Thus, the proportionate morbidity is not an acquisition incidence rate

of travel-related illness and cannot infer absolute risk. Differences in the proportions (categorical variables) were tested using Fisher exact tests, and Kruskal–Wallis tests were used for continuous variables. p Values <0.05 were considered significant. Odds ratios (ORs) (older travelers vs young adult travelers) by diagnosis were estimated by logistic regression and adjusted for travel reason, sex, pre-travel advice, region of exposure, and clinical setting. The Mantel–Haenszel statistic was used to test for diagnosis trends by age classes. All statistical tests were two-sided. Percentages and ORs (with 95% confidence intervals), comparisons, and graphic analyses were carried out using the R 2.8.1 LY2109761 cell line environment (www.r-project.org).14 A total of 89,521 ill travelers recorded in the GeoSentinel

database during the study Vorinostat period. A total of 63,076 ill adult travelers were included in the study of which 7,034 were aged 60 years and over, accounting for 8.4% of the whole population seen at GeoSentinel clinics during the study period. The mean age was 66 years in the older group (median: 65, range 60–98 y) and 31 years in the adult reference group (median: 30, range 18–45 y). A total of 1,532 ill travelers were aged 70 years and over, accounting for 22% of the older group. Demographic and travel data showed several statistically significant differences according to age (Table

1). Compared to younger patients, older patients presenting to GeoSentinel sites were more likely to be male, to be resident in North America and Canada and to travel for tourism; there were fewer business travelers in the older group. The median travel duration was shorter in the older traveler group. The proportion of individuals traveling in pre-arranged or organized trips was higher among older patients compared to younger patients, but the proportion of those Protein tyrosine phosphatase who had sought travel advice was lower among the older group. The travel region differed among age groups, with Europe, the Middle East, and North America being more frequently visited among older individuals. The proportionate morbidity of broad syndromes also differed between older and younger travelers (Table 2). Acute diarrhea was the most common complaint in both groups of ill travelers, although comparatively it was significantly less frequent in the older group. While febrile systemic illness was the second most common complaint in the younger group, respiratory disease ranked as the second most frequent reason for presentation to a GeoSentinel site in the older group. Among other syndromes, non-diarrheal gastrointestinal disease, musculoskeletal disorders, neurological, genitourinary, and cardiovascular-related morbidity were comparatively higher in the older group, as were chronic diseases.