Despite the emphasis on infectious disease in travel medicine, the single most common preventable cause of death amongst travellers is accidental injury (Prociv, 1995; Steffen, 1991). About 35% of deaths of Australian travellers abroad were the result of ischemic heart disease, with natural causes overall accounting for some 50% of deaths (Prociv, 1995). Trauma accounted for 25% of deaths of Australians abroad (Prociv, 1995). Injuries were the reported cause of 18% of all deaths, with the major group being motor vehicle accidents, accounting for 7% of all deaths, which appeared to be over-represented in developing countries (Prociv, 1995). A similar pattern of mortality was observed in Swiss (Steffen, 1991), American (Baker et al., 1992), and Canadian (MacPherson et al., 2000) travellers abroad. Deaths of Australian tourists overseas have also resulted from air crashes, drowning, boating accidents, skiing accidents, bombs and electrocution (Prociv, 1995). Homicides, suicides and executions combined accounted for about 8% of all deaths (Prociv, 1995). Most fatal accidents in American and Swiss travellers were traffic or swimming accidents (Steffen, 1991; Baker et al., 1992). Deaths of tourists visiting Australia was similarly found to be due mainly to motor vehicle accidents and accidental drowning (Wilks et al., 2003). Infectious disease was reported as the cause of death in only 2.4% of Australians who died while travelling abroad (Prociv, 1995).

Prociv P. Deaths of Australian travellers overseas. Med J Aust 1995; 163: 27-30.

Steffen R. Travel medicine: prevention based on epidemiological data. Trans R Soc Trop Med Hyg 1991;85:156-162.

Baker TD, Hargarten SW, Guptill KS. The uncounted dead - American civilians dying overseas. Public Health Rep 1992; 107: 155-159.

MacPherson DW, Gurillot F, Streiner DL, Ahmed K, Gushulak BD, Pardy G. Death and dying abroad: The Canadian experience. J Travel Med 2000; 7: 227-233.

Wilks J, Pendergast D, Wood N. Accidental deaths of overseas visitors in Australia 1997-2000. J Hospitality Tourism Management 2003; 10: 79-89.