Travel-associated infections in Europe

Abstract

www.thelancet.com/infection Vol 15 August 2015 879 Diseases with severe presentation are probably not captured by travel clinics. For example, most patients with travel-associated Legionnaires’ disease—a disorder with a substantial risk for European travellers—are directly admitted to hospitals. Travel-associated infections in migrants are complex for various reasons. Epidemiology can be affected by changing trends in the migrant’s country of origin, such as those with HIV originating from subSaharan countries. Destination of travel, exposure and risk behaviours while travelling, and health-seeking behaviour on return might differ between affluent tourists and migrants with low income visiting relatives. First, it is essential to determine the representativeness of migrants attending travel clinics compared with all migrants living in Europe. Second, specifi cities in terms of destination or diseases should be reported. Last, I would question the inclusion of patients whose only purpose of travel was to emigrate to Europe, since these migrants would have been out of reach of prevention strategies. The Comment by Eskild Petersen and Lin Hwei Chen published alongside the Article pointed out the lack of denominator data as the main limitation of the study. I would suggest to use available data on tourism patterns (eg, Eurostat or the UN World Tourism Organization) for further analyses.