Illness among US resident student travellers after return to the USA: a GeoSentinel analysis, 2007–17

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.

Epidemiology of imported infectious diseases, China, 2014–18

“… 11 Several studies based on GeoSentinel, a worldwide network of specialized tropical and travel medicine clinics, reported the most commonly encountered disorders to be gastrointestinal, systemic febrile illness, dermatologic and respiratory problems. 3 , 7 , 9 The travel destination could greatly affect infection types, e.g. the most common and specific diagnosis amongst travellers arriving from West Africa was malaria (310 of 770, 40.3%), 12 while travellers to northern Africa commonly reported gastrointestinal illnesses.…”

Dengue vaccine development by the year 2020: challenges and prospects

“… 45 ], more frequent than ‘traditional’ travel-associated infectious diseases such as typhoid fever [ 46 ], rabies [ 47 ], and yellow fever [ 48 , 49 ]. GeoSentinel is an international network of travel medicine providers to monitor trends in travel-associated diseases [ 50 , 51 , 52 ] which has reported a substantial increase of dengue over the past decade [ 53 ]. Dengue can affect tourist travelers, business travelers and expatriates [ 12 , 52 ], migrants including those visiting friends and relatives (VFR) [ 54 ], and pilgrims [ 55 ]; both in adult and pediatric travelers [ 11 , 42 , 56 ].…”

GeoSentinel: past, present and future

“… 28 There have also been analyses of travel-specific destinations including common febrile illnesses in West African countries confronted with the Ebola outbreak, 29 travelers to the USA 30 and illness among travelers to Brazil. 31 In addition, there have been a number of analyses on special populations such as student travelers, 32 travelers visiting friends and relatives, 33 European travelers, 34 skin diseases among Canadian travelers 35 and animal exposures among travelers 36 as well as migrant health, e.g. US migrants, 37 the spectrum of illness in Syrian migrants 38 and malaria in Eritrean migrants.…”