Lin H Chen1, Karin Leder2, Kira A Barbre3, Patricia Schlagenhauf4, Michael Libman5, Jay Keystone6, Marc Mendelson7, Philippe Gautret8, Eli Schwartz9, Marc Shaw10, Sue MacDonald11, Anne McCarthy12, Bradley A Connor13, Douglas H Esposito3, Davidson Hamer14, Mary E Wilson15,16. 1. Mount Auburn Hospital, Cambridge, Massachusetts, and Harvard Medical School, Boston, MA, USA. 2. Royal Melbourne Hospital and School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. 3. Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA. 4. University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland. 5. Montreal General Hospital and McGill University, Montreal, Quebec, Canada. 6. Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada. 7. Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa. 8. Aix Marseille Université, IHU-Méditerranée Infection, Marseille, France. 9. The Chaim Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine Tel-Aviv University, Israel. 10. Worldwise Travellers Health Centres New Zealand and James Cook University, Australia. 11. Medicine and Quality, Interior Health, and University of British Columbia, Kelowna, British Columbia, Canada. 12. Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada. 13. The New York Center for Travel and Tropical Medicine and Weill Medical College of Cornell University, New York, NY, USA. 14. Center for Global Health and Development, Boston University School of Public Health, and Boston University School of Medicine, Boston, MA, USA. 15. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 16. Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA.
Abstract
Background: Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers. Methods: GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 through 31 December 2014. Results: Among 12 203 business travelers seen 1997-2014 (14 045 eligible diagnoses), the majority (97%) were adults aged 20-64 years; most (74%) reported from Western Europe or North America; two-thirds were male. Most (86%) were outpatients. Fewer than half (45%) reported a pre-travel healthcare encounter. Frequent regions of exposure were sub-Saharan Africa (37%), Southeast Asia (15%) and South Central Asia (14%). The most frequent diagnoses were malaria (9%), acute unspecified diarrhea (8%), viral syndrome (6%), acute bacterial diarrhea (5%) and chronic diarrhea (4%). Species was reported for 973 (90%) of 1079 patients with malaria, predominantly Plasmodium falciparum acquired in sub-Saharan Africa. Of 584 (54%) with malaria chemoprophylaxis information, 92% took none or incomplete courses. Thirteen deaths were reported, over half of which were due to malaria; others succumbed to pneumonia, typhoid fever, rabies, melioidosis and pyogenic abscess. Conclusions: Diarrheal illness was a major cause of morbidity. Malaria contributed substantial morbidity and mortality, particularly among business travelers to sub-Saharan Africa. Underuse or non-use of chemoprophylaxis contributed to malaria cases. Deaths in business travelers could be reduced by improving adherence to malaria chemoprophylaxis and targeted vaccination for vaccine-preventable diseases. Pre-travel advice is indicated for business travelers and is currently under-utilized and needs improvement.
Background: Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers. Methods: GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 through 31 December 2014. Results: Among 12 203 business travelers seen 1997-2014 (14 045 eligible diagnoses), the majority (97%) were adults aged 20-64 years; most (74%) reported from Western Europe or North America; two-thirds were male. Most (86%) were outpatients. Fewer than half (45%) reported a pre-travel healthcare encounter. Frequent regions of exposure were sub-Saharan Africa (37%), Southeast Asia (15%) and South Central Asia (14%). The most frequent diagnoses were malaria (9%), acute unspecified diarrhea (8%), viral syndrome (6%), acute bacterial diarrhea (5%) and chronic diarrhea (4%). Species was reported for 973 (90%) of 1079 patients with malaria, predominantly Plasmodium falciparum acquired in sub-Saharan Africa. Of 584 (54%) with malaria chemoprophylaxis information, 92% took none or incomplete courses. Thirteen deaths were reported, over half of which were due to malaria; others succumbed to pneumonia, typhoid fever, rabies, melioidosis and pyogenic abscess. Conclusions: Diarrheal illness was a major cause of morbidity. Malaria contributed substantial morbidity and mortality, particularly among business travelers to sub-Saharan Africa. Underuse or non-use of chemoprophylaxis contributed to malaria cases. Deaths in business travelers could be reduced by improving adherence to malaria chemoprophylaxis and targeted vaccination for vaccine-preventable diseases. Pre-travel advice is indicated for business travelers and is currently under-utilized and needs improvement.
Authors: Johannes Berg; Daan Breederveld; Anna H Roukens; Yvonne Hennink; Marjolijn Schouten; Judy K Wendt; Leo G Visser Journal: J Travel Med Date: 2011-10-12 Impact factor: 8.490
Authors: Sharyn Toner; Derkje H Andrée Wiltens; Johannes Berg; Hector Williams; Susan Klein; Simon Marshall; Neil Nerwich; Ryan Copeland Journal: J Travel Med Date: 2017-05-01 Impact factor: 8.490
Authors: Edith R Lederman; Leisa H Weld; Iqbal R F Elyazar; Frank von Sonnenburg; Louis Loutan; Eli Schwartz; Jay S Keystone Journal: Int J Infect Dis Date: 2008-03-14 Impact factor: 3.623
Authors: Lin H Chen; Pauline V Han; Mary E Wilson; Rhett J Stoney; Emily S Jentes; Christine Benoit; Winnie W Ooi; Elizabeth D Barnett; Davidson H Hamer Journal: Travel Med Infect Dis Date: 2016-10-02 Impact factor: 6.211
Authors: Yesim Tozan; Tyler Y Headley; Maquines Odhiambo Sewe; Eli Schwartz; Tamar Shemesh; Jakob P Cramer; Kirsten A Eberhardt; Michael Ramharter; Nicole Harrison; Karin Leder; Andrea Angheben; Christoph Hatz; Andreas Neumayr; Lin Hwei Chen; Cornelis A De Pijper; Martin P Grobusch; Annelies Wilder-Smith Journal: Am J Trop Med Hyg Date: 2019-06 Impact factor: 2.345
Authors: Hana Akselrod; Matthew J Swierzbinski; Zhaonian Zheng; John Keiser; David M Parenti; Gary L Simon Journal: Am J Trop Med Hyg Date: 2018-12 Impact factor: 2.345
Authors: Adilson José DePina; Alex Jailson Barbosa Andrade; Abdoulaye Kane Dia; António Lima Moreira; Ullardina Domingos Furtado; Helga Baptista; Ousmane Faye; Ibrahima Seck; El Hadji Amadou Niang Journal: Trop Med Health Date: 2019-01-07
Authors: Annelies Wilder-Smith; Raman Preet; Elizabeth B Brickley; Ricardo Arraes de Alencar Ximenes; Demócrito de Barros Miranda-Filho; Celina Maria Turchi Martelli; Thália Velho Barreto de Araújo; Ulisses Ramos Montarroyos; Maria Elisabeth Moreira; Marília Dalva Turchi; Tom Solomon; Bart C Jacobs; Carlos Pardo Villamizar; Lyda Osorio; Ana Maria Bispo de Filipps; Johan Neyts; Suzanne Kaptein; Ralph Huits; Kevin K Ariën; Hugh J Willison; Julia M Edgar; Susan C Barnett; Rosanna Peeling; Debi Boeras; Maria G Guzman; Aravinda M de Silva; Andrew K Falconar; Claudia Romero-Vivas; Michael W Gaunt; Alessandro Sette; Daniela Weiskopf; Louis Lambrechts; Helen Dolk; Joan K Morris; Ieda M Orioli; Kathleen M O'Reilly; Laith Yakob; Joacim Rocklöv; Cristiane Soares; Maria Lúcia Brito Ferreira; Rafael Freitas de Oliveira Franca; Alexander R Precioso; James Logan; Trudie Lang; Nina Jamieson; Eduardo Massad Journal: Glob Health Action Date: 2019 Impact factor: 2.640