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Volume 19, Number 7—July 2013

Travel-associated Illness Trends and Clusters, 2000–2010

Karin LederComments to Author , Joseph Torresi, John S. Brownstein, Mary E. Wilson, Jay S. Keystone, Elizabeth Barnett, Eli Schwartz, Patricia Schlagenhauf, Annelies Wilder-Smith, Francesco Castelli, Frank von Sonnenburg, David O. Freedman, and Allen C. Cheng, for the GeoSentinel Surveillance Network
Author affiliations: Royal Melbourne Hospital, Parkville, Victoria, Australia (K. Leder); Monash University, Melbourne, Victoria, Australia (K. Leder, A.C. Cheng); Austin Hospital, Heidelberg, Victoria, Australia (J. Torresi); University of Melbourne, Parkville (J. Torresi); Children’s Hospital, Boston, Massachusetts, USA (J.S. Brownstein); Harvard Medical School, Boston (J.S. Brownstein); Harvard School of Public Health, Boston (M.E. Wilson); Toronto General Hospital, Toronto, Ontario, Canada (J.S. Keystone); University of Toronto, Toronto (J.S. Keystone); Boston Medical Center, Boston (E. Barnett); Sheba Medical Center, Tel Hashomer, Isreal (E. Schwartz); Tel Aviv University, Tel Aviv, Israel (E. Schwartz); University of Zurich WHO Collaborating Centre for Travellers’ Health, Zurich, Switzerland (P. Schlagenhauf); Lee Kong Chian School of Medicine, Singapore (A. Wilder-Smith); University of Brescia, Brescia, Italy (F. Castelli); University of Munich, Munich, Germany (F. von Sonnenburg); University of Alabama at Birmingham, Birmingham, Alabama, USA (D.O. Freedman); Alfred Hospital, Melbourne (A.C. Cheng)

Main Article

Table 2

Main clusters detected among GeoSentinel patients, 2000–2010

Diagnosis, cluster Location and dates of clusters Cases/no. ill travelers (no. expected cases, p value) Comments
Cluster A Benin, Togo, Ghana, Burkina Faso, Nigeria, Cote d'Ivoire, 2007 mid Jul–mid Oct 44/185 (2.6, p<0.0001) No definitive outbreaks discernible on ProMED-mail or in published literature corresponding to these clusters
Cluster B
Mauritania, Western Sahara, Mali, Senegal, 2000 mid Sep–mid Oct
19/53, (0.5, p<0.0001)
Enteric fever
Nepal, 2009 Oct 5–20
24/40 (0.03, p<0.0001)
Associated with an outbreak of Salmonella paratyphi A among Israeli travelers to Nepal (5)
Cluster A Thailand, 2002 Apr–Jul 44/257 (1.7, p<0.0001) Reported in (6)
Cluster B India, 2003 Sep–Nov 13/368 (0.9, p<0.0001)

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1Additional members of the GeoSentinel Surveillance Network who contributed data (in descending order of contribution): Kevin Kain and Andrea Boggild, Toronto, Ontario, Canada; Louis Loutan and François Chappuis, Geneva, Switzerland; DeVon C. Hale, Rahul Anand, and Stephanie S. Gelman, Salt Lake City, Utah, USA; Graham Brown, Melbourne, Victoria, Australia; Giampiero Carosi, Brescia, Italy; Bradley A. Connor, New York, New York, USA; N. Jean Haulman, David Roesel, and Elaine C. Jong, Seattle, Washington, USA; Phyllis E. Kozarsky, Jessica Fairley, and Carlos Franco-Paredes, Atlanta, Georgia, USA; Marc Shaw and Annemarie Hern, Auckland, New Zealand; Christina M. Coyle and Murray Wittner, Bronx, New York, USA; Lin H. Chen, Cambridge, Massachusetts, USA; Noreen Hynes, R. Bradley Sack, and Robin McKenzie, Baltimore, Maryland, USA; Carmelo Licitra and Antonio Crespo, Orlando, Florida, USA; and Thomas B. Nutman and Amy D. Klion, Bethesda, Maryland, USA.

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