Volume 24, Number 4—April 2018
Dispatch
Region-Specific, Life-Threatening Diseases among International Travelers from Israel, 2004–2015
Chen Avni, Shmuel Stienlauf, Eyal Meltzer, Yechezkel Sidi, Eli Schwartz
, and Eyal Leshem
, and Eyal Leshem
Table 1
Characteristics of travel-associated hospitalizations of citizens of Israel at Sheba Medical Center, Israel, 2004–2015*Category
| Category | Africa, n = 267 | Asia, n = 330 | South America, n = 43 | Central America/ Caribbean, n = 30 | North America/ Europe, n = 26 | Other,† n = 26 | Total, n = 722 |
|---|---|---|---|---|---|---|---|
| Patient characteristics | |||||||
| Sex | |||||||
| M | 226 (85) | 219 (66) | 28 (65) | 20 (67) | 21 (81) | 16 (62) | 530 (73) |
| F | 41 (15) | 111 (34) | 15 (35) | 10 (33) | 5 (19) | 10 (38) | 192 (27) |
| Age, median (IQR) | 41 (29–53) | 29 (24–43) | 24 (23–43) | 29 (27–46) | 55 (39–64) | 27 (23–41) | 33 (26–50) |
| Age ≥60 y |
37 (14) |
27 (8) |
4 (9) |
3 (10) |
8 (31) |
4 (15) |
83 (11) |
| Category of travelers | |||||||
| Tourism | 154 (58) | 313 (95) | 41 (95) | 29 (97) | 23 (88) | 26 (100) | 586 (81) |
| Business travelers | 93 (35) | 17 (5) | 2 (5) | 1 (3) | 3 (12) | 0 | 116 (16) |
| Visiting friends or relatives |
19 (7) |
1 (<1) |
0 |
0 |
0 |
0 |
20 (3) |
| Type of illness | |||||||
| Potentially preventable |
85 (32) |
25 (8) |
0 |
1 (3) |
0 |
1 (4) |
112 (16) |
| Febrile conditions | |||||||
| Malaria | |||||||
| Plasmodium falciparum‡ | 82 (30) | 4 (1) | 0 | 0 | 0 | 0 | 86 (12) |
| P. vivax | 23 (9) | 7 (2) | 3 (7) | 0 | 0 | 3 (12) | 36 (5) |
| P. ovale | 8 (3) | 0 | 0 | 0 | 0 | 0 | 8 (1) |
| P. malariae | 7 (3) | 0 | 0 | 0 | 0 | 0 | 7 (<1) |
| Unidentified malaria | 6 (2) | 2 (<1) | 0 | 0 | 0 | 0 | 8 (1) |
| Dengue fever | 4 (1) | 59 (18) | 2 (5) | 8 (27) | 0 | 1 (4) | 74 (10) |
| Enteric fever | |||||||
| Salmonella enterica serovar Typhi | 2 (<1) | 19 (6) | 0 | 1 (3) | 0 | 1 (4) | 23 (3) |
| S. enterica ser. Paratyphi | 0 | 36 (11) | 0 | 0 | 0 | 0 | 36 (5) |
| Leptospirosis | 1 (<1) | 18 (5) | 0 | 7 (23) | 1 (4) | 2 (8) | 29 (4) |
| Pneumonia | 10 (4) | 11 (3) | 0 | 1 (3) | 5 (19) | 1 (4) | 28 (4) |
| Febrile diarrheal diseases | 10 (4) | 5 (2) | 1 (2) | 0 | 2 (8) | 1 (4) | 19 (3) |
| Acute schistosomiasis | 16 (6) | 3 (<1) | 0 | 0 | 0 | 0 | 19 (3) |
| Influenza | 0 | 7 (2) | 0 | 0 | 0 | 1 (4) | 8 (1) |
| Epstein–Barr virus | 1 (<1) | 6 (2) | 1 (2) | 0 | 0 | 0 | 8 (1) |
| Cytomegalovirus | 4 (1) | 2 (<1) | 2 (5) | 0 | 0 | 0 | 8 (1) |
| Amebic liver abscess | 0 | 5 (2) | 0 | 0 | 0 | 2 (8) | 7 (<1) |
| Rickettsial diseases | 3 (1) | 3 (<1) | 0 | 0 | 0 | 0 | 6 (<1) |
| Upper respiratory tract infection | 4 (1) | 1 (<1) | 0 | 0 | 0 | 0 | 5 (<1) |
| Unspecified febrile illness | 34 (13) | 55 (17) | 7 (16) | 3 (10) | 6 (23) | 4 (15) | 109 (15) |
| Other febrile conditions |
15 (6) |
29 (9) |
8 (19) |
2 (7) |
3 (12) |
2 (8) |
59 (8) |
| Afebrile conditions | |||||||
| Afebrile diarrheal diseases | 5 (2) | 7 (2) | 2 (5) | 0 | 4 (15) | 0 | 18 (2) |
| Afebrile eosinophilia | 4 (1) | 6 (2) | 2 (5) | 1 (3) | 1 (4) | 2 (8) | 16 (2) |
| Skin disease | 7 (3) | 4 (1) | 2 (5) | 1 (3) | 0 | 0 | 14 (2) |
| Afebrile nondiarrheal GI illness | 3 (1) | 8 (2) | 2 (5) | 0 | 0 | 0 | 13 (2) |
| Viral hepatitis | 2 (<1) | 8 (2) | 0 | 2 (7) | 0 | 0 | 12 (2) |
| Leishmaniasis | 2 (<1) | 0 | 9 (21) | 0 | 0 | 0 | 11 (2) |
| Giardiasis | 0 | 4 (1) | 0 | 1 (3) | 0 | 0 | 5 (<1) |
| Other afebrile |
14 (5) |
21 (6) |
2 (5) |
3 (10) |
4 (15) |
6 (23) |
50 (7) |
| Outcome | |||||||
| Intensive care unit hospitalization | 4 (1) | 4 (1) | 0 | 0 | 2 (8) | 1 (4) | 11 (2) |
| Death | 1 (<1) | 1 (<1) | 0 | 0 | 0 | 0 | 2 (<1) |
*Values are no. (%) patients except as indicated. Further details are available in online Technical Appendix Table 1 (https://wwwnc.cdc.gov/EID/article/24/4/17-1542-Techapp1.pdf). GI, gastrointestinal; IQR, interquartile range.
†Other comprises case-patients in Oceania (n = 6) and those for whom exact region of infection was undetermined (n = 26).
‡One patient returning from Asia with malaria had a coinfection with P. falciparum and P. vivax. In this table, we listed the patient under P. falciparum.
Page created: June 01, 2018
Page updated: June 01, 2018
Page reviewed: June 01, 2018
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