The impact of international travel on the epidemiology of enteric infections, British Columbia, 2008.

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 BC and lead to more targeted public health actions.