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The Impact of International Travel on the Epidemiology of Enteric Infections, British Columbia, 2008

  • Quantitative Research
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Abstract

Objective

Travel-related enteric infections likely represent a large proportion of all enteric infections in British Columbia (BC). The objective of this study was to assess the proportion of enteric infections in BC reported in 2008 associated with international travel in order to understand trends in infections so that targeted interventions can be implemented.

Methods

Travel information for all reported cases of salmonellosis, verotoxigenic E. coli (VTEC) infection, shigellosis, Vibrio parahemolyticus infection, botulism, cholera, listeriosis, typhoid fever, paratyphoid fever, hepatitis A infection, cryptosporidiosis, cyclosporiasis and a representative proportion of campylobacteriosis was collected. Temporal, demographic and geographic analysis was conducted comparing locally-acquired infections to infections acquired during international travel. Travel destination was compared between cases of enteric infections and the BC population.

Results

Of the 3,120 enteric infections reported in 2008, 60% were classified as locally-acquired and 40% were associated with international travel. The proportion of infections associated with international travel was highest among 30 to 39 year olds. Locally-acquired infections were highest in the summer months and international travel-related infections were highest in the winter. Asia and Mexico were the most common destinations in relation to enteric infections acquired internationally. The proportion of enteric infections was significantly higher than the proportion of the BC population travelling to these areas.

Conclusions

The proportion of enteric infections in BC associated with international travel is significant. Identification and assessment of locally-acquired infections separately from those associated with international travel will improve assessment of trends and rates for enteric infections in B. and lead to more targeted public health actions.

Résumé

Objectif

Les infections entériques liées aux voyages représentent probablement une grande proportion des infections entériques en Colombie-Britannique (C.-B.). Nous avons cherché à déterminer la proportion des infections entériques déclarées en 2008 en C.-B. associées aux voyages internationaux pour mieux comprendre les tendances dans ces infections et permettre la mise en œuvre d’interventions ciblées.

Méthode

Nous avons recueilli des renseignements sur les voyages pour tous les cas déclarés de salmonellose, d’infection à E.coli producteur de vérotoxine (ECPV), de shigellose, d’infection par le vibrio parahémolytique, de botulisme, de choléra, de listériose, de fièvre typhoïde, de fièvre paratyphoïde, d’hépatite A, de cryptosporidiose et de cyclosporose, et pour une proportion représentative des cas de campylobactériose. Des analyses temporelles, démographiques et géographiques ont été menées pour comparer les infections contractées localement à celles contractées en voyage à l’étranger. Nous avons comparé les destinations de voyage pour les cas d’infections entériques et pour la population britanno-colombienne.

Résultats

Sur les 3 120 infections entériques déclarées en 2008, 60 % avaient été contractées localement et 40 % étaient associées à des voyages internationaux. La plus forte proportion d’infections associées aux voyages à l’étranger était observée chez les 30 à 39 ans. Les infections contractées localement atteignaient un sommet durant les mois d’été, et les infections liées aux voyages internationaux, durant l’hiver. L’Asie et le Mexique étaient les destinations internationales où l’on a le plus souvent contracté des infections entériques. La proportion d’infections entériques était sensiblement plus élevée que la proportion d’habitants de la C.-B. à voyager dans ces régions.

Conclusion

Une importante proportion d’infections entériques en C.-B. est associée aux voyages internationaux. En séparant l’identification et l’évaluation des infections contractées localement et des infections associées aux voyages internationaux, on pourrait améliorer l’évaluation des tendances et des taux d’infections entériques en C.-B. et mieux cibler les efforts de santé publique.

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Author information

Authors and Affiliations

  1. British Columbia Centre for Disease Control, Vancouver, BC, V5Z 4R4, Canada, 655 West 12th Ave

    Marsha Taylor MSc, Laura MacDougall MSc, Min Li MHA & Eleni Galanis MD, MPH, FRCPC

  2. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

    Eleni Galanis MD, MPH, FRCPC

  3. Interior Health Authority (IHA), Canada

    Judi Ekkert

  4. Fraser Health Authority (FHA), Canada

    Larry Gustafson

  5. Vancouver Coastal Health Authority, Canada

    Jessica Ip

  6. Northern Health Authority, Canada

    Jennifer Jeyes

  7. Vancouver Island Health Authority, Canada

    Craig Nowakowski

  8. IHA, Canada

    Robert Parker

  9. FHA, Canada

    Jason Stone

Authors
  1. Marsha Taylor MSc
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  2. Laura MacDougall MSc
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  3. Min Li MHA
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  4. Eleni Galanis MD, MPH, FRCPC
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  5. Judi Ekkert
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  6. Larry Gustafson
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  7. Jessica Ip
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  8. Jennifer Jeyes
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  9. Craig Nowakowski
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  10. Robert Parker
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  11. Jason Stone
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Consortia

BC Enteric Policy Working Group

Corresponding author

Correspondence to Marsha Taylor MSc.

Additional information

Acknowledgements: The authors acknowledge representatives from Fraser Health Authority, Interior Health Authority, Northern Health Authority, Vancouver Coastal Health Authority and Vancouver Island Health Authority for their support of this work; Sara Forsting, VCH, for data extraction; Colette Gaulin, BCCDC, for review of the manuscript; and the clinical microbiology laboratories in BC responsible for diagnosis of enteric infections.

Conflict of Interest: None to declare.

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Taylor, M., MacDougall, L., Li, M. et al. The Impact of International Travel on the Epidemiology of Enteric Infections, British Columbia, 2008. Can J Public Health 101, 332–336 (2010). https://doi.org/10.1007/BF03405297

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  • DOI: https://doi.org/10.1007/BF03405297

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