Regional variation in travel-related illness acquired in Africa, March 1997-May 2011

• Authors: Marc Mendelson, University of Cape Town; Pauline V. Han, Centers for Disease Control and Prevention; Peter Vincent, Tokai Medicross Travel Clinic; Frank von Sonnenburg, University of Munich; Jakob P. Cramer, Universitatsklinikum Hamburg-Eppendorf und Medizinische Fakultat; Louis Loutan, University of Geneva; Kevin C. Kain, University of Toronto; Philippe Parola, North University Hospital; Stefan Hagmann, Bronx-Lebanon Hospital Center; Effrossyni Gkrania-Klotsas, National Health Service; Mark Sotir, Centers for Disease Control and Prevention; Patricia Schlagenhauf, University of Zurich; Phyllis E Kozarsky, Emory University; Of The Members, GeoSentinel Surveillance Network
• Journal Title: Emerging Infectious Disease
• Volume: Volume 20, Number 4
• Publisher: Centers for Disease Control and Prevention | 2014-01-01, Pages 532-541
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.3201/eid2004.131128
• Subjects: Health Sciences, Public Health; Health Sciences, Epidemiology
• Keywords: Africa; HIV; bacteria; dengue; diarrhea; endemic; enteric; falciparum; helminth; malaria; malariae; ovale; parasites; plasmodium; podcast; rabies; respiratory; schistosomiasis; strongyloidiasis; travel; tuberculosis and other mycobacteria; vaccine; vector; vector-borne infections; viruses; vivax; zoonoses; Africa; Communicable Diseases; Female; Humans; Male; Middle Aged; Travel

Abstract

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.