The Role of the Traveler in Emerging Infections and Magnitude of Travel

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Abstract

Travel and trade have grown immensely. Travelers interact with people and microbes during their journeys, and can introduce infectious agents to new areas and populations. Studying illnesses in travelers is a source of knowledge into diseases of resource-poor regions and the control of these diseases. Travel-associated illnesses also serve to detect emerging infections.

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Most cited references 82

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The detection of monkeypox in humans in the Western Hemisphere.

Kurt Reed, John Melski, Mary Graham … (2004)

During May and June 2003, an outbreak of febrile illness with vesiculopustular eruptions occurred among persons in the midwestern United States who had had contact with ill pet prairie dogs obtained through a common distributor. Zoonotic transmission of a bacterial or viral pathogen was suspected. We reviewed medical records, conducted interviews and examinations, and collected blood and tissue samples for analysis from 11 patients and one prairie dog. Histopathological and electron-microscopical examinations, microbiologic cultures, and molecular assays were performed to identify the etiologic agent. The initial Wisconsin cases evaluated in this outbreak occurred in five males and six females ranging in age from 3 to 43 years. All patients reported having direct contact with ill prairie dogs before experiencing a febrile illness with skin eruptions. We found immunohistochemical or ultrastructural evidence of poxvirus infection in skin-lesion tissue from four patients. Monkeypox virus was recovered in cell cultures of seven samples from patients and from the prairie dog. The virus was identified by detection of monkeypox-specific DNA sequences in tissues or isolates from six patients and the prairie dog. Epidemiologic investigation suggested that the prairie dogs had been exposed to at least one species of rodent recently imported into the United States from West Africa. Our investigation documents the isolation and identification of monkeypox virus from humans in the Western Hemisphere. Infection of humans was associated with direct contact with ill prairie dogs that were being kept or sold as pets. Copyright 2004 Massachusetts Medical Society

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Spectrum of disease and relation to place of exposure among ill returned travelers.

David O Freedman, Leisa Weld, Phyllis E. Kozarsky … (2006)

Approximately 8 percent of travelers to the developing world require medical care during or after travel. Current understanding of morbidity profiles among ill returned travelers is based on limited data from the 1980s. Thirty GeoSentinel sites, which are specialized travel or tropical-medicine clinics on six continents, contributed clinician-based sentinel surveillance data for 17,353 ill returned travelers. We compared the frequency of occurrence of each diagnosis among travelers returning from six developing regions of the world. Significant regional differences in proportionate morbidity were detected in 16 of 21 broad syndromic categories. Among travelers presenting to GeoSentinel sites, systemic febrile illness without localizing findings occurred disproportionately among those returning from sub-Saharan Africa or Southeast Asia, acute diarrhea among those returning from south central Asia, and dermatologic problems among those returning from the Caribbean or Central or South America. With respect to specific diagnoses, malaria was one of the three most frequent causes of systemic febrile illness among travelers from every region, although travelers from every region except sub-Saharan Africa and Central America had confirmed or probable dengue more frequently than malaria. Among travelers returning from sub-Saharan Africa, rickettsial infection, primarily tick-borne spotted fever, occurred more frequently than typhoid or dengue. Travelers from all regions except Southeast Asia presented with parasite-induced diarrhea more often than with bacterial diarrhea. When patients present to specialized clinics after travel to the developing world, travel destinations are associated with the probability of the diagnosis of certain diseases. Diagnostic approaches and empiric therapies can be guided by these destination-specific differences. Copyright 2006 Massachusetts Medical Society.

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Transmission of infectious diseases during commercial air travel

Alexandra Mangili, Mark Gendreau (2005)

Summary Because of the increasing ease and affordability of air travel and mobility of people, airborne, food-borne, vector-borne, and zoonotic infectious diseases transmitted during commercial air travel are an important public health issue. Heightened fear of bioterrorism agents has caused health officials to re-examine the potential of these agents to be spread by air travel. The severe acute respiratory syndrome outbreak of 2002 showed how air travel can have an important role in the rapid spread of newly emerging infections and could potentially even start pandemics. In addition to the flight crew, public health officials and health care professionals have an important role in the management of infectious diseases transmitted on airlines and should be familiar with guidelines provided by local and international authorities.

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Author and article information

Contributors

Lin H. Chen

Journal

Journal ID (nlm-ta): Med Clin North Am

Journal ID (iso-abbrev): Med. Clin. North Am

Title: The Medical Clinics of North America

Publisher: W B Saunders

ISSN (Print): 0025-7125

ISSN (Electronic): 1557-9859

Publication date PMC-release: 6 November 2008

Publication date (Print): November 2008

Publication date (Electronic): 6 November 2008

Volume: 92

Issue: 6

Pages: 1409-1432

Affiliations

[a ]Travel Medicine Center, Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02238, USA

[b ]Harvard Medical School and Harvard School of Public Health, Boston, MA, USA

Author notes

[∗ ]Corresponding author. lchen@ 123456hms.harvard.edu

Article

Publisher ID: S0025-7125(08)00095-3

DOI: 10.1016/j.mcna.2008.07.005

PMC ID: 7094659

PubMed ID: 19061759

SO-VID: 75e3c99a-8ea7-4581-a537-8b9e759e2267

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Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

The Role of the Traveler in Emerging Infections and Magnitude of Travel

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Most cited references 82

The detection of monkeypox in humans in the Western Hemisphere.

Spectrum of disease and relation to place of exposure among ill returned travelers.

Transmission of infectious diseases during commercial air travel

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