33–35 A large study of influenza virus infection in persons travelling to tropical and sub-tropical countries found that 1.1% of the travellers enrolled in the study seroconverted and that 40% of those who seroconverted had sought medical attention during their travel: a highly significant number. 25 Influenza virus infections were acquired largely from Asia (47.5%), Africa (27.5%) and Latin America (25%). 25 It is important to note that, independent of travel, seasonal influenza outbreaks have been repeatedly associated with poor outcomes even in patients without co-morbidities: including small numbers who develop severe and even lethal influenza as well as life-threatening complications.
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