Travel medicine : knowledge, attitude, practice and immunisation

Abstract

In an epoch where every generation travels more frequently and at longer distances than the previous generation, with a mean increase of 30 million travellers per year from 1995 until today, physicians throughout the world are confronted with new diseases. In absolute numbers, this implies that each year, roughly 4 million travellers appeal to specialised health care, either abroad or at home, because of systemic febrile illness, diarrhoea or dermatologic disorders. During the last decades, travel medicine has evolved into a distinct discipline of Infectious Diseases, eventhough transmission of infectious agents into vulnerable populations through travel has been well know for centuries. Improvement of of protection against travel-related diseases can be achieved through knowledge on the following topics; 1. Epidemiology of travel-related diseases, 2. Morbidity and mortality of these illnesses in specific groups of travellers, 3. Adherence to travel health precautions, 4. Responsivity against vaccination, and 5. Availability of preventive measures, such as vaccines. The research described in this thesis addresses these various topics.