title: A survey of notified travel-associated infections: implications for travel health advice.
abstract: BACKGROUND
  Travel-associated illness affects at least 25 per cent of UK residents who travel abroad each year. Notified cases form only a small proportion of the total community burden of disease but nevertheless represent a substantial workload for community infection control services. The aim of the study was to describe the incidence of notified travel-associated infectious illness, the extent and sources of travel health advice, and the nature of risk-avoiding behaviour in that population.
  
  
  METHODS
  A questionnaire survey was carried out of 190 consecutive notifications of food poisoning and malaria over a nine-month period where travel abroad was an identifiable factor.
  
  
  RESULTS
  The incidence of notified travel-associated food poisoning during the study period was 204 per million resident population per year. Thirteen per cent of respondents reported taking no precautions against food poisoning, and up to 75 per cent of the cases could have taken better precautions. Only 36 per cent of cases recalled advice from their travel agent. Half the cases did not visit their general practitioner before travel (20 per cent of travellers to high-risk destinations). There was a strong association between receiving advice before travelling and risk-avoiding behaviour. The source of advice did not appear to affect the extent of precautions taken. The cases clearly expressed a need for additional written travel health information in the appropriate style and language for their ethnic group. Ethnic minority cases utilized official travel health advice to the same extent as the Caucasian cases.
  
  
  CONCLUSIONS
  In this case series, 75 per cent of travellers did not take sufficient basic precautions against infection. There was a need to improve advice about simple precautions to avoid infection. General practice was the commonest source of advice for the travellers in this study. The apparently low level of advice from travel agents needs to be addressed in any local initiative to improve the health of travellers.
authors.forename: C J
authors.initials: CJ
authors.lastname: Packham
mesh_terms: D016009:Chi-Square Distribution; D003140:Communicable Disease Control; D018563:Disease Notification; D005006:Ethnicity; D005517:Foodborne Diseases / Q000453:epidemiology; D015438:Health Behavior; D006301:Health Services Needs and Demand; D006801:Humans; D008288:Malaria / Q000453:epidemiology; D015203:Reproducibility of Results; D015983:Selection Bias; D014195:Travel; D006113:United Kingdom / Q000453:epidemiology