title: Travel illness in British package holiday tourists: prospective cohort study.
abstract: OBJECTIVE
  To examine the relationship between knowledge of travel health matters, health preparation for travel and risk of travel related illness.
  
  
  METHODS
  Travellers on holiday charter flights from Cardiff-Wales Airport provided information on holiday preparation before departure and were surveyed 2 weeks after return for details of holiday lifestyle and travel illness.
  
  
  RESULTS
  Travellers' diarrhoea was reported by 25.7% of 1469 travellers; 24.4% had sunburn and 7.6% had respiratory infection. Attack rates for travellers' diarrhoea were highest in people aged 15-34 years (34.1%). Rates were higher the shorter the interval between holiday booking and departure (chi(2)for linear trend 13.5, 1df, P <0.001) and lower in travellers who sought advice from their general practitioner before departure (adjusted odds ratio 0.6, 95% confidence interval 0.4-0.9). The most important predictors for travellers' diarrhoea were travel with friends, country of destination, stay in room only or bed and breakfast accommodation, and type of meals most frequently eaten.
  
  
  CONCLUSIONS
  Better holiday preparation seems to reduce risk of travel illness, even after adjusting for variables that may reflect the more cautious personality of the traveller. Encouragement to book early, take medical advice and travel well prepared could have a positive health benefit, but intervention studies are required.
authors.affiliation: Department of Public Health Medicine, South Glamorgan Health Authority, Temple of Peace and Health, Cardiff, UK. meirion.evans@phls.wales.nhs.uk
authors.forename: M R
authors.initials: MR
authors.lastname: Evans
authors.forename: D
authors.initials: D
authors.lastname: Shickle
authors.forename: M Z
authors.initials: MZ
authors.lastname: Morgan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003967:Diarrhea; D005260:Female; D006266:Health Education; D006693:Holidays; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012141:Respiratory Tract Infections; D013471:Sunburn; D011795:Surveys and Questionnaires; D014195:Travel; D014852:Wales