Abstract
We analyzed prospective data on 17,228 European patients who sought treatment at GeoSentinel sites from 1997 to 2007. Gastrointestinal illness (particularly in tourists), fever (those visiting friends and relatives [VFRs]), and skin disorders (in tourists) were the most common reasons for seeking medical care. Diagnoses varied by country of origin, region visited, or categories of travelers. VFRs who returned from sub-Saharan Africa and Indian Ocean islands were more likely to experience falciparum malaria than any other group. Multiple correspondence analysis identified Italian, French, and Swiss VFRs and expatriate travelers to sub-Saharan Africa and Indian Ocean Islands as most likely to exhibit febrile illnesses. German tourists to Southeast and south-central Asia were most likely to seek treatment for acute diarrhea. Non-European travelers (12,663 patients from other industrialized countries) were less likely to acquire certain travel-associated infectious diseases. These results should be considered in the practice of travel medicine and development of health recommendations for European travelers.
Highlights
We analyzed prospective data on 17,228 European patients who sought treatment at GeoSentinel sites from 1997 to 2007
European patients’ main destination was Africa, followed by Asia; the proportion of patients returning from sub-Saharan Africa, Indian Ocean islands, and south-central Asia was higher in sites in Italy, France, and the United Kingdom, respectively (Figure 2)
Acute diarrhea is the most common travel-associated disease [10], and we show here that some destinations are more frequently associated with some specific causes
Summary
We analyzed prospective data on 17,228 European patients who sought treatment at GeoSentinel sites from 1997 to 2007. Non-European travelers (12,663 patients from other industrialized countries) were less likely to acquire certain travel-associated infectious diseases. International references include the World Health Organization green book [3], which emphasizes risk assessment by rates of diseases in local populations; and the Centers for Disease Control and Prevention yellow book [4], which examines risk in the context of American travelers Whether these guidelines are appropriate in the European context is not known. After CHIKV-infected persons in eastern Africa, Indian Ocean islands, India, and Southeast Asia, a new CHIKV variant reached Europe and affected local populations in Italy through 1 infected traveler (the index case-patient) and transmission by indigenous European mosquito vectors [8]. In April 2009, an influenza A pandemic (H1N1) 2009 virus emerged in humans in North America and reached Europe soon after through returned travelers [9]
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