title: The contribution of travellers visiting friends and relatives to notified infectious diseases in Australia: state-based enhanced surveillance.
abstract: Immigrants and their children who return to their country of origin to visit friends and relatives (VFR) are at increased risk of acquiring infectious diseases compared to other travellers. VFR travel is an important disease control issue, as one quarter of Australia's population are foreign-born and one quarter of departing Australian international travellers are visiting friends and relatives. We conducted a 1-year prospective enhanced surveillance study in New South Wales and Victoria, Australia to determine the contribution of VFR travel to notifiable diseases associated with travel, including typhoid, paratyphoid, measles, hepatitis A, hepatitis E, malaria and chikungunya. Additional data on characteristics of international travel were collected. Recent international travel was reported by 180/222 (81%) enhanced surveillance cases, including all malaria, chikungunya and paratyphoid cases. The majority of cases who acquired infections during travel were immigrant Australians (96, 53%) or their Australian-born children (43, 24%). VFR travel was reported by 117 (65%) travel-associated cases, highest for typhoid (31/32, 97%). Cases of children (aged <18 years) (86%) were more frequently VFR travellers compared to adult travellers (57%, P < 0·001). VFR travel is an important contributor to imported disease in Australia. Communicable disease control strategies targeting these travellers, such as targeted health promotion, are likely to impact importation of these travel-related infections.
authors: School of Public Health & Community Medicine,UNSW Australia,Sydney,NSW,Australia.
authors: A E
authors: AE
authors: Heywood
authors: School of Public Health & Community Medicine,UNSW Australia,Sydney,NSW,Australia.
authors: N
authors: N
authors: Zwar
authors: Public Health Unit,Nepean Blue Mountains Local Health District,NSW,Australia.
authors: B L
authors: BL
authors: Forssman
authors: School of Public Health & Community Medicine,UNSW Australia,Sydney,NSW,Australia.
authors: H
authors: H
authors: Seale
authors: Health Protection Branch,Victorian Department of Health and Human Services,Melbourne,Victoria,Australia.
authors: N
authors: N
authors: Stephens
authors: NSW Ministry of Health,Sydney,NSW,Australia.
authors: J
authors: J
authors: Musto
authors: Health Protection Branch,Victorian Department of Health and Human Services,Melbourne,Victoria,Australia.
authors: C
authors: C
authors: Lane
authors: NSW Ministry of Health,Sydney,NSW,Australia.
authors: B
authors: B
authors: Polkinghorne
authors: School of Public Health & Community Medicine,UNSW Australia,Sydney,NSW,Australia.
authors: M
authors: M
authors: Sheikh
authors: NSW Refugee Health Service,NSW,Australia.
authors: M
authors: M
authors: Smith
authors: School of Public Health & Community Medicine,UNSW Australia,Sydney,NSW,Australia.
authors: H
authors: H
authors: Worth
authors: School of Public Health & Community Medicine,UNSW Australia,Sydney,NSW,Australia.
authors: C R
authors: CR
authors: Macintyre
keywords: Australia; enhanced surveillance; immigrants; infectious diseases; travel; visiting friends and relatives