Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Mar 19;158(6):456-68.
doi: 10.7326/0003-4819-158-6-201303190-00005.

GeoSentinel surveillance of illness in returned travelers, 2007-2011

Collaborators, Affiliations

GeoSentinel surveillance of illness in returned travelers, 2007-2011

Karin Leder et al. Ann Intern Med. .

Abstract

Background: International travel continues to increase, particularly to Asia and Africa. Clinicians are increasingly likely to be consulted for advice before travel or by ill returned travelers.

Objective: To describe typical diseases in returned travelers according to region, travel reason, and patient demographic characteristics; describe the pattern of low-frequency travel-associated diseases; and refine key messages for care before and after travel.

Design: Descriptive, using GeoSentinel records.

Setting: 53 tropical or travel disease units in 24 countries.

Patients: 42 173 ill returned travelers seen between 2007 and 2011.

Measurements: Frequencies of demographic characteristics, regions visited, and illnesses reported.

Results: Asia (32.6%) and sub-Saharan Africa (26.7%) were the most common regions where illnesses were acquired. Three quarters of travel-related illness was due to gastrointestinal (34.0%), febrile (23.3%), and dermatologic (19.5%) diseases. Only 40.5% of all ill travelers reported pretravel medical visits. The relative frequency of many diseases varied with both travel destination and reason for travel, with travelers visiting friends and relatives in their country of origin having both a disproportionately high burden of serious febrile illness and very low rates of advice before travel (18.3%). Life-threatening diseases, such as Plasmodium falciparum malaria, melioidosis, and African trypanosomiasis, were reported.

Limitations: Sentinel surveillance data collected by specialist clinics do not reflect healthy returning travelers or those with mild or self-limited illness. Data cannot be used to infer quantitative risk for illness.

Conclusion: Many illnesses may have been preventable with appropriate advice, chemoprophylaxis, or vaccination. Clinicians can use these 5-year GeoSentinel data to help tailor more efficient pretravel preparation strategies and evaluate possible differential diagnoses of ill returned travelers according to destination and reason for travel.

Primary funding source: Centers for Disease Control and Prevention.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Proportion of major syndromic groupings for gastrointestinal, febrile, dermatologic, and respiratory illnesses among ill returned travelers.
Figure 2
Figure 2
Top identified specific causes for gastrointestinal, febrile, dermatologic, and respiratory illnesses by region among ill returned travelers.
Figure 3
Figure 3
Top 10 specific diagnoses, by main reasons for travel.

Comment in

  • Illness in returned travelers.
    Blanc PD. Blanc PD. Ann Intern Med. 2013 Jun 18;158(12):924. doi: 10.7326/0003-4819-158-12-201306180-00020. Ann Intern Med. 2013. PMID: 23778919 No abstract available.
  • Illness in returned travelers.
    Leder K, Libman MD, Sotir MJ. Leder K, et al. Ann Intern Med. 2013 Jun 18;158(12):924. doi: 10.7326/0003-4819-158-12-201306180-00021. Ann Intern Med. 2013. PMID: 23778920 No abstract available.

Similar articles

Cited by

References

    1. United Nations World Tourism Organization UNWTO Tourism Highlights: 2011 Edition. Accessed at http://mkt.unwto.org/sites/all/files/docpdf/unwtohighlights11enlr_1.pdf on 28 August 2012.
    1. LaRocque RC, Rao SR, Lee J, Ansdell V, Yates JA, Schwartz BS, et al. Global TravEpiNet Consortium. Global TravEpiNet: a national consortium of clinics providing care to international travelers—analysis of demographic characteristics, travel destinations, and pretravel healthcare of high-risk US international travelers, 2009–2011. Clin Infect Dis. 2012;54:455–62. PMID: 22144534. - PubMed
    1. Bacaner N, Stauffer B, Boulware DR, Walker PF, Keystone JS. Travel medicine considerations for North American immigrants visiting friends and relatives. JAMA. 2004;291:2856–64. PMID: 15199037. - PubMed
    1. Angell SY, Cetron MS. Health disparities among travelers visiting friends and relatives abroad. Ann Intern Med. 2005;142:67–72. PMID: 15630110. - PubMed
    1. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, et al. GeoSentinel Surveillance Network. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med. 2006;354:119–30. PMID: 16407507. - PubMed

Publication types

MeSH terms