHH and EDB: Receive some salary funding from GeoSentinel, LHC is an advisor for Shoreland, Inc., All remaining authors have no conflicts of interest.

References

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    1. McMillan LR. Exploring the world outside to increase cultural competence of the educator within. J Cult Div 2012; 19:23–5. - PubMed
    1. Rhodes G, DeRomaña I, Pedone BN. Study abroad & other international student travel In: Brunette G (ed.). Yellow Book. New York, NY: Oxford University Press, 2018, pp.621–6.
    1. NAFSA. Trends in study abroad 2015/2016 data. http://www.nafsa.org/Policy_and_Advocacy/Policy_Resources/Policy_Trends_... (20 February 2018, date last accessed).
    1. International Institute of Education. U.S. students study abroad 2015/2016 data. 2017. https://www.iie.org/Research-and-Insights/Open-Doors/Data/US-Study-Abroad. (26 December 2017, date last accessed).

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