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Characteristics and Spectrum of Disease Among Ill Returned Travelers from Pre- and Post-Earthquake Haiti: The GeoSentinel Experience

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  • Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, Georgia; Emory University School of Medicine, Division of Infectious Disease, Atlanta, Georgia; HealthPartners Travel Medicine Clinics, University of Minnesota, Minneapolis/St. Paul, Minnesota; Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom; Boston Medical Center, Maxwell Finland Laboratory for Infectious Diseases, Boston, Massachusetts; McGill University, J. D. MacLean Centre for Tropical Diseases, Montreal, Canada; Ottawa Hospital General Campus, Division of Infectious Diseases, Ottawa, Canada; InterHealth, London, United Kingdom; Weill Medical College, Cornell University, New York, New York; Center for Geographic Medicine, Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; University Hospital of Northern British Columbia, Prince George, Canada

To describe patient characteristics and disease spectrum among foreign visitors to Haiti before and after the 2010 earthquake, we used GeoSentinel Global Surveillance Network data and compared 1 year post-earthquake versus 3 years pre-earthquake. Post-earthquake travelers were younger, predominantly from the United States, more frequently international assistance workers, and more often medically counseled before their trip than pre-earthquake travelers. Work-related stress and upper respiratory tract infections were more frequent post-earthquake; acute diarrhea, dengue, and Plasmodium falciparum malaria were important contributors of morbidity both pre- and post-earthquake. These data highlight the importance of providing destination- and disaster-specific pre-travel counseling and post-travel evaluation and medical management to persons traveling to or returning from a disaster location, and evaluations should include attention to the psychological wellbeing of these travelers. For travel to Haiti, focus should be on mosquito-borne illnesses (dengue and P. falciparum malaria) and travelers' diarrhea.

Author Notes

*Address correspondence to Douglas H. Esposito, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Travelers' Health Branch, 1600 Clifton Road, NE, MS E-03, Atlanta, GA 30333. E-mail: desposito@cdc.gov†In addition to the authors, members of the GeoSentinel Surveillance Network who contributed data (in descending order) are Brian Ward and J. Dick Maclean, McGill University, Montreal, Canada; Louis Loutan and François Chappuis, University of Geneva, Geneva, Switzerland; William M. Stauffer, University of Minnesota, Minneapolis, MN; John D. Cahill and George McKinley, St. Luke's–Roosevelt Hospital Center, New York, NY; Carmelo Licitra and Antonio Crespo, Orlando Regional Health Center, Orlando, FL; Jessica Fairley and Carlos Franco-Paredes, Emory University, Atlanta, GA; Eric Caumes and Alice Pérignon, Hôpital Pitié-Salpêtrière, Paris, France; Jay S. Keystone and Kevin C. Kain, University of Toronto, Toronto, Canada; Noreen Hynes, R. Bradley Sack, and Robin McKenzie, Johns Hopkins University, Baltimore, MD; Frank von Sonnenburg, University of Munich, Munich, Germany; Christina M. Coyle and Murray Wittner, Albert Einstein School of Medicine, Bronx, NY; David O. Freedman, University of Alabama, Birmingham, AL; Gerd-Dieter Burchard, Bernhard-Nocht Institute for Tropical Medicine, Hamburg, Germany; Christophe Rapp and Olivier Aoun, Hôpital d'instruction des armées Bégin, Saint Mandé, France; N. Jean Haulman, David Roesel, and Elaine C. Jong, University of Washington, Seattle, WA; Peter de Vries and Kartini Gadroen, University of Amsterdam, Amsterdam, The Netherlands; Lin H. Chen, Mount Auburn Hospital, Harvard University, Cambridge, MA; Cecilia Perret, Pontificia Universidad Católica de Chile, Santiago, Chile; Marc Mendelson and Peter Vincent, University of Cape Town and Tokai Medicross Travel Clinic, Cape Town, South Africa; Michael W. Lynch, Fresno International Travel Medical Center, Fresno, CA (through February of 2010); Shuzo Kanagawa and Yasuyuki Kato, International Medical Center of Japan, Tokyo, Japan; and DeVon C. Hale, Rahul Anand, and Stefanie S. Gelman, University of Utah, Salt Lake City, UT.

Financial support: GeoSentinel is supported by a cooperative agreement (5U50CI000359) from the Centers for Disease Control and Prevention and an initial pilot grant from the International Society of Travel Medicine. The Cambridge UK Site is also supported by the National Institute of Health Research Cambridge Biomedical Research Centre.

Authors' addresses: Douglas H. Esposito, Pauline V. Han, and Mark J. Sotir, Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Traveler's Health Branch, Atlanta, GA, E-mails: desposito@cdc.gov, phan@cdc.gov, and msotir@cdc.gov. Phyllis E. Kozarsky, Emory University School of Medicine, Division of Infectious Diseases, Atlanta, GA, E-mail: pkozars@emory.edu. Patricia F. Walker, HealthPartners Travel Medicine Clinics, University of Minnesota, Minneapolis/St. Paul, MN, E-mail: patricia.f.walker@healthpartners.com. Effrossyni Gkrania-Klotsas, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom, E-mail: effrossyni.gkrania-klotsas@mrc-epid.cam.ac.uk. Elizabeth D. Barnett, Boston Medical Center, Maxwell Finland Laboratory for Infectious Diseases, Boston, MA, E-mail: elizabeth.barnett@bmc.org. Michael Libman, McGill University, J. D. MacLean Centre for Tropical Diseases, Montreal, Canada, E-mail: michael.libman@mcgill.ca. Anne E. McCarthy, Ottawa Hospital General Campus, Division of Infectious Diseases, Ottawa, Canada, E-mail: amccarthy@ottawahospital.on.ca. Vanessa Field, InterHealth, London, United Kingdom, E-mail: vanessafield@doctors.org.uk. Bradley A. Connor, Weill Medical College, Cornell University, New York, New York, E-mail: bconnor@pol.net. Eli Schwartz, Center for Geographic Medicine, Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, E-mail: elischwa@post.tau.ac.il. Susan MacDonald, University Hospital of Northern British Columbia, Prince George, Canada, E-mail: susanmacdonald@telus.net.

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