title: Travel-associated illness in older adults (>60 y).
abstract: BACKGROUND
  Older individuals represent a substantial proportion of international travelers. Because of physiological changes and the increased probability of underlying medical conditions, older travelers might be at higher risk for at least some travel-associated diseases.
  
  
  METHODS
  With the aim of describing the epidemiology of travel-associated diseases in older adults, medical data were prospectively collected on ill international travelers presenting to GeoSentinel sites from 1997 to 2009. Seven thousand thirty-four patients aged 60 years and over were identified as older travelers and were compared to 56,042 patients aged 18-45 years, who were used as the young adult reference population.
  
  
  RESULTS
  The proportionate morbidity of several etiological diagnoses was higher in older ill travelers compared to younger ill, including notably lower respiratory tract infections, high-altitude pulmonary edema, phlebitis and pulmonary embolism, arthropod bites, severe malaria, rickettsiosis, gastritis, peptic ulcers, esophagitis and gastroesophageal reflux disease, trauma and injuries, urinary tract infections, heart disease, and death. In contrast, acute diarrhea, upper respiratory tract infections, flu and flu-like illnesses, malaria, dengue, genital infections, sexually transmitted diseases, and schistosomiasis proportionate morbidities were lower among the older group.
  
  
  CONCLUSIONS
  Older ill travelers are more likely to suffer from certain life-threatening diseases and would benefit from reinforcement of specific preventive measures including use of anti-thrombosis compression stockings and sufficient hydration and exercises during long-distance flights, hand hygiene, use of disposable handkerchiefs, consideration of face-masks in crowded conditions, influenza and pneumococcal vaccines, progressive acclimatization to altitude, consideration of acetazolamide, and use of repellents and mosquito nets. Antibiotics for the presumptive treatment of respiratory and urinary tract infections may be considered, as well as antacid medications. At-risk patients should be referred to a specialist for medical evaluation before departing, and optimal control of co-morbidities such as cardiovascular and chronic obstructive pulmonary diseases should be achieved, particularly for high-altitude travel.
authors.affiliation: Infectious Diseases and Tropical Medicine Unit, North University Hospital, AP-HM, Marseille, France. philippe.gautret@club-internet.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
authors.forename: Jean
authors.initials: J
authors.lastname: Gaudart
authors.forename: Karin
authors.initials: K
authors.lastname: Leder
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
authors.forename: Poh Lian
authors.initials: PL
authors.lastname: Lim
authors.forename: Holly
authors.initials: H
authors.lastname: Murphy
authors.forename: Jay
authors.initials: J
authors.lastname: Keystone
authors.forename: Jakob
authors.initials: J
authors.lastname: Cramer
authors.forename: Jacob
authors.initials: J
authors.lastname: Cramer
authors.forename: Marc
authors.initials: M
authors.lastname: Shaw
authors.forename: Jacques
authors.initials: J
authors.lastname: Boddaert
authors.forename: Frank
authors.initials: F
authors.lastname: von Sonnenburg
authors.forename: Philippe
authors.initials: P
authors.lastname: Parola
mesh_terms: D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D002388:Catastrophic Illness / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011446:Prospective Studies; D012306:Risk; D014195:Travel