Filariasis in travelers presenting to the GeoSentinel Surveillance Network

Ettie M. Lipner*, Melissa A. Law, Elizabeth Barnett, Jay S. Keystone, Frank von Sonnenburg, Louis Loutan, D. Rebecca Prevots, Amy D. Klion, Thomas B. Nutman, Graham Brown, Joseph Torresi, Giampiero Carosi, Francesco Castelli, Lin Chen, Bradley Connor, Jean Delmont, Philippe Parola, Carles Franco, Phyllis Kozarsky, David FreedmanStefanie Gelman, Devon Hall, Alejandra Guruman, Jean Haulman, Elaine Jong, Kevin Kain, Carmelo Licitra, Prativa Pandey, Patricia Schlagenhauf, Robert Steffen, Eli Schwartz, Mark Shaw, Mary Wilson, Murray Wittner, Albert Einstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: As international travel increases, there is rising exposure to many pathogens not traditionally encountered in the resource-rich countries of the world. Filarial infections, a great problem throughout the tropics and subtropics, are relatively rare among travelers even to filaria-endemic regions of the world. The GeoSentinel Surveillance Network, a global network of medicine/travel clinics, was established in 1995 to detect morbidity trends among travelers. Principal Findings: We examined data from the GeoSentinel database to determine demographic and travel characteristics associated with Filaria acquisition and to understand the differences in clinical presentation between nonendemic visitors and those born in filaria endemic regions of the world. Filarial infections comprised 0.62% (n=271) of all medical conditions reported to the GeoSentinel Network from travelers; 37% of patients were diagnosed with Onchocerca volvulus, 25% were infected to the Loa loa, and another 25% were diagnosed with Wuchereria bancrofti. Most infections were reported from immigrants and from those immigrants returning to their country of origin (those visiting friends and relatives)l; the majority of filarial infections were acquired in sub-Saharan Africa. Among the patients who were natives of filaria-nonendemic regions, 70.6% acquired their filarial infection with exposure greater than 1 month. Moreover, nonendemic visitors to filaria-endemic regions were more likely to present to GeoSentinel sites with clinically symptomatic conditions compared with those who had lifelong exposure. Significance: Codifying the filarial infections presenting to the GeoSentinel Surveillance Network has provided insights into the clinical differences seen among filaria-infected expatriates and those from endemic regions and demonstrated that O. volvulus infection can be acquired with short-term travel.

Original languageEnglish
Article numbere88
JournalPLoS Neglected Tropical Diseases
Volume1
Issue number3
DOIs
StatePublished - Dec 2007
Externally publishedYes

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