Length of travel appears to be associated with health risks. GeoSentinel Surveillance Network data for 4,039 long-term travelers (trip duration >6 months) seen after travel during June 1, 1996, through December 31, 2008, were compared with data for 24,807 short-term travelers (trip duration <1 month). Long-term travelers traveled more often than short-term travelers for volunteer activities (39.7% vs. 7.0%) and business (25.2% vs. 13.8%). More long-term travelers were men (57.2% vs. 50.1%) and expatriates (54.0% vs. 8.9%); most had pretravel medical advice (70.3% vs. 48.9%). Per 1,000 travelers, long-term travelers more often experienced chronic diarrhea, giardiasis, Plasmodium falciparum and P. vivax malaria, irritable bowel syndrome (postinfectious), fatigue >1 month, eosinophilia, cutaneous leishmaniasis, schistosomiasis, and Entamoeba histolytica diarrhea. Areas of concern for long-term travelers were vector-borne diseases, contact-transmitted diseases, and psychological problems. Our results can help prioritize screening for and diagnosis of illness in long-term travelers and provide evidence-based pretravel advice.
Travelers have many reasons for long durations of travel, including diplomatic work, education and research, missionary work, Peace Corps volunteer (PCV) work, military operations, backpacking trips, and corporate expatriate assignments (1–7). Longer trips often are assumed to be associated with increased risk for some health problems, but few studies have compared the types and causes of illness in travelers on the basis of duration of travel. Previous studies suggested that long-term travelers are more likely than short-term travelers to acquire malaria (8) and that recommendations should be tailored individually (9). Other illness also might be more common in long-term than in short-term travelers.
To evaluate the effect of trip duration on illness, we compared illnesses by duration of travel for travelers seeking treatment at GeoSentinel Surveillance Network sites. We also characterized long-term travelers’ demographics, travel patterns, and travel-related illnesses.