Department of Infectious Diseases and Tropical Medicine, Division of Tropical Medicine and Clinical International Health, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France.
Global Health in the Global South - University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219 - Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France.
J Travel Med. 2024 Oct 19;31(7). doi: 10.1093/jtm/taae089.
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 to 2022.
We retrieved GeoSentinel records of dengue among travellers residing in non-endemic countries. We considered dengue confirmed when diagnosed by a positive dengue virus (DENV)-specific reverse-transcriptase polymerase chain reaction, 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 World Health Organization guidance. Complicated dengue was defined as either severe dengue or dengue with presence of any warning sign. Analyses were descriptive.
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 South East 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.
A broad range of international travellers should be aware of the risk of acquiring dengue and receive appropriate pre-travel 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.
登革热是国际旅行者发热疾病的主要原因。我们旨在描述 2007 年至 2022 年期间在 GeoSentinel 站点评估的返回旅行者中输入性登革热的流行病学和临床特征。
我们检索了居住在非流行国家的旅行者中 GeoSentinel 记录的登革热。当通过阳性登革热病毒 (DENV)-特异性逆转录酶聚合酶链反应、阳性 NS-1 抗原和/或抗 DENV IgG 血清转化来诊断时，我们认为登革热得到了确认，当通过单份抗 DENV IgM 或高滴度抗 DENV IgG 检测来诊断时，我们认为是可能的。根据 2009 年世界卫生组织的指导，严重登革热被定义为有临床意义的血浆渗漏或出血、器官衰竭或休克的证据。复杂登革热被定义为严重登革热或有任何警告信号的登革热。分析是描述性的。
本分析包括 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）。从发病到 GeoSentinel 就诊的中位时间为 7 天（IQR：4-15）。旅行的最常见原因是旅游（67.3%）、探亲访友（12.2%）和商务（11.0%）。最常发生的感染地区是东南亚（50.4%）、中南亚（14.9%）、加勒比地区（10.9%）和南美洲（9.2%）。95 名（1.6%）旅行者患有复杂登革热，其中 27 名（0.5%）患有严重登革热，1 名死亡。在可获得数据的 2710 名旅行者中，有 724 名（26.7%）住院。2019 年报告的病例数最多（n = 835）。
应让广泛的国际旅行者意识到感染登革热的风险，并就预防措施接受适当的旅行前咨询。需要前瞻性队列研究来进一步阐明按目的地和随时间推移的登革热风险，以及因旅行相关登革热导致的严重后果和延长的发病率（长登革热）。
