• Ben Warne, Leisa H Weld, Jakob P Cramer, Vanessa K Field, Martin P Grobusch, Eric Caumes, Mogens Jensenius, Philippe Gautret, Patricia Schlagenhauf, Francesco Castelli, David G Lalloo, Johan Ursing, François Chappuis, Frank von Sonnenburg, Rogelio López-Vélez, Christophe Rapp, Kitty C Smith, Philippe Parola, Effrossyni Gkrania-Klotsas, and EuroTravNet Network.
• Department of Infectious Diseases, Addenbrooke's Hospital, Cambridge, UK.
• J Travel Med. 2014 Jul 1; 21 (4): 248-54.

BackgroundLimited data exist on infectious diseases imported to various locations in Europe, particularly after travel within the continent.MethodsTo investigate travel-related disease relevant to Europe that is potentially preventable through pre-travel intervention, we analyzed the EuroTravNet database of 5,965 ill travelers reported by 16 centers in "Western" Europe in 2011.ResultsThere were 54 cases of vaccine-preventable disease, mostly hepatitis A (n = 16), typhoid fever (n = 11), and measles (n = 8); 6 cases (including 3 measles cases) were associated with travel within "Western" Europe. Malaria was the most commonly diagnosed infection (n = 482, 8.1% of all travel-related morbidity). Among patients with malaria, the military most commonly received pre-travel advice (95%), followed by travelers for missionary, volunteer, research, or aid work (81%) but travelers visiting friends and relatives (VFRs) were least likely to receive pre-travel advice (21%). The vast majority (96%) of malaria patients were resident in "Western" Europe, but over half (56%) were born elsewhere. Other significant causes of morbidity, which could be reduced through advice and behavioral change, include Giardia (n = 221, 3.7%), dengue (n = 146, 2.4%), and schistosomiasis (n = 131, 2.2%). Of 206 (3.5%) travelers with exposure in "Western" Europe, 75% were tourists; the highest burden of disease was acute gastrointestinal infection (35% cases). Travel from "Eastern" Europe (n = 132, 2.2%) was largely associated with migration-related travel (53%); among chronic infectious diseases, tuberculosis was frequently diagnosed (n = 20). Travelers VFRs contributed the largest group of malaria patients (46%), but also had the lowest documented rate of pre-travel health advice in this subset (20%). Overall, 44% of nonimmigrant ill travelers did not receive pre-travel advice.ConclusionThere is a burden of infectious diseases in travelers attending European health centers that is potentially preventable through comprehensive pre-travel advice, chemoprophylaxis, and vaccination. Targeted interventions for high-risk groups such as travelers VFRs and migration-associated travelers are of particular importance.© 2014 International Society of Travel Medicine.

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