Browsing by Author "Connor, Bradley A."

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    Characteristics and spectrum of disease among ill returned travelers from pre- and post-earthquake Haiti: The geosentinel experience
    (2012) Esposito, Douglas H.; Han, Pauline V.; Kozarsky, Phyllis E.; Walker, Patricia F.; Patricia F. Walker,; Gkrania-Klotsas, Effrossyni; Barnett, Elizabeth D.; Libman, Michael; McCarthy, Anne E.; Field, Vanessa; Connor, Bradley A.; Schwartz, Eli; MacDonald, Susan; Sotir, Mark J.; Perret Pérez. Cecilia; GeoSentinel Surveillance Network
    To describe patient characteristics and disease spectrum among foreign visitors to Haiti before and after the 2010 earthquake, we used GeoSentinel Global Surveillance Network data and compared 1 year post-earthquake versus 3 years pre-earthquake. Post-earthquake travelers were younger, predominantly from the United States, more frequently international assistance workers, and more often medically counseled before their trip than pre-earthquake travelers. Work-related stress and upper respiratory tract infections were more frequent post-earthquake; acute diarrhea, dengue, and Plasmodium falciparum malaria were important contributors of morbidity both pre- and post-earthquake. These data highlight the importance of providing destination- and disaster-specific pre-travel counseling and post-travel evaluation and medical management to persons traveling to or returning from a disaster location, and evaluations should include attention to the psychological wellbeing of these travelers. For travel to Haiti, focus should be on mosquito-borne illnesses (dengue and P. falciparum malaria) and travelers' diarrhea.
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    Intestinal protozoa in returning travellers: a GeoSentinel analysis from 2007 to 2019
    (2024) Weitzel, Thomas; Brown, Ashley; Libman, Michael; Perret, Cecilia; Huits, Ralph; Chen, Lin; Leung, Daniel T.; Leder, Karin; Connor, Bradley A.; Menendez, Marta D.; Asgeirsson, Hilmir; Schwartz, Eli; Salvador, Fernando; Malvy, Denis; Saio, Mauro; Norman, Francesca F.; Amatya, Bhawana; Duvignaud, Alexandre; Vaughan, Stephen; Glynn, Marielle; Angelo, Kristina M.
    Background Prolonged diarrhoea is common amongst returning travellers and is often caused by intestinal protozoa. However, the epidemiology of travel-associated illness caused by protozoal pathogens is not well described. Methods We analysed records of returning international travellers with illness caused by Giardia duodenalis, Cryptosporidium spp., Cyclospora cayetanensis or Cystoisospora belli, reported to the GeoSentinel Network during January 2007-December 2019. We excluded records of travellers migrating, with an unascertainable exposure country, or from GeoSentinel sites that were not located in high-income countries. Results There were 2517 cases, 82.3% giardiasis (n = 2072), 11.4% cryptosporidiosis (n = 287), 6.0% cyclosporiasis (n = 150) and 0.3% cystoisosporiasis (n = 8). Overall, most travellers were tourists (64.4%) on long trips (median durations: 18-30 days). Cryptosporidiosis more frequently affected people < 18 years (13.9%) and cyclosporiasis affected people >= 40 years (59.4%). Giardiasis was most frequently acquired in South Central Asia (45.8%) and sub-Saharan Africa (22.6%), cryptosporidiosis in sub-Saharan Africa (24.7%) and South-Central Asia (19.5%), cyclosporiasis in South East Asia (31.3%) and Central America (27.3%), and cystoisosporiasis in sub-Saharan Africa (62.5%). Cyclosporiasis cases were reported from countries of uncertain endemicity (e.g. Cambodia) or in countries with no previous evidence of this parasite (e.g. French Guiana). The time from symptom onset to presentation at a GeoSentinel site was the longest amongst travellers with giardiasis (median: 30 days). Over 14% of travellers with cryptosporidiosis were hospitalized. Conclusions This analysis provides new insights into the epidemiology and clinical significance of four intestinal protozoa that can cause morbidity in international travellers. These data might help optimize pretravel advice and post-travel management of patients with travel-associated prolonged gastrointestinal illnesses. This analysis reinforces the importance of international travel-related surveillance to identify sentinel cases and areas where protozoal infections might be undetected or underreported.