Eli Schwartza b, Leisa H. Weldc, Annelies Wilder‐Smithd, Frank von Sonnenburge f, Jay S. Keystoneg h, Kevin C. Kaing h, Joseph Torresii j, David O. Freedmank✉, for the GeoSentinel Surveillance Network
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We examined seasonality and annual trends for dengue cases among 522 returned travelers reported to the international GeoSentinel Surveillance Network.Dengue cases showed region-specifi c peaks for Southeast Asia (June, September), South Central Asia (October), South America (March), and the Caribbean (August, October).Travel-related dengue exhibited annual oscillations with several epidemics occurring during the study period.In Southeast Asia, annual proportionate morbidity increased from 50 dengue cases per 1,000 ill returned travelers in nonepidemic years to an average of 159 cases per 1,000 travelers during epidemic years.Dengue can thus be added to the list of diseases for which pretravel advice should include information on relative risk according to season.Also, dengue cases detected at atypical times in sentinel travelers may inform the international community of the onset of epidemic activity in specifi c areas.A n estimated 100 million cases of dengue fever (DF) and 250,000 cases of dengue hemorrhagic fever (DHF) occur annually (1).The past 20 years have seen a dramatic geographic expansion of epidemic DF and DHF from Southeast Asia to the South Pacifi c Islands, the Caribbean, and the Americans.An increasing number of reports of DF and associated illness among travelers to dengue virus-infected areas parallel the changing epidemiology of dengue in local populations (2-8).As part of a comprehensive analysis of the spectrum of disease in travelers, the GeoSentinel Surveillance Network, a multifaceted international practice network, has noted that in terms of cumulative case numbers over the past decade, dengue has emerged as a more frequent diagnosis than malaria in ill travelers who have returned from all tropical regions outside of Africa (9,10).Dengue accounts for up to 2% of all illness in returned travelers who visit GeoSentinel clinics (9).Dengue is also a major cause of hospitalization in febrile returned travelers Seasonality, Annual Trends, and Characteristics of Dengue among IllReturned Travelers, 1997Travelers, -2006
TL;DRAtypical patterns may indicate onset of epidemic activity in the setting of an infectious disease. (Semantic Scholar)
