Business travel-associated illness: a GeoSentinel analysis

Chen, Lin H., Leder, Karin, Barbre, Kira A., Schlagenhauf, Patricia, Libman, Michael, Keystone, Jay, Mendelson, Marc, Gautret, Philippe, Schwartz, Eli, Shaw, Marc, MacDonald, Sue, McCarthy, Anne, Connor, Bradley A., Esposito, Douglas H., Hamer, Davidson, Wilson, Mary E., and GeoSentinel Surveillance Network, (2018) Business travel-associated illness: a GeoSentinel analysis. Journal of Travel Medicine, 25 (1). tax097.

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Abstract

Background: Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers.

Methods: GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 through 31 December 2014.

Results: Among 12 203 business travelers seen 1997-2014 (14 045 eligible diagnoses), the majority (97%) were adults aged 20-64 years; most (74%) reported from Western Europe or North America; two-thirds were male. Most (86%) were outpatients. Fewer than half (45%) reported a pre-travel healthcare encounter. Frequent regions of exposure were sub-Saharan Africa (37%), Southeast Asia (15%) and South Central Asia (14%). The most frequent diagnoses were malaria (9%), acute unspecified diarrhea (8%), viral syndrome (6%), acute bacterial diarrhea (5%) and chronic diarrhea (4%). Species was reported for 973 (90%) of 1079 patients with malaria, predominantly Plasmodium falciparum acquired in sub-Saharan Africa. Of 584 (54%) with malaria chemoprophylaxis information, 92% took none or incomplete courses. Thirteen deaths were reported, over half of which were due to malaria; others succumbed to pneumonia, typhoid fever, rabies, melioidosis and pyogenic abscess.

Conclusions: Diarrheal illness was a major cause of morbidity. Malaria contributed substantial morbidity and mortality, particularly among business travelers to sub-Saharan Africa. Underuse or non-use of chemoprophylaxis contributed to malaria cases. Deaths in business travelers could be reduced by improving adherence to malaria chemoprophylaxis and targeted vaccination for vaccine-preventable diseases. Pre-travel advice is indicated for business travelers and is currently under-utilized and needs improvement.

Item ID: 56581
Item Type: Article (Research - C1)
ISSN: 1708-8305
Keywords: travel, business, diarrhea, malaria, occupational medicine, vaccine-preventable disease, death
Copyright Information: © International Society of Travel Medicine 2018. Published by Oxford University Press. All rights reserved.
Additional Information:

For the GeoSentinel Surveillance Network.

Funders: GeoSentinal of the International Society of Travel Medicine (ISTM), Centers for Disease Control and Prevention (CDCP), Public Health Agency of Canada (PHAC)
Projects and Grants: ISTM/CDCP U50CK00189
Date Deposited: 12 Dec 2018 07:35
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111717 Primary Health Care @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110399 Clinical Sciences not elsewhere classified @ 50%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 50%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified @ 50%
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