In 2009, 607 TALD cases were reported among European residents traveling in EU/EEA countries, of which 363 (60%) were related to domestic travel (Table 1).
Calculating on the basis of 2 billion nights spent in Europe by European residents and 607 cases, the average risk for TALD in Europe in 2009 was 0.
Based on these figures, 1,127 TALD cases would be expected to be reported in European residents traveling in Europe (Table 3).
We report risk estimates of TALD for domestic and international travelers in Europe.
The low TALD risk in nondomestic travelers to the Netherlands and the United Kingdom could be explained by the fact that both countries receive proportionately far fewer and younger tourists than Mediterranean countries.
This study clearly indicates an increasing risk of TALD from northwestern to southeastern Europe.
The magnitude of TALD underascertainment in Austria, where German travelers accounted for 60% of all nights spent by nondomestic travelers, demonstrates the effect that the lack of participation in reporting by Germany had on epidemiologic studies of the EU/EEA (As of September 2012, Germany participates in the European TALD surveillance).
Third, the study clearly highlights the lack of data for Eastern European countries, probably because tourism is lower than elsewhere in Europe and because TALD is under-identified.
In conclusion, these European TALD risk estimates can provide data for several purposes.