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 - AUTHOR GROUP
AU - Kain, Kevin C.
AU - Gelman, Stephanie S.
AU - Ward, Brian
AU - Dick Maclean, J.
AU - Jean Haulman, N.
AU - Roesel, David
AU - Jong, Elaine C.
AU - Schwartz, Eli
AU - Stauffer, William M.
AU - Walker, Patricia F.
AU - Kozarsky, Phyllis E.
AU - Franco-Paredes, Carlos
AU - Pandey, Prativa
AU - Murphy, Holly
AU - Loutan, Louis
AU - Chappuis, François
AU - McCarthy, Anne
AU - Connor, Bradley A.
AU - Chen, Lin H.
AU - Wilson, Mary E.
AU - Lynch, Michael W.
AU - Licitra, Carmelo
AU - Crespo, Antonio
AU - Caumes, Eric
AU - Pérignon, Alice
AU - de Vries, Peter J.
AU - Gadroen, Kartini
AU - Nutman, Thomas B.
AU - Klion, Amy D.
AU - Hynes, Noreen
AU - Bradley Sack, R.
AU - McKenzie, Robin
AU - Field, Vanessa
AU - Gurtman, Alejandra
AU - Coyle, Christina M.
AU - Wittner, Murray
AU - Parola, Philippe
AU - Simon, Fabrice
AU - Delmont, Jean
PY - 2011
Y1 - 2011
N2 - 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. 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. 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. 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
AB - 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. 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. 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. 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
U2 - 10.1093/cid/cir468
DO - 10.1093/cid/cir468
M3 - Article
C2 - 21832261
SN - 1058-4838
VL - 53
SP - 523
EP - 531
JO - Clinical infectious diseases
JF - Clinical infectious diseases
IS - 6
ER -
SDG 3 Good Health and Well-being