Travel Patterns and Risk Behavior in Solid Organ Transplant Recipients

Authors

  • K. Andrea Boggild,

    1. Andrea K. Boggild, MD, Marie Sano, BSc, Atul Humar, MD, FRCPC, and Irving Salit, MD, FRCPC: Faculty of Medicine, University of Toronto; Division of Infectious Diseases, Department of Medicine, UHN-Toronto General Hospital, Toronto, ON, Canada
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  • Marie Sano,

    1. Andrea K. Boggild, MD, Marie Sano, BSc, Atul Humar, MD, FRCPC, and Irving Salit, MD, FRCPC: Faculty of Medicine, University of Toronto; Division of Infectious Diseases, Department of Medicine, UHN-Toronto General Hospital, Toronto, ON, Canada
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  • Atul Humar,

    1. Andrea K. Boggild, MD, Marie Sano, BSc, Atul Humar, MD, FRCPC, and Irving Salit, MD, FRCPC: Faculty of Medicine, University of Toronto; Division of Infectious Diseases, Department of Medicine, UHN-Toronto General Hospital, Toronto, ON, Canada
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  • Matt Gilman,

    1. Matt Gilman, BSc: Tropical Disease Unit, Department of Medicine, UHN-Toronto General Hospital, Toronto, ON, Canada
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  • Irving Salit,

    1. Andrea K. Boggild, MD, Marie Sano, BSc, Atul Humar, MD, FRCPC, and Irving Salit, MD, FRCPC: Faculty of Medicine, University of Toronto; Division of Infectious Diseases, Department of Medicine, UHN-Toronto General Hospital, Toronto, ON, Canada
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  • Kevin C. Kain

    Corresponding author
    1. Kevin C. Kain, MD, FRCPC: Faculty of Medicine, University of Toronto; Tropical Disease Unit, Department of Medicine, UHN-Toronto General Hospital; Division of Infectious Diseases, Department of Medicine, UHN-Toronto General Hospital; Global Health Program, McLaughlin Center for Molecular Medicine, University of Toronto, Toronto, ON, Canada.
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  • The authors had no financial or other conflicts of interest to disclose.

Reprint requests: Kevin C. Kain, MD, FRCPC, Toronto General Hospital, 200 Elizabeth Street, ES-3-430A, Toronto, ON M5G 2C4, Canada.

Abstract

Background International travel is associated with an increased risk of enteric, vector-borne and bloodborne infections. The risk of acquiring travel-related illness is higher in those who are immunocompromised. However, little is known about travel practices and risk behaviors in transplant recipients who travel. We herein profile transplant recipients who travel, and characterize their pretravel precautions, travel activities, burden of illness, and exposure history.

Methods With the use of a standardized and validated questionnaire, patients attending a transplant clinic were surveyed regarding recent travel and risk behaviors.

Results Of 267 transplant recipients who participated, 95 (36%) indicated that they had recently traveled outside Canada and the USA. Their mean age was 49.9 years, 54% were male, and 54% were born outside Canada. Eighty-six percent of travelers were receiving at least two immunosuppressive drugs at the time of their trip. Sixty-six percent of travelers sought pretravel advice, primarily from their transplant physician. Sixty-three percent traveled to areas where hepatitis A is endemic, but only 5% had received hepatitis A immunization. Fifty percent traveled to dengue- and malaria-endemic areas, but <25% adhered to mosquito prevention measures. Ten percent reported behaviors that exposed them to blood or body fluids, including injections, body piercing, and casual sexual activity.

Conclusions Solid organ transplant recipients represent a unique group of compromised travelers; however, few were adequately protected against travel-associated enteric, vector-borne and bloodborne pathogens.

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