Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea

A cross-sectional study from the Geosentinel surveillance network

GeoSentinel Surveillance Network

Research output: Contribution to journalArticle

23 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 languageEnglish (US)
Pages (from-to)757-764
Number of pages8
JournalAnnals of internal medicine
Volume162
Issue number11
DOIs
StatePublished - Jun 2 2015
Externally publishedYes

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Liberia
Sierra Leone
Guinea
Ebola Hemorrhagic Fever
Differential Diagnosis
Cross-Sectional Studies
Western Africa
Malaria
Travel Medicine
Ebolavirus
Tropical Medicine
Dengue
Falciparum Malaria
Typhoid Fever
Plasmodium falciparum
North America
Urinary Tract Infections
Respiratory Tract Infections
Human Influenza
HIV Infections

ASJC Scopus subject areas

  • Internal Medicine

Cite this

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

In: Annals of internal medicine, Vol. 162, No. 11, 02.06.2015, p. 757-764.

Research output: Contribution to journalArticle

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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 = "{GeoSentinel Surveillance Network} and Boggild, {Andrea K.} and Esposito, {Douglas H.} and Kozarsky, {Phyllis E.} and Verno Ansdell and Beeching, {Nicholas J.} 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, {Christina 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 D. Lalloo and Y. Yoshimura",
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T1 - Differential diagnosis of illness in travelers arriving from sierra Leone, Liberia, or guinea

T2 - A cross-sectional study from the Geosentinel surveillance network

AU - GeoSentinel Surveillance Network

AU - Boggild, Andrea K.

AU - Esposito, Douglas H.

AU - Kozarsky, Phyllis E.

AU - Ansdell, Verno

AU - Beeching, Nicholas J.

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, Christina 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, D.

AU - Yoshimura, Y.

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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.

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DO - 10.7326/M15-0074

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JF - Annals of Internal Medicine

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