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Clin Infect Dis. 2014 May;58(10):1347-56. doi: 10.1093/cid/ciu122. Epub 2014 Feb 28.

Illness in travelers returned from Brazil: the GeoSentinel experience and implications for the 2014 FIFA World Cup and the 2016 Summer Olympics.

Collaborators (306)

Burchard GD, Anand R, Gelman SS, Kain K, Boggild A, Perret C, Valdivieso F, Loutan L, Chappuis F, Schlagenhauf P, Weber R, Steffen R, Caumes E, Pérignon A, Libman MD, Ward B, Maclean JD, Grobusch MC, Goorhuis A, de Vries P, Gadroen K, Mockenhaupt F, Harms G, Parola P, Simon F, Delmont J, Carosi G, Castelli F, Connor BA, Kozarsky PE, Wu H, Fairley J, Franco-Paredes C, Using J, Fröberg G, Askling HH, Bronner U, Haulman NJ, Roesel D, Jong EC, López-Vélez R, Perez Molina JA, Torresi J, Brown G, Licitra C, Crespo A, McCarthy A, Field V, Cahill JD, McKinley G, van Genderen PJ, Gkrania-Klotsas E, Stauffer WM, Walker PF, Kanagawa S, Kato Y, Mizunno Y, Shaw M, Hern A, Vincelette J, Freedman DO, Anderson S, Hynes N, Sack RB, McKenzie R, Nutman TB, Klion AD, Rapp C, Aoun O, Doyle P, Ghesquiere W, Valdez LM, Siu H, Tachikawa N, Kurai H, Sagara H, Lalloo DG, Beeching NJ, Gurtman A, McLellan S, Barnett ED, Hagmann S, Henry M, Miller AO, Mendelson M, Vincent P, Lynch MW, Hoang Phu PT, Anderson N, Batchelor T, Meisch D, Yates J, Ansdell V, Pandey P, Pradhan R, Murphy H, Basto F, Abreu C, Orduna T, Watson A, Forde AM, Koeck T, Buzzolini T, Mills D, Quarry D, Kenafake J, Douglas A, Streeton C, Matchett L, Foong L, Haditsch M, Kollaritsch H, van Gompel A, Van Laethem Y, Callens S, Alves J, Rocha J, Mayhew WJ, Meatherall B, Vaughan S, Devraj-kizuk R, Siemens R, Cherniwchan DP, Mistry D, MacDonald SC, Plourde P, Owsianik WD, Baran G, Dixon H, McKee R, Lingley M, Gamble K, Whitsitt P, Geduld J, Kazemi M, Teitelbaum P, Abdulla A, Schell L, Wittes RC, Cyr L, Hii JH, Lam R, Husain A, Cooke R, Billick K, Boisvert C, Lavoie N, Dumontet C, Lavoie H, Diener T, Rodriguez-Morales AJ, Nikolic N, Buhl M, Petersen E, Magnussen P, Larson CS, Kantele A, Siikamäki H, Rummukainen M, Bouchaud O, Mechain M, Rouen JP, Steiner F, Zanger P, D'Almeida R, Gerolymatos KG, Pavli A, Cheng M, Simon J, Wong CK, Felkai P, Collins S, Borenstein A, Odolini S, Foti F, Kimura M, Kurosu J, Takeshita N, Koga T, Sakai MN, Nesbitt S, Vrij-Mazee H, Partridge Y, Ingram JH, Visser J, Celis-Salinas JC, de lou Saulog V, Varandas L, Fonseca AG, Pombal R, Basto F, Florescu SA, Popescu CP, Erovichenkov A, Dobrodenkova S, Kotar T, Perez-Arellano JL, Rombo L, Meurling S, Luchinger PA, Poumerol G, Balestra S, Gerber F, Landry P, Gammeter H, Schmid S, Smit Y, Kedward M, Thomas MJ, Ellis M, Bryceson A, Miller AR, Dawood R, Zuckerman J, Cave W, Ross J, Townend M, Kassianos G, Genasi F, Harris S, Klecka E, Krotzer SS, Dover A, Wai SA, Tran LD, Grassman L, Jacobson S, Lynch MW, Fink R, Sommer S, Goad J, Johnson RO, Lehrhoff H, Petrie A, Petrie L, Spees DN, Nguyen PT, Habis J, Barry M, Harte J, Sperry C, Hammer J, Nash E, Dardick K, Smith K, Beaulieu N, Leshem E, Phillips B, Goodale R, Allen JE, Lee J, Roque D, Trauscht A, Jones JG, Mclellan SL, Seybolt L, Sauri M, Riddle F, Hamer D, Ooi W, Butler EP, Bank LM, Bacaner N, Zents JH, Anglim A, King T, Galle R, Natarajan U, Barnish M, Olmstead F, Bunnell L, Chapnick E, Neumann K, Wittner M, Acosta AM, Johnson S, Kalish S, Narula R, Oran B, Primas RA, Wynne S, Lee RV, Ritz H, Brieff D, Leach RP, Blair DC, Hall J, Hall S, Rhodes CW, Siraj D, Mawhorter SD, Czachor JS, Mull J, Daya M, Gardner A, Knouse MC, Sfedu E, Urevick P, Neuburger K, Hall J, Stocks S, Benson LS, Magill AJ, Smith RL, Lambe M, Galka TJ.

Author information

1
Global Health and Population, Harvard School of Public Health, Boston.

Abstract

BACKGROUND:

Brazil will host the 2014 FIFA World Cup and the 2016 Olympic and Paralympic Games, events that are expected to attract hundreds of thousands of international travelers. Travelers to Brazil will encounter locally endemic infections as well as mass event-specific risks.

METHODS:

We describe 1586 ill returned travelers who had visited Brazil and were seen at a GeoSentinel Clinic from July 1997 through May 2013.

RESULTS:

The most common travel-related illnesses were dermatologic conditions (40%), diarrheal syndromes (25%), and febrile systemic illness (19%). The most common specific dermatologic diagnoses were cutaneous larva migrans, myiasis, and tungiasis. Dengue and malaria, predominantly Plasmodium vivax, were the most frequently identified specific causes of fever and the most common reasons for hospitalization after travel. Dengue fever diagnoses displayed marked seasonality, although cases were seen throughout the year. Among the 28 ill returned travelers with human immunodeficiency virus (HIV) infection, 11 had newly diagnosed asymptomatic infection and 9 had acute symptomatic HIV.

CONCLUSIONS:

Our analysis primarily identified infectious diseases among travelers to Brazil. Knowledge of illness in travelers returning from Brazil can assist clinicians to advise prospective travelers and guide pretravel preparation, including itinerary-tailored advice, vaccines, and chemoprophylaxis; it can also help to focus posttravel evaluation of ill returned travelers. Travelers planning to attend mass events will encounter other risks that are not captured in our surveillance network.

KEYWORDS:

Brazil; dengue; dermatologic; mass gatherings; travelers

PMID:
24585698
DOI:
10.1093/cid/ciu122
[Indexed for MEDLINE]
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