Volume 77, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Increasingly, families travel to tropical destinations exposing them to infectious agents and tropical diseases not encountered at home. We studied 157 children (0–16 years) and their adult relatives traveling to the tropics, who attended a pretravel clinic and were generally adherent to prescribed advice. Incidence rates of common illness in children and adults were respectively 16.9 (14.3–19.7) and 15.1 (12.7–17.8) episodes/100 person-weeks. Diarrhea, abdominal pain, and fever were the most frequent complaints. There was no significant difference in the incidence of morbid episodes between children and adults, except for fever (more frequent in children). Most episodes occurred in the first 10 days of travel. The similar incidence of morbidity in children and adults and the episodes’ mildness challenge the view that it is unwise to travel with small children.


Article metrics loading...

Loading full text...

Full text loading...



  1. Riordan FA, Tarlow MJ, 1998. Imported infections in east Birmingham children. Postgrad Med J 74 : 36–37.
  2. Brouwer ML, Tolboom JJ, Hardeman JH, 1999. Routine screening of children returning home from the tropics: retrospective study. BMJ 318 : 568–569.
  3. Genton B, Gehri M, 1999. Authors’ definition of asymptomatic children is not the one usually accepted. BMJ 319: 121 [letter, discussion of Brouwer ML, Tolboom JJ, Hardeman JH, 1999. Routine screening of children returning home from the tropics: retrospective study. BMJ 318: 568–569]; author reply. BMJ 319 : 122.
  4. Klein JL, Millman GC, 1998. Prospective, hospital based study of fever in children in the United Kingdom who had recently spent time in the tropics. BMJ 316 : 1425–1426.
  5. Brabin BJ, Ganley Y, 1997. Imported malaria in children in the UK. Arch Dis Child 77 : 76–81.
  6. West NS, Riordan FA, 2003. Fever in returned travellers: a prospective review of hospital admissions for a 2½ year period. Arch Dis Child 88 : 432–434.
  7. Steffen R, van der Linde F, Meyer HE, 1978. Risk of disease in 10,500 travelers to tropical countries and 1,300 tourists to North America [in German]. Schweiz Med Wochenschr 108 : 1485–1495.
  8. Steffen R, Rickenbach M, Wilhelm U, Helminger A, Schar M, 1987. Health problems after travel to developing countries. J Infect Dis 156 : 84–91.
  9. Hill DR, 2000. Health problems in a large cohort of Americans traveling to developing countries. J Travel Med 7 : 259–266.
  10. Martin DO, Austin H, 1996. Exact estimates for a rate ratio. Epidemiology 7 : 29–33.
  11. Mickey RM, Greenland S, 1989. The impact of confounder selection criteria on effect estimation. Am J Epidemiol 129 : 125–137.
  12. Bishop Y, Fienberg S, Holland P, 1975. Summary measures of goodness of fit. Discrete Multivariate Analysis: Theory and Practice. Cambridge: The MIT Press, 125–130.
  13. International Labour Organisation, 1998. International Standard Classification of Occupations (ISCO-88). Geneva: International Labour Organisation.
  14. Groupe Suisse de Travail pour les Conseils Médicaux aux Voyageurs, 2006. Medical recommendations for travelers [in French]. Available from: http://www.safetravel.ch. Accessed June 19, 2006.
  15. Cossar JH, Reid D, Fallon RJ, Bell EJ, Riding MH, Follett EA, Dow BC, Mitchell S, Grist NR, 1990. A cumulative review of studies on travellers, their experience of illness and the implications of these findings. J Infect 21 : 27–42.
  16. Bruni M, Steffen R, 1997. Impact of travel-related health impairments. J Travel Med 4 : 61–64.
  17. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, Keystone JS, Pandey P, Cetron MS, 2006. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354 : 119–130.
  18. Hill DR, 2000. Occurrence and self-treatment of diarrhea in a large cohort of Americans traveling to developing countries. Am J Trop Med Hyg 62 : 585–589.
  19. Dudink J, Mearin L, Sukhai R, 2003. Ileus after the use of loperamide in a child with acute diarrhea. Ned Tijdsch Geneeskd 147 : 670–672.
  20. Cezard JP, Bingen E, Lambert-Zechovsky N, Marchand M, Marinier E, Navarro J, 1987. Effect of loperamide on fecal flora of children with severe prolonged diarrhea [in French]. Arch Fr Pediatr 44 : 109–114.
  21. Pitzinger B, Steffen R, Tschopp A, 1991. Incidence and clinical features of traveler’s diarrhea in infants and children. Pediatr Infect Dis J 10 : 719–723.
  22. Steffen R, Heusser R, Mächler R, Bruppacher R, Naef U, Chen D, Hofmann AM, Somaini B, 1990. Malaria chemoprophylaxis among European tourists in tropical Africa: use, adverse reactions, and efficacy. Bull World Health Organ 68 : 313–322.
  23. Steffen R, Fuchs E, Schildknecht J, Naef U, Funk M, Schlagenhauf P, Phillips-Howard P, Nevill C, Sturchler D, 1993. Mefloquine compared with other malaria- chemoprophylactic regimens in tourists visiting east Africa. Lancet 341 : 1299–1303.
  24. Phillips-Howard PA, Radalowicz A, Mitchell J, Bradley DJ, 1990. Risk of malaria in British residents returning from malarious areas. BMJ 300 : 499–503.
  25. Phillips-Howard PA, Bradley DJ, Blaze M, Hurn M, 1988. Malaria in Britain: 1977–86. Br Med J (Clin Res Ed) 296 : 245–248.
  26. Lobel HO, Phillips-Howard PA, Brandling-Bennett AD, Steffen R, Campbell CC, Huong AY, Were JB, Moser R, 1990. Malaria incidence and prevention among European and North American travellers to Kenya. Bull World Health Organ 68 : 209–215.
  27. Lackritz EM, Lobel HO, Howell BJ, Bloland P, Campbell CC, 1991. Imported Plasmodium falciparum malaria in American travelers to Africa. Implications for prevention strategies. JAMA 265 : 383–385.
  28. Hamer DH, Connor BA, 2004. Travel health knowledge, attitudes and practices among United States travelers. J Travel Med 11 : 23–26.
  29. Gisler S, Steffen R, Mutsch M, 2005. Knowledge, attitudes and practices among travellers to tropical and subtropical countries [in German]. Schweiz Rundsch Med Prax 94 : 967–974.

Data & Media loading...

  • Received : 17 Feb 2007
  • Accepted : 13 Jun 2007

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error