Background. International travel poses a risk of destination-specific illness and may contribute to the global spread of infectious diseases. Despite this, little is known about the health characteristics and pretravel healthcare of US international travelers, particularly those at higher risk of travel-associated illness. Methods. We formed a national consortium (Global TravEpiNet) of 18 US clinics registered to administer yellow fever vaccination. We collected data regarding demographic and health characteristics, destinations, purpose of travel, and pretravel healthcare from 13235 international travelers who sought pretravel consultation at these sites from January 2009 through January 2011.Results.The destinations and itineraries of Global TravEpiNet travelers differed from those of the overall population of US international travelers. The majority of Global TravEpiNet travelers were visiting low-or lower-middle-income countries, and Africa was the most frequently visited region. Seventy-five percent of travelers were visiting malaria-endemic countries, and 38% were visiting countries endemic for yellow fever. Fifty-nine percent of travelers reported ≥1 medical condition. Atovaquone/proguanil was the most commonly prescribed antimalarial drug, and most travelers received an antibiotic for self-treatment of travelers' diarrhea. Hepatitis A and typhoid were the most frequently administered vaccines. Conclusions. Data from Global TravEpiNet provide insight into the characteristics and pretravel healthcare of US international travelers who are at increased risk of travel-associated illness due to itinerary, purpose of travel, or existing medical conditions. Improved understanding of this epidemiologically significant population may help target risk-reduction strategies and interventions to limit the spread of infections related to global travel.
Bibliographical noteFunding Information:
Potential conflicts of interest. B. A. C. has received grant support from Salix Pharmaceuticals, royalties from Elsevier Publishing, and payment for lectures from Novartis Vaccines, GlaxoSmithKline, and Salix Pharmaceuticals. J. A. G. has received payment for lectures from Merck. P. K. has consulted for Crucell Biologics, has received payment for lectures from GlaxoSmithKline, has received royalties from Elsevier Publishing, and has received an honorarium for the development of educational materials from Sanofi. All other authors report no potential conflicts.
Financial support. This work was supported by grants from the US Centers for Disease Control and Prevention (CDC; U19CI000514 and U01CK000175).
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