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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Travel-associated infection presenting in Europe (2008-12): An analysis of EuroTravNet longitudinal, surveillance data, and evaluation of the effect of the pre-travel consultation
The Lancet Infectious Diseases, Volume 15, No. 1, Year 2015
Notification
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Description
Background: Travel is important in the acquisition and dissemination of infection. We aimed to assess European surveillance data for travel-related illness to profile imported infections, track trends, identify risk groups, and assess the usefulness of pre-travel advice. Methods: We analysed travel-associated morbidity in ill travellers presenting at EuroTravNet sites during the 5-year period of 2008-12. We calculated proportionate morbidity per 1000 ill travellers and made comparisons over time and between subgroups. We did 5-year trend analyses (2008-12) by testing differences in proportions between subgroups using Pearson's χ2 test. We assessed the effect of the pre-travel consultation on infection acquisition and outcome by use of proportionate morbidity ratios. Findings: The top diagnoses in 32 136 patients, ranked by proportionate morbidity, were malaria and acute diarrhoea, both with high proportionate morbidity (>60). Dengue, giardiasis, and insect bites had high proportionate morbidity (>30) as well. 5-year analyses showed increases in vector borne infections with significant peaks in 2010; examples were increased Plasmodium falciparum malaria (χ2=37·57, p<0·001); increased dengue fever (χ2=135·9, p<0·001); and a widening geographic range of acquisition of chikungunya fever. The proportionate morbidity of dengue increased from 22 in 2008 to 36 in 2012. Five dengue cases acquired in Europe contributed to this increase. Dermatological diagnoses increased from 851 in 2008 to 1102 in 2012, especially insect bites and animal-related injuries. Respiratory infection trends were dominated by the influenza H1N1 pandemic in 2009. Illness acquired in Europe accounted for 1794 (6%) of all 32 136 cases-mainly, gastrointestinal (634) and respiratory (357) infections. Migration within Europe was associated with more serious infection such as hepatitis C, tuberculosis, hepatitis B, and HIV/AIDS. Pre-travel consultation was associated with significantly lower proportionate morbidity ratios for P falciparum malaria and also for acute hepatitis and HIV/AIDS. Interpretation: The pattern of travel-related infections presenting in Europe is complex. Trend analyses can inform on emerging infection threats. Pre-travel consultation is associated with reduced malaria proportionate morbidity ratios and less severe illness. These findings support the importance and effectiveness of pre-travel advice on malaria prevention, but cast doubt on the effectiveness of current strategies to prevent travel-related diarrhoea. Funding: European Centre for Disease Prevention and Control, University Hospital Institute Méditerranée Infection, US Centers for Disease Control and Prevention, and the International Society of Travel Medicine. © 2015 Elsevier Ltd.
Authors & Co-Authors
Schlagenhauf, Patricia
Switzerland, Zurich
Universität Zürich
Weld, Leisa H.
Unknown Affiliation
Goorhuis, Abram
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Gautret, Philippe
France, Marseille
Aix Marseille Université
Weber, Rainer
Switzerland, Zurich
Universität Zürich
von Sonnenburg, Frank F.
Germany, Munich
Ludwig-maximilians-universität München
Lopéz-Véléz, Rogelio
Spain, Madrid
Hospital Universitario Ramón y Cajal
Jensenius, Mogens
Norway, Oslo
Oslo Universitetssykehus
Cramer, Jakob Peter
Germany, Hamburg
Bernhard Nocht Institut Fur Tropenmedizin Hamburg
Field, Vanessa K.
Unknown Affiliation
Odolini, Silvia
Italy, Brescia
Spedali Civili Di Brescia
Gkrania-Klotsas, Effrossyni
United Kingdom, Cambridge
Addenbrooke's Hospital
Chappuis, François P.
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Malvy, Denis Jean Marie
Unknown Affiliation
van Genderen, Perry J.J.
Netherlands, Rotterdam
Harbour Hospital
Mockenhaupt, Frank Peter
Germany, Berlin
Charité – Universitätsmedizin Berlin
Jauréguiberry, Stèphane
France, Paris
Hôpital Universitaire Pitié Salpêtrière
Smith, Catherine C.
United Kingdom, Edinburgh
Nhs National Services Scotland
Beeching, Nicholas J.
United Kingdom, Royston
National Institute for Health and Care Research
Ursing, Johan
Sweden, Stockholm
Karolinska Universitetssjukhuset
Parola, Philippe
France, Marseille
Aix Marseille Université
Grobusch, Martín Peter
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Statistics
Citations: 190
Authors: 22
Affiliations: 16
Identifiers
Doi:
10.1016/S1473-3099(14)71000-X
ISSN:
14733099
Research Areas
Health System And Policy
Infectious Diseases
Violence And Injury
Study Design
Cohort Study