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Illness among US resident student travellers after return to the USA: a GeoSentinel analysis, 2007-17.
J Travel Med. 2018 01 01; 25(1)JT

Abstract

Background

The number of US students studying abroad more than tripled during the past 20 years. As study abroad programmes' destinations diversify, students increasingly travel to resource-limited countries, placing them at risk for infectious diseases. Data describing infections acquired by US students while travelling internationally are limited. We describe illnesses among students who returned from international travel and suggest how to prevent illness among these travellers.

Methods

GeoSentinel is a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. This study included the records of US resident student international travellers, 17-24 years old, who returned to the USA, had a confirmed travel-related illness at one of 15 US GeoSentinel sites during 2007-17 and had a documented exposure region. Records were analysed to describe demographic and travel characteristics and diagnoses.

Results

The study included 432 students. The median age was 21 years; 69% were female. More than 70% had a pre-travel consultation with a healthcare provider. The most common exposure region was sub-Saharan Africa (112; 26%). Students were most commonly exposed in India (44; 11%), Ecuador (28; 7%), Ghana (25; 6%) and China (24; 6%). The median duration of travel abroad was 40 days (range: 1-469) and presented to a GeoSentinel site a median of 8 days (range: 0-181) after travel; 98% were outpatients. Of 581 confirmed diagnoses, the most common diagnosis category was gastrointestinal (45%). Acute diarrhoea was the most common gastrointestinal diagnosis (113 of 261; 43%). Thirty-one (7%) students had vector-borne diseases [14 (41%) malaria and 11 (32%) dengue]. Three had vaccine-preventable diseases (two typhoid; one hepatitis A); two had acute human immunodeficiency virus infection.

Conclusions

Students experienced travel-related infections, despite the majority having a pre-travel consultation. US students should receive pre-travel advice, vaccinations and chemoprophylaxis to prevent gastrointestinal, vector-borne, sexually transmitted and vaccine-preventable infections.

Authors+Show Affiliations

Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.Hall Health Center, University of Washington, Seattle, WA, USA.Hall Health Center, University of Washington, Seattle, WA, USA.Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, USA.Division of Infectious Diseases, Mt. Auburn Hospital, Cambridge, MA, USA. Department of Medicine, Harvard Medical School, Boston, MA, USA.Department of Pediatrics, Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA.Division of Pediatric Infectious Disease, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY, USA. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA.New York Center for Travel and Tropical Medicine, New York, NY, USA. Weill Department of Medicine, Weill Cornell Medical College, New York, NY, USA.Department of Medicine/Infectious Diseases, Stanford University, Palo Alto, CA, USA.Department of Medicine, University of Ottawa, Ottawa, Canada.James Cook University, Queensland, Australia. Worldwise Travellers' Health Centres, Auckland, New Zealand.Institute for Tropical Diseases, Harbour Hospital, Rotterdam, The Netherlands.Department of Global Health, Boston University School of Public Health, Boston, MA, USA. Department of Medicine, Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

30202952

Citation

Angelo, Kristina M., et al. "Illness Among US Resident Student Travellers After Return to the USA: a GeoSentinel Analysis, 2007-17." Journal of Travel Medicine, vol. 25, no. 1, 2018.
Angelo KM, Haulman NJ, Terry AC, et al. Illness among US resident student travellers after return to the USA: a GeoSentinel analysis, 2007-17. J Travel Med. 2018;25(1).
Angelo, K. M., Haulman, N. J., Terry, A. C., Leung, D. T., Chen, L. H., Barnett, E. D., Hagmann, S. H. F., Hynes, N. A., Connor, B. A., Anderson, S., McCarthy, A., Shaw, M., Van Genderen, P. J. J., & Hamer, D. H. (2018). Illness among US resident student travellers after return to the USA: a GeoSentinel analysis, 2007-17. Journal of Travel Medicine, 25(1). https://doi.org/10.1093/jtm/tay074
Angelo KM, et al. Illness Among US Resident Student Travellers After Return to the USA: a GeoSentinel Analysis, 2007-17. J Travel Med. 2018 01 1;25(1) PubMed PMID: 30202952.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Illness among US resident student travellers after return to the USA: a GeoSentinel analysis, 2007-17. AU - Angelo,Kristina M, AU - Haulman,N Jean, AU - Terry,Anne C, AU - Leung,Daniel T, AU - Chen,Lin H, AU - Barnett,Elizabeth D, AU - Hagmann,Stefan H F, AU - Hynes,Noreen A, AU - Connor,Bradley A, AU - Anderson,Susan, AU - McCarthy,Anne, AU - Shaw,Marc, AU - Van Genderen,Perry J J, AU - Hamer,Davidson H, PY - 2018/06/01/received PY - 2018/08/20/accepted PY - 2018/9/12/pubmed PY - 2019/7/16/medline PY - 2018/9/12/entrez JF - Journal of travel medicine JO - J Travel Med VL - 25 IS - 1 N2 - Background: The number of US students studying abroad more than tripled during the past 20 years. As study abroad programmes' destinations diversify, students increasingly travel to resource-limited countries, placing them at risk for infectious diseases. Data describing infections acquired by US students while travelling internationally are limited. We describe illnesses among students who returned from international travel and suggest how to prevent illness among these travellers. Methods: GeoSentinel is a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. This study included the records of US resident student international travellers, 17-24 years old, who returned to the USA, had a confirmed travel-related illness at one of 15 US GeoSentinel sites during 2007-17 and had a documented exposure region. Records were analysed to describe demographic and travel characteristics and diagnoses. Results: The study included 432 students. The median age was 21 years; 69% were female. More than 70% had a pre-travel consultation with a healthcare provider. The most common exposure region was sub-Saharan Africa (112; 26%). Students were most commonly exposed in India (44; 11%), Ecuador (28; 7%), Ghana (25; 6%) and China (24; 6%). The median duration of travel abroad was 40 days (range: 1-469) and presented to a GeoSentinel site a median of 8 days (range: 0-181) after travel; 98% were outpatients. Of 581 confirmed diagnoses, the most common diagnosis category was gastrointestinal (45%). Acute diarrhoea was the most common gastrointestinal diagnosis (113 of 261; 43%). Thirty-one (7%) students had vector-borne diseases [14 (41%) malaria and 11 (32%) dengue]. Three had vaccine-preventable diseases (two typhoid; one hepatitis A); two had acute human immunodeficiency virus infection. Conclusions: Students experienced travel-related infections, despite the majority having a pre-travel consultation. US students should receive pre-travel advice, vaccinations and chemoprophylaxis to prevent gastrointestinal, vector-borne, sexually transmitted and vaccine-preventable infections. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/30202952/Illness_among_US_resident_student_travellers_after_return_to_the_USA:_a_GeoSentinel_analysis_2007_17_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1093/jtm/tay074 DB - PRIME DP - Unbound Medicine ER -