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Author Notes:

Correspondence: Kristina M. Angelo; kangelo@cdc.gov

Author Contributions: Kristina M. Angelo, DO, MPH&TM: Literature search, primary contributor to data analysis and interpretation, primary writer.

Phyllis E. Kozarsky, MD: Literature search, data analysis and interpretation, and writing.

Edward T. Ryan, MD: Literature search, critical revision, data analysis and interpretation, and writing.

Lin H. Chen, MD: Literature search, technical editing and critical revision, data analysis and interpretation, and writing.

Mark J. Sotir, PhD: Conception and study design, literature search, technical editing, data interpretation, and writing.

Acknowledgments: We would like to thank Dr Robert Steffen, MD, for his input on the manuscript.

Disclosures: Dr Lin Chen serves as an advisor to Shoreland, Inc and serves on the Data Safety and Monitoring Board for Valneva on vaccine development.

The remaining authors have declared no conflicts of interest.


Research Funding:

This work did not receive funding.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Public, Environmental & Occupational Health
  • Infectious Diseases
  • Medicine, General & Internal
  • General & Internal Medicine
  • International travel
  • travel
  • illness

What proportion of international travellers acquire a travel-related illness? A review of the literature


Journal Title:

Journal of Travel Medicine


Volume 24, Number 5


Type of Work:

Article | Post-print: After Peer Review


Introduction: As international travel increases, travellers may be at increased risk of acquiring infectious diseases not endemic in their home countries. Many journal articles and reference books related to travel medicine cite that between 22-64% of international travellers become ill during or after travel; however, this information is minimal, outdated and limited by poor generalizability. We aim to provide a current and more accurate estimate of the proportion of international travellers who acquire a travel-related illness.Methods: We identified studies via PubMed or travel medicine experts, published between January 1, 1976-December 31, 2016 that included the number of international travellers acquiring a travel-related illness. We excluded studies that focused on a single disease or did not determine a rate based on the total number of travellers. We abstracted information on traveller demographics, trip specifics, study enrollment and follow-up and number of ill travellers and their illnesses.Results: Of 743 studies, nine met the inclusion criteria. The data sources were from North America (four studies) and Europe (five studies). Most travellers were tourists, the most frequent destination regions were Asia and Africa, and the median trip duration ranged from 8-21 days. Six studies enrolled participants at the travellers' pre-travel consultation. All studies collected data through either extraction from the medical record, weekly diaries, or pre- and post-travel questionnaires. Data collection timeframes varied by study. Between 6-87% of travellers became ill across all studies. Four studies provided the best estimate: between 43-79% of travellers who frequently visited developing nations (e.g. India, Tanzania, and Kenya) became ill; travellers most frequently reported diarrhoea.Conclusion: This is the most comprehensive assessment available on the proportion of international travellers that develop a travel-related illness. Additional cohort studies would provide needed data to more precisely determine the rates of illness in international travellers.Keywords: International travel, travel, illness.

Copyright information:

Published by Oxford University Press 2017. This work is written by US Government employees and is in the public domain in the US.

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