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22. Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data

Author

Grobusch, Martin P., Weld, Leisa, Goorhuis, Abraham, Hamer, Davidson H., Schunk, Mirjam, Jordan, Sabine, Mockenhaupt, Frank P., Chappuis, François, Asgeirsson, Hilmir, Caumes, Eric, Jensenius, Mogens, van Genderen, Perry J.J., Castelli, Francesco, López-Velez, Rogelio, Field, Vanessa, Bottieau, Emmanuel, Molina, Israel, Rapp, Christophe, Ménendez, Marta Díaz, Gkrania-Klotsas, Effrossyni, Larsen, Carsten S., Malvy, Denis, Lalloo, David, Gobbi, Federico, Florescu, Simin A., Gautret, Philippe, Schlagenhauf, Patricia, Stijnis, Kees, van Vugt, Michèle, Rothe, Camilla, von Sonnenburg, Frank, Vinnemeier, Christof, Ramharter, Michael, Equihua Martinez, Gabriela, Gertler, Maximilian, Eperon, Gilles, Ursing, Johan, Glans, Hedvig, Hægeland, Arnhild, Joof, Mona, Stuij, Corine, Odolini, Silvia, Tomasoni, Lina, Chamorro, Sandra, Lankester, Ted, Salvador, Fernando, Serre-Delcor, Nuria, Ficko, Cécile, Trigo, Elena, Warne, Benjamin, Jespersen, Sanne, Weijse, Christian, Duvignaud, Alexandre, Pistone, Thierry, Beeching, Nicholas, Beadsworth, Mike, Rodari, Paola, Moro, Lucia, Popescu, Corneliu P., Zaharia, Mihaela F., Javelle, Emilie, Parola, Philippe, Weber, Rainer, and Schmid-Stoll, Sabine

Subjects
wa_108
Abstract

Background\ud Disease epidemiology of (re-)emerging infectious diseases is changing rapidly, rendering surveillance of travel-associated illness important.\ud \ud Methods\ud We evaluated travel-related illness encountered at EuroTravNet clinics, the European surveillance sub-network of GeoSentinel, between March 1, 1998 and March 31, 2018.\ud \ud Findings\ud 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.\ud \ud Interpretation\ud 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.\ud \ud Funding\ud 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.

Published
2020

23. Expatriates

Author

Gamble, Kenneth, primary, Lankester, Ted, additional, Lovell-Hawker, Deborah, additional, and Sharp, Evelyn, additional

Published
2013
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24. List of Contributors

Author

Alberer, Martin, primary, Anderson, Susan A., additional, Ansdell, Vernon, additional, Arguin, Paul M., additional, Aw, James, additional, Backer, Howard, additional, Bagshaw, Michael, additional, Band, Roger A., additional, Barbeau, Deborah N., additional, Barnett, Elizabeth D., additional, Batchelor, Trish, additional, Behrens, Ronald H., additional, Beran, Jiri, additional, Burchard, Gerd D., additional, Callahan, Michael, additional, Cannegieter, Suzanne C., additional, Castelli, Francesco, additional, Caumes, Eric, additional, Chen, Lin Hwei, additional, Chicoine, Jean-Francois, additional, Clerinx, Jan, additional, Connor, Bradley A., additional, Deye, Gregory A., additional, Dietz, Thomas E., additional, Epstein, Yoram, additional, Ericsson, Charles D., additional, Fischer, Philip R., additional, Fradin, Mark S., additional, Frazer, Tifany, additional, Freedman, David O., additional, Gamble, Kenneth L., additional, Giorgetti, Pier F., additional, Goad, Jeff, additional, Gompel, Alfons Van, additional, Goodyer, Larry, additional, Grieve, Sandra, additional, Med, Dip Trav, additional, Grobusch, Martin P., additional, Hackett, Peter H., additional, Hamer, Davidson H., additional, Hargarten, Stephen, additional, Hatz, Christoph F.R., additional, Hawker, Deborah M., additional, Hill, Carter D., additional, Hill, David R., additional, Kain, Kevin C., additional, Keystone, Jay S., additional, Klion, Amy D., additional, Kollaritsch, Herwig, additional, Kozarsky, Phyllis E., additional, Kuhn, Susan M., additional, Lange, Beth, additional, Lang, William L., additional, Lankester, Ted, additional, Leder, Karin, additional, Lee, C. Virginia, additional, Löscher, Thomas, additional, Mackell, Sheila M., additional, Magill, Alan J., additional, Marienau, Karen J., additional, Matteelli, Alberto, additional, Mendelson, Marc, additional, Mileno, Maria D., additional, Moran, Daniel S., additional, McCarthy, Anne E., additional, McLellan, Susan L.F., additional, Nothdurft, Hans D., additional, Parola, Philippe, additional, Pechel, Susanne M., additional, Puius, Yoram A., additional, Punta, Veronica Del, additional, Rendi-Wagner, Pamela, additional, Riddle, Mark S., additional, Rosendaal, Frits, additional, Rosselot, Gail A., additional, Ryan, Edward T., additional, Saleri, Nuccia, additional, Sanders, John W., additional, Schlagenhauf, Patricia, additional, Schwartz, Eli, additional, Sharpe, Evelyn, additional, Shlim, David R., additional, Sonder, Gerard J.B., additional, Starr, Mike, additional, Steffen, Robert, additional, Suh, Kathryn N., additional, Summer, Andrea P., additional, Taggart, Linda R., additional, Taylor, David N., additional, Tenenboim, Shiri, additional, Tessier, Dominique, additional, Torresi, Joseph, additional, Valk, Thomas H., additional, Weiss, Eric L., additional, Wiedermann, Ursula, additional, Wilder-Smith, Annelies, additional, and Wilson, Mary E., additional

Published
2013
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25. List of Contributors

Author

Anderson, Susan A., primary, Ansdell, Vernon, additional, Arguin, Paul M., additional, Backer, Howard, additional, Bagshaw, Michael, additional, Barnett, Elizabeth D., additional, Batchelor, Trish, additional, Behrens, Ronald H., additional, Brewster, Steven J., additional, Bunn, William B., additional, Callahan, Michael, additional, Castelli, Francesco, additional, Caumes, Eric, additional, Chicoine, Jean-Francois, additional, Clerinx, Jan, additional, Connor, Bradley A., additional, Cortés, Leslie M., additional, Dawood, Richard, additional, Dietz, Thomas, additional, Ericsson, Charles D., additional, Epstein, Yoram, additional, Fischer, Philip R., additional, Fradin, Mark S., additional, Franco-Paredes, Carlos, additional, Freedman, David O., additional, Gamble, Ken L., additional, Grobusch, Martin P., additional, Hackett, Peter H., additional, Hamer, Davidson H., additional, Hargarten, Stephen, additional, Hellgren, Urban, additional, Herzstein, Jessica, additional, Hicks, Lauri A., additional, Hill, David R., additional, Jong, Elaine C., additional, Kain, Kevin C., additional, Keystone, Jay S., additional, Klion, Amy D., additional, Kollaritsch, Herwig, additional, Kozarsky, Phyllis E., additional, Kuhn, Susan M., additional, Lankester, Ted, additional, Löscher, Thomas, additional, Lovell-Hawker, Deborah M., additional, Mackell, Sheila M., additional, Magill, Alan J., additional, Matteelli, Alberto, additional, McCarthy, Anne E., additional, McKay, Marilynne, additional, McLellan, Susan L.F., additional, Mileno, Maria D., additional, Mitruka, Kiren, additional, Moran, Daniel S., additional, Nicolls, Deborah J., additional, Nothdurft, Hans D., additional, Pini, Alessandro, additional, Pizzocolo, Cecilia, additional, Reed, Christie M., additional, Rendi-Wagner, Pamela, additional, Riddle, Mark S., additional, Riesland, Nicholas J., additional, Saleri, Nuccia, additional, Sanders, John W., additional, Schlagenhauf-Lawlor, Patricia, additional, Schwartz, Eli, additional, Sharpe, Evelyn, additional, Shlim, David R., additional, Spira, Alan M., additional, Steffen, Robert, additional, Sugden, Richard, additional, Suh, Kathryn N., additional, Summer, Andrea P., additional, Taylor, David N., additional, Tessier, Dominique, additional, Valk, Thomas H., additional, van Gompel, Alfons, additional, Virk, Abinash, additional, Weiss, Eric A., additional, Weiss, Eric L., additional, Wheeler, Robert E., additional, Wilson, Mary Elizabeth, additional, Wolfe, Martin S., additional, and Acosta, Rebecca Wolfe, additional

Published
2008
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41. Aid Workers, Expatriates and Travel.

Author

Gamble, Kenneth L., Lovell, Debbie, Lankester, Ted, and Keystone, Jay S.

Subjects
TRAVEL hygiene, TRAVELERS, CRISIS management, NONCITIZENS, COMMUNICABLE diseases, MEDICAL care, SEXUALLY transmitted diseases, HIV infections
Abstract

Assignments range for less than 3 months to many years, and the risk of illness among expatriates is influenced by a variety of factors which affect other travellers including age, sex, behaviour, climate and the environment, infectious diseases and injuries. However, the complexity of cross-cultural assignments and the varied physical and emotional responses predisposes expatriates to medical problems that are not shared by the short-term traveller. These include increased morbidity and mortality, psychological problems (particularly stress, depression and significant rates of suicide) and premature return home. Pre-departure assessment is therefore important including medical and selective laboratory investigations. Psychological assessment should be deployed. Guidelines for pre-departure preparation including immunisations, chemoprophylaxis for malaria, safety and others are as for the short-term traveller with some modifications, which are discussed. Excessive alcohol consumption and a high rate of extra-marital sexual activity, including the risk of sexually transmitted diseases and HIV are common among certain groups of expatriates. The vexed issue of post-exposure HIV prophylaxis following occupational health exposure and sexual assault is discussed. Safety while abroad is an important issue including crisis management, risk of hostage taking and assassination, assault and kidnapping. Caring for expatriates in international settings is reviewed. Health care screening and management on return are discussed including the importance of debriefing and support. [ABSTRACT FROM PUBLISHER]

Published
2001

43. Obituary

Author

Lankester, Ted, primary, Molyneux, Malcolm, additional, Parry, Eldryd, additional, and Barker, Anthony, additional

Published
1993
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45. The World Health Organization Engaging with Civil Society Networks to Promote Primary Health Care: A Case Study.

Author

Dickerson, Claire, Grills, Nathan, Henwood, Nick, Jeffreys, Susannah, and Lankester, Ted

Subjects
PUBLIC health research, CIVIL society, PRIMARY health care, MEDICAL care research
Abstract

Engagement between the World Health Organization (WHO) and civil society organizations (CSOs), gains importance as CSOs increase their contribution to public health; particularly to primary health care. To better engage civil society in revitalizing primary health care the WHO collaborated with the Community Health Global Network (CHGN), a civil society network. This article uses the WHO-CHGN relationship to demonstrate how this collaboration enabled the WHO to inform and to learn from those with current primary health care experience. Learning from a systematic documentation of the collaboration provides insight into the WHO and CHGN perspectives concerning the relationship; informs future WHO-CSO collaborations and contributes to the understanding of the ways in which the WHO accesses and hears those actively engaged in health care programs. [ABSTRACT FROM AUTHOR]

Published
2012

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