title: Illness in children after international travel: analysis from the GeoSentinel Surveillance Network.
abstract: OBJECTIVE
  By using a large, multicenter database, we investigated the characteristics and morbidities of 1591 children returning from 218 global destinations and presenting for care in 19 countries.
  
  
  METHODS
  Data reported to the GeoSentinel Surveillance Network between January 1997 and November 2007 were analyzed, to assess demographic features, travel characteristics, and clinical diagnoses of ill pediatric travelers. Data were compared between children and adults and among 3 pediatric age groups (0-5 years, 6-11 years, and 12-17 years).
  
  
  RESULTS
  Children were predominantly tourist travelers returning from Asia, sub-Saharan Africa, or Latin America. Compared with adults, children disproportionately presented within 7 days after return, required hospitalization, lacked pretravel health advice, and had traveled for the purpose of visiting friends and relatives. Diarrhea (28%), dermatologic conditions (25%), systemic febrile illnesses (23%), and respiratory disorders (11%) accounted for the majority of diagnoses reported for children. No fatalities were reported. Diarrhea occurred disproportionately among children after exposure to the Middle East/North Africa, dermatologic conditions after exposure to Latin America, systemic febrile illnesses after exposure to sub-Saharan Africa or Asia, and respiratory disorders after exposure to Europe or North America. The proportionate morbidity rates of travel-associated diseases differed among the pediatric age groups and between children and adults.
  
  
  CONCLUSIONS
  The health care utilization patterns before and after travel and the profiles of travel-associated health problems differed between children and adults. Health professionals providing pretravel advice need to consider destination- and age-specific susceptibility to travel-related morbidities and develop prevention strategies accordingly.
authors.affiliation: Division of Pediatric Infectious Diseases, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10457, USA. shagmann@bronxleb.org
authors.forename: Stefan
authors.initials: S
authors.lastname: Hagmann
authors.forename: Richard
authors.initials: R
authors.lastname: Neugebauer
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
authors.forename: Cecilia
authors.initials: C
authors.lastname: Perret
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Barnett
authors.forename: William M
authors.initials: WM
authors.lastname: Stauffer
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control; D003141:Communicable Diseases / Q000453:epidemiology* / Q000635:transmission*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D040362:Geographic Information Systems; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D016017:Odds Ratio; D011159:Population Surveillance; D012737:Sex Factors; D014195:Travel; D014481:United States