Pre-travel advice may not reduce risk of illnesses during travel

Travelling abroad involves risk of illnesses and carriage of antibiotic resistant bacteria, especially among students. Illnesses such as travellers' diarrhoea and respiratory tract infections are most common. Even if travellers follow the travel medicine clinics' advice on how to reduce risks during travel, the risk of falling ill is not reduced. This according to a dissertation at Umeå University in Sweden.

"The reasons why following the pre-travel advice do not reduce the risk of falling ill can be many, for instance, poor hygiene in restaurants lies behind great parts of the problem concerning travellers' diarrhoea. Every other student who travelled abroad on a student exchange fell ill. We found that younger travellers take greater risks in comparison to older travellers, and hence also fall ill more often," says Martin Angelin, physician and PhD student at the Department of Clinical Microbiology at Umeå University, author of the dissertation.

Martin Angelin has conducted a survey study on travellers who visited the Travel Medicine Clinic at the University Hospital of Umeå before travelling as well as a second study investigating Swedish university students from Umeå, Stockholm and Gothenburg who undertook parts of their studies abroad.

Healthcare students turned out to have higher illness rates and risk exposure when abroad compared to students from other disciplines. The healthcare students were given more advice before travelling but still exposed themselves to higher risks, in traffic for instance. Other than that, one in three healthcare students became carriers of antibiotic resistant gut microbiota, so-called ESBL-PE bacteria, after travel. Beside ESBL bacteria, healthcare student also became carriers of many other types of antibiotic resistant bacteria; many of which have previously not been found in travellers.

The risk for carriage of ESBL bacteria was increased depending on destination and potential antibiotic treatment during travel. Those who travelled to India had the highest risk of carriage. The consequences of carrying antibiotic resistance are often minimal for the healthy individual, but they contribute to an increase in antibiotic resistance in Sweden and more susceptible individuals risk infectious diseases caused by these resistant bacteria.