title: Description and burden of travel-related cases caused by enteropathogens reported in a Canadian community.
abstract: BACKGROUND
  Risk of infections by enteropathogens among individuals traveling outside their country of residence is considered important. Such travel-related cases (TRC) have been poorly estimated and described in Canada.
  
  
  METHODS
  Data from an enhanced, passive surveillance system of diseases caused by enteropathogens within a Canadian community from June 2005 to May 2009 were used to describe TRC in terms of disease (pathogen, symptoms, hospitalization, duration, and timing of sickness relative to return); demographics (age and gender); and travel (destination, length, and accommodation); and to compare them with non-TRC.
  
  
  RESULTS
  Among 1,773 reported cases, 446 (25%) were classified as TRC with 9% of them being new immigrants. The main TRC diseases were campylobacteriosis, salmonellosis, and giardiasis. Disease onset occurred before return in 42% of TRC. Main destinations were Latin America/Caribbean and Asia. No differences by month and year were observed for onset, departure, and return dates. In addition to new immigrants, three subgroups of TRC based on travel destination, length of travel, type of accommodation, and age were identified and some diseases were more frequently observed in these subgroups. Generally, TRC did not differ from domestic cases in terms of age, gender, symptoms, hospitalization, and disease duration. Campylobacter coli and Salmonella enteritidis were significantly more frequent among TRC.
  
  
  CONCLUSIONS
  TRC of diseases caused by enteropathogens that are reportable in Canada represent a significant proportion of the burden of the total diseases. Subgroups of TRC exist and are associated with certain diseases. These results help inform the assessment of the actual risk related to travel for each subgroup of travelers and quantify the attribution of traveling abroad to the overall burden of these gastrointestinal diseases.
authors.affiliation: Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Faculté de Médecine Vétérinaire, Pavillon de Santé Publique Vétérinaire, 3190 rue Sicotte, Saint-Hyacinthe, Québec, Canada. andre.ravel@phac-aspc.gc.ca
authors.forename: André
authors.initials: A
authors.lastname: Ravel
authors.forename: Andrea
authors.initials: A
authors.lastname: Nesbitt
authors.forename: Barbara
authors.initials: B
authors.lastname: Marshall
authors.forename: Nancy
authors.initials: N
authors.lastname: Sittler
authors.forename: Frank
authors.initials: F
authors.lastname: Pollari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000175:diagnosis* / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003906:Developing Countries; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011159:Population Surveillance; D015995:Prevalence; D011322:Primary Prevention / Q000458:organization & administration; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data; D012621:Seasons; D014195:Travel / Q000706:statistics & numerical data*