In Western Europe the incidence of tick-borne encephalitis (TBE) has increased over the last 30 years, coupled with changes in distribution. Modifications in the TBE enzootic cycle, through a combination of changes in temperature, vertebrate abundance and habitat suitability may have increased the risk of TBE in recent years. In Switzerland, analysis using satellite-derived climate data demonstrated that the environment of areas with TBE since the 1980s and areas that recently became endemic for TBE have become more similar between 2001 and 2009. This was coupled with an increase in April, May and June temperature, which could have affected the tick population and/or human exposure to ticks. Deer and boar abundance also changed in some cantons. In Germany, spatio-temporal modelling demonstrated the importance of temperature, vertebrate abundance and unemployment in the incidence and distribution of TBE between 2001 and 2009. Changes in TBE reporting, April, May and June temperature, vertebrate abundance and pesticide use may have contributed to increases in TBE in 1992 and 2001. Human exposure patterns, however, appear to be as important as the enzootic cycle in shaping the incidence of TBE, not only in determining the overall trend but also in interacting with the weekly, seasonal and yearly patterns of tick hazard to give the observed incidence. In Switzerland, in weeks with warm, sunny weather, human exposure to ticks is promoted and short-term increases in tick bites are seen. Human outdoor activity also shifts the seasonal pattern of tick bites, when compared with tick questing. There was no apparent increase in time spent in outdoor activities between the 1990s and 2000s in Italy, Germany and Austria, but survey data demonstrated that walking and hiking were already popular activities across Europe by the 1990s. The popularity of mushroom and berry foraging as a source of income in Latvia, Lithuania and Poland, coupled with the expense of vaccination, provide an inverse link between economic wellbeing and TBE risk. Correspondingly, in 2009, the economic recession was associated with an increase with TBE in these three countries.

Objectius. Conèixer l’evolució del perfil del viatger durant el període 2003-2008. Pels atesos el 2008, caracteritzar l’adherència a les recomanacions i la incidència de problemes de salut relacionats amb el viatge. Mètodes. Estudi transversal pel període esmentat i seguiment de la cohort dels atesos el 2008. La informació es va obtenir de la fitxa del viatger (previatge) i d’una enquesta telefònica a la tornada. Es va mesurar la prevalença i la tendència lineal al llarg del període, l’adherència a les recomanacions i la incidència i el risc relatiu de problemes de salut. Resultats. Al llarg del període, es va produir un augment de la demanda i del risc dels viatges, tant en autòctons com en immigrants. Llevat de les vacunacions, es van observar deficiències en l’adherència i el seguiment de les recomanacions durant el viatge, especialment en immigrants. Una tercera part va presentar problemes de salut durant el viatge, bàsicament gastrointestinals. Els immigrants perceben menys el risc però milloren amb el temps d’arribada. Conclusions. Les recomanacions han de tenir en compte les actituds, les motivacions i la disponibilitat al canvi. / Objetivos. Conocer la evolución del perfil del viajero durante el periodo 2003-2008. Para los atendidos en el 2008, caracterizar la adherencia a las recomendaciones y la incidencia de problemas de salud relacionados con el viaje. Métodos. Estudio transversal del periodo mencionado y seguimiento de la cohorte de los atendidos durante 2008. La información se obtuvo de la ficha del viajero (previaje) y de una encuesta telefónica realizada al regreso. Se midieron la prevalencia y la tendencia lineal a lo largo del periodo, la adherencia a las recomendaciones y la incidencia y el riesgo relativo de problemas de salud. Resultados. A lo largo del periodo se produjo un aumento de la demanda y del riesgo de los viajes, tanto en autóctonos como en inmigrantes. Excepto en lo relativo a las vacunaciones se observaron deficiencias en la adherencia y seguimiento de las recomendaciones durante el viaje, especialmente por parte de los inmigrantes. Una tercera parte presentaron problemas de salud durante el viaje, básicamente gastrointestinales. Los inmigrantes perciben menos el riesgo pero esta percepción mejora a medida que aumenta el tiempo de estancia en nuestro país. Conclusiones. Las recomendaciones han de tener en cuenta las actitudes, motivaciones y disponibilidad para el cambio. / Objectives. Determine the evolution of the traveler’s profile during the period 2003-2008 and, for those demanding attention in 2008, describe the adherence to the recommendations and the incidence of health problems related to the trip. Methods. We carried out a cross-sectional study with those demanding attention during that period and a cohort study for those demanding in 2008. The information was obtained from the encounter before travel and the telephone survey performed when coming back. We measured the prevalence and the linear trend over the period, adherence to the recommendations and the incidence and relative risk of health problems. Results. Throughout the period, there was an increase in demand and the risk of trips, both local as immigrants. Except for vaccinations, deficiencies were observed in the adherence of the recommendations during the trip (starting and keeping on), especially in immigrants. One third had health problems during the trip, mostly gastrointestinal. Immigrants perceive less risk but improve with time of arrival. Conclusions. The recommendations must take into account the attitudes, motivations and availability to change.