Dengue virus infection among long-term travelers from the Netherlands: A prospective study, 2008-2011.
Dengue is increasing rapidly in endemic regions. Data on incidence among travelers to these areas are limited. Five prospective studies have been performed thus far, mainly among short-term travelers.To obtain the attack and incidence rate (AR, IR) of dengue virus (DENV) infection among long-term tr...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5802908?pdf=render |
| _version_ | 1818272863345442816 |
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| author | Femke W Overbosch Janke Schinkel Ineke G Stolte Maria Prins Gerard J B Sonder |
| author_facet | Femke W Overbosch Janke Schinkel Ineke G Stolte Maria Prins Gerard J B Sonder |
| author_sort | Femke W Overbosch |
| collection | DOAJ |
| description | Dengue is increasing rapidly in endemic regions. Data on incidence among travelers to these areas are limited. Five prospective studies have been performed thus far, mainly among short-term travelers.To obtain the attack and incidence rate (AR, IR) of dengue virus (DENV) infection among long-term travelers and identify associated risk factors.A prospective study was performed among long-term travelers (12-52 weeks) attending the Public Health Service in Amsterdam. Clients planning to travel to (sub)tropical countries were invited to participate. Participants kept a travel diary, recording itinerary, symptoms, and physician visits. Pre- and post-travel blood samples were serologically tested for the presence of Anti-DENV IgG antibodies. Seroconversion was considered suggestive of a primary DENV infection. Anti-DENV IgG present in both corresponding samples in combination with a post-/pre-travel ratio of ≥4:1 was suggestive of a secondary infection. Risk factors for a DENV infection were studied using poisson regression.In total, 600 participants were included; median age was 25 years (IQR: 23-29), 35.5% were male, and median travel duration was 20 weeks (IQR: 15-25). In 39 of 600 participants (AR: 6.5%; 95% CI 4.5-8.5%) anti-DENV IgG test results were suggestive of a recent infection, yielding an IR of 13.9 per 1,000 person-months traveling (95%CI: 9.9-19.1). No secondary infections were found. IR for Asia, Africa, and America were comparable and 13.5, 15.8, and 13.6 per 1,000 person-months respectively. Of participants with a recent DENV infection, 51% did not report dengue-like illness (DLI) or fever, but 10% were hospitalized. In multivariable analysis, travelers who seroconverted were significantly more likely to be vaccinated with ≥2 flavivirus vaccines for the current trip or to have reported DLI in >1 consecutive weeks.Long-term travelers are at substantial risk of DENV infection. Half of those with a DENV infection reported no symptoms, but 10% were hospitalized, demonstrating the importance of advising anti-mosquito measures during travel. |
| first_indexed | 2024-12-12T21:48:49Z |
| format | Article |
| id | doaj.art-761b7d68379f4a69a804934db924c919 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T21:48:49Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-761b7d68379f4a69a804934db924c9192022-12-22T00:10:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01132e019219310.1371/journal.pone.0192193Dengue virus infection among long-term travelers from the Netherlands: A prospective study, 2008-2011.Femke W OverboschJanke SchinkelIneke G StolteMaria PrinsGerard J B SonderDengue is increasing rapidly in endemic regions. Data on incidence among travelers to these areas are limited. Five prospective studies have been performed thus far, mainly among short-term travelers.To obtain the attack and incidence rate (AR, IR) of dengue virus (DENV) infection among long-term travelers and identify associated risk factors.A prospective study was performed among long-term travelers (12-52 weeks) attending the Public Health Service in Amsterdam. Clients planning to travel to (sub)tropical countries were invited to participate. Participants kept a travel diary, recording itinerary, symptoms, and physician visits. Pre- and post-travel blood samples were serologically tested for the presence of Anti-DENV IgG antibodies. Seroconversion was considered suggestive of a primary DENV infection. Anti-DENV IgG present in both corresponding samples in combination with a post-/pre-travel ratio of ≥4:1 was suggestive of a secondary infection. Risk factors for a DENV infection were studied using poisson regression.In total, 600 participants were included; median age was 25 years (IQR: 23-29), 35.5% were male, and median travel duration was 20 weeks (IQR: 15-25). In 39 of 600 participants (AR: 6.5%; 95% CI 4.5-8.5%) anti-DENV IgG test results were suggestive of a recent infection, yielding an IR of 13.9 per 1,000 person-months traveling (95%CI: 9.9-19.1). No secondary infections were found. IR for Asia, Africa, and America were comparable and 13.5, 15.8, and 13.6 per 1,000 person-months respectively. Of participants with a recent DENV infection, 51% did not report dengue-like illness (DLI) or fever, but 10% were hospitalized. In multivariable analysis, travelers who seroconverted were significantly more likely to be vaccinated with ≥2 flavivirus vaccines for the current trip or to have reported DLI in >1 consecutive weeks.Long-term travelers are at substantial risk of DENV infection. Half of those with a DENV infection reported no symptoms, but 10% were hospitalized, demonstrating the importance of advising anti-mosquito measures during travel.http://europepmc.org/articles/PMC5802908?pdf=render |
| spellingShingle | Femke W Overbosch Janke Schinkel Ineke G Stolte Maria Prins Gerard J B Sonder Dengue virus infection among long-term travelers from the Netherlands: A prospective study, 2008-2011. PLoS ONE |
| title | Dengue virus infection among long-term travelers from the Netherlands: A prospective study, 2008-2011. |
| title_full | Dengue virus infection among long-term travelers from the Netherlands: A prospective study, 2008-2011. |
| title_fullStr | Dengue virus infection among long-term travelers from the Netherlands: A prospective study, 2008-2011. |
| title_full_unstemmed | Dengue virus infection among long-term travelers from the Netherlands: A prospective study, 2008-2011. |
| title_short | Dengue virus infection among long-term travelers from the Netherlands: A prospective study, 2008-2011. |
| title_sort | dengue virus infection among long term travelers from the netherlands a prospective study 2008 2011 |
| url | http://europepmc.org/articles/PMC5802908?pdf=render |
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