Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data

Martin P. Grobusch; Leisa Weld; Abraham Goorhuis; Davidson H. Hamer; Mirjam Schunk; Sabine Jordan; Frank P. Mockenhaupt; François Chappuis; Hilmir Asgeirsson; Eric Caumes; Mogens Jensenius; Perry J.J. van Genderen; Francesco Castelli; Rogelio López-Velez; Vanessa Field; Emmanuel Bottieau; Israel Molina; Christophe Rapp; Marta Díaz Ménendez; Effrossyni Gkrania-Klotsas; Carsten S. Larsen; Denis Malvy; David Lalloo; Federico Gobbi; Simin A. Florescu; Philippe Gautret; Patricia Schlagenhauf

doi:10.1016/j.lanepe.2020.100001

Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data

Martin P. Grobusch
, Leisa Weld
, Abraham Goorhuis
, Davidson H. Hamer
, Mirjam Schunk
, Sabine Jordan
, Frank P. Mockenhaupt
, François Chappuis
, Hilmir Asgeirsson
, Eric Caumes
, Mogens Jensenius
, Perry J.J. van Genderen
, Francesco Castelli
, Rogelio López-Velez
, Vanessa Field
, Emmanuel Bottieau
, Israel Molina
, Christophe Rapp
, Marta Díaz Ménendez
, Effrossyni Gkrania-Klotsas

Carsten S. Larsen, Denis Malvy, David Lalloo, Federico Gobbi, Simin A. Florescu, Philippe Gautret, Patricia Schlagenhauf

Academic Medical Center
Statistical Consultant
Boston University
Ludwig Maximilian University of Munich
University of Hamburg
Charité – Universitätsmedizin Berlin
University of Geneva
Karolinska Institutet
Sorbonne Université
University of Oslo
Erasmus University Rotterdam
University of Brescia
Hospital Ramon y Cajal
InterHealth Worldwide
Institute of Tropical Medicine Antwerp
Hospital Vall d'Hebron
Hôpital d'instruction des armées Bégin
Hospital Universitario La Paz
University of Cambridge
Aarhus University
Centre Hospitalier Universitaire de Bordeaux
Liverpool University Hospitals NHS Foundation Trust
IRCCS Sacro Cuore Don Calabria
Victor Babes National Institute
Aix Marseille University
University of Zurich

Research output: Contribution to journal › Article › peer-review

70 Citations (Scopus)

Abstract

Background

Disease 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.

Findings

103,739 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.

Interpretation

Travel 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.

Funding

This 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.

Original language	English
Article number	100001
Pages (from-to)	100001
Journal	The Lancet Regional Health - Europe
Volume	1
Early online date	15 Dec 2020
DOIs	https://doi.org/10.1016/j.lanepe.2020.100001
Publication status	Published - 1 Feb 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Eurotravnet
Geosentinel
Infectious diseases
Sentinel surveillance
travel

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10.1016/j.lanepe.2020.100001Licence: CC BY

1-s2Accepted author manuscript, 1.43 MBLicence: CC BY

Cite this

Grobusch, M. P., Weld, L., Goorhuis, A., Hamer, D. H., Schunk, M., Jordan, S., Mockenhaupt, F. P., Chappuis, F., Asgeirsson, H., Caumes, E., Jensenius, M., van Genderen, P. J. J., Castelli, F., López-Velez, R., Field, V., Bottieau, E., Molina, I., Rapp, C., Ménendez, M. D., ... Schlagenhauf, P. (2021). Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data. The Lancet Regional Health - Europe, 1, 100001. Article 100001. https://doi.org/10.1016/j.lanepe.2020.100001

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title = "Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data",

abstract = "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.",

keywords = "Eurotravnet, Geosentinel, Infectious diseases, Sentinel surveillance, travel",

author = "Grobusch, \{Martin P.\} and Leisa Weld and Abraham Goorhuis and Hamer, \{Davidson H.\} and Mirjam Schunk and Sabine Jordan and Mockenhaupt, \{Frank P.\} and Fran{\c c}ois Chappuis and Hilmir Asgeirsson and Eric Caumes and Mogens Jensenius and \{van Genderen\}, \{Perry J.J.\} and Francesco Castelli and Rogelio L{\'o}pez-Velez and Vanessa Field and Emmanuel Bottieau and Israel Molina and Christophe Rapp and M{\'e}nendez, \{Marta D{\'i}az\} and Effrossyni Gkrania-Klotsas and Larsen, \{Carsten S.\} and Denis Malvy and David Lalloo and Federico Gobbi and Florescu, \{Simin A.\} and Philippe Gautret and Patricia Schlagenhauf",

year = "2021",

month = feb,

day = "1",

doi = "10.1016/j.lanepe.2020.100001",

language = "English",

volume = "1",

pages = "100001",

journal = "The Lancet Regional Health - Europe",

issn = "2666-7762",

publisher = "Elsevier Ltd",

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Grobusch, MP, Weld, L, Goorhuis, A, Hamer, DH, Schunk, M, Jordan, S, Mockenhaupt, FP, Chappuis, F, Asgeirsson, H, Caumes, E, Jensenius, M, van Genderen, PJJ, Castelli, F, López-Velez, R, Field, V, Bottieau, E, Molina, I, Rapp, C, Ménendez, MD, Gkrania-Klotsas, E, Larsen, CS, Malvy, D, Lalloo, D, Gobbi, F, Florescu, SA, Gautret, P & Schlagenhauf, P 2021, 'Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data', The Lancet Regional Health - Europe, vol. 1, 100001, pp. 100001. https://doi.org/10.1016/j.lanepe.2020.100001

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 -

Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data

Abstract

UN SDGs

Keywords

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