1921
Volume 88, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

We performed a descriptive analysis of acute and potentially life-threatening tropical diseases among 82,825 ill western travelers reported to GeoSentinel from June of 1996 to August of 2011. We identified 3,655 patients (4.4%) with a total of 3,666 diagnoses representing 13 diseases, including falciparum malaria (76.9%), enteric fever (18.1%), and leptospirosis (2.4%). Ninety-one percent of the patients had fever; the median time from travel to presentation was 16 days. Thirteen (0.4%) patients died: 10 with falciparum malaria, 2 with melioidosis, and 1 with severe dengue. Falciparum malaria was mainly acquired in West Africa, and enteric fever was largely contracted on the Indian subcontinent; leptospirosis, scrub typhus, and murine typhus were principally acquired in Southeast Asia. Western physicians seeing febrile and recently returned travelers from the tropics need to consider a wide profile of potentially life-threatening tropical illnesses, with a specific focus on the most likely diseases described in our large case series.

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2017-09-20
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References

  1. World Tourism Organization, 2010. UNWTO Tourism Highlights, 2010 ed. Available at: http://www.unwto.org/facts/eng/pdf/highlights/UNWTO_Highlights10_en_LR.pdf. Accessed April 15, 2011.
  2. Potter R, , 1999. The Greatest Benefit to Mankind. A Medical History of Humanity from Antiquity to the Present. London, UK: Fontana Press.
  3. Tarantola A, Nabeth P, Tattevin P, Michelet C, Zeller H, , 2006. Lookback exercise with imported Crimean-Congo hemorrhagic fever, Senegal and France. Emerg Infect Dis 12: 14241426.[Crossref]
  4. Smith AD, Bradley DJ, Smith V, Blaze M, Behrens RH, Chiodini PL, Whitty CJ, , 2008. Imported malaria and high risk groups: observational study using UK surveillance data 1987–2006. BMJ 337: a120.[Crossref]
  5. Connor BA, Schwartz E, , 2005. Typhoid and paratyphoid fever in travellers. Lancet Infect Dis 5: 623628.[Crossref]
  6. Jensenius M, Davis X, von Sonnenburg F, Schwartz E, Keystone JS, Leder K, Lopéz-Véléz R, Caumes E, Cramer JP, Chen L, Parola P, for the GeoSentinel. Surveillance Network , 2009. A multicenter GeoSentinel analysis of rickettsial diseases in international travelers, 1996–2008. Emerg Infect Dis 15: 17911798.[Crossref]
  7. Badran S, Pedersen TI, Roed C, Lunding S, Birk N, Vestergaard H, Røder B, Lillelund HK, Kurtzhals JA, Kemp M, Christensen JJ, , 2010. Imported melioidosis in Danish travellers: a diagnostic challenge. Scand J Infect Dis 42: 445449.[Crossref]
  8. Waagsbø B, Sundøy A, Høyvoll LR, , 2010. Febrile illness in a returned traveller from Thailand. J Clin Virol 47: 303305.[Crossref]
  9. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, Keystone JS, Pandey P, Cetron MS, , 2006. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354: 119130.[Crossref]
  10. Raoult D, Fournier PE, Fenollar F, Jensenius M, Prioe T, de Pina JJ, Caruso G, Jones N, Laferl H, Rosenblatt JE, Marrie TJ, , 2001. Rickettsia africae, a tick-borne pathogen in travelers to sub-Saharan Africa. N Engl J Med 344: 15041510.[Crossref]
  11. World Health Organization, 2000. Severe falciparum malaria. Trans R Soc Trop Med Hyg 94 (Suppl 1): 190.
  12. WHO, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control, 2nd ed. Geneva, Switzerland: World Health Organization.
  13. United Nations Statistics Division. Available at: http://unstats.un.org. Accessed April 15, 2011.
  14. Beeching NJ, Fletcher TE, Hill DR, Thomson GL, , 2010. Travellers and viral haemorrhagic fevers: what are the risks? Int J Antimicrob Agents 36S: S26S35.[Crossref]
  15. Stuart BM, Pullen RL, , 1946. Typhoid: clinical analysis of three hundred and sixty cases. Ann Intern Med 78: 629661.[Crossref]
  16. Lynch MF, Blanton EM, Bulens S, Polyak C, Vojdani J, Stevenson J, Medalla F, Barzilay E, Joyce K, Barrett T, Mintz ED, , 2009. Typhoid fever in the United States, 1999–2006. JAMA 302: 859865.[Crossref]
  17. Patel TA, Armstrong M, Morris-Jones SD, Wright SG, Doherty T, , 2010. Imported enteric fever: case series from the Hospital for Tropical Diseases, London, United Kingdom. Am J Trop Med Hyg 82: 11211126.[Crossref]
  18. Adamson R, Reddy V, Jones L, Antwi M, Bregman B, Weiss D, Phillips M, Horowitz HW, , 2010. Epidemiology and burden of hepatitis A, malaria, and typhoid in New York City associated with travel: implications for public health policy. Am J Public Health 100: 12491252.[Crossref]
  19. Woods CW, Murdoch DR, Zimmerman MD, Glover WA, Basnyat B, Wolf L, Belbase RH, Reller LB, , 2006. Emergence of Salmonella enterica serotype A as a major cause of enteric fever in Katmandu, Nepal. Trans R Soc Trop Med Hyg 100: 10631067.[Crossref]
  20. Leshem E, Segal G, Barnea A, Yitzhaki S, Ostfeld I, Pitlik S, Schwartz E, , 2010. Travel-related leptospirosis in Israel: a nationwide study. Am J Trop Med Hyg 82: 459463.[Crossref]
  21. Gétaz L, Abbas M, Loutan L, Schrenzel J, Iten A, Simon F, Decosterd A, Studer R, Sudre P, Michel Y, Merlani P, Emonet S, , 2011. Fatal acute melioidosis in a tourist returning from Martinique Island, Novemeber 2010. Euro Surveill 16: pii: 19758.
  22. Stäger K, Legros F, Krause G, Low N, Bradley D, Desai M, Graf S, D'Amato S, Mizuno Y, Janzon R, Petersen E, Kester J, Steffen R, Schlagenhauf P, , 2009. Imported malaria in children in industrialized countries, 1992–2002. Emerg Infect Dis 15: 185191.[Crossref]
  23. Checkley AM, Smith A, Smith V, Blaze M, Bradley D, Chiodini PL, Whitty CJ, , 2012. Risk factors for mortality from imported falciparum malaria in the United Kingdom over 20 years: an observational study. BMJ 344: e2116.[Crossref]
  24. Bouchaud O, Cot M, Kony S, Durand R, Schiemann R, Ralaimazava P, Coulaud JP, Le Bras J, Deloron P, , 2005. Do African immigrants living in France have long-term malarial immunity? Am J Trop Med Hyg 72: 2125.
  25. Leder K, Black J, O'Brien D, Greenwood Z, Kain KC, Schwartz E, Brown G, Torresi J, , 2004. Malaria in travelers: a review of the GeoSentinel Surveillance network. Clin Infect Dis 39: 11041112.[Crossref]
  26. Stienlauf S, Segal G, Sidi Y, Schwartz E, , 2005. Epidemiology of travel-related hospitalization. J Travel Med 12: 136141.[Crossref]
  27. Simarro PP, Franco JR, Cecchi G, Paone M, Diarra A, Ruiz Postigo JA, Jannin JG, , 2012. Human African trypanosomiasis in non-endemic countries (2000–2010). J Travel Med 19: 4453.[Crossref]
  28. Wilson ME, Weld LH, Boggild A, Keystone JS, Kain KC, von Sonnenburg F, Schwartz E, , 2007. Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clin Infect Dis 44: 15601568.[Crossref]
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  • Received : 05 Sep 2012
  • Accepted : 02 Nov 2012

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