TY - JOUR
T1 - Infectious diseases acquired by international travellers visiting the USA
AU - For the GeoSentinel Surveillance Network
AU - Stoney, Rhett J.
AU - Esposito, Douglas H.
AU - Kozarsky, Phyllis
AU - Hamer, Davidson H.
AU - Grobusch, Martin P.
AU - Gkrania-Klotsas, Effrossyni
AU - Libman, Michael
AU - Gautret, Philippe
AU - Lim, Poh Lian
AU - Leder, Karin
AU - Schwartz, Eli
AU - Sotir, Mark J.
AU - Licitra, Carmelo
AU - Yansouni, Cedric
AU - Thomas, Ashley
AU - von Sonnenburg, Frank
AU - Rothe, Camilla
AU - Kain, Kevin
AU - Boggild, Andrea
AU - Cahill, John
AU - McKinley, George
AU - Yoshimura, Yokihiro
AU - Tachikawa, Natsuo
AU - Javelle, Emilie
AU - Borwein, Sarah
AU - Caumes, Eric
AU - Perignon, Alice
AU - Mockenhaupt, Frank
AU - Harms-Zwigenberger, Gundel
AU - Kanagawa, Shuzo
AU - Kato, Yasuyuki
AU - Schlagenhauf, Pat
AU - Weber, Rainer
AU - Plewes, Katherine
AU - Ghesquire, Wayne
AU - Mirzanejad, Yazdan
AU - Jordan, Sabine
AU - Vinnemeier, Christof
AU - Mendelson, Marc
AU - Parker, Salim
AU - McCarthy, Anne
AU - Vincelette, Jean
AU - Barkati, Sapha
AU - Asgeirsson, Hilmir
AU - Glans, Hedvig
AU - Castelli, Francesco
AU - Matteelli, Alberto
AU - Kuhn, Susan
AU - Warne, Ben
AU - Torresi, Joseph
N1 - Publisher Copyright:
© International Society of Travel Medicine, 2018. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: [email protected]
PY - 2018
Y1 - 2018
N2 - Background: Estimates of travel-related illness have focused predominantly on populations from highly developed countries visiting low- or middle-income countries, yet travel to and within high-income countries is very frequent. Despite being a top international tourist destination, few sources describe the spectrum of infectious diseases acquired among travellers to the USA. Methods: We performed a descriptive analysis summarizing demographic and travel characteristics, and clinical diagnoses among non-US-resident international travellers seen during or after travel to the USA at a GeoSentinel clinic from 1 January 1997 through 31 December 2016. Results: There were 1222 ill non-US-resident travellers with 1393 diagnoses recorded during the 20-year analysis period. Median age was 40 (range 0-86 years); 52% were female. Patients visited from 63 countries and territories, most commonly Canada (31%), Germany (14%), France (9%) and Japan (7%). Travellers presented with a range of illnesses; skin and soft tissue infections of unspecified aetiology were the most frequently reported during travel (29 diagnoses, 14% of during-travel diagnoses); arthropod bite/sting was the most frequently reported after travel (173 diagnoses, 15% after-travel diagnoses). Lyme disease was the most frequently reported arthropod-borne disease after travel (42, 4%). Nonspecific respiratory, gastrointestinal and systemic infections were also among the most frequently reported diagnoses overall. Low-frequency illnesses (<2% of cases) made up over half of diagnoses during travel and 41% of diagnoses after travel, including 13 cases of coccidioidomycosis and mosquito-borne infections like West Nile, dengue and Zika virus diseases. Conclusions: International travellers to the USA acquired a diverse array of mostly cosmopolitan infectious diseases, including nonspecific respiratory, gastrointestinal, dermatologic and systemic infections comparable to what has been reported among travellers to low- and middle-income countries. Clinicians should consider the specific health risks when preparing visitors to the USA and when evaluating and treating those who become ill.
AB - Background: Estimates of travel-related illness have focused predominantly on populations from highly developed countries visiting low- or middle-income countries, yet travel to and within high-income countries is very frequent. Despite being a top international tourist destination, few sources describe the spectrum of infectious diseases acquired among travellers to the USA. Methods: We performed a descriptive analysis summarizing demographic and travel characteristics, and clinical diagnoses among non-US-resident international travellers seen during or after travel to the USA at a GeoSentinel clinic from 1 January 1997 through 31 December 2016. Results: There were 1222 ill non-US-resident travellers with 1393 diagnoses recorded during the 20-year analysis period. Median age was 40 (range 0-86 years); 52% were female. Patients visited from 63 countries and territories, most commonly Canada (31%), Germany (14%), France (9%) and Japan (7%). Travellers presented with a range of illnesses; skin and soft tissue infections of unspecified aetiology were the most frequently reported during travel (29 diagnoses, 14% of during-travel diagnoses); arthropod bite/sting was the most frequently reported after travel (173 diagnoses, 15% after-travel diagnoses). Lyme disease was the most frequently reported arthropod-borne disease after travel (42, 4%). Nonspecific respiratory, gastrointestinal and systemic infections were also among the most frequently reported diagnoses overall. Low-frequency illnesses (<2% of cases) made up over half of diagnoses during travel and 41% of diagnoses after travel, including 13 cases of coccidioidomycosis and mosquito-borne infections like West Nile, dengue and Zika virus diseases. Conclusions: International travellers to the USA acquired a diverse array of mostly cosmopolitan infectious diseases, including nonspecific respiratory, gastrointestinal, dermatologic and systemic infections comparable to what has been reported among travellers to low- and middle-income countries. Clinicians should consider the specific health risks when preparing visitors to the USA and when evaluating and treating those who become ill.
KW - Coccidioidomycosis
KW - GeoSentinel
KW - Infectious diseases
KW - International travellers
KW - Lyme disease
KW - Travel medicine
KW - USA
UR - http://www.scopus.com/inward/record.url?scp=85063712154&partnerID=8YFLogxK
U2 - 10.1093/jtm/tay053
DO - 10.1093/jtm/tay053
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C2 - 30124885
AN - SCOPUS:85063712154
SN - 1195-1982
VL - 25
JO - Journal of Travel Medicine
JF - Journal of Travel Medicine
IS - 1
M1 - tay053
ER -