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dc.contributor.authorGrobusch, Martin P
dc.contributor.authorWeld, Leisa
dc.contributor.authorGoorhuis, Abraham
dc.contributor.authorHamer, Davidson H
dc.contributor.authorSchunk, Mirjam
dc.contributor.authorJordan, Sabine
dc.contributor.authorMockenhaupt, Frank P
dc.contributor.authorChappuis, François
dc.contributor.authorAsgeirsson, Hilmir
dc.contributor.authorCaumes, Eric
dc.contributor.authorJensenius, Mogens
dc.contributor.authorvan Genderen, Perry JJ
dc.contributor.authorCastelli, Francesco
dc.contributor.authorLópez-Velez, Rogelio
dc.contributor.authorField, Vanessa
dc.contributor.authorBottieau, Emmanuel
dc.contributor.authorMolina, Israel
dc.contributor.authorRapp, Christophe
dc.contributor.authorMénendez, Marta Díaz
dc.contributor.authorGkrania-Klotsas, Effrossyni
dc.contributor.authorLarsen, Carsten S
dc.contributor.authorMalvy, Denis
dc.contributor.authorLalloo, David
dc.contributor.authorGobbi, Federico
dc.contributor.authorFlorescu, Simin A
dc.contributor.authorGautret, Philippe
dc.contributor.authorSchlagenhauf, Patricia
dc.contributor.authorfor EuroTravNet
dc.descriptionFunder: Centers for Disease Control and Prevention
dc.description.abstractBACKGROUND: Disease epidemiology of (re-)emerging infectious diseases is changing rapidly, rendering surveillance of travel-associated illness important. METHODS: We evaluated travel-related illness encountered at EuroTravNet clinics, the European surveillance sub-network of GeoSentinel, between March 1, 1998 and March 31, 2018. FINDINGS: 103,739 ill travellers were evaluated, including 11,239 (10.8%) migrants, 89,620 (86.4%) patients seen post-travel, and 2,880 (2.8%) during and after travel. Despite increasing numbers of patient encounters over 20 years, the regions of exposure by year of clinic visits have remained stable. In 5-year increments, greater proportions of patients were migrants or visiting friends and relatives (VFR); business travel-associated illness remained stable; tourism-related illness decreased. Falciparum malaria was amongst the most-frequently diagnosed illnesses with 5,254 cases (5.1% of all patients) and the most-frequent cause of death (risk ratio versus all other illnesses 2.5:1). Animal exposures requiring rabies post-exposure prophylaxis increased from 0.7% (1998-2002) to 3.6% (2013-2018). The proportion of patients with seasonal influenza increased from zero in 1998-2002 to 0.9% in 2013-2018. There were 44 cases of viral haemorrhagic fever, most during the past five years. Arboviral infection numbers increased significantly as did the range of presenting arboviral diseases, dengue and chikungunya diagnoses increased by 2.6% and 1%, respectively. INTERPRETATION: Travel medicine must adapt to serve the changing profile of travellers, with an increase in migrants and persons visiting relatives and friends and the strong emergence of vector-borne diseases, with potential for further local transmission in Europe. FUNDING: This project was supported by a cooperative agreement (U50CK00189) between the Centers for Disease Control and Prevention to the International Society of Travel Medicine (ISTM) and funding from the ISTM and the Public Health Agency of Canada.
dc.publisherElsevier BV
dc.rightsAttribution 4.0 International
dc.sourcenlmid: 101777707
dc.sourceessn: 2666-7762
dc.subjectInfectious diseases
dc.subjectSentinel Surveillance
dc.titleTravel-related infections presenting in Europe: A 20-year analysis of EuroTravNet surveillance data.
prism.publicationNameLancet Reg Health Eur
dc.contributor.orcidGkrania-Klotsas, Effrossyni [0000-0002-0930-8330]
pubs.funder-project-idMedical Research Council (G0701652)

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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International