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Patterns of illness in travelers visiting Mexico and Central America: the GeoSentinel experience.
Clin Infect Dis. 2011 Sep; 53(6):523-31.CI

Abstract

BACKGROUND

Mexico and Central America are important travel destinations for North American and European travelers. There is limited information on regional differences in travel related morbidity.

METHODS

We describe the morbidity among 4779 ill travelers returned from Mexico and Central America who were evaluated at GeoSentinel network clinics during December 1996 to February 2010.

RESULTS

The most frequent presenting syndromes included acute and chronic diarrhea, dermatologic diseases, febrile systemic illness, and respiratory disease. A higher proportion of ill travelers from the United States had acute diarrhea, compared with their Canadian and European counterparts (odds ratio, 1.9; P < .0001). During the 2009 H1N1 influenza outbreak from March 2009 through February 2010, the proportionate morbidity (PM) associated with respiratory illnesses in ill travelers increased among those returned from Mexico, compared with prior years (196.0 cases per 1000 ill returned travelers vs 53.7 cases per 1000 ill returned travelers; P < .0001); the PM remained constant in the rest of Central America (57.3 cases per 1000 ill returned travelers). We identified 50 travelers returned from Mexico and Central America who developed influenza, including infection due to 2009 H1N1 strains and influenza-like illness. The overall risk of malaria was low; only 4 cases of malaria were acquired in Mexico (PM, 2.2 cases per 1000 ill returned travelers) in 13 years, compared with 18 from Honduras (PM, 79.6 cases per 1000 ill returned travelers) and 14 from Guatemala (PM, 34.4 cases per 1000 ill returned travelers) during the same period. Plasmodium vivax malaria was the most frequent malaria diagnosis.

CONCLUSIONS

Travel medicine practitioners advising and treating travelers visiting these regions should dedicate special attention to vaccine-preventable illnesses and should consider the uncommon occurrence of acute hepatitis A, leptospirosis, neurocysticercosis, acute Chagas disease, onchocerciasis, mucocutaneous leishmaniasis, neurocysticercosis, HIV, malaria, and brucellosis.

Authors+Show Affiliations

Center for Infectious Diseases, School of Public Health, Houston, Texas, USA. jose.flores.figueroa@uth.tmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

21832261

Citation

Flores-Figueroa, Jose, et al. "Patterns of Illness in Travelers Visiting Mexico and Central America: the GeoSentinel Experience." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 53, no. 6, 2011, pp. 523-31.
Flores-Figueroa J, Okhuysen PC, von Sonnenburg F, et al. Patterns of illness in travelers visiting Mexico and Central America: the GeoSentinel experience. Clin Infect Dis. 2011;53(6):523-31.
Flores-Figueroa, J., Okhuysen, P. C., von Sonnenburg, F., DuPont, H. L., Libman, M. D., Keystone, J. S., Hale, D. C., Burchard, G., Han, P. V., Wilder-Smith, A., & Freedman, D. O. (2011). Patterns of illness in travelers visiting Mexico and Central America: the GeoSentinel experience. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 53(6), 523-31. https://doi.org/10.1093/cid/cir468
Flores-Figueroa J, et al. Patterns of Illness in Travelers Visiting Mexico and Central America: the GeoSentinel Experience. Clin Infect Dis. 2011;53(6):523-31. PubMed PMID: 21832261.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns of illness in travelers visiting Mexico and Central America: the GeoSentinel experience. AU - Flores-Figueroa,Jose, AU - Okhuysen,Pablo C, AU - von Sonnenburg,Frank, AU - DuPont,Herbert L, AU - Libman,Michael D, AU - Keystone,Jay S, AU - Hale,Devon C, AU - Burchard,Gerd, AU - Han,Pauline V, AU - Wilder-Smith,Annelies, AU - Freedman,David O, AU - ,, Y1 - 2011/08/10/ PY - 2011/8/12/entrez PY - 2011/8/13/pubmed PY - 2012/2/11/medline SP - 523 EP - 31 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 53 IS - 6 N2 - BACKGROUND: Mexico and Central America are important travel destinations for North American and European travelers. There is limited information on regional differences in travel related morbidity. METHODS: We describe the morbidity among 4779 ill travelers returned from Mexico and Central America who were evaluated at GeoSentinel network clinics during December 1996 to February 2010. RESULTS: The most frequent presenting syndromes included acute and chronic diarrhea, dermatologic diseases, febrile systemic illness, and respiratory disease. A higher proportion of ill travelers from the United States had acute diarrhea, compared with their Canadian and European counterparts (odds ratio, 1.9; P < .0001). During the 2009 H1N1 influenza outbreak from March 2009 through February 2010, the proportionate morbidity (PM) associated with respiratory illnesses in ill travelers increased among those returned from Mexico, compared with prior years (196.0 cases per 1000 ill returned travelers vs 53.7 cases per 1000 ill returned travelers; P < .0001); the PM remained constant in the rest of Central America (57.3 cases per 1000 ill returned travelers). We identified 50 travelers returned from Mexico and Central America who developed influenza, including infection due to 2009 H1N1 strains and influenza-like illness. The overall risk of malaria was low; only 4 cases of malaria were acquired in Mexico (PM, 2.2 cases per 1000 ill returned travelers) in 13 years, compared with 18 from Honduras (PM, 79.6 cases per 1000 ill returned travelers) and 14 from Guatemala (PM, 34.4 cases per 1000 ill returned travelers) during the same period. Plasmodium vivax malaria was the most frequent malaria diagnosis. CONCLUSIONS: Travel medicine practitioners advising and treating travelers visiting these regions should dedicate special attention to vaccine-preventable illnesses and should consider the uncommon occurrence of acute hepatitis A, leptospirosis, neurocysticercosis, acute Chagas disease, onchocerciasis, mucocutaneous leishmaniasis, neurocysticercosis, HIV, malaria, and brucellosis. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/21832261/full_citation L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cir468 DB - PRIME DP - Unbound Medicine ER -