title: Pre-Travel Health Preparation of Pediatric International Travelers: Analysis From the Global TravEpiNet Consortium.
abstract: BACKGROUND
  Children frequently travel internationally. Health-related data on such children are limited. We sought to investigate the demographics, health characteristics, and preventive interventions of outbound US international pediatric travelers.
  
  
  METHODS
  We analyzed data from 32 099 travelers presenting for pre-travel healthcare at the Global TravEpiNet (GTEN), a national consortium of 19 travel clinics, from January 1, 2009 to June 6, 2012.
  
  
  RESULTS
  A total of 3332 (10%) of all GTEN travelers were children (<18 years of age). These children traveled mostly for leisure (36%) or to visit friends or relatives (VFR) (36%). Most popular destination regions were Africa (41%), Southeast Asia (16%), Central America (16%), and the Caribbean (16%). Compared with children traveling for leisure, VFR children were more likely to present <14 days before departure for pre-travel consultation (44% vs 28%), intended to travel for 28 days or longer (70% vs 22%), and to travel to Africa (62% vs 32%). Nearly half of the pediatric travelers (46%) received at least 1 routine vaccine, and most (83%) received at least 1 travel-related vaccine. Parents or guardians of one third of the children (30%) refused at least 1 recommended travel-related vaccine. Most pediatric travelers visiting a malaria-endemic country (72%) received a prescription for malaria chemoprophylaxis.
  
  
  CONCLUSIONS
  Ten percent of travelers seeking pre-travel healthcare at GTEN sites are children. VFR-travel, pre-travel consultation close to time of departure, and refusal of recommended vaccines may place children at risk for travel-associated illness. Strategies to engage pediatric travelers in timely, pre-travel care and improve acceptance of pre-travel healthcare interventions are needed.
authors.affiliation: Division of Pediatric Infectious Diseases, Bronx Lebanon Hospital Center, and Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hagmann
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, and Department of Medicine, Harvard Medical School, Boston.
authors.forename: Regina C
authors.initials: RC
authors.lastname: LaRocque
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, and Center for Health Quality, Outcomes and Economic Research, Veterans Administration Medical Center, Bedford, Massachusetts.
authors.forename: Sowmya R
authors.initials: SR
authors.lastname: Rao
authors.affiliation: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Jentes
authors.affiliation: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sotir
authors.affiliation: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Gary
authors.initials: G
authors.lastname: Brunette
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, and Department of Medicine, Harvard Medical School, Boston.
authors.forename: Edward T
authors.initials: ET
authors.lastname: Ryan
keywords: Children; International; Preventioin; Travel; Travelers’ Health; Vaccination