TY - JOUR
T1 - Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data
AU - Grobusch, Martin P.
AU - Weld, Leisa
AU - Goorhuis, Abraham
AU - Hamer, Davidson H.
AU - Schunk, Mirjam
AU - Jordan, Sabine
AU - Mockenhaupt, Frank P.
AU - Chappuis, François
AU - Asgeirsson, Hilmir
AU - Caumes, Eric
AU - Jensenius, Mogens
AU - van Genderen, Perry J.J.
AU - Castelli, Francesco
AU - López-Velez, Rogelio
AU - Field, Vanessa
AU - Bottieau, Emmanuel
AU - Molina, Israel
AU - Rapp, Christophe
AU - Ménendez, Marta Díaz
AU - Gkrania-Klotsas, Effrossyni
AU - Larsen, Carsten S.
AU - Malvy, Denis
AU - Lalloo, David
AU - Gobbi, Federico
AU - Florescu, Simin A.
AU - Gautret, Philippe
AU - Schlagenhauf, Patricia
PY - 2021/2/1
Y1 - 2021/2/1
N2 - BackgroundDisease epidemiology of (re-)emerging infectious diseases is changing rapidly, rendering surveillance of travel-associated illness important. Methods We evaluated travel-related illness encountered at EuroTravNet clinics, the European surveillance sub-network of GeoSentinel, between March 1, 1998 and March 31, 2018. Findings103,739 ill travellers were evaluated, including 11,239 (10.8%) migrants, 89,620 (86.4%) patients seen post-travel, and 2,880 (2.8%) during and after travel. Despite increasing numbers of patient encounters over 20 years, the regions of exposure by year of clinic visits have remained stable. In 5-year increments, greater proportions of patients were migrants or visiting friends and relatives (VFR); business travel-associated illness remained stable; tourism-related illness decreased. Falciparum malaria was amongst the most-frequently diagnosed illnesses with 5,254 cases (5.1% of all patients) and the most-frequent cause of death (risk ratio versus all other illnesses 2.5:1). Animal exposures requiring rabies post-exposure prophylaxis increased from 0.7% (1998-2002) to 3.6% (2013-2018). The proportion of patients with seasonal influenza increased from zero in 1998-2002 to 0.9% in 2013-2018. There were 44 cases of viral haemorrhagic fever, most during the past five years. Arboviral infection numbers increased significantly as did the range of presenting arboviral diseases, Dengue and chikungunya diagnoses increased by 2.6% and 1%, respectively. InterpretationTravel medicine must adapt to serve the changing profile of travellers, with an increase in migrants and persons visiting relatives and friends and the strong emergence of vector-borne diseases, with potential for further local transmission in Europe. FundingThis project was supported by a cooperative agreement (U50CK00189) between the Centers for Disease Control and Prevention to the International Society of Travel Medicine (ISTM) and funding from the ISTM and the Public Health Agency of Canada.
AB - BackgroundDisease epidemiology of (re-)emerging infectious diseases is changing rapidly, rendering surveillance of travel-associated illness important. Methods We evaluated travel-related illness encountered at EuroTravNet clinics, the European surveillance sub-network of GeoSentinel, between March 1, 1998 and March 31, 2018. Findings103,739 ill travellers were evaluated, including 11,239 (10.8%) migrants, 89,620 (86.4%) patients seen post-travel, and 2,880 (2.8%) during and after travel. Despite increasing numbers of patient encounters over 20 years, the regions of exposure by year of clinic visits have remained stable. In 5-year increments, greater proportions of patients were migrants or visiting friends and relatives (VFR); business travel-associated illness remained stable; tourism-related illness decreased. Falciparum malaria was amongst the most-frequently diagnosed illnesses with 5,254 cases (5.1% of all patients) and the most-frequent cause of death (risk ratio versus all other illnesses 2.5:1). Animal exposures requiring rabies post-exposure prophylaxis increased from 0.7% (1998-2002) to 3.6% (2013-2018). The proportion of patients with seasonal influenza increased from zero in 1998-2002 to 0.9% in 2013-2018. There were 44 cases of viral haemorrhagic fever, most during the past five years. Arboviral infection numbers increased significantly as did the range of presenting arboviral diseases, Dengue and chikungunya diagnoses increased by 2.6% and 1%, respectively. InterpretationTravel medicine must adapt to serve the changing profile of travellers, with an increase in migrants and persons visiting relatives and friends and the strong emergence of vector-borne diseases, with potential for further local transmission in Europe. FundingThis project was supported by a cooperative agreement (U50CK00189) between the Centers for Disease Control and Prevention to the International Society of Travel Medicine (ISTM) and funding from the ISTM and the Public Health Agency of Canada.
KW - Eurotravnet
KW - Geosentinel
KW - Infectious diseases
KW - Sentinel surveillance
KW - travel
U2 - 10.1016/j.lanepe.2020.100001
DO - 10.1016/j.lanepe.2020.100001
M3 - Article
SN - 2666-7762
VL - 1
SP - 100001
JO - The Lancet Regional Health - Europe
JF - The Lancet Regional Health - Europe
M1 - 100001
ER -
