Philippe Gautret1, Kristina M Angelo2, Hilmir Asgeirsson3, Alexandre Duvignaud4, Perry J J van Genderen5, Emmanuel Bottieau6, Lin H Chen7, Salim Parker8, Bradley A Connor9, Elizabeth D Barnett10, Michael Libman11, Davidson H Hamer12. 1. Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France and IHU-Méditerranée Infection, Marseille, France. Electronic address: philippe.gautret@ap-hm.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.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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