Influenza and International TravelRobin Allen-Contreras, R.N., M.S.N., P.H.N., C.N.S.

AITC Immunization & Travel ClinicSan Francisco Dept. Public Health

October 17, 2012

http://izismile.com/2009/12/14/sneezing_people_12_pics-2.html

Asymptomatic Infections

Approximately 30% of influenza virus infections remained clinically undetected.

These asymptomatic cases unknowingly contribute to the spread of influenza.

Source: Clinical Infectious Diseases 2005; 40:1282-7

http://www.who.int/influenza/gisrs_laboratory/flunet/charts/en/index.html

Influenza Epidemiology by Season & Strain

Northern Hemisphere

SouthernHemisphere

Estimated Incidence per Month Among Travelers in Developing Countries, 2010

Travelers Play a Role in the Translocation of InfluenzaThe rapid spread of 2009 pandemic influenza A

(H1N1) was aided by infected travelersAlthough the virus was first identified in southern

California in April 2009, human illnesses appeared weeks earlier in Mexico.

Infected travelers who had visited Mexico were quickly detected in other parts of the world.

Aided by travel, this new virus found its way to dozens of countries in less than 2 months after it was identified, resulting in a June 2009 pandemic designation by the World Health Organization.

16.3 million visitors to Bay Area!

from WHY WE TRAVEL by Pico Iyer Salon.com 03/18/2000

We travel, initially, to lose ourselves; and we travel, next, to find ourselves.

We travel to open our hearts and eyes and learn more about the world than our newspapers will accommodate.

We travel to bring what little we can, in our ignorance and knowledge, to those parts of the globe whose riches are differently dispersed.

And we travel, in essence, to become young fools again — to slow time down and get taken in, and fall in love once more.

The Gambia West Africa 2009