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

Grobusch, Martin P., Weld, Leisa, Goorhuis, Abraham, Hamer, Davidson H., Schunk, Mirjam, Jordan, Sabine, Mockenhaupt, Frank P., Chappuis, François, Asgeirsson, Hilmir, Caumes, Eric, Jensenius, Mogens, van Genderen, Perry J.J., Castelli, Francesco, López-Velez, Rogelio, Field, Vanessa, Bottieau, Emmanuel, Molina, Israel, Rapp, Christophe, Ménendez, Marta Díaz, Gkrania-Klotsas, Effrossyni, Larsen, Carsten S., Malvy, Denis, Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200, Gobbi, Federico, Florescu, Simin A., Gautret, Philippe, Schlagenhauf, Patricia, Stijnis, Kees, van Vugt, Michèle, Rothe, Camilla, von Sonnenburg, Frank, Vinnemeier, Christof, Ramharter, Michael, Equihua Martinez, Gabriela, Gertler, Maximilian, Eperon, Gilles, Ursing, Johan, Glans, Hedvig, Hægeland, Arnhild, Joof, Mona, Stuij, Corine, Odolini, Silvia, Tomasoni, Lina, Chamorro, Sandra, Lankester, Ted, Salvador, Fernando, Serre-Delcor, Nuria, Ficko, Cécile, Trigo, Elena, Warne, Benjamin, Jespersen, Sanne, Weijse, Christian, Duvignaud, Alexandre, Pistone, Thierry, Beeching, Nicholas ORCID: https://orcid.org/0000-0002-7019-8791, Beadsworth, Mike, Rodari, Paola, Moro, Lucia, Popescu, Corneliu P., Zaharia, Mihaela F., Javelle, Emilie, Parola, Philippe, Weber, Rainer and Schmid-Stoll, Sabine (2020) 'Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data'. The Lancet Regional Health - Europe, Vol 1, p. 100001.

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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.

Item Type:	Article
Subjects:	WA Public Health > Preventive Medicine > WA 108 Preventive health services. Preventive medicine. Travel Medicine.
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > International Public Health Department Education
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.lanepe.2020.100001
SWORD Depositor:	JISC Pubrouter
Depositing User:	Stacy Murtagh
Date Deposited:	21 Dec 2020 11:36
Last Modified:	22 Feb 2021 16:10
URI:	https://archive.lstmed.ac.uk/id/eprint/16453

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