systemic febrile illnesses. Travelers most commonly contracted Falciparum malaria in West Africa, enteric fever on the Indian subcontinent, and leptospirosis, scrub typhus and murine (flea-borne) typhus in Southeast Asia.2 Respiratory illnesses include common cold, flu, upper respiratory infections and pneumonia. Common skin and soft tissue infections, mosquito bites (often infected) and allergic dermatitis were the most common skin conditions affecting travelers.3 U.S. citizens who seek medical help after returning from a trip abroad suffered most from Illnesses of the gastrointestinal tract (58 percent) followed by systemic febrile illnesses (18 percent) and dermatologic disorders (17 percent).4 A study of travelers returning to China from 2014 to 2018 reported an overall sickness rate of 41.64 per million travelers, with 27.44 per million becoming sick during travel and 14.2 per million developing illnesses within 14 days of return. Those who returned sick suffered mainly from respiratory infections such as influenza and rhinovirus and had returned from Asian countries. Travelers who got sick after return primarily had vector-borne diseases such as malaria and dengue and had returned from Africa.5 Risks during travel appear to be similar among Europeans of various nationalities. A study showed that 42.9 percent of German travelers reported illness, with 10 percent reporting more than one adverse health event. Gastrointestinal symptoms were 80 percent of reported illnesses, respiratory symptoms 13.7 percent and accidents 5 percent. The risk of getting ill significantly increased when visiting the Indian subcontinent or when traveling in areas with limited availability of modern medical care.6 Statistics for travelers from other countries and travelers to South America and the Caribbean are similar in the prevalence of disease categories, but specific diseases may vary due to the regional spread of diseases such as Zika or yellow fever.
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