We also found that the relative frequency of trauma and injuries

We also found that the relative frequency of trauma and injuries in travelers increased with advancing age, which may result from age-related decreased sensory, motor, and perceptual skills. Deaths were four times more frequent in the older group compared

to the younger one and mainly caused by infectious diseases which reflects the predominance of specialized infectious diseases clinics in GeoSentinel network, when deaths in travelers are usually caused by trauma and non-communicable diseases.11 The major strength of our analysis is its multicenter nature, which provided a large number of participants from many countries and captured all traveler types, and its focus on proportionate morbidity. The limitations of this method of analysis have been recently discussed.32 In particular, because the denominator data (number of travelers) cannot be ascertained, it is not possible to calculate incidence rates BI 2536 purchase or absolute risk. Also, this data might not be representative of the overall population of travelers, and the results do not represent the broad spectrum of illnesses typically seen at non-specialized

primary care practices where mild or self-limited conditions present with higher frequency. Due to the nature of GeoSentinel clinics, illnesses acquired after travel to non-tropical destinations or non-infectious check details travel-related illnesses may be underrepresented. Underlying chronic diseases are not documented by GeoSentinel which does not allow evaluation of their influence on travel-associated morbidity. However,

the GeoSentinel database (and associated analyses) has nevertheless been identified as a valuable source of data on the epidemiology Uroporphyrinogen III synthase of travel-related illnesses.13,32,33 In conclusion, older travelers represent a minority of patients in travel clinics but they are usually sicker with a higher relative proportion of life-threatening diseases (LRTI, HAPE, severe P falciparum malaria, cardiovascular disease, and pulmonary embolism),34 as well as a higher proportion of death, compared to younger patients. Older travelers should be specifically targeted for the prevention of such diseases and advised to obtain travel insurance that covers chronic stable medical conditions, acute illnesses, accidents, evacuation, and death. GeoSentinel is supported by a cooperative agreement (5U50CI000359) from the Centers for Disease Control and Prevention and by an initial pilot grant from the International Society of Travel Medicine. The authors state they have no conflicts of interest to declare. In addition to the authors, members of the GeoSentinel Surveillance Network who contributed data (in descending order) are as follows: Prativa Pandey, CIWEC Clinic Travel Medicine Center, Kathmandu, Nepal; Kevin C. Kain, University of Toronto, Toronto, Canada; Gerd-Dieter Burchard, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany; Michael D. Libman, Brian Ward, and J.

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