Morbidity of foreign travelers in Attica, Greece: a retrospective study

  • G. Theocharis
  • K. A. Polyzos
  • E. K. Vouloumanou
  • G. Peppas
  • T. Spiropoulos
  • S. G. Barbas
  • M. E. Falagas
Article

Abstract

Over the last decade, travel medicine was mainly focused on the epidemiology of diseases among travelers to developing countries. However, less is known about travel-related morbidity in Europe. We evaluated the demographic and clinical characteristics of foreign travelers to Greece during a 5-year period (01/01/2005 - 31/12/2009) who sought medical services from a network of physicians performing house-call visits (SOS Doctors) in the area of Attica, Greece. Overall, 3,414 foreign travelers [children (≤18 years of age): 27%] were identified; 151 (4.4%) required transfer to a hospital. The most common clinical entities were: respiratory disorders (34%), diarrheal disease (19%), musculoskeletal (12%), dermatologic (7%), non-diarrheal gastrointestinal (6%), and genitourinary (5%) disorders. Respiratory disorders were the most frequent diagnosis during all seasons, followed by diarrheal gastrointestinal and musculoskeletal disorders. Respiratory and dental conditions were observed significantly more frequently in children. Respiratory disorders were observed significantly more frequently during winter (47%) compared to spring (36.7%), summer (30.9%), and autumn (30.5%), (p < 0.01). Despite the limitations of the retrospective methodology, our findings suggest that mild, self-limited respiratory events may be the prevalent cause for seeking primary health care during travel to Greece. Our findings may be extrapolated to other countries with similar climatic and socioeconomic status.

Notes

Conflict of interest

None for all authors.

Funding

None.

Ethical approval

N/A.

Supplementary material

10096_2012_1548_MOESM1_ESM.doc (211 kb)
ESM 1 (DOC 211 kb)

References

  1. 1.
    Rack J, Wichmann O, Kamara B et al (2005) Risk and spectrum of diseases in travelers to popular tourist destinations. J Travel Med 12:248–253PubMedCrossRefGoogle Scholar
  2. 2.
    Freedman DO, Weld LH, Kozarsky PE et al (2006) Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354:119–130PubMedCrossRefGoogle Scholar
  3. 3.
    World Tourism Organization. International Tourism 2010: Multi-speed recovery. Available online at: http://85.62.13.114/media/news/en/press_det.php?id=7331&idioma=E. Accessed 6 Dec 2011
  4. 4.
    Field V, Gautret P, Schlagenhauf P et al (2010) Travel and migration associated infectious diseases morbidity in Europe, 2008. BMC Infect Dis 10:330PubMedCrossRefGoogle Scholar
  5. 5.
    Gautret P, Schlagenhauf P, Gaudart J et al (2009) Multicenter EuroTravNet/GeoSentinel study of travel-related infectious diseases in Europe. Emerg Infect Dis 15:1783–1790PubMedGoogle Scholar
  6. 6.
    EuroTravNet. European Travel and Tropical Medicine Network of the International Society of Travel Medicine. Travel risks, precautions and vaccination requirements. Available online at: http://www.istm.org/eurotravnet/requirements.html. Accessed 6 Dec 2011
  7. 7.
    World Tourism Organization. UNWTO World Tourism Barometer. Available online at: http://www.unwto.org/facts/eng/pdf/barometer/UNWTO_Barom10_1_en.pdf. Accessed 6 Dec 2011
  8. 8.
    Peppas G, Theocharis G, Karveli EA et al (2006) An analysis of patient house calls in the area of Attica, Greece. BMC Health Serv Res 6:112PubMedCrossRefGoogle Scholar
  9. 9.
    SOS Doctors. Home page at: http://www.sosiatroi.gr/en. Accessed 6 Dec 2011
  10. 10.
    Trenberth KE (1983) What are the seasons? Bull Am Meteor Soc 64:1276–1282CrossRefGoogle Scholar
  11. 11.
    Dean AK, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version 2.2.1. Updated 2008/04/06 [cited 2008/09/18]. Available online at: http://www.OpenEpi.com
  12. 12.
    SPSS for Windows, Rel. 17.0.0 (23 Aug 2008). Chicago: SPSS Inc.Google Scholar
  13. 13.
    Herwaldt BL, de Arroyave KR, Roberts JM et al (2000) A multiyear prospective study of the risk factors for and incidence of diarrheal illness in a cohort of Peace Corps volunteers in Guatemala. Ann Intern Med 132:982–988PubMedGoogle Scholar
  14. 14.
    Mirzaian E, Durham MJ, Hess K et al (2010) Mosquito-borne illnesses in travelers: a review of risk and prevention. Pharmacotherapy 30:1031–1043PubMedCrossRefGoogle Scholar
  15. 15.
    Hagmann S, Neugebauer R, Schwartz E et al (2010) Illness in children after international travel: analysis from the GeoSentinel Surveillance Network. Pediatrics 125:e1072–e1080PubMedCrossRefGoogle Scholar
  16. 16.
    Mourtzoukou EG, Falagas ME (2007) Exposure to cold and respiratory tract infections. Int J Tuberc Lung Dis 11:938–943PubMedGoogle Scholar
  17. 17.
    Falagas ME, Theocharis G, Spanos A et al (2008) Effect of meteorological variables on the incidence of respiratory tract infections. Respir Med 102:733–737PubMedCrossRefGoogle Scholar
  18. 18.
    Falagas ME, Peppas G, Matthaiou DK et al (2009) Effect of meteorological variables on the incidence of lower urinary tract infections. Eur J Clin Microbiol Infect Dis 28:709–712PubMedCrossRefGoogle Scholar
  19. 19.
    Levy K, Hubbard AE, Eisenberg JN (2009) Seasonality of rotavirus disease in the tropics: a systematic review and meta-analysis. Int J Epidemiol 38:1487–1496PubMedCrossRefGoogle Scholar
  20. 20.
    Lopman B, Armstrong B, Atchison C et al (2009) Host, weather and virological factors drive norovirus epidemiology: time-series analysis of laboratory surveillance data in England and Wales. PLoS One 4(8):e6671PubMedCrossRefGoogle Scholar
  21. 21.
    Hancox JG, Sheridan SC, Feldman SR et al (2004) Seasonal variation of dermatologic disease in the USA: a study of office visits from 1990 to 1998. Int J Dermatol 43:6–11PubMedCrossRefGoogle Scholar
  22. 22.
    Jefferson T, Del Mar C, Dooley L et al (2010) Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 20:CD006207Google Scholar
  23. 23.
    [No authors listed] (1997) Influenza vaccination for travellers. CMAJ 156:677–678Google Scholar
  24. 24.
    von Sonnenburg F, Tornieporth N, Waiyaki P et al (2000) Risk and aetiology of diarrhoea at various tourist destinations. Lancet 356:133–134CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • G. Theocharis
    • 1
  • K. A. Polyzos
    • 2
  • E. K. Vouloumanou
    • 2
  • G. Peppas
    • 1
    • 2
  • T. Spiropoulos
    • 1
  • S. G. Barbas
    • 1
  • M. E. Falagas
    • 2
    • 3
    • 4
  1. 1.SOS DoctorsAthensGreece
  2. 2.Alfa Institute of Biomedical Sciences (AIBS)Marousi, AthensGreece
  3. 3.Department of MedicineHenry Dunant HospitalAthensGreece
  4. 4.Department of MedicineTufts University School of MedicineBostonUSA

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