• Phimphan Pisutsan, Ngamphol Soonthornworasiri, Wasin Matsee, Weerapong Phumratanaprapin, Suda Punrin, Wattana Leowattana, Chayasin Mansanguan, Eyal Leshem, and Watcharapong Piyaphanee.
• Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
• J Travel Med. 2019 Oct 14; 26 (7).

BackgroundThere are few studies of the incidence of health problems among travelers to Southeast Asia. The current study sought to determine the incidence of self-reported health problems among travelers visiting the region.MethodsA prospective questionnaire-based study was conducted among travelers from high-income countries who visited Southeast Asia. Participants were enrolled at time of their pre-travel visit at Mahidol University, Bangkok, Thailand. Travelers were prospectively followed by self-administered questionnaires 2 weeks after arrival, upon return to their home country and 2 weeks after return.ResultsDuring January 2018-February 2019, 359 travelers were enrolled in Bangkok, Thailand, and the first questionnaire was administered. Follow-up questionnaires were returned by 191, 96 and 64 participants 2 weeks later, at the end of the trip and 2 weeks after return, respectively. A total of 6094 travel days were included in the final analysis. The incidence of acute diarrhea per month per 1000 travelers was 217 [95% confidence interval (CI), 189-248] episodes; skin problems, 197 (95% CI, 170-227); respiratory symptoms, 133 (95% CI, 111-158); fever, 49 (95% CI, 36-65); and potential rabies exposure, 34 (95% CI, 24-48). The incidence of acute diarrhea episodes per month per 1000 travelers was significantly higher during the first 2 weeks of travel compared with subsequent weeks of travel: 325 (95% CI, 291-362) vs 132 (95% CI, 110-1157) (P < 0.05). The incidence of outpatient visits and hospitalizations per month per 1000 travelers was 49 (95% CI, 36-65) and 5 (95% CI, 2-10), respectively.ConclusionsIn this prospective cohort study we observed substantial burden of acute diarrhea and skin and respiratory symptoms among travelers to Southeast Asia. The higher incidence of diarrhea in the first 2 weeks of travel should be further investigated.© International Society of Travel Medicine 2019. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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