Z. G., J. B., and L. W. contributed equally.
Gastrointestinal Infection Among International Travelers Globally
Article first published online: 20 JUL 2008
© 2008 International Society of Travel Medicine
Journal of Travel Medicine
Volume 15, Issue 4, pages 221–228, July/August 2008
How to Cite
Greenwood, Z., Black, J., Weld, L., O’Brien, D., Leder, K., Von Sonnenburg, F., Pandey, P., Schwartz, E., Connor, B. A., Brown, G., Freedman, D. O. and Torresi, J. (2008), Gastrointestinal Infection Among International Travelers Globally. Journal of Travel Medicine, 15: 221–228. doi: 10.1111/j.1708-8305.2008.00203.x
Members of the GeoSentinel Surveillance Network (GeoSentinel—The Global Surveillance Network of the International Society of Travel Medicine and the Centers for Disease Control and Prevention) are listed in the Appendix.
The views expressed in this report are those of the authors and do not necessarily represent the views of the funding agencies, the Centers for Disease Control and Prevention, and the International Society of Travel Medicine.
- Issue published online: 20 JUL 2008
- Article first published online: 20 JUL 2008
Background Data on relative rates of acquisition of gastrointestinal infections by travelers are incomplete. The objective of this study was to analyze infections associated with oral ingestion of pathogens in international travelers in relation to place of exposure.
Methods We performed a multicenter, retrospective observational analysis of 6,086 travelers ill enough with any gastrointestinal infection to seek medical care at a GeoSentinel clinic after completion of travel during 2000 to 2005. We determined regional and country-specific reporting rate ratios (RRRs) in comparison to risk in northern and western Europe.
Results Travel to sub-Saharan Africa (RRR = 282), South America (RRR = 203), and South Asia (RRR = 890) was associated with the greatest rate of gastrointestinal infections. RRRs were moderate (25–142) for travel to Oceania, the Middle East, North Africa, Central America, the Caribbean, and Southeast Asia. RRRs were least (<28) following travel to southern, central, and eastern Europe; North America; Northeast Asia; and Australasia. Income level of the country visited was inversely proportional to the RRR for gastrointestinal infection. For bacterial and parasitic infections examined separately, the regions group in the same way. RRRs could be estimated for 28 individual countries and together with regional data were used to derive a global RRR map for travel-related gastrointestinal infection.
Conclusions This analysis of morbidity associated with oral ingestion of pathogens abroad determines which parts of the world currently are high-risk destinations.