0% (n = 13) would use antivirals as influenza prophylaxis. Regarding prevention, the majority (78.9%; n = 498) of the travelers did not seek advice on influenza before going on their last business trip, 58.0% (n = 381) did not take any preventive measures against influenza, 27.2% (n = 179) had their annual vaccination, and 15.7% (n = 103) observed hand hygiene. Of the travelers, 9.7% (n = 64) carried

antiviral medication on their last business trip and 7.0% (n = 46) actually used this medication. Conclusions. Business travelers have a good kowledge about the transmission and the symptoms of influenza but guidelines are needed that concisely address the indications for influenza vaccination in travelers and the carriage and use of antiviral medication. The recent influenza A (H1N1) pandemic has brought influenza into the infectious disease limelight. In Europe, more than 29% of all confirmed influenza Endocrinology antagonist ABT-737 price A (H1N1) pandemic cases were travel related and were registered after importation into European Union/European Economic Area countries.1 Seasonal influenza

affects 5% to 15% of the world’s population annually and is considered to be among the most frequent vaccine-preventable infections in travelers.2,3 The attack rate of influenza in intercontinental travelers is estimated at 1%.4 A study which analyzed travel-associated pandemic (H1N1) infection in Singapore showed that one fourth of the case-patients traveled after illness onset, and 15% became ill while traveling.5 Wagner and colleagues showed that air travel

by one infectious individual, rather than causing a single outbreak of H1N1, could cause several simultaneous outbreaks, especially in Economy Class Mannose-binding protein-associated serine protease on long-haul flights.6 Fever in ill-returned travelers is a common presenting symptom and about 14% of presenting fevers can be attributed to a respiratory illness.7 In patients with severe acute respiratory syndromes, influenza viruses are prevalent 14.2%.8 Furthermore, the recent pandemic influenza showed an increased risk of infection and death among young adults who constitute a mobile population.9 In the temperate regions of the northern hemisphere, most influenza activity occurs from November through April, in the temperate regions of the southern hemisphere it is from April through October, whereas in the tropics the influenza virus circulates at low levels year-round.10 Thus, influenza is particularly associated with travel in the northern hemisphere during wintertime or travel in the southern hemisphere during their influenza season.11 Due to close contact of large numbers of individuals who may harbor influenza, travelers are at a higher risk for influenza.10,12,13 Air travel, in particular, facilitates the spread of influenza around the globe and as soon as influenza is spread to the top 50 global airports, the transmission is greatly accelerated.