What's the worst that could happen? The risk of illness, injury, and death related to international travel-the Australian experience

Abstract

Introduction

Medical advisors to travellers whose journeys begin and end in Australia will benefit from a review of the associated risks, to guide pre- and post-travel advice and care.

Methods

A literature search was conducted for original research on medical events in Australian residents related to international travel. Important findings were summarised, incidence and risk factor data extracted, and grouped thematically for narrative review.

Results

31 studies published between 1995 and 2024 were identified. Reports of medical events during travel ranged between 28 % and 82 % of travellers, most commonly respiratory and gastrointestinal in nature (34 %–63 % of cases combined). Trauma accounted for 25 %–49 %. 23 studies (74 %) provided data only on events identified or treated after the traveller had returned. Respiratory, gastrointestinal and febrile illnesses were the most frequent reasons for these presentations. Respiratory infection was more common in older returned travellers. Younger adult travellers, more commonly experienced gastrointestinal infection and traumatic injury, including animal bites. Travellers Visiting Friends and Relatives (VFR) were at a higher risk of introducing notifiable diseases to Australia, and contracting tropical diseases.

Conclusions

Many travellers seek care after returning from international travel, with the majority due to diseases which commonly occur in Australia. Tropical diseases, however, which can be life-threatening, and require high levels of care, must be excluded. The changing demographic of the migrant population presents a public health risk when VFR travellers are exposed to diseases with limited presence in Australia. Travel advice should include a discussion about possible rabies exposure.