1887
Research article Open Access
Like 0

Abstract

Travel may be associated with a higher risk of gonorrhoea and infection by antibiotic-resistant strains. The objective of this study was to estimate the risk for gonorrhoea among travellers from four Nordic European countries using surveillance data and to identify at-risk travellers to help target interventions. We retrieved gonorrhoea surveillance data from Denmark, Finland, Norway and Sweden and tourism denominator data from the Statistical Office of the European Union. A travel-associated case of gonorrhoea was defined as one for which the reported country of infection differed from the reporting country. During 2008−2013, the four countries reported 3,224 travel-associated gonorrhoea cases, of which 53% were among individuals below 35 years of age. The overall risk associated with travel abroad was 2.4 cases per million nights abroad. The highest risk was observed with travel to Asia (9.4). Cases more likely to be reported as travel-associated were: males, heterosexuals of both sexes, people older than 65 years, and foreign-born individuals. More effective interventions targeting young adults and other at-risk groups are needed. The use of travel-planning websites and social media should be explored further.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2017.22.20.30537
2017-05-18
2017-10-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2017.22.20.30537
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/22/20/eurosurv-22-20-1.html?itemId=/content/10.2807/1560-7917.ES.2017.22.20.30537&mimeType=html&fmt=ahah

References

  1. Holmes K, Sparling P, Stamm W, Piot P, Wasserheit J, Corey L, et al. Sexually Transmitted Diseases, Fourth Edition. 4 edition. New York: McGraw-Hill Professional; 2007. 2192 p.
  2. Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N, et al. Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting. PLoS One. 2015;10(12):e0143304.  https://doi.org/10.1371/journal.pone.0143304  PMID: 26646541 
  3. European Centre for Disease Prevention and Control (ECDC). Sexually transmitted infections in Europe 2013. Stockholm: ECDC; 2015. Available from: http://ecdc.europa.eu/en/publications/Publications/sexual-transmitted-infections-europe-surveillance-report-2013.pdf
  4. Clutterbuck DJ, Flowers P, Barber T, Wilson H, Nelson M, Hedge B, et al. UK national guideline on safer sex advice. Int J STD AIDS. 2012;23(6):381-8.  https://doi.org/10.1258/ijsa.2012.200312  PMID: 22807529 
  5. Bignell C, Unemo MEuropean STI Guidelines Editorial Board. 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults. Int J STD AIDS. 2013;24(2):85-92.  https://doi.org/10.1177/0956462412472837  PMID: 24400344 
  6. Lewis DA. Global resistance of Neisseria gonorrhoeae: when theory becomes reality. Curr Opin Infect Dis. 2014;27(1):62-7.  https://doi.org/10.1097/QCO.0000000000000025  PMID: 24275696 
  7. Brunette GW. CDC Health Information for International Travel 2014: The Yellow Book. Oxford University Press; 2013. 781 p.
  8. Abdullah ASM, Ebrahim SH, Fielding R, Morisky DE. Sexually transmitted infections in travelers: implications for prevention and control. Clin Infect Dis. 2004;39(4):533-8.  https://doi.org/10.1086/422721  PMID: 15356817 
  9. Ericsson CD, Steffen R, Matteelli A, Carosi G. Sexually transmitted diseases in travelers. Clin Infect Dis. 2001;32(7):1063-7.  https://doi.org/10.1086/319607  PMID: 11264035 
  10. Tapsall JW. Antibiotic resistance in Neisseria gonorrhoeae. Clin Infect Dis. 2005;41(s4) Suppl 4;S263-8.  https://doi.org/10.1086/430787  PMID: 16032562 
  11. Behrens RH, Carroll B. The challenges of disease risk ascertainment using accessible data sources for numbers of travelers. J Travel Med. 2013;20(5):296-302.  https://doi.org/10.1111/jtm.12062  PMID: 23992572 
  12. United Nations World Tourism Organization (UNWTO). UNWTO Tourism Highlights 2014 Edition. Madrid: United Nations World Tourism Organization; 2014. Available from: http://www.e-unwto.org/doi/pdf/10.18111/9789284416226
  13. European Commission. Commission Implementing Decision. 2012/506/EU of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council. Official Journal of the European Union. Luxembourg: Publications Office of the European Union. Communities. 3.4.2002:L 86/44. Available from: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2012:262:0001:0057:EN:PDF
  14. Demunter C, Dimitrakopoulou C. Tourism in Europe: Results for 2011. Eurostat; 2012. Statistics in focus. 28/2012. Available from: http://ec.europa.eu/eurostat/documents/3433488/5584904/KS-SF-12-028-EN.PDF/bbd8b1ea-4d49-49eb-a0d6-467c4b74e151
  15. Eurostat. Annual data on trips of EU residents. Luxembourg: Eurostat; [Accessed 18 Aug 2015]. Available from: http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=tour_dem_tnw&lang=en
  16. Mercer CH, Fenton KA, Wellings K, Copas AJ, Erens B, Johnson AM. Sex partner acquisition while overseas: results from a British national probability survey. Sex Transm Infect. 2007;83(7):517-22.  https://doi.org/10.1136/sti.2007.026377  PMID: 17991687 
  17. Danielsson M, Berglund T, Forsberg M, Larsson M, Rogala C, Tydén T. Sexual and reproductive health: Health in Sweden: The National Public Health Report 2012. Chapter 9. Scand J Public Health. 2012;40(9) Suppl;176-96.  https://doi.org/10.1177/1403494812459600  PMID: 23238407 
  18. European Centre for Disease Prevention and Control (ECDC). Thematic report: Men who have sex with men. Monitoring implementation of the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia: 2014 progress report. Stockholm: ECDC. 2015. Available from: http://ecdc.europa.eu/en/publications/Publications/dublin-declaration-msm-2014.pdf
  19. Low N, Unemo M, Skov Jensen J, Breuer J, Stephenson JM. Molecular diagnostics for gonorrhoea: implications for antimicrobial resistance and the threat of untreatable gonorrhoea. PLoS Med. 2014;11(2):e1001598.  https://doi.org/10.1371/journal.pmed.1001598  PMID: 24503544 
  20. Lewis CT, de Wildt G. Sexual behaviour of backpackers who visit Koh Tao and Koh Phangan, Thailand: a cross-sectional study. Sex Transm Infect. 2016;92(6):410-4.  https://doi.org/10.1136/sextrans-2015-052301  PMID: 27272532 
  21. Kaehler N, Piyaphanee W, Kittitrakul C, Kyi YP, Adhikari B, Sibunruang S, et al. Sexual behavior of foreign backpackers in the Khao San Road area, Bangkok. Southeast Asian J Trop Med Public Health. 2013;44(4):690-6. PMID: 24050104 
  22. Manieri M, Svensson H, Stafström M. Sex tourist risk behaviour--an on-site survey among Swedish men buying sex in Thailand. Scand J Public Health. 2013;41(4):392-7.  https://doi.org/10.1177/1403494813480572  PMID: 23470474 
  23. Bala M, Kakran M, Singh V, Sood S, Ramesh VMembers of WHO GASP SEAR Network. Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South-East Asia Region between 2009 and 2012: a retrospective analysis. Sex Transm Infect. 2013;89(Suppl 4):iv28-35.  https://doi.org/10.1136/sextrans-2012-050904  PMID: 24243876 
  24. World Health Organization (WHO). Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Geneva: WHO; 2012. Available from: http://apps.who.int/iris/bitstream/10665/44863/1/9789241503501_eng.pdf
  25. European Centre for Disease Prevention and Control (ECDC). EMIS 2010: The European Men-Who-Have-Sex-With-Men Internet Survey. Findings form 38 countries. Stockholm: ECDC; 2013. Available from: http://ecdc.europa.eu/en/publications/Publications/EMIS-2010-european-men-who-have-sex-with-men-survey.pdf
  26. Barnett ED, MacPherson DW, Stauffer WM, Loutan L, Hatz CF, Matteelli A, et al. The visiting friends or relatives traveler in the 21st century: time for a new definition. J Travel Med. 2010;17(3):163-70.  https://doi.org/10.1111/j.1708-8305.2010.00411.x  PMID: 20536884 
  27. Steffen R, deBernardis C, Baños A. Travel epidemiology--a global perspective. Int J Antimicrob Agents. 2003;21(2):89-95.  https://doi.org/10.1016/S0924-8579(02)00293-5  PMID: 12615369 
  28. Velicko I, Unemo M. Recent trends in gonorrhoea and syphilis epidemiology in Sweden: 2007 to 2011. Euro Surveill. 2012;17(29):20223. PMID: 22835468 
  29. Vivancos R, Abubakar I, Hunter PR. Foreign travel, casual sex, and sexually transmitted infections: systematic review and meta-analysis. Int J Infect Dis. 2010;14(10):e842-51.  https://doi.org/10.1016/j.ijid.2010.02.2251  PMID: 20580587 
  30. Croughs M, Remmen R, Van den Ende J. The effect of pre-travel advice on sexual risk behavior abroad: a systematic review. J Travel Med. 2014;21(1):45-51.  https://doi.org/10.1111/jtm.12084  PMID: 24354921 
  31. William MR, Rollnick S. Motivational Interviewing, Second Edition: Preparing People for Change. 2nd Revised edition edition. Milwaukee, Wis.: Guilford Press; 2002. 419 p.
  32. Van Herck K, Castelli F, Zuckerman J, Nothdurft H, Van Damme P, et al. Knowledge, attitudes and practices in travel-related infectious diseases: the European airport survey. J Travel Med. 2004;11(1):3-8.  https://doi.org/10.2310/7060.2004.13609  PMID: 14769280 
  33. Xiang Z, Gretzel U. Role of social media in online travel information search. Tour Manage. 2010;31(2):179-88.  https://doi.org/10.1016/j.tourman.2009.02.016 
  34. Kim H, Xiang Z, Fesenmaier DR. Use of the internet for trip planning: A generational analysis. J Travel Tour Mark. 2015;32(3):276-89.  https://doi.org/10.1080/10548408.2014.896765 
/content/10.2807/1560-7917.ES.2017.22.20.30537
Loading

Data & Media loading...

Comment has been disabled for this content
Submit comment
Close
Comment moderation successfully completed
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