背景:登革热是国际旅行者中高热疾病的主要原因。我们旨在描述2007-2022年在GeoSentinel站点评估的返回旅行者中进口登革热的流行病学和临床特征。
方法:我们检索了居住在非流行国家的旅行者中的GeoSentinel登革热记录。我们认为,当通过DENV特异性RT-PCR阳性诊断时,登革热得到证实,NS-1抗原阳性,和/或抗DENVIgG血清转化,通过单一抗DENVIgM或高滴度抗DENVIgG检测诊断时可能。严重登革热被定义为临床上显著的血浆渗漏或出血的证据。器官衰竭,或震惊,根据2009年世卫组织指南。复杂登革热定义为严重登革热或存在任何警告标志的登革热。分析是描述性的。
结果:该分析包括5958名确诊(n=4859;81.6%)或可能(n=1099;18.4%)登革热的旅行者。中位年龄为33岁(范围:<1-91);3007名(50.5%)旅行者为女性。中位旅行时间为21天(四分位距[IQR]:15-32)。发病与GeoSentinel实地考察之间的中位时间为7天(IQR:4-15)。旅行最常见的原因是旅游(67.3%),拜访亲朋好友(12.2%),和业务(11.0%)。收购最频繁的地区是东南亚(50.4%),中南亚(14.9%),加勒比海地区(10.9%),和南美洲(9.2%)。95名(1.6%)旅客患有复杂的登革热,其中27人(0.5%)患有严重登革热,一个人死了.在2710名有数据的旅行者中,724例(26.7%)住院。2019年报告的病例数量最多(n=835)。
结论:广泛的国际旅行者应意识到患登革热的风险,并接受有关预防措施的适当旅行前咨询。需要进行前瞻性队列研究,以进一步阐明目的地和随时间推移的登革热风险,以及旅行相关登革热导致的严重结局和长期发病率(长期登革热)。
BACKGROUND: Dengue is a leading cause of febrile illness among international travellers. We aimed to describe the epidemiology and clinical characteristics of imported dengue in returning travellers evaluated at GeoSentinel sites from 2007-2022.
METHODS: We retrieved GeoSentinel records of
dengue among travellers residing in non-endemic countries. We considered dengue confirmed when diagnosed by a positive DENV-specific RT-PCR, positive NS-1 antigen, and/or anti-DENV IgG seroconversion, and probable when diagnosed by single anti-DENV IgM or high titre anti-DENV IgG detection. Severe dengue was defined as evidence of clinically significant plasma leakage or bleeding, organ failure, or shock, according to the 2009 WHO guidance. Complicated
dengue was defined as either severe
dengue or
dengue with presence of any warning sign. Analyses were descriptive.
RESULTS: This analysis included 5958 travellers with confirmed (n = 4859; 81.6%) or probable (n = 1099; 18.4%) dengue. The median age was 33 years (range: < 1-91); 3007 (50.5%) travellers were female. The median travel duration was 21 days (interquartile range [IQR]: 15-32). The median time between illness onset and GeoSentinel site visit was 7 days (IQR: 4-15). The most frequent reasons for travel were tourism (67.3%), visiting friends or relatives (12.2%), and business (11.0%). The most frequent regions of acquisition were Southeast Asia (50.4%), South-Central Asia (14.9%), the Caribbean (10.9%), and South America (9.2%). Ninety-five (1.6%) travellers had complicated
dengue, of whom 27 (0.5%) had severe
dengue, and one died. Of 2710 travellers with data available, 724 (26.7%) were hospitalized. The largest number of cases (n = 835) was reported in 2019.
CONCLUSIONS: A broad range of international travellers should be aware of the risk of acquiring dengue and receive appropriate pretravel counselling regarding preventive measures. Prospective cohort studies are needed to further elucidate dengue risk by destination and over time, as well as severe outcomes and prolonged morbidity (long-
dengue) due to travel-related
dengue.