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...
| Main Authors: | , , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
| Published: |
2020
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| Subjects: | |
| Online Access: | https://hdl.handle.net/10356/139294 |
| _version_ | 1824454112108871680 |
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| 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 |
| 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 |
| author_sort | Stoney, Rhett J |
| collection | NTU |
| 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. |
| first_indexed | 2025-02-19T03:17:08Z |
| format | Journal Article |
| id | ntu-10356/139294 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2025-02-19T03:17:08Z |
| publishDate | 2020 |
| record_format | dspace |
| spelling | ntu-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. |
| 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 |
| title | 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_short | Infectious diseases acquired by international travellers visiting the USA |
| title_sort | infectious diseases acquired by international travellers visiting the usa |
| topic | Science::Medicine International Travellers Infectious Diseases |
| url | https://hdl.handle.net/10356/139294 |
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