Department of Public Health & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Department of Rheumatology, University Hospital of Zurich, Zurich, Switzerland.
Travel Med Infect Dis. 2020 Nov-Dec;38:101818. doi: 10.1016/j.tmaid.2020.101818. Epub 2020 Jul 23.
Patients with chronic conditions travel around the world more than ever. Only few studies have examined travel patterns and health outcomes of patients with rheumatic diseases during international travel.
We conducted a multi-centre prospective cohort study in Switzerland, in which we studied the immunogenicity and safety of vaccinations in patients with rheumatic diseases and travellers without rheumatic diseases (controls). Participants who travelled internationally received questionnaires 1 and 13 weeks post-travel. We compared travel patterns, risk behaviours, and travel-associated problems during and after the trips in both groups.
274 participants returned post-travel questionnaires (65 rheumatic patients, 209 controls). Controls more frequently travelled to subtropical/tropical destinations and stayed longer abroad. 64% of all participants experienced health problems during travel (74% rheumatic patients vs. 62% controls, P = 0.11). Pre-travel, patients reported a higher susceptibility to gastrointestinal infections . During travel, a higher percentage of rheumatic patients cancelled the day programme due to health problems (13% vs. 4%, P = 0.024). The main problems in rheumatic patients occurred due to the underlying rheumatic diseases, or were of psychological nature. Although not statistically significant, infectious disease symptoms (rhinitis, cough) occurred more frequently in controls. When only considering subtropical/tropical destinations, rheumatic patients more frequently had gastrointestinal problems during travel - and skin infections after the trip.
This study does not support the notion that patients with rheumatic diseases should avoid international travel for an increased risk of infections. In patients with subtropical/tropical destinations, however, gastrointestinal problems may be increased during travel - and skin infections post-travel.
患有慢性疾病的患者比以往任何时候都更频繁地在全球旅行。只有少数研究调查了国际旅行期间患有风湿性疾病的患者的旅行模式和健康结果。
我们在瑞士进行了一项多中心前瞻性队列研究，在该研究中，我们研究了风湿性疾病患者和无风湿性疾病的旅行者（对照）的疫苗免疫原性和安全性。国际旅行的参与者在旅行后 1 周和 13 周接受问卷调查。我们比较了两组患者在旅行中和旅行后的旅行模式、风险行为和与旅行相关的问题。
274 名参与者返回了旅行后问卷（65 名风湿患者，209 名对照）。对照组更频繁地前往亚热带/热带目的地，并在国外停留更长时间。所有参与者中有 64%（74%风湿患者与 62%对照，P=0.11）在旅行期间出现健康问题。旅行前，患者报告更容易患胃肠道感染。在旅行期间，由于健康问题，更多的风湿患者取消了当天的行程（13%对 4%，P=0.024）。风湿患者的主要问题是由潜在的风湿性疾病引起的，或属于心理性质。尽管没有统计学意义，但对照组更频繁地出现传染病症状（鼻炎、咳嗽）。仅考虑亚热带/热带目的地时，风湿患者在旅行期间更频繁地出现胃肠道问题-以及旅行后的皮肤感染。
本研究不支持风湿性疾病患者因感染风险增加而避免国际旅行的观点。然而，对于前往亚热带/热带目的地的患者，旅行期间可能会出现胃肠道问题-以及旅行后的皮肤感染。
