Travel-associated Illness Trends and Clusters, 2000–2010

Abstract

Longitudinal data examining travel-associated illness patterns are lacking. To address this need and determine trends and clusters in travel-related illness, we examined data for 2000–2010, prospectively collected for 42,223 ill travelers by 18 GeoSentinel sites. The most common destinations from which ill travelers returned were sub-Saharan Africa (26%), Southeast Asia (17%), south-central Asia (15%), and South America (10%). The proportion who traveled for tourism decreased significantly, and the proportion who traveled to visit friends and relatives increased. Among travelers returning from malaria-endemic regions, the proportionate morbidity (PM) for malaria decreased; in contrast, the PM trends for enteric fever and dengue (excluding a 2002 peak) increased. Case clustering was detected for malaria (Africa 2000, 2007), dengue (Thailand 2002, India 2003), and enteric fever (Nepal 2009). This multisite longitudinal analysis highlights the utility of sentinel surveillance of travelers for contributing information on disease activity trends and an evidence base for travel medicine recommendations.

Spectrum of Imported Infectious Diseases: A Comparative Prevalence Study of 16,817 German Travelers and 977 Immigrants from the Tropics and Subtropics

“…[12][13][14] The most immigrants were of African origin, followed by those of Asian and Latin American origin, as also seen in a previous multicenter study. 10 Regardless of the travel destination, most travelers were backpackers, followed by all-inclusive travelers and business travelers.…”

“…Consequently, no exact calculations on relative risk could be provided by this study. However, in contrast to the other studies using large numbers of patients, which were multicentric, [9][10][11][12][13][14][15][16][17] this study provides uniformity in patient referral patterns, consistency in coding of diagnoses by clinicians, and central laboratory reference facilities. [22][23][24][25][26][27] As all patients were subject of the same standardized process, maximal comparability of the data was possible in this comparative prevalence study.…”

“…Studies performed by GeoSentinel Surveillance analyzed large samples of more than 7,600 migrants and 82,800 travelers, with data collected from more than 40 sites on six continents, although none of these studies compared imported IDs among travelers and immigrants with a sample size as large as this study. [9][10][11][12][13][14] EuroTravNet is a European network that has collected data from more than 15 European sites and published studies with sample sizes of up to more than 900 migrants and 32,000 travelers. [15][16][17] As multicenter studies, these networks analyzed data of a highly heterogeneous international population, and consequently the comparability between the different study groups, such as type of travel or immigrants, was limited.…”

Dengue Among American Missionaries Returning from Jamaica, 2012

“…1,2 Dengue is endemic in Jamaica, where an epidemic occurred in 2012. 3 The Pan American Health Organization reported DENV-1 to be circulating in Jamaica during this outbreak.…”

“…Dengue is an acute febrile illness caused by four mosquitotransmitted dengue virus (DENV) types (1)(2)(3)(4) that are endemic throughout the tropics and a leading cause of morbidity among travelers returning from the Caribbean. 1,2 Dengue is endemic in Jamaica, where an epidemic occurred in 2012.…”