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GeoSentinel surveillance of illness in returned travelers, 2007-2011.
Ann Intern Med. 2013 Mar 19; 158(6):456-68.AIM

Abstract

BACKGROUND

International travel continues to increase, particularly to Asia and Africa. Clinicians are increasingly likely to be consulted for advice before travel or by ill returned travelers.

OBJECTIVE

To describe typical diseases in returned travelers according to region, travel reason, and patient demographic characteristics; describe the pattern of low-frequency travel-associated diseases; and refine key messages for care before and after travel.

DESIGN

Descriptive, using GeoSentinel records.

SETTING

53 tropical or travel disease units in 24 countries.

PATIENTS

42 173 ill returned travelers seen between 2007 and 2011.

MEASUREMENTS

Frequencies of demographic characteristics, regions visited, and illnesses reported.

RESULTS

Asia (32.6%) and sub-Saharan Africa (26.7%) were the most common regions where illnesses were acquired. Three quarters of travel-related illness was due to gastrointestinal (34.0%), febrile (23.3%), and dermatologic (19.5%) diseases. Only 40.5% of all ill travelers reported pretravel medical visits. The relative frequency of many diseases varied with both travel destination and reason for travel, with travelers visiting friends and relatives in their country of origin having both a disproportionately high burden of serious febrile illness and very low rates of advice before travel (18.3%). Life-threatening diseases, such as Plasmodium falciparum malaria, melioidosis, and African trypanosomiasis, were reported.

LIMITATIONS

Sentinel surveillance data collected by specialist clinics do not reflect healthy returning travelers or those with mild or self-limited illness. Data cannot be used to infer quantitative risk for illness.

CONCLUSION

Many illnesses may have been preventable with appropriate advice, chemoprophylaxis, or vaccination. Clinicians can use these 5-year GeoSentinel data to help tailor more efficient pretravel preparation strategies and evaluate possible differential diagnoses of ill returned travelers according to destination and reason for travel.

PRIMARY FUNDING SOURCE

Centers for Disease Control and Prevention.

Links

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Authors+Show Affiliations

Leder K
Victorian Infectious Disease Service, Royal Melbourne Hospital, Monash University, Austin Hospital, Melbourne University. karin.leder@monash.edu
Torresi J
No affiliation info available
Libman MD
No affiliation info available
Cramer JP
No affiliation info available
Castelli F
No affiliation info available
Schlagenhauf P
No affiliation info available
Wilder-Smith A
No affiliation info available
Wilson ME
No affiliation info available
Keystone JS
No affiliation info available
Schwartz E
No affiliation info available
Barnett ED
No affiliation info available
von Sonnenburg F
No affiliation info available
Brownstein JS
No affiliation info available
Cheng AC
No affiliation info available
Sotir MJ
No affiliation info available
Esposito DH
No affiliation info available
Freedman DO
No affiliation info available
GeoSentinel Surveillance Network
No affiliation info available

MeSH

AdolescentAdultAfrica South of the SaharaAgedAged, 80 and overAsiaCaribbean RegionChildChild, PreschoolFeverGastrointestinal DiseasesHumansInfantInfectionsLatin AmericaMiddle AgedRespiratory Tract InfectionsSentinel SurveillanceSkin DiseasesTravelYoung Adult

Pub Type(s)

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

Language

eng

PubMed ID

23552375

Citation

Leder, Karin, et al. "GeoSentinel Surveillance of Illness in Returned Travelers, 2007-2011." Annals of Internal Medicine, vol. 158, no. 6, 2013, pp. 456-68.
Leder K, Torresi J, Libman MD, et al. GeoSentinel surveillance of illness in returned travelers, 2007-2011. Ann Intern Med. 2013;158(6):456-68.
Leder, K., Torresi, J., Libman, M. D., Cramer, J. P., Castelli, F., Schlagenhauf, P., Wilder-Smith, A., Wilson, M. E., Keystone, J. S., Schwartz, E., Barnett, E. D., von Sonnenburg, F., Brownstein, J. S., Cheng, A. C., Sotir, M. J., Esposito, D. H., & Freedman, D. O. (2013). GeoSentinel surveillance of illness in returned travelers, 2007-2011. Annals of Internal Medicine, 158(6), 456-68. https://doi.org/10.7326/0003-4819-158-6-201303190-00005
Leder K, et al. GeoSentinel Surveillance of Illness in Returned Travelers, 2007-2011. Ann Intern Med. 2013 Mar 19;158(6):456-68. PubMed PMID: 23552375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - GeoSentinel surveillance of illness in returned travelers, 2007-2011. AU - Leder,Karin, AU - Torresi,Joseph, AU - Libman,Michael D, AU - Cramer,Jakob P, AU - Castelli,Francesco, AU - Schlagenhauf,Patricia, AU - Wilder-Smith,Annelies, AU - Wilson,Mary E, AU - Keystone,Jay S, AU - Schwartz,Eli, AU - Barnett,Elizabeth D, AU - von Sonnenburg,Frank, AU - Brownstein,John S, AU - Cheng,Allen C, AU - Sotir,Mark J, AU - Esposito,Douglas H, AU - Freedman,David O, AU - ,, PY - 2013/4/5/entrez PY - 2013/4/5/pubmed PY - 2013/5/15/medline SP - 456 EP - 68 JF - Annals of internal medicine JO - Ann Intern Med VL - 158 IS - 6 N2 - BACKGROUND: International travel continues to increase, particularly to Asia and Africa. Clinicians are increasingly likely to be consulted for advice before travel or by ill returned travelers. OBJECTIVE: To describe typical diseases in returned travelers according to region, travel reason, and patient demographic characteristics; describe the pattern of low-frequency travel-associated diseases; and refine key messages for care before and after travel. DESIGN: Descriptive, using GeoSentinel records. SETTING: 53 tropical or travel disease units in 24 countries. PATIENTS: 42 173 ill returned travelers seen between 2007 and 2011. MEASUREMENTS: Frequencies of demographic characteristics, regions visited, and illnesses reported. RESULTS: Asia (32.6%) and sub-Saharan Africa (26.7%) were the most common regions where illnesses were acquired. Three quarters of travel-related illness was due to gastrointestinal (34.0%), febrile (23.3%), and dermatologic (19.5%) diseases. Only 40.5% of all ill travelers reported pretravel medical visits. The relative frequency of many diseases varied with both travel destination and reason for travel, with travelers visiting friends and relatives in their country of origin having both a disproportionately high burden of serious febrile illness and very low rates of advice before travel (18.3%). Life-threatening diseases, such as Plasmodium falciparum malaria, melioidosis, and African trypanosomiasis, were reported. LIMITATIONS: Sentinel surveillance data collected by specialist clinics do not reflect healthy returning travelers or those with mild or self-limited illness. Data cannot be used to infer quantitative risk for illness. CONCLUSION: Many illnesses may have been preventable with appropriate advice, chemoprophylaxis, or vaccination. Clinicians can use these 5-year GeoSentinel data to help tailor more efficient pretravel preparation strategies and evaluate possible differential diagnoses of ill returned travelers according to destination and reason for travel. PRIMARY FUNDING SOURCE: Centers for Disease Control and Prevention. SN - 1539-3704 UR - https://www.unboundmedicine.com/medline/citation/23552375/full_citation L2 - https://www.acpjournals.org/doi/10.7326/0003-4819-158-6-201303190-00005?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -