tetano
Editor, Senior Moderator
Travel Med Infect Dis. 2019 Nov 7:101504. doi: 10.1016/j.tmaid.2019.101504. [Epub ahead of print] [h=1]International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study.[/h]
Gautret P[SUP]1[/SUP], Angelo KM[SUP]2[/SUP], Asgeirsson H[SUP]3[/SUP], Duvignaud A[SUP]4[/SUP], van Genderen PJJ[SUP]5[/SUP], Bottieau E[SUP]6[/SUP], Chen LH[SUP]7[/SUP], Parker S[SUP]8[/SUP], Connor BA[SUP]9[/SUP], Barnett ED[SUP]10[/SUP], Libman M[SUP]11[/SUP], Hamer DH[SUP]12[/SUP]; GeoSentinel Network.
[h=3]Collaborators (41)[/h]
[h=3]Author information[/h] 1 Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France and HU-M?diterran?e Infection, Marseille, France. Electronic address: philippe.gautret@club-internet.fr. 2 Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, GA, USA. 3 Department of Infectious Diseases, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. 4 Department of Infectious Diseases and Tropical Medicine, Division of Tropical Medicine and Clinical International Health, CHU Bordeaux, Bordeaux, France. 5 Department of Medical Microbiology and Infectious Diseases, University Hospital Erasmus Medical Centre, Rotterdam, the Netherlands. 6 Institute of Tropical Medicine, Antwerp, Belgium. 7 Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital and Harvard Medical School, MA, USA. 8 Division of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa. 9 Weill Cornell Medical College, New York, USA; New York Center for Travel and Tropical Medicine, New York, USA. 10 Department of Pediatrics, Boston University School of Medicine, MA, USA. 11 J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Canada. 12 Department of Global Health, Boston University School of Public Health, MA, USA; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, MA, USA. 13 IHU M?diterran?e Infection, Marseille, France. 14 Division of Infectious Diseases & HIV Medicine - Groote Schuur Hospital, Cape Town, South Africa. 15 Clinic of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden. 16 Service des Maladies Infectieuses et Tropicales, H?pital Piti?-Salp?tri?re, Sorbonne Universit?, Paris, France. 17 Travellers' Health & Vaccine Center, Singapore. 18 HealthPartners Center for International Health - Regions Hospital, Minneapolis, MN, USA. 19 Centre for Travel and Tropical Medicine - Toronto General Hospital, Toronto, Canada. 20 Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia. 21 Vancouver General Hospital and Tropical Medicine Expert Group BC, Vancouver, Canada. 22 Sant?-Voyages et M?decine Tropicale, H?pital Saint-Andr?, Bordeaux, France. 23 Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland. 24 TravelSafe Medical Centre - Central Health Medical Practice, Hong Kong, China. 25 Kaiser Permanente Honolulu Clinic, Honolulu, HI, USA. 26 McGill University Centre for Tropical Diseases - Montreal General Hospital, Montreal, Canada. 27 Emory TravelWell Center, Atlanta, GA, USA. 28 Antiga Escola de Infermeria, Hospital Universitari Vall d'Hebron, Barcelona, Spain. 29 Travel Medicine Center, Mt. Auburn Hospital, Cambridge, MA, USA. 30 International Travel Clinic, Miami, FL, USA. 31 Travel Clinic - National Center for Global Health and Medicine, Toyko, Japan. 32 Department of Infectious Disease - Aarhus University Hospital, Aarhus, Denmark. 33 John Hopkins Univ. School of Medicine - Geographic Medicine Center - Division of Infectious Diseases, Baltimore, MD, USA. 34 Tropical Medicine Clinic - Jacobi Medical Center, Bronx, NY, USA. 35 Alberta Children's Hospital, Calgary, Canada. 36 Centro de Enfermedades - Tropicales y Salud del Viajero - Pontificia Universidad Cat?lica de Chile, Santiago, Chile. 37 University Medical Centre Hamburg Eppendorf, Department of Medicine, Division of Infectious Diseases and Tropical Medicine, Bernhard-Nocht-Kilinik, Hamburg, Germany. 38 Nairobi Hospital, Nairobi, Kenya. 39 Liverpool School of Tropical Medicine, Liverpool, United Kingdom. 40 Department of Infectious Diseases - Oslo University Hospital, Ullev?l, Oslo, Norway. 41 Travel Medicine & Emergency/Urgent Care - Palo Alto Medical Foundation, Palo Alto, CA, USA. 42 University of Z?rich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Zurich, Switzerland.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Travelers to international mass gatherings may be exposed to conditions which increase their risk of acquiring infectious diseases. Most existing data come from single clinical sites seeing returning travelers, or relate to single events.
[h=4]METHODS:[/h] Investigators evaluated ill travelers returning from a mass gathering, and presenting to a GeoSentinel site between August 2015 and April 2019, and collected data on the nature of the event and the relation between final diagnoses and the mass gathering.
[h=4]RESULTS:[/h] Of 296 ill travelers, 51% were female and the median age was 54 years (range: 1-88). Over 82% returned from a religious mass gathering, most frequently Umrah or Hajj. Only 3% returned from the Olympics in Brazil or South Korea. Other mass gatherings included other sporting events, cultural or entertainment events, and conferences. Respiratory diseases accounted for almost 80% of all diagnoses, with vaccine preventable illnesses such as influenza and pneumonia accounting for 26% and 20% of all diagnoses respectively. This was followed by gastrointestinal illnesses, accounting for 4.5%. Sixty-three percent of travelers reported having a pre-travel encounter with a healthcare provider.
[h=4]CONCLUSIONS:[/h] Despite this surveillance being limited to patients presenting to GeoSentinel sites, our findings highlight the importance of respiratory diseases at mass gatherings, the need for pre-travel consultations before mass gatherings, and consideration of vaccination against influenza and pneumococcal disease..
Copyright ? 2019. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Mass gatherings; Oylmpics; Respiratory; Surveillance
PMID: 31707112 DOI: 10.1016/j.tmaid.2019.101504
Gautret P[SUP]1[/SUP], Angelo KM[SUP]2[/SUP], Asgeirsson H[SUP]3[/SUP], Duvignaud A[SUP]4[/SUP], van Genderen PJJ[SUP]5[/SUP], Bottieau E[SUP]6[/SUP], Chen LH[SUP]7[/SUP], Parker S[SUP]8[/SUP], Connor BA[SUP]9[/SUP], Barnett ED[SUP]10[/SUP], Libman M[SUP]11[/SUP], Hamer DH[SUP]12[/SUP]; GeoSentinel Network.
[h=3]Collaborators (41)[/h]
[h=3]Author information[/h] 1 Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France and HU-M?diterran?e Infection, Marseille, France. Electronic address: philippe.gautret@club-internet.fr. 2 Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, GA, USA. 3 Department of Infectious Diseases, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. 4 Department of Infectious Diseases and Tropical Medicine, Division of Tropical Medicine and Clinical International Health, CHU Bordeaux, Bordeaux, France. 5 Department of Medical Microbiology and Infectious Diseases, University Hospital Erasmus Medical Centre, Rotterdam, the Netherlands. 6 Institute of Tropical Medicine, Antwerp, Belgium. 7 Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital and Harvard Medical School, MA, USA. 8 Division of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa. 9 Weill Cornell Medical College, New York, USA; New York Center for Travel and Tropical Medicine, New York, USA. 10 Department of Pediatrics, Boston University School of Medicine, MA, USA. 11 J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Canada. 12 Department of Global Health, Boston University School of Public Health, MA, USA; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, MA, USA. 13 IHU M?diterran?e Infection, Marseille, France. 14 Division of Infectious Diseases & HIV Medicine - Groote Schuur Hospital, Cape Town, South Africa. 15 Clinic of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden. 16 Service des Maladies Infectieuses et Tropicales, H?pital Piti?-Salp?tri?re, Sorbonne Universit?, Paris, France. 17 Travellers' Health & Vaccine Center, Singapore. 18 HealthPartners Center for International Health - Regions Hospital, Minneapolis, MN, USA. 19 Centre for Travel and Tropical Medicine - Toronto General Hospital, Toronto, Canada. 20 Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia. 21 Vancouver General Hospital and Tropical Medicine Expert Group BC, Vancouver, Canada. 22 Sant?-Voyages et M?decine Tropicale, H?pital Saint-Andr?, Bordeaux, France. 23 Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland. 24 TravelSafe Medical Centre - Central Health Medical Practice, Hong Kong, China. 25 Kaiser Permanente Honolulu Clinic, Honolulu, HI, USA. 26 McGill University Centre for Tropical Diseases - Montreal General Hospital, Montreal, Canada. 27 Emory TravelWell Center, Atlanta, GA, USA. 28 Antiga Escola de Infermeria, Hospital Universitari Vall d'Hebron, Barcelona, Spain. 29 Travel Medicine Center, Mt. Auburn Hospital, Cambridge, MA, USA. 30 International Travel Clinic, Miami, FL, USA. 31 Travel Clinic - National Center for Global Health and Medicine, Toyko, Japan. 32 Department of Infectious Disease - Aarhus University Hospital, Aarhus, Denmark. 33 John Hopkins Univ. School of Medicine - Geographic Medicine Center - Division of Infectious Diseases, Baltimore, MD, USA. 34 Tropical Medicine Clinic - Jacobi Medical Center, Bronx, NY, USA. 35 Alberta Children's Hospital, Calgary, Canada. 36 Centro de Enfermedades - Tropicales y Salud del Viajero - Pontificia Universidad Cat?lica de Chile, Santiago, Chile. 37 University Medical Centre Hamburg Eppendorf, Department of Medicine, Division of Infectious Diseases and Tropical Medicine, Bernhard-Nocht-Kilinik, Hamburg, Germany. 38 Nairobi Hospital, Nairobi, Kenya. 39 Liverpool School of Tropical Medicine, Liverpool, United Kingdom. 40 Department of Infectious Diseases - Oslo University Hospital, Ullev?l, Oslo, Norway. 41 Travel Medicine & Emergency/Urgent Care - Palo Alto Medical Foundation, Palo Alto, CA, USA. 42 University of Z?rich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Zurich, Switzerland.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Travelers to international mass gatherings may be exposed to conditions which increase their risk of acquiring infectious diseases. Most existing data come from single clinical sites seeing returning travelers, or relate to single events.
[h=4]METHODS:[/h] Investigators evaluated ill travelers returning from a mass gathering, and presenting to a GeoSentinel site between August 2015 and April 2019, and collected data on the nature of the event and the relation between final diagnoses and the mass gathering.
[h=4]RESULTS:[/h] Of 296 ill travelers, 51% were female and the median age was 54 years (range: 1-88). Over 82% returned from a religious mass gathering, most frequently Umrah or Hajj. Only 3% returned from the Olympics in Brazil or South Korea. Other mass gatherings included other sporting events, cultural or entertainment events, and conferences. Respiratory diseases accounted for almost 80% of all diagnoses, with vaccine preventable illnesses such as influenza and pneumonia accounting for 26% and 20% of all diagnoses respectively. This was followed by gastrointestinal illnesses, accounting for 4.5%. Sixty-three percent of travelers reported having a pre-travel encounter with a healthcare provider.
[h=4]CONCLUSIONS:[/h] Despite this surveillance being limited to patients presenting to GeoSentinel sites, our findings highlight the importance of respiratory diseases at mass gatherings, the need for pre-travel consultations before mass gatherings, and consideration of vaccination against influenza and pneumococcal disease..
Copyright ? 2019. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Mass gatherings; Oylmpics; Respiratory; Surveillance
PMID: 31707112 DOI: 10.1016/j.tmaid.2019.101504