Self-reported illness among Boston-area international travelers: A prospective study.
BACKGROUND
The Boston Area Travel Medicine Network surveyed travelers on travel-related health problems.


METHODS
Travelers were recruited 2009-2011 during pre-travel consultation at three clinics. The investigation included pre-travel data, weekly during-travel diaries, and a post-travel questionnaire. We analyzed demographics, trip characteristics, health problems experienced, and assessed the relationship between influenza vaccination, influenza prevention advice, and respiratory symptoms.


RESULTS
Of 987 enrolled travelers, 628 (64%) completed all surveys, of which 400 (64%) reported health problems during and/or after travel; median trip duration was 12 days. Diarrhea affected the most people during travel (172) while runny/stuffy nose affected the most people after travel (95). Of those with health problems during travel, 25% stopped or altered plans; 1% were hospitalized. After travel, 21% stopped planned activities, 23% sought physician or other health advice; one traveler was hospitalized. Travelers who received influenza vaccination and influenza prevention advice had lower rates of respiratory symptoms than those that received influenza prevention advice alone (18% vs 28%, P = 0.03).


CONCLUSIONS
A large proportion of Boston-area travelers reported health problems despite pre-travel consultation, resulting in inconveniences. The combination of influenza prevention advice and influenza immunization was associated with fewer respiratory symptoms than those who received influenza prevention advice alone.
Travel Medicine Center, Mount Auburn Hospital, Cambridge, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: lchen@hms.harvard.edu.
Lin H
LH
Chen
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Pauline V
PV
Han
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Mary E
ME
Wilson
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Rhett J
RJ
Stoney
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Emily S
ES
Jentes
Children's Hospitals and Clinics of Minnesota, Department of Research and Sponsored Programs, Minneapolis, MN, USA.
Christine
C
Benoit
Travel and Tropical Medicine Clinic, Lahey Clinic Medical Center, Burlington, MA, USA.
Winnie W
WW
Ooi
Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, MA, USA.
Elizabeth D
ED
Barnett
Center for Global Health and Development, Boston University School of Public Health, Boston, MA, USA; Department of Global Health, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA. Electronic address: dhamer@bu.edu.
Davidson H
DH
Hamer
D000328:Adult; D001900:Boston; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007114:Immunization; D007252:Influenza Vaccines / Q000008:administration & dosage; D007251:Influenza, Human / Q000517:prevention & control; D038622:Internationality; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D057566:Self Report; D014195:Travel; D055815:Young Adult
D007252:Influenza Vaccines
Influenza; Knowledge-attitudes-practices; Survey; Travel; Travel-associated health problems
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