739. Self-Reported Prevalence of Insect Bites During International Travel

Abstract Background Vector borne diseases are responsible for almost one fifth of global infectious disease burden. International travelers are at risk for potentially life-threatening conditions when visiting areas with endemic vector borne disease, but this risk can be mitigated when proper insect precautions are taken. This study sought to evaluate the prevalence of insect precaution use and subsequent insect bites among Utah travelers who have attended pre-travel consultations. Methods A cross-sectional study at the University of Utah and Salt Lake County travel clinics was analyzed. Descriptive statistics and multivariable logistic regression were used to explore factors associated with insect repellant use, and reporting bug bites despite insect repellant use. Results A total of 463 individuals completed the survey and were included in our analytic sample. The majority of respondents (80%) reported using insect repellent, and close to half (45%) reported bug bites. Insect repellent use was positively associated with visiting rural/countryside (OR 2.78, 95% CI 1.50 – 5.15), and traveling to South East Asia (OR 3.16, 95% CI 1.40 – 7.26), or Americas regions (OR 3.34, 95% CI 1.45 – 7.92). Being of male gender (OR 0.37, 95% CI 0.21 – 0.64) or traveling to high altitude locations (OR 0.37, 95% CI 0.18 – 0.74) was negatively associated with using insect repellent. Longer trip duration (OR 1.01, 95% CI 1.00 – 1.02) was positively associated with reporting insect bites, while male gender (OR 0.51, 95% CI 0.33 – 0.80), older age (OR 0.96, 95% CI 0.95 – 0.98), and having an advanced degree (OR 0.47, 95% CI 0.22 – 0.99) were negatively associated. Estimated Risk Factors of Insect Bites and Insect Repellent Use Characteristics of international travelers were self-reported in a cross-sectional study. Use of insect repellent and reporting bug bites despite repellant use was examined through multivariate logistic regression and used to calculate odds ratios and 95% confidence intervals. Due to multicollinearity and data skewness, the following variables were omitted from the insect repellent model: Accommodation: Hotel/other enclosed structure, Location: European, Location: and Western Pacific. Reference categories are Gender: Female, Education: High school diploma/GED or less, Group size: 1 (Traveled alone), Location type: Urban, and Malaria region: No. All other categories are not mutually exclusive and evaluated as separate binary variables. Conclusion We show that gender, age, trip duration, and education level were associated with self-reported bug bites during travel abroad. Given the number of vector-borne diseases affecting health of travelers, our findings will contribute towards strategies to advise travelers for disease prevention. Disclosures All Authors: No reported disclosures

Background. In January-March 2020, the Centers for Disease Control and Prevention (CDC) issued multiple warnings regarding COVID-19 travel-associated risks. We sought to describe US travelers seeking pretravel consultation regarding international travel at US Global TravEpiNet (GTEN) sites before and after the initial COVID-19 travel warnings.
Methods. We prospectively collected data at 22 GTEN sites pre-COVID-19 (January-December 2019) and 18 GTEN sites during the COVID-19 pandemic (April 2020-March 2021). We excluded travelers evaluated during January-March 2020, when CDC travel guidance was evolving rapidly. Travelers used standardized questionnaires to self-report data regarding demographics and travel-related characteristics. Providers confirmed these data and documented their recommendations during pretravel consultation, which could be performed virtually. We conducted descriptive analyses of differences in demographics, travel-related characteristics, vaccinations, and medications (SAS v9.4;Cary,NC).
Results. Compared with 16,903 pre-COVID-19 consultations, only 1,564 consultations occurred during the COVID-19 pandemic, a 90% reduction (Table). During COVID-19, a greater proportion of travelers were children aged 1-5 years, visiting friends and relatives (VFR), with itineraries ≥ 30 days, and going to Africa; a smaller proportion of travelers were aged > 55 years, or traveling to Southeast Asia or the Western Pacific. During COVID-19, fewer vaccine-eligible travelers received vaccines at the pretravel consultation except for yellow fever, and a greater proportion were referred to another provider for vaccination (Figure). Table. Demographics and travel-related characteristics of international travelers seeking pretravel consultation at Global TravEpiNet sites before and during the COVID-19 pandemic Table continued. Demographics and travel-related characteristics of international travelers seeking pretravel consultation at Global TravEpiNet sites before and during the COVID-19 pandemic Among vaccine-eligible travelers, we summarized those who were vaccinated at the visit (blue) and not vaccinated (orange). We then categorized reasons for nonvaccination into: provider decision (solid), referral to another provider (dots), traveler refusal (striped), or other (hatched). COVID-19 vaccination was not available at GTEN sites during the analysis period; although COVID-19 vaccinations outside of GTEN sites might have affected vaccination recommendations, they were unlikely to have had a large effect given their limited availability in January-March 2021.
Conclusion. Compared with pre-COVID-19, US travelers seeking pretravel consultations at GTEN sites during the pandemic might be at higher risk for travel-related infections given VFR status, traveling for ≥ 30 days, and going to Africa. Fewer vaccine-eligible travelers were vaccinated at pretravel consultations, which could reflect more virtual pretravel consultations. Counseling and vaccination for international travelers continue to be priorities during the COVID-19 pandemic.
Disclosures. Background. Vector borne diseases are responsible for almost one fifth of global infectious disease burden. International travelers are at risk for potentially life-threatening conditions when visiting areas with endemic vector borne disease, but this risk can be mitigated when proper insect precautions are taken. This study sought to evaluate the prevalence of insect precaution use and subsequent insect bites among Utah travelers who have attended pre-travel consultations.

Methods.
A cross-sectional study at the University of Utah and Salt Lake County travel clinics was analyzed. Descriptive statistics and multivariable logistic regression were used to explore factors associated with insect repellant use, and reporting bug bites despite insect repellant use.