Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Hall Health Center, University of Washington, Seattle, WA, USA.
J Travel Med. 2018 Jan 1;25(1). doi: 10.1093/jtm/tay074.
The 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.
GeoSentinel 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.
The 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.
Students 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.
在过去的 20 年里, 前往海外留学的美国学生人数增加了两倍多。随着留学项目目的地的多样化,越来越多的学生前往资源有限的国家,使他们面临传染病的风险。关于美国学生在国际旅行中感染的描述数据有限。我们描述了从国际旅行返回的学生中的疾病,并提出了如何预防这些旅行者患病的建议。
GeoSentinel 是一个旅行和热带医学提供者的全球监测网络,监测与旅行相关的发病率。这项研究包括 2007 年至 2017 年间返回美国的 17-24 岁的美国居民学生国际旅行者的记录,这些旅行者在 15 个美国 GeoSentinel 地点之一出现了确诊的与旅行相关的疾病,并记录了其暴露地区。对记录进行了分析,以描述人口统计学和旅行特征以及诊断。
研究包括 432 名学生。中位数年龄为 21 岁;69%为女性。超过 70%的学生在旅行前咨询过医疗保健提供者。最常见的暴露地区是撒哈拉以南非洲(112;26%)。学生在印度(44;11%)、厄瓜多尔(28;7%)、加纳(25;6%)和中国(24;6%)的暴露率最高。出国旅行的平均时间为 40 天(范围:1-469),在旅行后平均 8 天(范围:0-181)到达 GeoSentinel 地点;98%为门诊患者。在 581 例确诊诊断中,最常见的诊断类别是胃肠道(45%)。急性腹泻是最常见的胃肠道诊断(261 例中有 113 例;43%)。31 名(7%)学生患有虫媒疾病[14 名(41%)疟疾和 11 名(32%)登革热]。有 3 名学生患有疫苗可预防疾病(2 名伤寒;1 名甲型肝炎);2 名患有急性人类免疫缺陷病毒感染。
尽管大多数学生都进行了旅行前咨询,但学生仍经历了与旅行相关的感染。美国学生应接受旅行前咨询、疫苗接种和化学预防,以预防胃肠道、虫媒、性传播和疫苗可预防的感染。