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Infectious diseases acquired by international travelers visiting the United States
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8 01 2018
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Source: J Travel Med. 25(1)
[PDF-130.25 KB]
Details:
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Alternative Title:J Travel Med
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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 travelers to the United States.
Methods:
We performed a descriptive analysis summarizing demographic and travel characteristics, and clinical diagnoses among non-US-resident international travelers seen during or after travel to the United States at a GeoSentinel clinic from 1 January 1997 through 31 December 2016.
Results:
There were 1,222 ill non-US-resident travelers with 1,393 diagnoses recorded during the 20-year analysis period. Median age was 40 years (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%). Travelers presented with a range of illnesses; skin and soft tissue infections of unspecified etiology 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 travelers to the United States acquired a diverse array of mostly cosmopolitan infectious diseases, including nonspecific respiratory, gastrointestinal, dermatologic, and systemic infections comparable to what has been reported among travelers to low- and middle-income countries. Clinicians should consider the specific health risks when preparing visitors to the United States and when evaluating and treating those who become ill.
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Pubmed ID:30124885
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Pubmed Central ID:PMC6638561
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