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Travel-Associated Illness in Older Adults (>60 y) for the GeoSentinel Surveillance Network See Appendix 1 for members of the GeoSentinel Surveillance Network

Identifieur interne : 000664 ( Hal/Corpus ); précédent : 000663; suivant : 000665

Travel-Associated Illness in Older Adults (>60 y) for the GeoSentinel Surveillance Network See Appendix 1 for members of the GeoSentinel Surveillance Network

Auteurs : Philippe Gautret ; Jean Gaudart ; Karin Leder ; Eli Schwartz ; Francesco Castelli ; Lian Lim ; Holly Murphy ; Jay Keystone ; Jacob Cramer ; Marc Shaw ; Jacques Boddaert ; Frank Von Sonnenburg ; Philippe Parola

Source :

RBID : Hal:hal-01313286

Abstract

Background. Older individuals represent a substantial proportion of international travelers. Because of physiological changes andthe increased probability of underlying medical conditions, older travelersmight be at higher risk for at least some travel-associateddiseases.Methods. With the aim of describing the epidemiology of travel-associated diseases in older adults,medical data were prospectivelycollected on ill international travelers presenting to GeoSentinel sites from 1997 to 2009. Seven thousand thirty-four patientsaged 60 years and over were identified as older travelers and were compared to 56,042 patients aged 18–45 years, who were usedas the young adult reference population.Results. The proportionate morbidity of several etiological diagnoses was higher in older ill travelers compared to youngerill, including notably lower respiratory tract infections, high-altitude pulmonary edema, phlebitis and pulmonary embolism,arthropod bites, severe malaria, rickettsiosis, gastritis, peptic ulcers, esophagitis and gastroesophageal reflux disease, trauma andinjuries, urinary tract infections, heart disease, and death. In contrast, acute diarrhea, upper respiratory tract infections, flu andflu-like illnesses, malaria, dengue, genital infections, sexually transmitted diseases, and schistosomiasis proportionate morbiditieswere lower among the older group.Conclusion. Older ill travelers are more likely to suffer from certain life-threatening diseases and would benefit from reinforcementof specific preventive measures including use of anti-thrombosis compression stockings and sufficient hydration and exercisesduring long-distance flights, hand hygiene, use of disposable handkerchiefs, consideration of face-masks in crowded conditions,influenza and pneumococcal vaccines, progressive acclimatization to altitude, consideration of acetazolamide, and use of repellentsand mosquito nets. Antibiotics for the presumptive treatment of respiratory and urinary tract infections may be considered, aswell as antacid medications. At-risk patients should be referred to a specialist for medical evaluation before departing, and optimalcontrol of co-morbidities such as cardiovascular and chronic obstructive pulmonary diseases should be achieved, particularly forhigh-altitude travel.

Url:
DOI: 10.1111/j.1708-8305.2012.00613.x

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Hal:hal-01313286

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<div type="abstract" xml:lang="en">Background. Older individuals represent a substantial proportion of international travelers. Because of physiological changes andthe increased probability of underlying medical conditions, older travelersmight be at higher risk for at least some travel-associateddiseases.Methods. With the aim of describing the epidemiology of travel-associated diseases in older adults,medical data were prospectivelycollected on ill international travelers presenting to GeoSentinel sites from 1997 to 2009. Seven thousand thirty-four patientsaged 60 years and over were identified as older travelers and were compared to 56,042 patients aged 18–45 years, who were usedas the young adult reference population.Results. The proportionate morbidity of several etiological diagnoses was higher in older ill travelers compared to youngerill, including notably lower respiratory tract infections, high-altitude pulmonary edema, phlebitis and pulmonary embolism,arthropod bites, severe malaria, rickettsiosis, gastritis, peptic ulcers, esophagitis and gastroesophageal reflux disease, trauma andinjuries, urinary tract infections, heart disease, and death. In contrast, acute diarrhea, upper respiratory tract infections, flu andflu-like illnesses, malaria, dengue, genital infections, sexually transmitted diseases, and schistosomiasis proportionate morbiditieswere lower among the older group.Conclusion. Older ill travelers are more likely to suffer from certain life-threatening diseases and would benefit from reinforcementof specific preventive measures including use of anti-thrombosis compression stockings and sufficient hydration and exercisesduring long-distance flights, hand hygiene, use of disposable handkerchiefs, consideration of face-masks in crowded conditions,influenza and pneumococcal vaccines, progressive acclimatization to altitude, consideration of acetazolamide, and use of repellentsand mosquito nets. Antibiotics for the presumptive treatment of respiratory and urinary tract infections may be considered, aswell as antacid medications. At-risk patients should be referred to a specialist for medical evaluation before departing, and optimalcontrol of co-morbidities such as cardiovascular and chronic obstructive pulmonary diseases should be achieved, particularly forhigh-altitude travel.</div>
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<abstract xml:lang="en">Background. Older individuals represent a substantial proportion of international travelers. Because of physiological changes andthe increased probability of underlying medical conditions, older travelersmight be at higher risk for at least some travel-associateddiseases.Methods. With the aim of describing the epidemiology of travel-associated diseases in older adults,medical data were prospectivelycollected on ill international travelers presenting to GeoSentinel sites from 1997 to 2009. Seven thousand thirty-four patientsaged 60 years and over were identified as older travelers and were compared to 56,042 patients aged 18–45 years, who were usedas the young adult reference population.Results. The proportionate morbidity of several etiological diagnoses was higher in older ill travelers compared to youngerill, including notably lower respiratory tract infections, high-altitude pulmonary edema, phlebitis and pulmonary embolism,arthropod bites, severe malaria, rickettsiosis, gastritis, peptic ulcers, esophagitis and gastroesophageal reflux disease, trauma andinjuries, urinary tract infections, heart disease, and death. In contrast, acute diarrhea, upper respiratory tract infections, flu andflu-like illnesses, malaria, dengue, genital infections, sexually transmitted diseases, and schistosomiasis proportionate morbiditieswere lower among the older group.Conclusion. Older ill travelers are more likely to suffer from certain life-threatening diseases and would benefit from reinforcementof specific preventive measures including use of anti-thrombosis compression stockings and sufficient hydration and exercisesduring long-distance flights, hand hygiene, use of disposable handkerchiefs, consideration of face-masks in crowded conditions,influenza and pneumococcal vaccines, progressive acclimatization to altitude, consideration of acetazolamide, and use of repellentsand mosquito nets. Antibiotics for the presumptive treatment of respiratory and urinary tract infections may be considered, aswell as antacid medications. At-risk patients should be referred to a specialist for medical evaluation before departing, and optimalcontrol of co-morbidities such as cardiovascular and chronic obstructive pulmonary diseases should be achieved, particularly forhigh-altitude travel.</abstract>
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