Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 14, Number 7—July 2008
Research

Seasonality, Annual Trends, and Characteristics of Dengue among Ill Returned Travelers, 1997–2006

Eli Schwartz*†, Leisa H. Weld‡, Annelies Wilder-Smith§, Frank von Sonnenburg¶, Jay S. Keystone#**, Kevin C. Kain#**, Joseph Torresi††‡‡, David O. Freedman§§Comments to Author , and for the GeoSentinel Surveillance Network
Author affiliations: *Chaim Sheba Medical Center, Tel Hashomer, Israel; †Tel Aviv University, Tel Aviv, Israel; ‡Statistical Consult, Victoria, British Columbia, Canada; §National University Singapore, Singapore; ¶University of Munich, Munich, Germany; #Toronto General Hospital, Toronto, Ontario, Canada; **University of Toronto, Toronto; ††University of Melbourne, Parkville, Victoria, Australia‡‡Royal Melbourne Hospital, Parkville; §§University of Alabama at Birmingham, Birmingham, Alabama, USA;

Main Article

Table 1

Dengue and malaria diagnoses as a proportion of all morbidity in ill returned travelers according to region or country of acquisition

Region* or country of exposure No. ill returned travelers with dengue No. ill returned travelers with malaria Total no. ill returned travelers Dengue proportionate morbidity† Malaria proportionate morbidity†
Southeast Asia 264 103 3,694 71 28
Thailand 154 9 1,523 101 5
Indonesia
38
53
652
58
81
South Central Asia 90 70 3,303 27 21
India
66
57
2,119
31
27
Caribbean
47
14
1,470
32
9
South America 40 49 2,427 16 20
Brazil
22
12
685
32
18
Central America
37
27
1,867
20
14
Africa 25 1,216 7,231 3 168
Sub-Saharan Africa
23
1,201
6,201
4
194
Oceania
11
91
303
36
300
Other‡ or multiple regions of exposure 7 23 4,443 2 5
Country missing
1
12
182
5
66
Total 522 1,605 24,920 21 64

*Regions defined per (9).
†Proportionate morbidity expressed per 1,000 ill returned travelers seen at GeoSentinel clinics.
‡No cases were acquired in Canada, United States, Western Europe, Japan, or Australia.

Main Article

References
  1. Guzman  MG, Kouri  G. Dengue: an update. Lancet Infect Dis. 2002;2:3342. DOIPubMedGoogle Scholar
  2. Wilder-Smith  A, Schwartz  E. Dengue in travelers. N Engl J Med. 2005;353:92432. DOIPubMedGoogle Scholar
  3. Lindbäck  H, Lindbäck  J, Tegnell  A, Janzon  R, Vene  S, Ekdahl  K. Dengue fever in travelers to the tropics, 1998 and 1999. Emerg Infect Dis. 2003;9:43842.PubMedGoogle Scholar
  4. Jelinek  T, Mühlberger  N, Harms  G, Corachán  M, Grobusch  MP, Knobloch  J, European Network on Imported Infectious Disease Surveillance. Epidemiology and clinical features of imported dengue fever in Europe: sentinel surveillance data from TropNetEurop. Clin Infect Dis. 2002;35:104752. DOIPubMedGoogle Scholar
  5. Schwartz  E, Mendelson  E, Sidi  Y. Dengue fever among travelers. Am J Med. 1996;101:51620. DOIPubMedGoogle Scholar
  6. Badiaga  S, Barrau  K, Brouqui  P, Durant  J, Malvy  D, Janbon  F, Infectio-Sud Group. Imported dengue in French university hospitals: a 6-year survey. J Travel Med. 2003;10:2869.PubMedGoogle Scholar
  7. O’Brien  DP, Leder  K, Matchett  E, Brown  GV, Torresi  J. Illness in returned travelers and immigrants/refugees: the 6-year experience of two Australian infectious diseases units. J Travel Med. 2006;13:14552. DOIPubMedGoogle Scholar
  8. Bottieau  E, Clerinx  J, Schrooten  W, Van den Enden  E, Wouters  R, Van Esbroeck  M, Etiology and outcome of fever after a stay in the tropics. Arch Intern Med. 2006;166:16428. DOIPubMedGoogle Scholar
  9. Freedman  DO, Weld  LH, Kozarsky  PE, Fisk  T, Robins  R, von Sonnenburg  F, GeoSentinel Surveillance Network. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med. 2006;354:11930. DOIPubMedGoogle Scholar
  10. Wilson  ME, Weld  LH, Boggild  A, Keystone  JS, Kain  KC, von Sonnenburg  F, GeoSentinel Surveillance Network. Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clin Infect Dis. 2007;44:15608. DOIPubMedGoogle Scholar
  11. Stienlauf  S, Segal  G, Sidi  Y, Schwartz  E. Epidemiology of travel-related hospitalization. J Travel Med. 2005;12:13641.PubMedGoogle Scholar
  12. Cobelens  FG, Groen  J, Osterhaus  AD, Leentvaar-Kuipers  A, Wertheim-van Dillen  PM, Kager  PA. Incidence and risk factors of probable dengue virus infection among Dutch travellers to Asia. Trop Med Int Health. 2002;7:3318. DOIPubMedGoogle Scholar
  13. Potasman  I, Srugo  I, Schwartz  E. Dengue seroconversion among Israeli travelers to tropical countries. Emerg Infect Dis. 1999;5:8247.PubMedGoogle Scholar
  14. Freedman  DO, Kozarsky  PE, Weld  LH, Cetron  MS. GeoSentinel: the global emerging infections sentinel network of the International Society of Travel Medicine. J Travel Med. 1999;6:948. DOIPubMedGoogle Scholar
  15. Centers for Disease Control and Prevention. Travel-associated dengue—United States, 2005. MMWR Morb Mortal Wkly Rep. 2006;55:7002.PubMedGoogle Scholar
  16. Centers for Disease Control and Prevention. Travel-associated dengue infections—United States, 2001–2004. MMWR Morb Mortal Wkly Rep. 2005;54:5568.PubMedGoogle Scholar
  17. Centers for Disease Control and Prevention. Imported dengue—United States, 1999 and 2000. MMWR Morb Mortal Wkly Rep. 2002;51:2813.PubMedGoogle Scholar
  18. Rigau-Perez  JG, Laufer  MK. Dengue-related deaths in Puerto Rico, 1992–1996: diagnosis and clinical alarm signals. Clin Infect Dis. 2006;42:12416. DOIPubMedGoogle Scholar
  19. Leder  K, Black  J, O'Brien  D, Greenwood  Z, Kain  KC, Schwartz  E, Malaria in travelers: a review of the GeoSentinel surveillance network. Clin Infect Dis. 2004;39:110412. DOIPubMedGoogle Scholar
  20. World Health Organization Regional Office for South East Asia. Dengue/DHF: seasonal trends of DF/DHF in selected countries in SEA Region. [cited 2007 Oct 26]. Available from http://www.searo.who.int/EN/Section10/Section332_9482.htm
  21. Chakravarti  A, Kumaria  R. Eco-epidemiological analysis of dengue infection during an outbreak of dengue fever, India. Virol J. 2005;2:32 [cited 2008 May 29]. Available from http://www.virologyj.com/content/2/1/32
  22. Siqueira  JB Jr, Martelli  CM, Coelho  GE, Simplicio  AC, Hatch  DL. Dengue and dengue hemorrhagic fever, Brazil, 1981–2002. Emerg Infect Dis. 2005;11:4853.PubMedGoogle Scholar
  23. Genton  B, D’Acremont  V. Clinical features of malaria in returning travelers and migrants. In: Schlagenhauf P, editor. Travelers’ malaria. Hamilton: BC, Ontario, Canada, Decker; 2001. p. 371–92.
  24. World Health Organization. Country list: yellow fever vaccination requirements and recommendations; and malaria situation. In: International travel and health: situation as of 1 January 2007. Geneva: World Health Organization; 2007.
  25. Halstead  SB, Jacobson  J. Japanese encephalitis. Adv Virus Res. 2003;61:10338. DOIPubMedGoogle Scholar
  26. Halstead  SB. Dengue. Curr Opin Infect Dis. 2002;15:4716.PubMedGoogle Scholar
  27. Cummings  DA, Irizarry  RA, Huang  NE, Endy  TP, Nisalak  A, Ungchusak  K, Travelling waves in the occurrence of dengue haemorrhagic fever in Thailand. Nature. 2004;427:3447. DOIPubMedGoogle Scholar
  28. Wearing  HJ, Rohani  P. Ecological and immunological determinants of dengue epidemics. Proc Natl Acad Sci U S A. 2006;103:118027. DOIPubMedGoogle Scholar
  29. Bartley  LM, Donnelly  CA, Garnett  GP. The seasonal pattern of dengue in endemic areas: mathematical models of mechanisms. Trans R Soc Trop Med Hyg. 2002;96:38797. DOIPubMedGoogle Scholar
  30. Schwartz  E, Moskovitz  A, Potasman  I, Peri  G, Grossman  Z, Alkan  ML. Changing epidemiology of dengue fever in travelers to Thailand. Eur J Clin Microbiol Infect Dis. 2000;19:7846. DOIPubMedGoogle Scholar
  31. Freedman  DO, Kozarsky  P, Schwartz  E. Thailand: out of season dengue outbreak in travellers to Koh Phangan. ProMed. April 26, 2002.[cited 2008 May 19]. Available from: http://www.promedmail.org, archive number: 20020426.4039.
  32. Frank  C, Schöneberg  I, Krause  G, Claus  H, Ammon  A, Stark  K. Increase in imported dengue, Germany, 2001–2002. Emerg Infect Dis. 2004;10:9036.PubMedGoogle Scholar
  33. Centers for Disease Control and Prevention. Transmission of malaria in resort areas—Dominican Republic, 2004. MMWR Morb Mortal Wkly Rep. 2005;53:11958.PubMedGoogle Scholar
  34. Centers for Disease Control and Prevention. Malaria—Great Exuma, Bahamas, May–June 2006. MMWR Morb Mortal Wkly Rep. 2006;55:10136.PubMedGoogle Scholar

Main Article

1In addition to the authors, members of the GeoSentinel Surveillance Network who contributed data are: Elizabeth Barnett, Boston University, Boston, Massachusetts, USA; Graham Brown, Royal Melbourne Hospital, Parkville, Victoria, Australia; Giampiero Carosi and Francesco Castelli, University of Brescia, Brescia, Italy; Lin Chen and Mary Wilson, Harvard University, Cambridge, Massachusetts, USA; Bradley Connor, Cornell University, New York, New York, USA; Jean Delmont and Philippe Parola, Hôpital Nord, Marseille, France; Devon Hale and Stefanie Gelman, University of Utah, Salt Lake City, Utah, USA; Elaine Jong and Jean Haulman, University of Washington, Seattle, Washington, USA; Phyllis Kozarsky and Carlos Franco, Emory University, Atlanta, Georgia, USA; Carmelo Licitra, Orlando Regional Health Center, Orlando, Florida, USA; Louis Loutan and Francois Chappuis, University of Geneva, Geneva, Switzerland; Poh Lian Lim, Tan Tock Seng Hospital, Singapore; Michael Lynch, Fresno International Travel Medical Center, Fresno, California, USA; Susan McLellan, Tulane University, New Orleans, Louisiana, USA; Prativa Pandey, CIWEC Clinic Travel Medicine Center, Kathmandu, Nepal; Cecilia Perret, Pontificia Universidad Católica de Chile, Santiago, Chile; Bradley Sack and Robin McKenzie, Johns Hopkins University, Baltimore, Maryland, USA; Hiroko Sagara, Yokohama Municipal Citizen's Hospital, Yokohama, Japan; Marc Shaw, Worldwise Travellers Health and Vaccination Centre, Auckland, New Zealand; Robert Steffan and Patricia Schlagenhauf, University of Zurich, Zurich, Switzerland; William Stauffer and Patricia Walker, University of Minnesota, Minneapolis, Minnesota, USA; and Murray Wittner, Albert Einstein School of Medicine, Bronx, New York, USA.

Page created: July 12, 2010
Page updated: July 12, 2010
Page reviewed: July 12, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external