Epidemiological Characteristics of Infectious Diseases Among Travelers Between China and Foreign Countries Before and During the Early Stage of the COVID-19 Pandemic.

Background: International travel during the Coronavirus disease 2019 (COVID-19) pandemic carries a certain magnitude of infection risk both to travelers and their destination, which may be difficult to assess in the early stage. The characteristics of common infectious diseases of tourists may provide some clues to identify the high-risk travelers and protect susceptible population. Methods: From among 48,444 travelers screened at Shanghai Port, we analyzed 577 travelers with 590 infectious diseases for age, sex, disease type, and World Health Organization (WHO) regions. We used the Joinpoint Regression Program to identify the average percent changes (APC) in the various trends among these individuals. Results: Hepatitis B, syphilis, and HIV were the most common infectious diseases in travelers entering China, and Hepatitis B, pulmonary tuberculosis, and syphilis in Chinese nationals traveling abroad (overall detection rates, 1.43 and 0.74%, respectively; P < 0.05). Africa (2.96%), the Americas (1.68%), and the Western Pacific (1.62%) exhibited the highest detection rates. This trend did not decrease since the COVID-19 pandemic (P > 0.05) and rather showed an upward trend with increasing age [APC 95% CI = 5.46 (3.41,7.56)%, P < 0.05]. However, there were no evident trends in monthly infection rates of travelers exiting and entering China from different WHO regions (all P > 0.05). Conclusion: Travelers always carry a transmission risk of common infectious diseases. It may be reasonable to adjust strategies for airport screening and quarantine according to the age and departure area of travelers to prevent and control new infectious diseases.

背景：在2019冠状病毒病（COVID - 19）大流行期间，国际旅行对旅行者及其目的地都存在一定程度的感染风险，在早期可能难以评估。旅行者常见传染病的特征可能为识别高风险旅行者和保护易感人群提供一些线索。 方法：在上海口岸筛查的48444名旅行者中，我们分析了577名患有590种传染病的旅行者的年龄、性别、疾病类型以及世界卫生组织（WHO）区域情况。我们使用Joinpoint回归程序来确定这些个体中各种趋势的平均百分比变化（APC）。 结果：乙型肝炎、梅毒和艾滋病是入境中国旅行者中最常见的传染病，而乙型肝炎、肺结核和梅毒是出国的中国公民中最常见的传染病（总体检出率分别为1.43%和0.74%；P < 0.05）。非洲（2.96%）、美洲（1.68%）和西太平洋地区（1.62%）的检出率最高。自COVID - 19大流行以来，这一趋势并未下降（P > 0.05），而且随着年龄增长呈上升趋势[APC 95%置信区间 = 5.46（3.41，7.56）%，P < 0.05]。然而，从不同世卫组织区域进出中国的旅行者的月度感染率没有明显趋势（所有P > 0.05）。 结论：旅行者总是携带常见传染病的传播风险。根据旅行者的年龄和出发地区调整机场筛查和检疫策略以预防和控制新的传染病可能是合理的。