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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 2

Demographic characteristics and type of travel for ill returned travelers with dengue, malaria, or any other diagnosis

Characteristic
Ill returned travelers with dengue
Ill returned travelers with malaria
Ill returned travelers without dengue or malaria
Total ill returned travelers
No. cases 522 1,605 22,793 24,920
Age group, %*
<18 y 1.3 5.6 3.9 3.9
18–44 y 79.2 68.4 69.1 69.3
45–55 y 12.4 17.2 14.7 14.7
>56 y
7.1
8.9
12.4
12.0
Female sex, %*
46.1
30.1
49.7
48.3
Pretravel encounter, %*
Yes 61.3 42.8 53.6 53.1
No 28.6 43.7 33.6 34.1
Unknown
10.1
13.5
12.8
12.8
Inpatient, %*
24.8
50.3
6.6
9.8
Duration of travel, d*
25% travelers 14 d 21 d 14 d 14 d
50% travelers 28 d 34 d 28 d 28 d
75% travelers
67 d
95 d
132 d
123 d
Time from travel to symptoms, %*
<2 week 75.5 53.3 41.8 43.3
>2 week
24.5
46.7
58.2
56.7
Patient classification %*
Immigrant 7.9 35.1 13.6 14.9
Temporary visitor 4.2 2.2 1.6 1.7
Expatriate 8.4 13.7 10.0 10.2
All other travelers
79.5
48.4
74.5
73.1
Reason for recent travel, %*
Tourism 69.3 29.1 60.3 58.5
Business 10.5 16.0 14.0 14.1
Research/education or
 Missionary/volunteer 10.2 14.5 12.7 12.8
Visiting friends or relatives† 9.8 40.1 12.5 14.2

*Significant differences in travelers with dengue vs. malaria (p<0.05).
†1st or 2nd generation immigrant originally from a low-income country now living in a high-income country, visiting friend and relatives in the country of the family’s origin.

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.

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