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What proportion of international travellers acquire a travel-related illness? A review of the literature.
J Travel Med. 2017 Sep 01; 24(5)JT

Abstract

Introduction

As international travel increases, travellers may be at increased risk of acquiring infectious diseases not endemic in their home countries. Many journal articles and reference books related to travel medicine cite that between 22-64% of international travellers become ill during or after travel; however, this information is minimal, outdated and limited by poor generalizability. We aim to provide a current and more accurate estimate of the proportion of international travellers who acquire a travel-related illness.

Methods

We identified studies via PubMed or travel medicine experts, published between January 1, 1976-December 31, 2016 that included the number of international travellers acquiring a travel-related illness. We excluded studies that focused on a single disease or did not determine a rate based on the total number of travellers. We abstracted information on traveller demographics, trip specifics, study enrollment and follow-up and number of ill travellers and their illnesses.

Results

Of 743 studies, nine met the inclusion criteria. The data sources were from North America (four studies) and Europe (five studies). Most travellers were tourists, the most frequent destination regions were Asia and Africa, and the median trip duration ranged from 8-21 days. Six studies enrolled participants at the travellers' pre-travel consultation. All studies collected data through either extraction from the medical record, weekly diaries, or pre- and post-travel questionnaires. Data collection timeframes varied by study. Between 6-87% of travellers became ill across all studies. Four studies provided the best estimate: between 43-79% of travellers who frequently visited developing nations (e.g. India, Tanzania, and Kenya) became ill; travellers most frequently reported diarrhoea.

Conclusion

This is the most comprehensive assessment available on the proportion of international travellers that develop a travel-related illness. Additional cohort studies would provide needed data to more precisely determine the rates of illness in international travellers.

Keywords

International travel, travel, illness.

Authors+Show Affiliations

Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329, USA.Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329, USA. Department of Medicine, Emory University, 1364 Clifton Rd NE, Atlanta, GA 30322, USA.Massachusetts General Hospital Travelers' Advice and Immunization Center, 55 Fruit Street, Boston, MA 02114, USA. Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA.Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA. Mount Auburn Hospital, 330 Mt. Auburn St, Cambridge, MA, 02138, USA.Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28931136

Citation

Angelo, Kristina M., et al. "What Proportion of International Travellers Acquire a Travel-related Illness? a Review of the Literature." Journal of Travel Medicine, vol. 24, no. 5, 2017.
Angelo KM, Kozarsky PE, Ryan ET, et al. What proportion of international travellers acquire a travel-related illness? A review of the literature. J Travel Med. 2017;24(5).
Angelo, K. M., Kozarsky, P. E., Ryan, E. T., Chen, L. H., & Sotir, M. J. (2017). What proportion of international travellers acquire a travel-related illness? A review of the literature. Journal of Travel Medicine, 24(5). https://doi.org/10.1093/jtm/tax046
Angelo KM, et al. What Proportion of International Travellers Acquire a Travel-related Illness? a Review of the Literature. J Travel Med. 2017 Sep 1;24(5) PubMed PMID: 28931136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What proportion of international travellers acquire a travel-related illness? A review of the literature. AU - Angelo,Kristina M, AU - Kozarsky,Phyllis E, AU - Ryan,Edward T, AU - Chen,Lin H, AU - Sotir,Mark J, PY - 2017/06/07/accepted PY - 2017/9/21/entrez PY - 2017/9/21/pubmed PY - 2018/5/16/medline JF - Journal of travel medicine JO - J Travel Med VL - 24 IS - 5 N2 - Introduction: As international travel increases, travellers may be at increased risk of acquiring infectious diseases not endemic in their home countries. Many journal articles and reference books related to travel medicine cite that between 22-64% of international travellers become ill during or after travel; however, this information is minimal, outdated and limited by poor generalizability. We aim to provide a current and more accurate estimate of the proportion of international travellers who acquire a travel-related illness. Methods: We identified studies via PubMed or travel medicine experts, published between January 1, 1976-December 31, 2016 that included the number of international travellers acquiring a travel-related illness. We excluded studies that focused on a single disease or did not determine a rate based on the total number of travellers. We abstracted information on traveller demographics, trip specifics, study enrollment and follow-up and number of ill travellers and their illnesses. Results: Of 743 studies, nine met the inclusion criteria. The data sources were from North America (four studies) and Europe (five studies). Most travellers were tourists, the most frequent destination regions were Asia and Africa, and the median trip duration ranged from 8-21 days. Six studies enrolled participants at the travellers' pre-travel consultation. All studies collected data through either extraction from the medical record, weekly diaries, or pre- and post-travel questionnaires. Data collection timeframes varied by study. Between 6-87% of travellers became ill across all studies. Four studies provided the best estimate: between 43-79% of travellers who frequently visited developing nations (e.g. India, Tanzania, and Kenya) became ill; travellers most frequently reported diarrhoea. Conclusion: This is the most comprehensive assessment available on the proportion of international travellers that develop a travel-related illness. Additional cohort studies would provide needed data to more precisely determine the rates of illness in international travellers. Keywords: International travel, travel, illness. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/28931136/full_citation L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1093/jtm/tax046 DB - PRIME DP - Unbound Medicine ER -