News BBC. Haiti will not die, President Rene Preval insists. Available at: http://news.bbc.co.uk/1/hi/world/americas/8511997.stm. Accessed May 31, 2011.
PAHO/WHO, 2011. Earthquake in Haiti—One Year Later, PAHO/WHO Report on the Health Situation, January 2011. Available at: http://www.who.int/hac/crises/hti/en/. Accessed May 31, 2011.
World Health Organization, 2011. Meeting of the International Task Force for Disease Eradication—October 2010. Wkly Epidemiol Rec 86: 53–59.
CDC, 2006. Malaria–Great Exuma, Bahamas, May–June 2006. MMWR Morb Mortal Wkly Rep 55: 1013–1016.
Schneider MC, Aguilera XP, Barbosa da Silva Junior J, Ault SK, Najera P, Martinez J, Requejo R, Nicholls RS, Yadon Z, Silva JC, Leanes LF, Periago MR, 2011. Elimination of neglected diseases in Latin America and the Caribbean: a mapping of selected diseases. PLoS Negl Trop Dis 5: e964.
Schneider MC, Belotto A, Adé MP, Hendrickx S, Leanes LF, Rodrigues MJ, Medina G, Correa E, 2007. Current status of human rabies transmitted by dogs in Latin America. Cad Saude Publica 23: 2049–2063.
Rioth M, Beauharnais CA, Noel F, Ikizler MR, Mehta S, Zhu Y, Long CA, Pape JW, Wright PF, 2011. Serologic imprint of dengue virus in urban Haiti: characterization of humoral immunity to dengue in infants and young children. Am J Trop Med Hyg 84: 630–636.
WHO, 2010. Public Health Risk Assessment and Interventions. Earthquake: Haiti. Available at: http://www.who.int/diseasecontrol_emergencies/publications/haiti_earthquake_20100118.pdf. Accessed May 24, 2011.
WHO, 2010. Progress on Drinking Water and Sanitation: 2010 Update. Available at: http://whqlibdoc.who.int/publications/2010/9789241563956_eng_full_text.pdf. Accessed May 24, 2011.
Dowell SF, Tappero JW, Frieden TR, 2011. Public health in Haiti—challenges and progress. N Engl J Med 364: 300–301.
Degennaro V Jr, Degennaro V Sr, Ginzburg E, 2011. Haiti's dilemma: how to incorporate health professionals to assist in short-term recovery while capacity building for the future. J Public Health 33: 459–461
CDC, 2005. Human rabies—Florida, 2004. MMWR Morb Mortal Wkly Rep 54: 767–769.
CDC, 2010. Malaria acquired in Haiti—2010. MMWR Morb Mortal Wkly Rep 59: 217–219.
CDC, 2010. Travel-associated dengue surveillance—United States, 2006–2008. MMWR Morb Mortal Wkly Rep 59: 715–719.
CDC, 2010. Update on cholera—Haiti, Dominican Republic, and Florida, 2010. MMWR Morb Mortal Wkly Rep 59: 1637–1641.
Neuberger A, Zaulan O, Tenenboim S, Vernet S, Pex R, Held K, Urman M, Garpenfeldt K, Schwartz E, 2011. Malaria among patients and aid workers consulting a primary healthcare centre in Leogane, Haiti, November 2010 to February 2011—a prospective observational study. Euro Surveill 16: 19829.
Sharp TM, Pillai P, Hunsperger E, Santiago GA, Anderson T, Vap T, Collinson J, Buss BF, Safranek TJ, Sotir MJ, Jentes ES, Munoz-Jordan JL, Arguello DF, 2012. A cluster of dengue cases in American missionaries returning from Haiti, 2010. Am J Trop Med Hyg 86: 16–22.
Steinberg EB, Bishop R, Haber P, Dempsey AF, Hoekstra RM, Nelson JM, Ackers M, Calugar A, Mintz ED, 2004. Typhoid fever in travelers: who should be targeted for prevention? Clin Infect Dis 39: 186–191.
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: 119–130.
CDC, 2010. Rapid establishment of an internally displaced persons disease surveillance system after an earthquake—Haiti, 2010. MMWR Morb Mortal Wkly Rep 59: 939–945.
Keystone JS, Dismukes R, Sawyer L, Kozarsky PE, 1994. Inadequacies in health recommendations provided for international travelers by North American travel health advisors. J Travel Med 1: 72–78.
CDC, 2012. Cholera outbreak—Haiti, 2010. MMWR Morb Mortal Wkly Rep 59: 1411.
News BBC. Fatal floods as hurricane Tomas sweeps over Haiti. Available at: http://www.bbc.co.uk/news/world-latin-america-11700977. Accessed May 30, 2011.
CDC, 2012. CDC Health Information for International Travel 2012. New York: Oxford University Press.
Boe HJ, Holgersen KH, Holen A, 2011. Mental health outcomes and predictors of chronic disorders after the North Sea oil rig disaster: 27-year longitudinal follow-up study. J Nerv Ment Dis 199: 49–54.
Gupta J, Agrawal A, 2010. Chronic aftershocks of an earthquake on the well-being of children in Haiti: violence, psychosocial health and slavery. CMAJ 182: 1997–1999.
Thormar SB, Gersons BP, Juen B, Marschang A, Djakababa MN, Olff M, 2010. The mental health impact of volunteering in a disaster setting: a review. J Nerv Ment Dis 198: 529–538.
Bills CB, Levy NA, Sharma V, Charney DS, Herbert R, Moline J, Katz CL, 2008. Mental health of workers and volunteers responding to events of 9/11: review of the literature. Mt Sinai J Med 75: 115–127.
Hagh-Shenas H, Goodarzi MA, Dehbozorgi G, Farashbandi H, 2005. Psychological consequences of the Bam earthquake on professional and nonprofessional helpers. J Trauma Stress 18: 477–483.
Fullerton CS, Ursano RJ, Wang L, 2004. Acute stress disorder, posttraumatic stress disorder and depression in disaster or rescue workers. Am J Psychiatry 161: 1370–1376.
Guo YJ, Chen CH, Lu ML, Tan HK, Lee HW, Wang TN, 2004. Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan. Psychiatry Res 127: 35–41.
Robinson B, Alatas MF, Robertson A, Steer H, 2011. Natural disasters and the lung. Respirology 16: 386–395.
Ozdogan S, Hocaoglu A, Caglayan B, Imamoglu OU, Aydin D, 2001. Thorax and lung injuries arising from the two earthquakes in Turkey in 1999. Chest 120: 1163–1166.
CDC, 2010. Potential exposures to airborne and settled surface dust in residential areas of lower Manhattan following the collapse of the World Trade Center—New York City, November 4–December 11, 2001. MMWR Morb Mortal Wkly Rep 52: 131–136.
CDC, 2010. Injuries and illnesses among New York City Fire Department rescue workers after responding to the World Trade Center attacks. MMWR Morb Mortal Wkly Rep 51: 1–5.
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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.
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.
News BBC. Haiti will not die, President Rene Preval insists. Available at: http://news.bbc.co.uk/1/hi/world/americas/8511997.stm. Accessed May 31, 2011.
PAHO/WHO, 2011. Earthquake in Haiti—One Year Later, PAHO/WHO Report on the Health Situation, January 2011. Available at: http://www.who.int/hac/crises/hti/en/. Accessed May 31, 2011.
World Health Organization, 2011. Meeting of the International Task Force for Disease Eradication—October 2010. Wkly Epidemiol Rec 86: 53–59.
CDC, 2006. Malaria–Great Exuma, Bahamas, May–June 2006. MMWR Morb Mortal Wkly Rep 55: 1013–1016.
Schneider MC, Aguilera XP, Barbosa da Silva Junior J, Ault SK, Najera P, Martinez J, Requejo R, Nicholls RS, Yadon Z, Silva JC, Leanes LF, Periago MR, 2011. Elimination of neglected diseases in Latin America and the Caribbean: a mapping of selected diseases. PLoS Negl Trop Dis 5: e964.
Schneider MC, Belotto A, Adé MP, Hendrickx S, Leanes LF, Rodrigues MJ, Medina G, Correa E, 2007. Current status of human rabies transmitted by dogs in Latin America. Cad Saude Publica 23: 2049–2063.
Rioth M, Beauharnais CA, Noel F, Ikizler MR, Mehta S, Zhu Y, Long CA, Pape JW, Wright PF, 2011. Serologic imprint of dengue virus in urban Haiti: characterization of humoral immunity to dengue in infants and young children. Am J Trop Med Hyg 84: 630–636.
WHO, 2010. Public Health Risk Assessment and Interventions. Earthquake: Haiti. Available at: http://www.who.int/diseasecontrol_emergencies/publications/haiti_earthquake_20100118.pdf. Accessed May 24, 2011.
WHO, 2010. Progress on Drinking Water and Sanitation: 2010 Update. Available at: http://whqlibdoc.who.int/publications/2010/9789241563956_eng_full_text.pdf. Accessed May 24, 2011.
Dowell SF, Tappero JW, Frieden TR, 2011. Public health in Haiti—challenges and progress. N Engl J Med 364: 300–301.
Degennaro V Jr, Degennaro V Sr, Ginzburg E, 2011. Haiti's dilemma: how to incorporate health professionals to assist in short-term recovery while capacity building for the future. J Public Health 33: 459–461
CDC, 2005. Human rabies—Florida, 2004. MMWR Morb Mortal Wkly Rep 54: 767–769.
CDC, 2010. Malaria acquired in Haiti—2010. MMWR Morb Mortal Wkly Rep 59: 217–219.
CDC, 2010. Travel-associated dengue surveillance—United States, 2006–2008. MMWR Morb Mortal Wkly Rep 59: 715–719.
CDC, 2010. Update on cholera—Haiti, Dominican Republic, and Florida, 2010. MMWR Morb Mortal Wkly Rep 59: 1637–1641.
Neuberger A, Zaulan O, Tenenboim S, Vernet S, Pex R, Held K, Urman M, Garpenfeldt K, Schwartz E, 2011. Malaria among patients and aid workers consulting a primary healthcare centre in Leogane, Haiti, November 2010 to February 2011—a prospective observational study. Euro Surveill 16: 19829.
Sharp TM, Pillai P, Hunsperger E, Santiago GA, Anderson T, Vap T, Collinson J, Buss BF, Safranek TJ, Sotir MJ, Jentes ES, Munoz-Jordan JL, Arguello DF, 2012. A cluster of dengue cases in American missionaries returning from Haiti, 2010. Am J Trop Med Hyg 86: 16–22.
Steinberg EB, Bishop R, Haber P, Dempsey AF, Hoekstra RM, Nelson JM, Ackers M, Calugar A, Mintz ED, 2004. Typhoid fever in travelers: who should be targeted for prevention? Clin Infect Dis 39: 186–191.
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: 119–130.
CDC, 2010. Rapid establishment of an internally displaced persons disease surveillance system after an earthquake—Haiti, 2010. MMWR Morb Mortal Wkly Rep 59: 939–945.
Keystone JS, Dismukes R, Sawyer L, Kozarsky PE, 1994. Inadequacies in health recommendations provided for international travelers by North American travel health advisors. J Travel Med 1: 72–78.
CDC, 2012. Cholera outbreak—Haiti, 2010. MMWR Morb Mortal Wkly Rep 59: 1411.
News BBC. Fatal floods as hurricane Tomas sweeps over Haiti. Available at: http://www.bbc.co.uk/news/world-latin-america-11700977. Accessed May 30, 2011.
CDC, 2012. CDC Health Information for International Travel 2012. New York: Oxford University Press.
Boe HJ, Holgersen KH, Holen A, 2011. Mental health outcomes and predictors of chronic disorders after the North Sea oil rig disaster: 27-year longitudinal follow-up study. J Nerv Ment Dis 199: 49–54.
Gupta J, Agrawal A, 2010. Chronic aftershocks of an earthquake on the well-being of children in Haiti: violence, psychosocial health and slavery. CMAJ 182: 1997–1999.
Thormar SB, Gersons BP, Juen B, Marschang A, Djakababa MN, Olff M, 2010. The mental health impact of volunteering in a disaster setting: a review. J Nerv Ment Dis 198: 529–538.
Bills CB, Levy NA, Sharma V, Charney DS, Herbert R, Moline J, Katz CL, 2008. Mental health of workers and volunteers responding to events of 9/11: review of the literature. Mt Sinai J Med 75: 115–127.
Hagh-Shenas H, Goodarzi MA, Dehbozorgi G, Farashbandi H, 2005. Psychological consequences of the Bam earthquake on professional and nonprofessional helpers. J Trauma Stress 18: 477–483.
Fullerton CS, Ursano RJ, Wang L, 2004. Acute stress disorder, posttraumatic stress disorder and depression in disaster or rescue workers. Am J Psychiatry 161: 1370–1376.
Guo YJ, Chen CH, Lu ML, Tan HK, Lee HW, Wang TN, 2004. Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan. Psychiatry Res 127: 35–41.
Robinson B, Alatas MF, Robertson A, Steer H, 2011. Natural disasters and the lung. Respirology 16: 386–395.
Ozdogan S, Hocaoglu A, Caglayan B, Imamoglu OU, Aydin D, 2001. Thorax and lung injuries arising from the two earthquakes in Turkey in 1999. Chest 120: 1163–1166.
CDC, 2010. Potential exposures to airborne and settled surface dust in residential areas of lower Manhattan following the collapse of the World Trade Center—New York City, November 4–December 11, 2001. MMWR Morb Mortal Wkly Rep 52: 131–136.
CDC, 2010. Injuries and illnesses among New York City Fire Department rescue workers after responding to the World Trade Center attacks. MMWR Morb Mortal Wkly Rep 51: 1–5.
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