• Kristina M Angelo, N Jean Haulman, Anne C Terry, Daniel T Leung, Lin H Chen, Elizabeth D Barnett, HagmannStefan H FSHFDivision of Pediatric Infectious Disease, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY, USA.Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA., Noreen A Hynes, Bradley A Connor, Susan Anderson, Anne McCarthy, Marc Shaw, Van GenderenPerry J JPJJInstitute for Tropical Diseases, Harbour Hospital, Rotterdam, The Netherlands., and Davidson H Hamer.
• Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.
• J Travel Med. 2018 Jan 1; 25 (1).

BackgroundThe 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.MethodsGeoSentinel 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.ResultsThe 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.ConclusionsStudents 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.

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