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Infectious diseases in returned travellers, NSW, 2010-2011
Praveena Gunaratnam1, Sean Tobin2, Holly Seale3
1NSW Public Health Officer Training Program, NSW Ministry of Health.
Aim:
To quantify the proportion of selected notified diseases in NSW attributable to overseas travel and assess the quality of data on travel-associated risk factors, to inform prevention strategies.
Methods:
2010 and 2011 notification data for dengue, hepatitis A, hepatitis E, malaria, paratyphoid fever, shigellosis and typhoid fever were extracted from the NSW Notifiable Conditions Information Management System and analysed for travel-associated risk factors.
Results:
Where place of acquisition was known, the proportion of cases for whom the disease was acquired overseas ranged from 48.7% for shigellosis to 100% for hepatitis E, malaria and typhoid. Over half of hepatitis A (53.3%), hepatitis E (74.2%), malaria (54.5%), paratyphoid (53.3%) and typhoid (65.7%) cases were associated with travel to the person's country of birth. Hepatitis A vaccination rates were significantly lower among overseas-acquired than locally-acquired cases (4.8% vs 22.2%, Χ(2)=6.58, p<0.02).
Conclusion:
A large proportion of selected enteric and vectorborne disease case notifications were associated with overseas travel. All potential travellers should be made aware of the risks and available preventive measures, such as vaccination against hepatitis A and typhoid fever, taking precautions with food and water and use of malaria chemoprophylaxis, where appropriate. Improvements in data on risk factors, reason for travel and barriers to the use of preventive measures would better inform prevention strategies.
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