title: Illness in long-term travelers visiting GeoSentinel clinics.
abstract: Length of travel appears to be associated with health risks. GeoSentinel Surveillance Network data for 4,039 long-term travelers (trip duration >6 months) seen after travel during June 1, 1996, through December 31, 2008, were compared with data for 24,807 short-term travelers (trip duration <1 month). Long-term travelers traveled more often than short-term travelers for volunteer activities (39.7% vs. 7.0%) and business (25.2% vs. 13.8%). More long-term travelers were men (57.2% vs. 50.1%) and expatriates (54.0% vs. 8.9%); most had pretravel medical advice (70.3% vs. 48.9%). Per 1,000 travelers, long-term travelers more often experienced chronic diarrhea, giardiasis, Plasmodium falciparum and P. vivax malaria, irritable bowel syndrome (postinfectious), fatigue >1 month, eosinophilia, cutaneous leishmaniasis, schistosomiasis, and Entamoeba histolytica diarrhea. Areas of concern for long-term travelers were vector-borne diseases, contact-transmitted diseases, and psychological problems. Our results can help prioritize screening for and diagnosis of illness in long-term travelers and provide evidence-based pretravel advice.
authors.affiliation: Harvard University, Boston, Massachusetts, USA. lchen@hms.harvard.edu
authors.forename: Lin H
authors.initials: LH
authors.lastname: Chen
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wilson
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Davis
authors.forename: Louis
authors.initials: L
authors.lastname: Loutan
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
authors.forename: Jay
authors.initials: J
authors.lastname: Keystone
authors.forename: Devon
authors.initials: D
authors.lastname: Hale
authors.forename: Poh Lian
authors.initials: PL
authors.lastname: Lim
authors.forename: Anne
authors.initials: A
authors.lastname: McCarthy
authors.forename: Effrossyni
authors.initials: E
authors.lastname: Gkrania-Klotsas
authors.forename: Patricia
authors.initials: P
authors.lastname: Schlagenhauf
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D000818:Animals; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D004199:Disease Vectors; D005260:Female; D014943:Global Health; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D011159:Population Surveillance; D013577:Syndrome; D013997:Time Factors; D014195:Travel; D014947:Wounds and Injuries / Q000453:epidemiology; D055815:Young Adult