title: Profile of travel-associated illness in children, Zürich, Switzerland.
abstract: BACKGROUND
  The number of families traveling with their children to their country of origin and/or to tropical destinations has increased in Switzerland and includes a changing profile and multinational range of patients. Defining the profile of reported travel-associated illnesses will help to improve the prevention and treatment of such illnesses in children.
  
  
  METHODS
  This study includes children aged up to 16 years who sought medical advice for a presumed travel-related illness at the emergency room of the University of Zürich Children's Hospital during the period July 2007 to December 2008.
  
  
  RESULTS
  We analyzed data on 328 children (58.8% male, mean age: 4.62 y) who presented with travel-associated illness. Our analysis included 155 traditional (mainly tourist) travelers, 162 children who were visiting friends and relatives (VFR), and 11 immigrants. Some 11% were hospitalized. No deaths occurred. The main conditions recorded were diarrheal illness (39%), respiratory (28.7%) and febrile/systemic illness (13.4%). With increasing age, the proportion of children with diarrheal disease increased, while the proportion with respiratory illness declined. There were significant associations between geographic area of exposure and the profile of travel-related disease (p < 0.001). Among 36 children with more serious diseases requiring hospitalization, 12 (3.7% overall) presented with potentially serious diseases: malaria (n = 2), Salmonella typhi (n = 3), Salmonella paratyphi (n = 2), meningococcal meningitis (n = 1), tuberculosis (n = 2), visceral leishmania (n = 1), and hepatitis A (n = 1). Eleven of the 12 children presenting with these potentially serious illnesses were VFR or immigrant children.
  
  
  CONCLUSIONS
  The main diagnoses for ill-returned Zürich children who presented for emergency care were diarrhea, respiratory, and febrile/systemic illness. A broad spectrum of morbidity was seen including meningococcal meningitis, malaria, tuberculosis, typhoid fever, leishmania, and hepatitis A. Diagnoses varied between geographic regions visited, and VFR child travelers constituted a large proportion of sick-returned children presenting for emergency care.
authors.affiliation: University of Zürich Centre for Travel Medicine, World Health Organisation Collaborating Centre for Travellers' Health, University of Zürich, Zürich, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hunziker
authors.forename: Christoph
authors.initials: C
authors.lastname: Berger
authors.forename: Georg
authors.initials: G
authors.lastname: Staubli
authors.forename: Alois
authors.initials: A
authors.lastname: Tschopp
authors.forename: Rainer
authors.initials: R
authors.lastname: Weber
authors.forename: David
authors.initials: D
authors.lastname: Nadal
authors.forename: Christoph
authors.initials: C
authors.lastname: Hatz
authors.forename: Patricia
authors.initials: P
authors.lastname: Schlagenhauf
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D005334:Fever / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009017:Morbidity; D012140:Respiratory Tract Diseases / Q000453:epidemiology; D012306:Risk; D017678:Sex Distribution; D013557:Switzerland / Q000453:epidemiology; D014195:Travel; D014329:Tropical Climate