[2] As recently reported by the Global TravEpiNet, up to 59% of selected travelers have an underlying medical condition and many immunocompromised patients are traveling to developing countries.[3] Previous studies have documented that 20% to 64% of international travelers will develop some health problem while abroad.[4] We set out to perform a retrospective, observational analysis of 3 years of post-travel survey data to determine associations between travel-related illness and unique features of the travel itinerary, along with other specific demographic variables. We hypothesized that we selleck would be better able

to define high-risk travel destinations, determine predictors, and develop a more meaningful survey tool to monitor the quality of itinerary-specific care delivered in the clinic. Our travel medicine clinic is best described as a medium-size practice CYC202 manufacturer incorporated into a large Infectious Diseases practice. We are located in the third largest catchment in Pennsylvania.

For 14 years, we have been collecting post-travel survey data for purposes of quality control and process improvement. Each year, we see more than 500 individuals, including those traveling in large group trips, for pre-travel medical care and counseling. The number of visits has been increasing by about 10% per year for the past 3 years. The travel medicine database and survey tool used in the study were approved by our network’s institutional review board. We mailed one-page surveys (Appendix 1) to all previously counseled travelers within 1 month of their planned departure date, with instructions to complete and mail back the surveys upon their return. No repeat mailings or other reminders were sent. Travelers were queried if they became ill, what symptoms they experienced, and if they sought medical help (arbitrarily defined as a serious illness). We also obtained information D-malate dehydrogenase about their diagnoses and the medications prescribed. If travelers developed diarrhea, they were asked to record the type of medication that they used

for treatment. Data gathered from all surveys returned over a 14-year period were entered into a de-identified database, from which we identified a retrospective cohort of 525 individuals who were seen in the travel clinic from May 2007 through December 2010. From this cohort, simple percentages were calculated for rates of illness by category (gastrointestinal, respiratory, etc.) and also rates of illness based on the destination continent. We then compared the travel-specific itinerary and demographics, including age of traveler, lag time from pre-travel visit to travel, the destination (by continent), and duration of travel related to the likelihood of illness, travel-related gastrointestinal illness (usually diarrhea), and the likelihood of seeing a medical care provider.