title: Vaccine preventable diseases in returned international travelers: results from the GeoSentinel Surveillance Network.
abstract: Vaccine preventable diseases (VPDs) threaten international travelers, but little is known about their epidemiology in this group. We analyzed records of 37,542 ill returned travelers entered into the GeoSentinel Surveillance Network database. Among 580 (1.5%) with VPDs, common diagnoses included enteric fever (n=276), acute viral hepatitis (n=148), and influenza (n=70). Factors associated with S. typhi included VFR travel (p<0.016) to South Central Asia (p<0.001). Business travel was associated with influenza (p<0.001), and longer travel with hepatitis A virus (p=0.02). 29% of those with VPDs had pre-travel consultations. At least 55% of those with VPDs were managed as inpatients, compared to 9.5% of those with non-VPDs. Three deaths occurred; one each due to pneumococcal meningitis, S. typhi, and rabies. VPDs are significant contributors to morbidity and potential mortality in travelers. High rates of hospitalization make them an attractive target for pre-travel intervention.
authors.affiliation: Tropical Disease Unit, UHN-Toronto General Hospital, 200 Elizabeth Street, North Wing, Toronto, ON, M5G 2C4, Canada. andrea.boggild@utoronto.ca
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Boggild
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
authors.forename: Joseph
authors.initials: J
authors.lastname: Torresi
authors.forename: Frank
authors.initials: F
authors.lastname: von Sonnenburg
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Barnett
authors.forename: Christina A
authors.initials: CA
authors.lastname: Greenaway
authors.forename: Poh-Lian
authors.initials: PL
authors.lastname: Lim
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
authors.forename: Annelies
authors.initials: A
authors.lastname: Wilder-Smith
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wilson
mesh_terms: D000328:Adult; D001208:Asia / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D014943:Global Health; D006525:Hepatitis, Viral, Human / Q000453:epidemiology; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology; D008297:Male; D018571:Sentinel Surveillance; D014195:Travel; D057236:Travel Medicine / Q000379:methods*; D014435:Typhoid Fever / Q000453:epidemiology