title: GeoSentinel surveillance of illness in returned travelers, 2007-2011.
abstract: BACKGROUND
  International travel continues to increase, particularly to Asia and Africa. Clinicians are increasingly likely to be consulted for advice before travel or by ill returned travelers.
  
  
  OBJECTIVE
  To describe typical diseases in returned travelers according to region, travel reason, and patient demographic characteristics; describe the pattern of low-frequency travel-associated diseases; and refine key messages for care before and after travel.
  
  
  METHODS
  Descriptive, using GeoSentinel records.
  
  
  METHODS
  53 tropical or travel disease units in 24 countries.
  
  
  METHODS
  42 173 ill returned travelers seen between 2007 and 2011.
  
  
  METHODS
  Frequencies of demographic characteristics, regions visited, and illnesses reported.
  
  
  RESULTS
  Asia (32.6%) and sub-Saharan Africa (26.7%) were the most common regions where illnesses were acquired. Three quarters of travel-related illness was due to gastrointestinal (34.0%), febrile (23.3%), and dermatologic (19.5%) diseases. Only 40.5% of all ill travelers reported pretravel medical visits. The relative frequency of many diseases varied with both travel destination and reason for travel, with travelers visiting friends and relatives in their country of origin having both a disproportionately high burden of serious febrile illness and very low rates of advice before travel (18.3%). Life-threatening diseases, such as Plasmodium falciparum malaria, melioidosis, and African trypanosomiasis, were reported.
  
  
  CONCLUSIONS
  Sentinel surveillance data collected by specialist clinics do not reflect healthy returning travelers or those with mild or self-limited illness. Data cannot be used to infer quantitative risk for illness.
  
  
  CONCLUSIONS
  Many illnesses may have been preventable with appropriate advice, chemoprophylaxis, or vaccination. Clinicians can use these 5-year GeoSentinel data to help tailor more efficient pretravel preparation strategies and evaluate possible differential diagnoses of ill returned travelers according to destination and reason for travel.
  
  
  BACKGROUND
  Centers for Disease Control and Prevention.
authors.affiliation: Victorian Infectious Disease Service, Royal Melbourne Hospital, Monash University, Austin Hospital, Melbourne University. karin.leder@monash.edu
authors.forename: Karin
authors.initials: K
authors.lastname: Leder
authors.forename: Joseph
authors.initials: J
authors.lastname: Torresi
authors.forename: Michael D
authors.initials: MD
authors.lastname: Libman
authors.forename: Jakob P
authors.initials: JP
authors.lastname: Cramer
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
authors.forename: Patricia
authors.initials: P
authors.lastname: Schlagenhauf
authors.forename: Annelies
authors.initials: A
authors.lastname: Wilder-Smith
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wilson
authors.forename: Jay S
authors.initials: JS
authors.lastname: Keystone
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Barnett
authors.forename: Frank
authors.initials: F
authors.lastname: von Sonnenburg
authors.forename: John S
authors.initials: JS
authors.lastname: Brownstein
authors.forename: Allen C
authors.initials: AC
authors.lastname: Cheng
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sotir
authors.forename: Douglas H
authors.initials: DH
authors.lastname: Esposito
authors.forename: David O
authors.initials: DO
authors.lastname: Freedman
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000453:epidemiology; D017691:Caribbean Region / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005334:Fever / Q000453:epidemiology*; D005767:Gastrointestinal Diseases / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007239:Infections / Q000453:epidemiology*; D007843:Latin America / Q000453:epidemiology; D008875:Middle Aged; D012141:Respiratory Tract Infections / Q000453:epidemiology; D018571:Sentinel Surveillance; D012871:Skin Diseases / Q000453:epidemiology*; D014195:Travel; D055815:Young Adult
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