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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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Related in: MedlinePlus

Proportionate morbidity (PM) for dengue (no. dengue cases/1,000 returned GeoSentinel patients) by region, 2000–2010.
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Figure 5: Proportionate morbidity (PM) for dengue (no. dengue cases/1,000 returned GeoSentinel patients) by region, 2000–2010.

Mentions: With regard to dengue, 50% of patients had visited Southeast Asia; 17% south-central Asia; 9%–10% each Central America, South America, or the Caribbean; and 5% sub-Saharan Africa. There was considerable year-to-year PM variation not accounted for by a linear trend, largely because of a clear peak in 2002 (associated with an outbreak in Thailand) (6) (Figure 5). Excluding this peak, the underlying dengue PM (+26/1,000, p = 0.006) and case numbers (26 in 2000, 169 in 2010) increased significantly, especially among ill travelers returning from Southeast Asia (+71/1,000, p = 0.004) and sub-Saharan Africa (+8/1,000, 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)

Proportionate morbidity (PM) for dengue (no. dengue cases/1,000 returned GeoSentinel patients) by region, 2000–2010.
© Copyright Policy
Related In: Results  -  Collection

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

Figure 5: Proportionate morbidity (PM) for dengue (no. dengue cases/1,000 returned GeoSentinel patients) by region, 2000–2010.
Mentions: With regard to dengue, 50% of patients had visited Southeast Asia; 17% south-central Asia; 9%–10% each Central America, South America, or the Caribbean; and 5% sub-Saharan Africa. There was considerable year-to-year PM variation not accounted for by a linear trend, largely because of a clear peak in 2002 (associated with an outbreak in Thailand) (6) (Figure 5). Excluding this peak, the underlying dengue PM (+26/1,000, p = 0.006) and case numbers (26 in 2000, 169 in 2010) increased significantly, especially among ill travelers returning from Southeast Asia (+71/1,000, p = 0.004) and sub-Saharan Africa (+8/1,000, 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