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Travel-associated illness trends and clusters, 2000-2010.

Leder K, Torresi J, Brownstein JS, Wilson ME, Keystone JS, Barnett E, Schwartz E, Schlagenhauf P, Wilder-Smith A, Castelli F, von Sonnenburg F, Freedman DO, Cheng AC, GeoSentinel Surveillance Netwo - Emerging Infect. Dis. (2013)

Bottom Line: Longitudinal data examining travel-associated illness patterns are lacking.The proportion who traveled for tourism decreased significantly, and the proportion who traveled to visit friends and relatives increased.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.

View Article: PubMed Central - PubMed

Affiliation: Royal Melbourne Hospital, Parkville, Victoria,Australia. karin.leder@monash.edu

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.

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A) Proportionate morbidity (PM) for malaria (no. malaria cases/1,000 ill returned GeoSentinel patients) by region, 2000–2010. B) Absolute case numbers and proportionate morbidity for malaria (no. malaria cases/1,000 ill returned GeoSentinel patients) after travel to sub-Saharan Africa, 2000–2010. There were 1,363 total reported cases of malaria after travel to sub-Saharan Africa among the 18 GeoSentinel sites.
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Figure 3: A) Proportionate morbidity (PM) for malaria (no. malaria cases/1,000 ill returned GeoSentinel patients) by region, 2000–2010. B) Absolute case numbers and proportionate morbidity for malaria (no. malaria cases/1,000 ill returned GeoSentinel patients) after travel to sub-Saharan Africa, 2000–2010. There were 1,363 total reported cases of malaria after travel to sub-Saharan Africa among the 18 GeoSentinel sites.

Mentions: The most common sites for acquiring malaria were sub-Saharan Africa (77%), Oceania (6%), and south-central and Southeast Asia (5% each). However, the PM for malaria was greater for ill travelers returning from Oceania (average 248 malaria cases/1,000 ill travelers from the region) than for those returning from sub-Saharan Africa (average 135 cases/1,000 travelers). In 2000, the overall PM for malaria was 68 cases/1,000 ill travelers, and during 2000–2010, the rate decreased by an average of 30/1,000 (p = 0.002) (Figure 3, panel A). Despite overall increasing visits to GeoSentinel sites during the study period, absolute case numbers for malaria decreased (211 malaria cases reported in 2000; 151 in 2006, 124 in 2008, 189 in 2010) (Figure 3, panel B). The PM (and absolute case numbers) rose marginally during 2009–2010, compared with 2008, but did not negate the overall decreasing trend over the study period, which was most marked among ill travelers returning from Oceania (–204/1,000, p = 0.010), sub-Saharan Africa (–68/1,000, p = 0.003), and Southeast Asia (–31/1,000, p = 0.005).


Travel-associated illness trends and clusters, 2000-2010.

Leder K, Torresi J, Brownstein JS, Wilson ME, Keystone JS, Barnett E, Schwartz E, Schlagenhauf P, Wilder-Smith A, Castelli F, von Sonnenburg F, Freedman DO, Cheng AC, GeoSentinel Surveillance Netwo - Emerging Infect. Dis. (2013)

A) Proportionate morbidity (PM) for malaria (no. malaria cases/1,000 ill returned GeoSentinel patients) by region, 2000–2010. B) Absolute case numbers and proportionate morbidity for malaria (no. malaria cases/1,000 ill returned GeoSentinel patients) after travel to sub-Saharan Africa, 2000–2010. There were 1,363 total reported cases of malaria after travel to sub-Saharan Africa among the 18 GeoSentinel sites.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713975&req=5

Figure 3: A) Proportionate morbidity (PM) for malaria (no. malaria cases/1,000 ill returned GeoSentinel patients) by region, 2000–2010. B) Absolute case numbers and proportionate morbidity for malaria (no. malaria cases/1,000 ill returned GeoSentinel patients) after travel to sub-Saharan Africa, 2000–2010. There were 1,363 total reported cases of malaria after travel to sub-Saharan Africa among the 18 GeoSentinel sites.
Mentions: The most common sites for acquiring malaria were sub-Saharan Africa (77%), Oceania (6%), and south-central and Southeast Asia (5% each). However, the PM for malaria was greater for ill travelers returning from Oceania (average 248 malaria cases/1,000 ill travelers from the region) than for those returning from sub-Saharan Africa (average 135 cases/1,000 travelers). In 2000, the overall PM for malaria was 68 cases/1,000 ill travelers, and during 2000–2010, the rate decreased by an average of 30/1,000 (p = 0.002) (Figure 3, panel A). Despite overall increasing visits to GeoSentinel sites during the study period, absolute case numbers for malaria decreased (211 malaria cases reported in 2000; 151 in 2006, 124 in 2008, 189 in 2010) (Figure 3, panel B). The PM (and absolute case numbers) rose marginally during 2009–2010, compared with 2008, but did not negate the overall decreasing trend over the study period, which was most marked among ill travelers returning from Oceania (–204/1,000, p = 0.010), sub-Saharan Africa (–68/1,000, p = 0.003), and Southeast Asia (–31/1,000, p = 0.005).

Bottom Line: Longitudinal data examining travel-associated illness patterns are lacking.The proportion who traveled for tourism decreased significantly, and the proportion who traveled to visit friends and relatives increased.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.

View Article: PubMed Central - PubMed

Affiliation: Royal Melbourne Hospital, Parkville, Victoria,Australia. karin.leder@monash.edu

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.

Show MeSH
Related in: MedlinePlus