title: Travel-related infection in European travelers, EuroTravNet 2011.
abstract: BACKGROUND
  Limited data exist on infectious diseases imported to various locations in Europe, particularly after travel within the continent.
  
  
  METHODS
  To investigate travel-related disease relevant to Europe that is potentially preventable through pre-travel intervention, we analyzed the EuroTravNet database of 5,965 ill travelers reported by 16 centers in "Western" Europe in 2011.
  
  
  RESULTS
  There were 54 cases of vaccine-preventable disease, mostly hepatitis A (n = 16), typhoid fever (n = 11), and measles (n = 8); 6 cases (including 3 measles cases) were associated with travel within "Western" Europe. Malaria was the most commonly diagnosed infection (n = 482, 8.1% of all travel-related morbidity). Among patients with malaria, the military most commonly received pre-travel advice (95%), followed by travelers for missionary, volunteer, research, or aid work (81%) but travelers visiting friends and relatives (VFRs) were least likely to receive pre-travel advice (21%). The vast majority (96%) of malaria patients were resident in "Western" Europe, but over half (56%) were born elsewhere. Other significant causes of morbidity, which could be reduced through advice and behavioral change, include Giardia (n = 221, 3.7%), dengue (n = 146, 2.4%), and schistosomiasis (n = 131, 2.2%). Of 206 (3.5%) travelers with exposure in "Western" Europe, 75% were tourists; the highest burden of disease was acute gastrointestinal infection (35% cases). Travel from "Eastern" Europe (n = 132, 2.2%) was largely associated with migration-related travel (53%); among chronic infectious diseases, tuberculosis was frequently diagnosed (n = 20). Travelers VFRs contributed the largest group of malaria patients (46%), but also had the lowest documented rate of pre-travel health advice in this subset (20%). Overall, 44% of nonimmigrant ill travelers did not receive pre-travel advice.
  
  
  CONCLUSIONS
  There is a burden of infectious diseases in travelers attending European health centers that is potentially preventable through comprehensive pre-travel advice, chemoprophylaxis, and vaccination. Targeted interventions for high-risk groups such as travelers VFRs and migration-associated travelers are of particular importance.
authors.affiliation: Department of Infectious Diseases, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Warne
authors.forename: Leisa H
authors.initials: LH
authors.lastname: Weld
authors.forename: Jakob P
authors.initials: JP
authors.lastname: Cramer
authors.forename: Vanessa K
authors.initials: VK
authors.lastname: Field
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
authors.forename: Eric
authors.initials: E
authors.lastname: Caumes
authors.forename: Mogens
authors.initials: M
authors.lastname: Jensenius
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
authors.forename: Patricia
authors.initials: P
authors.lastname: Schlagenhauf
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
authors.forename: David G
authors.initials: DG
authors.lastname: Lalloo
authors.forename: Johan
authors.initials: J
authors.lastname: Ursing
authors.forename: François
authors.initials: F
authors.lastname: Chappuis
authors.forename: Frank
authors.initials: F
authors.lastname: von Sonnenburg
authors.forename: Rogelio
authors.initials: R
authors.lastname: López-Vélez
authors.forename: Christophe
authors.initials: C
authors.lastname: Rapp
authors.forename: Kitty C
authors.initials: KC
authors.lastname: Smith
authors.forename: Philippe
authors.initials: P
authors.lastname: Parola
authors.forename: Effrossyni
authors.initials: E
authors.lastname: Gkrania-Klotsas
mesh_terms: D003141:Communicable Diseases / Q000175:diagnosis / Q000453:epidemiology*; D003715:Dengue / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006506:Hepatitis A / Q000453:epidemiology; D006801:Humans; D008297:Male; D008457:Measles / Q000453:epidemiology; D011159:Population Surveillance; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012552:Schistosomiasis / Q000453:epidemiology; D012871:Skin Diseases / Q000453:epidemiology; D014195:Travel / Q000706:statistics & numerical data*; D014435:Typhoid Fever / Q000453:epidemiology