Risk factors for infections in international travelers: An analysis of travel-related notifiable communicable diseases

SummaryBackgroundWe sought to describe travel-related illness among our residents and gain insight into targeting pre-travel health advice to prevent travel-related illness.MethodsA supplemental travel questionnaire was developed and administered for cases with a legally notifiable communicable disease reported in 2011–2012, who spent at least part of their exposure period outside the United States.ResultsAmong 451 cases meeting the eligibility criteria, 259 were interviewed. Forty four percent reported receiving pre-travel advice. Two-thirds adhered fully with risk behavior recommendations; 94% followed immunization recommendations partially or fully; and 84% adhered fully with malaria prophylaxis recommendations. The primary reasons for not obtaining pre-travel advice were being unaware of the need (47.5%), or believing they already knew what to do (34.5%). Adults (OR = 2.8, 95% CI = 1.4–5.5), males (OR = 1.8, 95% CI = 1.1–3.0), those born outside the United States (OR = 2.0, 95% CI = 1.1–3.7), and those with planning time under two weeks (OR = 4.8, 95% CI = 1.5–15.9) or travel duration less than 7 days (OR = 7.9, 95% CI = 3.0–20.9) were more likely to travel without seeking pre-travel advice.ConclusionsThe majority of cases reported not receiving pre-travel advice. Understanding the predictors of failure to receive pre-travel advice may help target public health prevention efforts.