InterHealth and National Travel Health Network and Centre, London, UK.
BMC Infect Dis. 2010 Nov 17;10:330. doi: 10.1186/1471-2334-10-330.
Europeans represent the majority of international travellers and clinicians encountering returned patients have an essential role in recognizing, and communicating travel-associated public health risks.
To investigate the morbidity of travel associated infectious diseases in European travellers, we analysed diagnoses with demographic, clinical and travel-related predictors of disease, in 6957 ill returned travellers who presented in 2008 to EuroTravNet centres with a presumed travel associated condition.
Gastro-intestinal (GI) diseases accounted for 33% of illnesses, followed by febrile systemic illnesses (20%), dermatological conditions (12%) and respiratory illnesses (8%). There were 3 deaths recorded; a sepsis caused by Escherichia coli pyelonephritis, a dengue shock syndrome and a Plasmodium falciparum malaria.GI conditions included bacterial acute diarrhea (6.9%), as well as giardiasis and amebasis (2.3%). Among febrile systemic illnesses with identified pathogens, malaria (5.4%) accounted for most cases followed by dengue (1.9%) and others including chikungunya, rickettsial diseases, leptospirosis, brucellosis, Epstein Barr virus infections, tick-borne encephalitis (TBE) and viral hepatitis. Dermatological conditions were dominated by bacterial infections, arthropod bites, cutaneous larva migrans and animal bites requiring rabies post-exposure prophylaxis and also leishmaniasis, myasis, tungiasis and one case of leprosy. Respiratory illness included 112 cases of tuberculosis including cases of multi-drug resistant or extensively drug resistant tuberculosis, 104 cases of influenza like illness, and 5 cases of Legionnaires disease. Sexually transmitted infections (STI) accounted for 0.6% of total diagnoses and included HIV infection and syphilis. A total of 165 cases of potentially vaccine preventable diseases were reported. Purpose of travel and destination specific risk factors was identified for several diagnoses such as Chagas disease in immigrant travellers from South America and P. falciparum malaria in immigrants from sub-Saharan Africa. Travel within Europe was also associated with health risks with distinctive profiles for Eastern and Western Europe.
In 2008, a broad spectrum of travel associated diseases were diagnosed at EuroTravNet core sites. Diagnoses varied according to regions visited by ill travellers. The spectrum of travel associated morbidity also shows that there is a need to dispel the misconception that travel, close to home, in Europe, is without significant health risk.
欧洲人是国际旅行者的主要群体，而接触到归国患者的临床医生在识别和传播与旅行相关的公共卫生风险方面发挥着重要作用。
为了调查欧洲旅行者中与旅行相关的传染病发病率，我们分析了 6957 名患有疑似与旅行相关疾病的旅行者的诊断，这些旅行者于 2008 年在 EuroTravNet 中心就诊，这些旅行者的诊断具有人口统计学、临床和与旅行相关的疾病预测因素。
胃肠道（GI）疾病占疾病的 33%，其次是发热性全身性疾病（20%）、皮肤病（12%）和呼吸道疾病（8%）。记录了 3 例死亡；一例由大肠杆菌肾盂肾炎引起的败血症、一例登革热休克综合征和一例恶性疟原虫疟疾。GI 疾病包括细菌性急性腹泻（6.9%），以及贾第虫病和阿米巴病（2.3%）。在确定病原体的发热性全身性疾病中，疟疾（5.4%）占大多数，其次是登革热（1.9%）和其他疾病，包括基孔肯雅热、立克次体病、钩端螺旋体病、布鲁氏菌病、埃博拉病毒感染、蜱传脑炎（TBE）和病毒性肝炎。皮肤病以细菌感染为主，还有节肢动物叮咬、皮肤幼虫移行和动物咬伤需要狂犬病暴露后预防，还有利什曼病、蝇蛆病、滴虫病和一例麻风病。呼吸道疾病包括 112 例肺结核，其中包括耐多药或广泛耐药肺结核病例，104 例流感样病例，5 例军团病。性传播感染（STI）占总诊断的 0.6%，包括艾滋病毒感染和梅毒。共报告了 165 例潜在可通过疫苗预防的疾病。例如，南美的移民旅行者中存在恰加斯病，来自撒哈拉以南非洲的移民旅行者中存在恶性疟原虫疟疾等，这与旅行目的和目的地的特定风险因素有关。欧洲内部的旅行也与具有独特特征的健康风险有关，东欧和西欧的风险特征不同。
2008 年，EuroTravNet 核心站点诊断出了广泛的与旅行相关的疾病。旅行者就诊时的疾病诊断因旅行地点的不同而有所不同。旅行相关发病率谱还表明，需要消除一种误解，即认为离家近、在欧洲旅行没有显著的健康风险。
