Pathogens and People: The travel bug can be infectiousBy EDWARD McSWEEGAN, For The CapitalPublished 05/03/09
Summer is approaching and that means it's time to start planning vacations to the far side of theChesapeake Bay, and the far side of the world. Travel is a seasonal migration worth $1.6 trillionto the U.S. travel and tourism industry. Worldwide, some 2 million people cross international borders every day. At peak times, there are 5,000 planes crisscrossing U.S. skies. In 2007, 458million people were traveling on vacations.Long-distance travel is a relatively new phenomenon. A few years ago, London epidemiologistDavid Bradley used four generations of his family to illustrate the expansion of personal travel.His great-grandfather was confined to a 40-kilometer corner of southeast England. Hisgrandfather stretched those boundaries to about 400 km. His father reached the continent(courtesy of the British Army) and wandered over 4,000 km. David, the son, has since extendedhis own range across six continents and 40,000 km. Great-grandpa would be shocked.Technology has made David's kind of long-distance travel easy. Not surprisingly, the ease andscope of modern travel has created new economic and social consequences. There are alsoinfectious disease consequences because when we pack for a trip we also pack along our microbes. When we arrive, we unpack those germs and pick up new ones as if they were tinysouvenirs. Travel - especially international travel - often encourages a laissez faire exchange of microbes. Usually the exchange is harmless. Sometimes it causes illness (e.g., traveler'sdiarrhea). Sometimes it sparks an epidemic.During the age of sail, sick passengers usually got better - or died - before their ships ever reached port. The vagaries of wind and tide helped to slow the spread of many infectiousdiseases. (Four of my ancestors died of "ship fever" (typhus) sailing from Ireland in 1847.)The steam engine changed patterns of disease transmission by quickly moving passengers between ports while some of them were still contagious. A 19th-century sailing trip from India toFiji took 70 days, but insured any passengers with measles either died or recovered before theship made landfall. Steamships made the same journey in half the time and carried more passengers. Enough sick passengers survived the trips to ignite devastating measles epidemics inFiji.Steamships also carried plague-infected rats and fleas around the world in the late 19th century.Bubonic plague from China reached Hawaii in 1899 and San Francisco in 1900. (Plague is stillin the U.S. today, having found a comfortable home among the squirrels and prairie dogs of theWest.)Modern jets have made the problem of travel and infections much worse. Many long-range planes can now reach almost any part of the globe in 24 hours. That means visitors to WestAfrica can be exposed to deadly viruses such as Lassa and Marburg, and fly home to the U.S. or Europe before they show symptoms of infection. Eco-tourists can bring home water-borneillnesses such as leptospirosis or amoebic dysentery, rabies or H5N1 influenza from wildlife,encephalitis viruses from ticks and mosquitoes, and rare but deadly hemorrhagic viruses from
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