title: Travel-associated illness trends and clusters, 2000-2010.
abstract: Longitudinal data examining travel-associated illness patterns are lacking. To address this need and determine trends and clusters in travel-related illness, we examined data for 2000-2010, prospectively collected for 42,223 ill travelers by 18 GeoSentinel sites. The most common destinations from which ill travelers returned were sub-Saharan Africa (26%), Southeast Asia (17%), south-central Asia (15%), and South America (10%). The proportion who traveled for tourism decreased significantly, and the proportion who traveled to visit friends and relatives increased. Among travelers returning from malaria-endemic regions, the proportionate morbidity (PM) for malaria decreased; in contrast, the PM trends for enteric fever and dengue (excluding a 2002 peak) increased. Case clustering was detected for malaria (Africa 2000, 2007), dengue (Thailand 2002, India 2003), and enteric fever (Nepal 2009). This multisite longitudinal analysis highlights the utility of sentinel surveillance of travelers for contributing information on disease activity trends and an evidence base for travel medicine recommendations.
authors.affiliation: Royal Melbourne Hospital, Parkville, Victoria,Australia. karin.leder@monash.edu
authors.forename: Karin
authors.initials: K
authors.lastname: Leder
authors.forename: Joseph
authors.initials: J
authors.lastname: Torresi
authors.forename: John S
authors.initials: JS
authors.lastname: Brownstein
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wilson
authors.forename: Jay S
authors.initials: JS
authors.lastname: Keystone
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barnett
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
authors.forename: Patricia
authors.initials: P
authors.lastname: Schlagenhauf
authors.forename: Annelies
authors.initials: A
authors.lastname: Wilder-Smith
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
authors.forename: Frank
authors.initials: F
authors.lastname: von Sonnenburg
authors.forename: David O
authors.initials: DO
authors.lastname: Freedman
authors.forename: Allen C
authors.initials: AC
authors.lastname: Cheng
mesh_terms: D016000:Cluster Analysis; D003715:Dengue / Q000453:epidemiology*; D006693:Holidays; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008288:Malaria / Q000453:epidemiology*; D018571:Sentinel Surveillance; D014195:Travel; D014435:Typhoid Fever / Q000453:epidemiology*
keywords: VFRs; case clusters; illness; surveillance; travel; trends; visiting friends and relatives