Dimensions Of International Travel And Migration

During recent decades, global migration has expanded tremendously (Figure 2.2). In 1997, the figures for worldwide travel exceeded 600 million international arrivals, and it is estimated that there will be more than 1 billion travellers per annum before the year 2015 (WTO, 1998). The reasons for international travel are mainly tourism,

Table 2.2 Important examples of emerging resistance

Methicillin-resistant Staphylococcus aureus (MRSA) Glycopeptide-resistant enterococci and staphylococci Gram-negative enterobacteria Streptococcus pneumoniae and Neisseria spp. Salmonella and other bacteria causing diarrhoeal disease Tuberculosis

Malaria (Plasmodium falciparum) HIV

business and education; however, in some regions of the world, migrant workers and refugees contribute substantially to international migration (Table 2.5).

In 1996, Germany was ranked as the world's top spender on international tourism (Table 2.6), with 77.7 million international departures, including more than 4 million destinations to developing countries in tropical and subtropical regions. On the other hand, more than 9% of the population registered in Germany during 1997 were foreign nationals, with 75% originating from countries outside the European Union, and an increasing number of foreigners originating from tropical countries. The main reasons for nontourist immigration to Germany, as is the case in the whole of Europe, are work, family reunification, education and political reasons (refugees, asylum seekers). There is a considerable fluctuation of this population, with both immigration and emigration rates of approximately 10% per annum (Statistisches Bundesamt, 1998).

EPIDEMIOLOGY OF HEALTH RISKS AND TRAVEL Table 2.3 Global burden of tropical infectious diseases (thousands, WHO estimates in 1997)

Cases

__Persons with

New All severe limitation

Disease Deaths (incidence) (prevalence) of activity

Cases

__Persons with

New All severe limitation

Disease Deaths (incidence) (prevalence) of activity

Malaria"

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