title: Spectrum of imported infectious diseases among children and adolescents returning from the tropics and subtropics.
abstract: BACKGROUND
  About 50 million people travel each year from industrialized countries to destinations in the tropics and subtropics. Among them, there are more than 2 million minors traveling. Although their number is increasing constantly, data on health risks during travel are limited.
  
  
  METHODS
  This study analyzed demographic, travel, and clinical data of 890 travelers of age <20 years presenting at the outpatient travel clinic of the University of Munich between 1999 and 2009 after returning from the tropics and subtropics.
  
  
  RESULTS
  Most (87%) of these young travelers were born in Germany. Among them, the main travel destination was Africa (46%), followed by Asia (35%) and Latin America (19%). The most frequent syndrome groups were acute diarrhea (25%, especially in age 0-4 y), dermatologic disorders (21%, especially in age 0-9 y), febrile/systemic diseases (20%), respiratory disorders (8%), chronic diarrhea (5%), and genitourinary disorders (3%). The 10 most frequent diagnosed infectious diseases were giardiasis (8%), schistosomiasis (4%), superinfected insect bites (4%), Campylobacter enteritis (4%), Salmonella enteritis (4%), cutaneous larva migrans (3%), amebiasis (3%), dengue fever (2%), mononucleosis (2%), and malaria (2%). The relative risk (RR) for acquiring any infectious disease during travel was highest in Central, West, and East Africa, followed by South America, South Asia, and Southeast Asia.
  
  
  CONCLUSIONS
  Age of young travelers and destination of travel were the most important variables being strongly correlated with the risk for acquiring infectious diseases in the tropics and subtropics. The highest risk was carried by very young travelers and those staying in sub-Saharan Africa (except Southern Africa).
authors.affiliation: Department of Infectious Diseases and Tropical Medicine-DITM, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany. herbinger@lrz.uni-muenchen.de
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Herbinger
authors.forename: Lukas
authors.initials: L
authors.lastname: Drerup
authors.forename: Martin
authors.initials: M
authors.lastname: Alberer
authors.forename: Hans-Dieter
authors.initials: HD
authors.lastname: Nothdurft
authors.forename: Frank von
authors.initials: Fv
authors.lastname: Sonnenburg
authors.forename: Thomas
authors.initials: T
authors.lastname: Löscher
mesh_terms: D000293:Adolescent; D000349:Africa; D017677:Age Distribution; D001210:Asia, Southeastern; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000453:epidemiology*; D003967:Diarrhea / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012306:Risk; D013020:South America; D014195:Travel; D014329:Tropical Climate; D055815:Young Adult