Epidemiology and Burden of Hepatitis A, Malaria, and Typhoid in New York City Associated With Travel: Implications for Public Health Policy

Abstract

We examined New York City Department of Health and Mental Hygiene surveillance data on hepatitis A, malaria, and typhoid to determine the proportion of these diseases related to travel and their geographic distribution. We found that 61% of hepatitis A cases, 100% of malaria cases, and 78% of typhoid cases were travel related and that cases clustered in specific populations and neighborhoods at which public health interventions could be targeted. High-risk groups include Hispanics (for hepatitis A), West Africans living in the Bronx (for malaria), and South Asians (for typhoid).

Acute and Potentially Life-Threatening Tropical Diseases in Western Travelers—A GeoSentinel Multicenter Study, 1996–2011

“…15 However, consistent with recent studies from developed countries, 16,17 no fatalities were identified among the 661 patients in this analysis, a finding that may reflect the efficacy of modern treatment of enteric fever. Most of our cases were acquired by males and travelers to the Indian subcontinent, but in contrast to other studies, [16][17][18] we identified most cases in tourists and relatively fewer among VFR (8) 17 (7) 8 (9) 4 (14) 0 (0) 2 (15) 1 (14) 3 (50) VFR 123 (28) 54 (23) 3 (4) 4 (14) 3 (19) 0 (0) 1 (14) 0 (0) Other 59 (14) 31 (13) 5 (6) 1 (4) 4 (25) 0 (0) 3 (43) 0 (0) Pre-travel consultation (n, %) 160 (40) 113 (53) 32 (40) 12 (43) 5 (33) 6 (50) 3 (43) 1 (20) Exposure region (n, %) Caribbean 10 (2) 1 ( 1) 7 (8) 2 (7) 0 (0) 0 (0) 0 (0) 1 (17) Central America 25 (6) 1 ( 1) 15 (17) 4 (14) 1 (6) …”

Barriers to malaria prevention in US-based travellers visiting friends and relatives abroad: a qualitative study of West African immigrant travellers†

“…1 From 2004 to 2006, over half of the confirmed malaria cases in New York City followed visits to Nigeria and Ghana, with the Bronx having twice the malaria incidence of other city boroughs. 8 Over 22 500 persons born in West Africa reside in Minnesota (MN, USA), 20 000 of whom live in the seven-county Minneapolis-St. Paul metro area. 9 Minnesota also has the largest Liberian population in the USA.…”

Outbreak of Hepatitis A in a Nursery School

“…However, foodborne outbreaks [3] have occurred, for example, after ingestion of shellfish living in sewage-polluted waters [4] or through contaminated vegetable salads [5]. In addition, HAV infection may occur in individuals or groups with high risk of infection, such as travellers to areas of high endemicity [6], men who have sex with men [7], intravenous drug users, and in other specific subpopulations [8]. …”