Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea: A cross-sectional study from the Geosentinel surveillance network: A cross-sectional study from the Geosentinel surveillance network

Andrea K. Boggild; Douglas H. Esposito; Phyllis E. Kozarsky; Verno Ansdell; Nicholas Beeching; Danie Campion; Francesc Castelli; Eri Caumes; Francoi Chappuis; Jakob P. Cramer; Effrossyn Gkrania-Klotsas; Martin P. Grobusch; Stefan H.F. Hagmann; Noreen A. Hynes; Po Lian Lim; Rogeli Lopez-Velez; Denis J.M. Malvy; Mar Mendelson; Philipp Parola; Mark J. Sotir; Henry M. Wu; Davidson H. Hamer; V. Field; M. D. Libman; C. Rothe; E. D. Barnett; E. Schwartz; P. Gautret; F. von Sonnenburg; P. van Genderen; M. Jensenius; W. M. Stauffer; F. Mockenhaupt; K. C. Kain; S. Kanagawa; C. M. Coyle; B. A. Connor; J. Ursing; K. Leder; J. Haulman; P. Schlagenhauf; J. Vincelette; A. McCarthy; P. Pandey; L. H. Chen; J. D. Cahill; C. Rapp; B. Kendall; David Lalloo; Y. Yoshimura

doi:10.7326/m15-0074

Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea: A cross-sectional study from the Geosentinel surveillance network: A cross-sectional study from the Geosentinel surveillance network

Andrea K. Boggild, Douglas H. Esposito, Phyllis E. Kozarsky, Verno Ansdell, Nicholas Beeching, Danie Campion, Francesc Castelli, Eri Caumes, Francoi Chappuis, Jakob P. Cramer, Effrossyn Gkrania-Klotsas, Martin P. Grobusch, Stefan H.F. Hagmann, Noreen A. Hynes, Po Lian Lim, Rogeli Lopez-Velez, Denis J.M. Malvy, Mar Mendelson, Philipp Parola, Mark J. SotirHenry M. Wu, Davidson H. Hamer, V. Field, M. D. Libman, C. Rothe, E. D. Barnett, E. Schwartz, P. Gautret, F. von Sonnenburg, P. van Genderen, M. Jensenius, W. M. Stauffer, F. Mockenhaupt, K. C. Kain, S. Kanagawa, C. M. Coyle, B. A. Connor, J. Ursing, K. Leder, J. Haulman, P. Schlagenhauf, J. Vincelette, A. McCarthy, P. Pandey, L. H. Chen, J. D. Cahill, C. Rapp, B. Kendall, David Lalloo, Y. Yoshimura

Clinical Sciences

Research output: Contribution to journal › Article › peer-review

38 Citations (Scopus)

Abstract

Background: The largest-ever outbreak of Ebola virus disease (EVD), ongoing in West Africa since late 2013, has led to export of cases to Europe and North America. Clinicians encountering ill travelers arriving from countries with widespread Ebola virus transmission must be aware of alternate diagnoses associated with fever and other nonspecific symptoms. Objective: To define the spectrum of illness observed in persons returning from areas of West Africa where EVD transmission has been widespread. Design: Descriptive, using GeoSentinel records. Setting: 57 travel or tropical medicine clinics in 25 countries. Patients: 805 ill returned travelers and new immigrants from Sierra Leone, Liberia, or Guinea seen between September 2009 and August 2014. Measurements: Frequencies of demographic and travelrelated characteristics and illnesses reported. Results: The most common specific diagnosis among 770 nonimmigrant travelers was malaria (n = 310 [40.3%]), with Plasmodium falciparum or severe malaria in 267 (86%) and non-P. falciparum malaria in 43 (14%). Acute diarrhea was the second most common diagnosis among nonimmigrant travelers (n= 95 [12.3%]). Such common diagnoses as upper respiratory tract infection, urinary tract infection, and influenza-like illness occurred in only 26, 9, and 7 returning travelers, respectively. Few instances of typhoid fever (n = 8), acute HIV infection (n = 5), and dengue (n = 2) were encountered.

Original language	English
Pages (from-to)	757-764
Number of pages	8
Journal	Annals of Internal Medicine
Volume	162
Issue number	11
DOIs	https://doi.org/10.7326/m15-0074
Publication status	Published - 2 Jun 2015

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Boggild, A. K., Esposito, D. H., Kozarsky, P. E., Ansdell, V., Beeching, N., Campion, D., Castelli, F., Caumes, E., Chappuis, F., Cramer, J. P., Gkrania-Klotsas, E., Grobusch, M. P., Hagmann, S. H. F., Hynes, N. A., Lian Lim, P., Lopez-Velez, R., Malvy, D. J. M., Mendelson, M., Parola, P., ... Yoshimura, Y. (2015). Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea: A cross-sectional study from the Geosentinel surveillance network: A cross-sectional study from the Geosentinel surveillance network. Annals of Internal Medicine, 162(11), 757-764. https://doi.org/10.7326/m15-0074

Boggild, Andrea K. ; Esposito, Douglas H. ; Kozarsky, Phyllis E. et al. / Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea: A cross-sectional study from the Geosentinel surveillance network: A cross-sectional study from the Geosentinel surveillance network. In: Annals of Internal Medicine. 2015 ; Vol. 162, No. 11. pp. 757-764.

@article{b11e475fac784921ba2c8785579f45da,

title = "Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea: A cross-sectional study from the Geosentinel surveillance network: A cross-sectional study from the Geosentinel surveillance network",

abstract = "Background: The largest-ever outbreak of Ebola virus disease (EVD), ongoing in West Africa since late 2013, has led to export of cases to Europe and North America. Clinicians encountering ill travelers arriving from countries with widespread Ebola virus transmission must be aware of alternate diagnoses associated with fever and other nonspecific symptoms. Objective: To define the spectrum of illness observed in persons returning from areas of West Africa where EVD transmission has been widespread. Design: Descriptive, using GeoSentinel records. Setting: 57 travel or tropical medicine clinics in 25 countries. Patients: 805 ill returned travelers and new immigrants from Sierra Leone, Liberia, or Guinea seen between September 2009 and August 2014. Measurements: Frequencies of demographic and travelrelated characteristics and illnesses reported. Results: The most common specific diagnosis among 770 nonimmigrant travelers was malaria (n = 310 [40.3\%]), with Plasmodium falciparum or severe malaria in 267 (86\%) and non-P. falciparum malaria in 43 (14\%). Acute diarrhea was the second most common diagnosis among nonimmigrant travelers (n= 95 [12.3\%]). Such common diagnoses as upper respiratory tract infection, urinary tract infection, and influenza-like illness occurred in only 26, 9, and 7 returning travelers, respectively. Few instances of typhoid fever (n = 8), acute HIV infection (n = 5), and dengue (n = 2) were encountered.",

author = "Boggild, \{Andrea K.\} and Esposito, \{Douglas H.\} and Kozarsky, \{Phyllis E.\} and Verno Ansdell and Nicholas Beeching and Danie Campion and Francesc Castelli and Eri Caumes and Francoi Chappuis and Cramer, \{Jakob P.\} and Effrossyn Gkrania-Klotsas and Grobusch, \{Martin P.\} and Hagmann, \{Stefan H.F.\} and Hynes, \{Noreen A.\} and \{Lian Lim\}, Po and Rogeli Lopez-Velez and Malvy, \{Denis J.M.\} and Mar Mendelson and Philipp Parola and Sotir, \{Mark J.\} and Wu, \{Henry M.\} and Hamer, \{Davidson H.\} and V. Field and Libman, \{M. D.\} and C. Rothe and Barnett, \{E. D.\} and E. Schwartz and P. Gautret and \{von Sonnenburg\}, F. and \{van Genderen\}, P. and M. Jensenius and Stauffer, \{W. M.\} and F. Mockenhaupt and Kain, \{K. C.\} and S. Kanagawa and Coyle, \{C. M.\} and Connor, \{B. A.\} and J. Ursing and K. Leder and J. Haulman and P. Schlagenhauf and J. Vincelette and A. McCarthy and P. Pandey and Chen, \{L. H.\} and Cahill, \{J. D.\} and C. Rapp and B. Kendall and David Lalloo and Y. Yoshimura",

year = "2015",

month = jun,

day = "2",

doi = "10.7326/m15-0074",

language = "English",

volume = "162",

pages = "757--764",

journal = "Annals of Internal Medicine",

issn = "0003-4819",

publisher = "American College of Physicians",

number = "11",

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Boggild, AK, Esposito, DH, Kozarsky, PE, Ansdell, V, Beeching, N, Campion, D, Castelli, F, Caumes, E, Chappuis, F, Cramer, JP, Gkrania-Klotsas, E, Grobusch, MP, Hagmann, SHF, Hynes, NA, Lian Lim, P, Lopez-Velez, R, Malvy, DJM, Mendelson, M, Parola, P, Sotir, MJ, Wu, HM, Hamer, DH, Field, V, Libman, MD, Rothe, C, Barnett, ED, Schwartz, E, Gautret, P, von Sonnenburg, F, van Genderen, P, Jensenius, M, Stauffer, WM, Mockenhaupt, F, Kain, KC, Kanagawa, S, Coyle, CM, Connor, BA, Ursing, J, Leder, K, Haulman, J, Schlagenhauf, P, Vincelette, J, McCarthy, A, Pandey, P, Chen, LH, Cahill, JD, Rapp, C, Kendall, B, Lalloo, D & Yoshimura, Y 2015, 'Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea: A cross-sectional study from the Geosentinel surveillance network: A cross-sectional study from the Geosentinel surveillance network', Annals of Internal Medicine, vol. 162, no. 11, pp. 757-764. https://doi.org/10.7326/m15-0074

Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea: A cross-sectional study from the Geosentinel surveillance network: A cross-sectional study from the Geosentinel surveillance network. / Boggild, Andrea K.; Esposito, Douglas H.; Kozarsky, Phyllis E. et al.
In: Annals of Internal Medicine, Vol. 162, No. 11, 02.06.2015, p. 757-764.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea: A cross-sectional study from the Geosentinel surveillance network: A cross-sectional study from the Geosentinel surveillance network

AU - Boggild, Andrea K.

AU - Esposito, Douglas H.

AU - Kozarsky, Phyllis E.

AU - Ansdell, Verno

AU - Beeching, Nicholas

AU - Campion, Danie

AU - Castelli, Francesc

AU - Caumes, Eri

AU - Chappuis, Francoi

AU - Cramer, Jakob P.

AU - Gkrania-Klotsas, Effrossyn

AU - Grobusch, Martin P.

AU - Hagmann, Stefan H.F.

AU - Hynes, Noreen A.

AU - Lian Lim, Po

AU - Lopez-Velez, Rogeli

AU - Malvy, Denis J.M.

AU - Mendelson, Mar

AU - Parola, Philipp

AU - Sotir, Mark J.

AU - Wu, Henry M.

AU - Hamer, Davidson H.

AU - Field, V.

AU - Libman, M. D.

AU - Rothe, C.

AU - Barnett, E. D.

AU - Schwartz, E.

AU - Gautret, P.

AU - von Sonnenburg, F.

AU - van Genderen, P.

AU - Jensenius, M.

AU - Stauffer, W. M.

AU - Mockenhaupt, F.

AU - Kain, K. C.

AU - Kanagawa, S.

AU - Coyle, C. M.

AU - Connor, B. A.

AU - Ursing, J.

AU - Leder, K.

AU - Haulman, J.

AU - Schlagenhauf, P.

AU - Vincelette, J.

AU - McCarthy, A.

AU - Pandey, P.

AU - Chen, L. H.

AU - Cahill, J. D.

AU - Rapp, C.

AU - Kendall, B.

AU - Lalloo, David

AU - Yoshimura, Y.

PY - 2015/6/2

Y1 - 2015/6/2

N2 - Background: The largest-ever outbreak of Ebola virus disease (EVD), ongoing in West Africa since late 2013, has led to export of cases to Europe and North America. Clinicians encountering ill travelers arriving from countries with widespread Ebola virus transmission must be aware of alternate diagnoses associated with fever and other nonspecific symptoms. Objective: To define the spectrum of illness observed in persons returning from areas of West Africa where EVD transmission has been widespread. Design: Descriptive, using GeoSentinel records. Setting: 57 travel or tropical medicine clinics in 25 countries. Patients: 805 ill returned travelers and new immigrants from Sierra Leone, Liberia, or Guinea seen between September 2009 and August 2014. Measurements: Frequencies of demographic and travelrelated characteristics and illnesses reported. Results: The most common specific diagnosis among 770 nonimmigrant travelers was malaria (n = 310 [40.3%]), with Plasmodium falciparum or severe malaria in 267 (86%) and non-P. falciparum malaria in 43 (14%). Acute diarrhea was the second most common diagnosis among nonimmigrant travelers (n= 95 [12.3%]). Such common diagnoses as upper respiratory tract infection, urinary tract infection, and influenza-like illness occurred in only 26, 9, and 7 returning travelers, respectively. Few instances of typhoid fever (n = 8), acute HIV infection (n = 5), and dengue (n = 2) were encountered.

AB - Background: The largest-ever outbreak of Ebola virus disease (EVD), ongoing in West Africa since late 2013, has led to export of cases to Europe and North America. Clinicians encountering ill travelers arriving from countries with widespread Ebola virus transmission must be aware of alternate diagnoses associated with fever and other nonspecific symptoms. Objective: To define the spectrum of illness observed in persons returning from areas of West Africa where EVD transmission has been widespread. Design: Descriptive, using GeoSentinel records. Setting: 57 travel or tropical medicine clinics in 25 countries. Patients: 805 ill returned travelers and new immigrants from Sierra Leone, Liberia, or Guinea seen between September 2009 and August 2014. Measurements: Frequencies of demographic and travelrelated characteristics and illnesses reported. Results: The most common specific diagnosis among 770 nonimmigrant travelers was malaria (n = 310 [40.3%]), with Plasmodium falciparum or severe malaria in 267 (86%) and non-P. falciparum malaria in 43 (14%). Acute diarrhea was the second most common diagnosis among nonimmigrant travelers (n= 95 [12.3%]). Such common diagnoses as upper respiratory tract infection, urinary tract infection, and influenza-like illness occurred in only 26, 9, and 7 returning travelers, respectively. Few instances of typhoid fever (n = 8), acute HIV infection (n = 5), and dengue (n = 2) were encountered.

U2 - 10.7326/m15-0074

DO - 10.7326/m15-0074

M3 - Article

SN - 0003-4819

VL - 162

SP - 757

EP - 764

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

IS - 11

ER -

Boggild AK, Esposito DH, Kozarsky PE, Ansdell V, Beeching N, Campion D et al. Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea: A cross-sectional study from the Geosentinel surveillance network: A cross-sectional study from the Geosentinel surveillance network. Annals of Internal Medicine. 2015 Jun 2;162(11):757-764. doi: 10.7326/m15-0074