Infectious diseases acquired by international travellers visiting the USA

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 desc...

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Main Authors: Stoney, Rhett J, Esposito, Douglas H., Kozarsky, Phyllis, Hamer, Davidson H., Grobusch, Martin P., Gkrania-Klotsas, Effrossyni, Libman, Michael, Gautret, Philippe, Lim, Poh Lian, Leder, Karin, Schwartz, Eli, Sotir, Mark J., Licitra, Carmelo
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2020
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Online Access:https://hdl.handle.net/10356/139294
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spelling sg-ntu-dr.10356-1392942020-05-18T09:21:24Z Infectious diseases acquired by international travellers visiting the USA Stoney, Rhett J Esposito, Douglas H. Kozarsky, Phyllis Hamer, Davidson H. Grobusch, Martin P. Gkrania-Klotsas, Effrossyni Libman, Michael Gautret, Philippe Lim, Poh Lian Leder, Karin Schwartz, Eli Sotir, Mark J. Licitra, Carmelo Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine International Travellers Infectious Diseases 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. 2020-05-18T09:21:24Z 2020-05-18T09:21:24Z 2018 Journal Article Stoney, R. J., Esposito, D. H., Kozarsky, P., Hamer, D. H., Grobusch, M. P., Gkrania-Klotsas, E., . . . Licitra, C. (2018). Infectious diseases acquired by international travellers visiting the USA. Journal of Travel Medicine, 25(1), 1-7, doi:10.1093/jtm/tay053 1195-1982 https://hdl.handle.net/10356/139294 10.1093/jtm/tay053 30124885 2-s2.0-85063712154 1 25 1 7 en Journal of Travel Medicine © 2018 International Society of Travel Medicine (published by Oxford University Press). All rights reserved.
institution Nanyang Technological University
building NTU Library
country Singapore
collection DR-NTU
language English
topic Science::Medicine
International Travellers
Infectious Diseases
spellingShingle Science::Medicine
International Travellers
Infectious Diseases
Stoney, Rhett J
Esposito, Douglas H.
Kozarsky, Phyllis
Hamer, Davidson H.
Grobusch, Martin P.
Gkrania-Klotsas, Effrossyni
Libman, Michael
Gautret, Philippe
Lim, Poh Lian
Leder, Karin
Schwartz, Eli
Sotir, Mark J.
Licitra, Carmelo
Infectious diseases acquired by international travellers visiting the USA
description 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.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Stoney, Rhett J
Esposito, Douglas H.
Kozarsky, Phyllis
Hamer, Davidson H.
Grobusch, Martin P.
Gkrania-Klotsas, Effrossyni
Libman, Michael
Gautret, Philippe
Lim, Poh Lian
Leder, Karin
Schwartz, Eli
Sotir, Mark J.
Licitra, Carmelo
format Article
author Stoney, Rhett J
Esposito, Douglas H.
Kozarsky, Phyllis
Hamer, Davidson H.
Grobusch, Martin P.
Gkrania-Klotsas, Effrossyni
Libman, Michael
Gautret, Philippe
Lim, Poh Lian
Leder, Karin
Schwartz, Eli
Sotir, Mark J.
Licitra, Carmelo
author_sort Stoney, Rhett J
title Infectious diseases acquired by international travellers visiting the USA
title_short Infectious diseases acquired by international travellers visiting the USA
title_full Infectious diseases acquired by international travellers visiting the USA
title_fullStr Infectious diseases acquired by international travellers visiting the USA
title_full_unstemmed Infectious diseases acquired by international travellers visiting the USA
title_sort infectious diseases acquired by international travellers visiting the usa
publishDate 2020
url https://hdl.handle.net/10356/139294
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