PROJECT SUMMARY/ABSTRACT International travel may not only increase the risk of infection for an individual traveler, but may also contribute to the global spread of infections. A better understanding of this epidemiologically important population could lead to improved interventions to promote the health of international travelers, and to diminish the spread of infections within their home communities. This renewal application focuses on Global TravEpiNet -- a consortium of clinics providing pre-travel health advice. In TravEpiNet, data on travelers are collected via a novel web-tool that simultaneously collects data, and aids health care practitioners in providing essential recommendations. Since beginning data collection in 2009, information regarding more than 11,000 U.S. international trips has been collected, and analyses focusing on subsets of high-risk travelers, interventions, and cost-analyses are ongoing. We propose to build upon this foundation in this renewal application. Specifically, we now propose four Specific Aims. In Specific Aim #1, we propose to (a) maintain, improve, and update the Global TravEpiNet web-tool, focusing on optimizing its ability to function as (i) an up-to-date interactive Yellow Book practice guidance tool and (ii) data collection surveillance system that (iii) integrates health care provider responses to assist practice guidance, (b) assess the impact of the TravEpiNet web-tool and system to facilitate optimal practice, and (c) work with CDC to maximize utility of comparisons of pre and post-travel surveillance data systems. In Specific Aim #2, we propose to (a) collect and analyze data on global international travelers, including travel demographics and preventative strategies, particularly focusing on high-risk travelers, and (b) assess the risk of illness in international travelers through an interactive web-based survey system. In Specific Aim #3, we propose to (a) maintain, improve and expand the Global TravEpiNet Consortium, especially focusing on expanding membership of clinics providing care to VFR travelers, high-risk travelers, students, and local health departments, and (b) expand access to the TravEpiNet web-tool to guide optimal practice beyond consortium membership, especially among primary care providers and non-expert practitioners. In Specific Aim #4, we propose to develop new approaches to increase pre-travel health-care seeking behavior by high-risk travelers, specifically, we propose to develop, test, deploy, and assess a traveler- oriented web-tool to inform travelers of potential travel-related health risks, and to facilitate interaction of international travelers with their health care providers.

PROJECT NARRATIVE International travel may not only increase the risk of infection for an individual traveler, but may also contribute to the global spread of infections. This renewal application focuses on Global TravEpiNet -- a consortium of clinics providing pre-travel health advice, and uses a novel web-tool that simultaneously collects data, and aids health care practitioners in providing essential recommendations. We propose to build upon the foundation provided by TravEpiNet to (1) maintain, enhance, expand access to, and assess impact of the TravEpiNet web-tool and consortium, (2) develop and assess a web-tool to assess risks of international travel, especially among high-risk travelers, (3) develop and assses a traveler-oriented web-tool to minimize health risks associated with international travel, and (4) analyze and communicate data to inform public health recommendations for international travelers, particularly regarding high-risk travelers, with the goal of preserving and advancing the health of the American public.