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 19, Number 7—July 2013
Research

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
Malaria
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)
Dengue
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)

Main Article

References
  1. World Tourism Organization. UNWTO tourism highlights: 2011 edition [cited 2012 Aug 28]. http://mkt.unwto.org/sites/all/files/docpdf/unwtohighlights11enlr_1.pdf
  2. World Tourism Organization. Arrivals by purpose of visit [cited 2012 Aug 28]. Available from http://www.unwto.org/facts/eng/pdf/indicators/ITA_purpose04.pdf
  3. Steffen  R, Rickenbach  M, Wilhelm  U, Helminger  A, Schar  M. Health problems after travel to developing countries. J Infect Dis. 1987;156:8491 . DOI
  4. Freedman  DO, Weld  LH, Kozarsky  PE, Fisk  T, Robins  R, von Sonnenburg  F, Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med. 2006;354:11930. DOI
  5. Gal-Mor  O, Suez  J, Elhadad  D, Porwollik  S, Leshem  E, Valinsky  L, Molecular and cellular characterization of a Salmonella enterica serovar Paratyphi A outbreak strain and the human immune response to infection. Clin Vaccine Immunol. 201219:14656.
  6. Schwartz  E, Weld  LH, Wilder-Smith  A, von Sonnenburg  F, Keystone  JS, Kain  KC, Seasonality, annual trends, and characteristics of dengue among ill returned travelers, 1997–2006. Emerg Infect Dis. 2008;14:10818. DOI
  7. Chen  LH, Wilson  ME. The role of the traveler in emerging infections and magnitude of travel. Med Clin North Am. 2008;92:140932. DOI
  8. Angell  SY, Cetron  MS. Health disparities among travelers visiting friends and relatives abroad. Ann Intern Med. 2005;142:6772. DOI
  9. Leder  K, Tong  S, Weld  L, Kain  KC, Wilder-Smith  A, von Sonnenburg  F, Illness in travelers visiting friends and relatives: a review of the GeoSentinel Surveillance Network. Clin Infect Dis. 2006;43:118593. DOI
  10. World Health Organization. World malaria report 2010 [cited 2012 Aug 10]. http://www.who.int/malaria/world_malaria_report_2010/en/
  11. Murray  CJ, Rosenfeld  LC, Lim  SS, Andrews  KG, Foreman  KJ, Haring  D, Global malaria mortality between 1980 and 2010: a systematic analysis. Lancet. 2012;379:41331. DOI
  12. United Nations General Assembly. 2001–2010: decade to roll back malaria in developing countries, particularly in Africa [cited 2012 Aug 10]. http://www.un.org/ga/search/view_doc.asp?symbol=A/66/169
  13. Health Protection Scotland. Malaria cases in Scotland and the UK: 2006–2010 [cited 2012 Aug 28]. http://www.hps.scot.nhs.uk/travel/wrdetail.aspx?id=48586&wrtype=6#
  14. Mali  S, Kachur  SP, Arguin  PM. Malaria surveillance—United States, 2010. MMWR Surveill Summ. 2012;61:117 .
  15. Crump  JA, Luby  SP, Mintz  ED. The global burden of typhoid fever. Bull World Health Organ. 2004;82:34653 .
  16. Zaki  SA, Karande  S. Multidrug-resistant typhoid fever: a review. J Infect Dev Ctries. 2011;5:32437 . DOI
  17. Lynch  MF, Blanton  EM, Bulens  S, Polyak  C, Vojdani  J, Stevenson  J, Typhoid fever in the United States, 1999–2006. JAMA. 2009;302:85965. DOI
  18. Connor  BA, Schwartz  E. Typhoid and paratyphoid fever in travellers. Lancet Infect Dis. 2005;5:6238. DOI
  19. Ekdahl  K, de Jong  B, Andersson  Y. Risk of travel-associated typhoid and paratyphoid fevers in various regions. J Travel Med. 2005;12:197204. DOI
  20. Meltzer  E, Schwartz  E. Enteric fever: a travel medicine oriented view. Curr Opin Infect Dis. 2010;23:4327. DOI
  21. Wilder-Smith  A, Gubler  DJ. Geographic expansion of dengue: the impact of international travel. Med Clin North Am. 2008;92:137790 and. DOI
  22. World Health Organization. Dengue: guidelines for diagnosis, treatment, prevention and control. Geneva: The Organization; 2009 [cited 2012 Aug 8]. http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf
  23. Gubler  DJ. The global emergence/resurgence of arboviral diseases as public health problems. Arch Med Res. 2002;33:33042. DOI
  24. Ooi  EE, Gubler  DJ. Dengue in Southeast Asia: epidemiological characteristics and strategic challenges in disease prevention. Cad Saude Publica. 2009;25(Suppl 1):S11524. DOI
  25. Baaten  GG, Sonder  GJ, Zaaijer  HL, van Gool  T, Kint  JA, van den Hoek  A. Travel-related dengue virus infection, the Netherlands, 2006–2007. Emerg Infect Dis. 2011;17:821–8 [cited 2012 Aug 8]. http://wwwnc.cdc.gov/eid/article/17/5/10-1125_article.htm
  26. 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. DOI
  27. Potasman  I, Srugo  I, Schwartz  E. Dengue seroconversion among Israeli travelers to tropical countries. Emerg Infect Dis. 1999;5:8247. DOI
  28. Ratnam  I, Black  J, Leder  K, Biggs  BA, Matchett  E, Padiglione  A, Incidence and seroprevalence of dengue virus infections in Australian travellers to Asia. Eur J Clin Microbiol Infect Dis. 2012;31:120310. DOI
  29. Frank  C, Schoneberg  I, Stark  K. Trends in imported chikungunya virus infections in Germany, 2006–2009. Vector Borne Zoonotic Dis. 2011;11:6316. DOI
  30. Staples  JE, Breiman  RF, Powers  AM. Chikungunya fever: an epidemiological review of a re-emerging infectious disease. Clin Infect Dis. 2009;49:9428. DOI
  31. Thiboutot  MM, Kannan  S, Kawalekar  OU, Shedlock  DJ, Khan  AS, Sarangan  G, Chikungunya: a potentially emerging epidemic? PLoS Negl Trop Dis. 2010;4:e623. DOI
  32. Thiptara  A, Atwill  ER, Kongkaew  W, Chomel  BB. Epidemiologic trends of rabies in domestic animals in southern Thailand, 1994–2008. Am J Trop Med Hyg. 2011;85:13845. DOI
  33. Pan American Health Organization. Epidemiologic situation of human rabies in Latin America in 2004 [cited 2012 Aug 6]. http://www.paho.org/english/dd/ais/be_v26n1-en-rabia_humana_al_2004.htm
  34. Si  H, Guo  ZM, Hao  YT, Liu  YG, Zhang  DM, Rao  SQ, Rabies trend in China (1990–2007) and post-exposure prophylaxis in the Guangdong province. BMC Infect Dis. 2008;8:113. DOI

Main Article

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.

Page created: June 17, 2013
Page updated: June 17, 2013
Page reviewed: June 17, 2013
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