title: Risk factors for infections in international travelers: an analysis of travel-related notifiable communicable diseases.
abstract: BACKGROUND
  We sought to describe travel-related illness among our residents and gain insight into targeting pre-travel health advice to prevent travel-related illness.
  
  
  METHODS
  A supplemental travel questionnaire was developed and administered for cases with a legally notifiable communicable disease reported in 2011-2012, who spent at least part of their exposure period outside the United States.
  
  
  RESULTS
  Among 451 cases meeting the eligibility criteria, 259 were interviewed. Forty four percent reported receiving pre-travel advice. Two-thirds adhered fully with risk behavior recommendations; 94% followed immunization recommendations partially or fully; and 84% adhered fully with malaria prophylaxis recommendations. The primary reasons for not obtaining pre-travel advice were being unaware of the need (47.5%), or believing they already knew what to do (34.5%). Adults (OR = 2.8, 95% CI = 1.4-5.5), males (OR = 1.8, 95% CI = 1.1-3.0), those born outside the United States (OR = 2.0, 95% CI = 1.1-3.7), and those with planning time under two weeks (OR = 4.8, 95% CI = 1.5-15.9) or travel duration less than 7 days (OR = 7.9, 95% CI = 3.0-20.9) were more likely to travel without seeking pre-travel advice.
  
  
  CONCLUSIONS
  The majority of cases reported not receiving pre-travel advice. Understanding the predictors of failure to receive pre-travel advice may help target public health prevention efforts.
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: atar.baer@kingcounty.gov.
authors.forename: Atar
authors.initials: A
authors.lastname: Baer
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: llibassi@uw.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Libassi
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: Jenny.Lloyd@kingcounty.gov.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Lloyd
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: Eileen.Benoliel@kingcounty.gov.
authors.forename: Eileen
authors.initials: E
authors.lastname: Benoliel
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: rsbrucker@comcast.net.
authors.forename: Rachel
authors.initials: R
authors.lastname: Brucker
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: Megan.Jones@kingcounty.gov.
authors.forename: Megan Q
authors.initials: MQ
authors.lastname: Jones
authors.affiliation: Northwest Center for Public Health Practice, University of Washington, 1107 NE 45th Street, Suite 400, Seattle, WA 98105, USA. Electronic address: kwangett@uw.edu.
authors.forename: Tao Sheng
authors.initials: TS
authors.lastname: Kwan-Gett
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: Shelly.McKeirnan@kingcounty.gov.
authors.forename: Shelly
authors.initials: S
authors.lastname: McKeirnan
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: monica.pecha@kingcounty.gov.
authors.forename: Monica
authors.initials: M
authors.lastname: Pecha
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: Krista.Rietberg@kingcounty.gov.
authors.forename: Krista
authors.initials: K
authors.lastname: Rietberg
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: Lauri.Serafin@kingcounty.gov.
authors.forename: Lauri
authors.initials: L
authors.lastname: Serafin
authors.affiliation: University of Washington, Box 357230, Seattle, WA 98195, USA. Electronic address: walkinsl@uw.edu.
authors.forename: Lina P
authors.initials: LP
authors.lastname: Walkinshaw
authors.affiliation: Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA 98104, USA. Electronic address: Jeff.Duchin@kingcounty.gov.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Duchin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000453:epidemiology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014195:Travel / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Communicable disease; Infectious disease; Notifiable conditions; Public health surveillance; Travel