{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T17:16:21Z","timestamp":1763399781816,"version":"3.41.2"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2018,8,17]],"date-time":"2018-08-17T00:00:00Z","timestamp":1534464000000},"content-version":"vor","delay-in-days":228,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100011015","name":"International Society of Travel Medicine","doi-asserted-by":"publisher","award":["U50CK00189"],"award-info":[{"award-number":["U50CK00189"]}],"id":[{"id":"10.13039\/100011015","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Estimates of travel-related illness have focused predominantly on populations from highly developed countries visiting low- or middle-income countries, yet travel to and within high-income countries is very frequent. Despite being a top international tourist destination, few sources describe the spectrum of infectious diseases acquired among travellers to the USA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a descriptive analysis summarizing demographic and travel characteristics, and clinical diagnoses among non-US-resident international travellers seen during or after travel to the USA at a GeoSentinel clinic from 1 January 1997 through 31 December 2016.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 1222 ill non-US-resident travellers with 1393 diagnoses recorded during the 20-year analysis period. Median age was 40 (range 0\u201386 years); 52% were female. Patients visited from 63 countries and territories, most commonly Canada (31%), Germany (14%), France (9%) and Japan (7%). Travellers presented with a range of illnesses; skin and soft tissue infections of unspecified aetiology were the most frequently reported during travel (29 diagnoses, 14% of during-travel diagnoses); arthropod bite\/sting was the most frequently reported after travel (173 diagnoses, 15% after-travel diagnoses). Lyme disease was the most frequently reported arthropod-borne disease after travel (42, 4%). Nonspecific respiratory, gastrointestinal and systemic infections were also among the most frequently reported diagnoses overall. Low-frequency illnesses (&amp;lt;2% of cases) made up over half of diagnoses during travel and 41% of diagnoses after travel, including 13 cases of coccidioidomycosis and mosquito-borne infections like West Nile, dengue and Zika virus diseases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>International travellers to the USA acquired a diverse array of mostly cosmopolitan infectious diseases, including nonspecific respiratory, gastrointestinal, dermatologic and systemic infections comparable to what has been reported among travellers to low- and middle-income countries. Clinicians should consider the specific health risks when preparing visitors to the USA and when evaluating and treating those who become ill.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/tay053","type":"journal-article","created":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T19:23:59Z","timestamp":1532633039000},"source":"Crossref","is-referenced-by-count":15,"title":["Infectious diseases acquired by international travellers visiting the USA\u2020"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4538-1463","authenticated-orcid":false,"given":"Rhett J","family":"Stoney","sequence":"first","affiliation":[{"name":"Travelers\u2019 Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention (CDC), 1825 Century Blvd NE, MS E-28, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas H","family":"Esposito","sequence":"additional","affiliation":[{"name":"Travelers\u2019 Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention (CDC), 1825 Century Blvd NE, MS E-28, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phyllis","family":"Kozarsky","sequence":"additional","affiliation":[{"name":"Travelers\u2019 Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention (CDC), 1825 Century Blvd NE, MS E-28, Atlanta, GA, USA"},{"name":"Department of Medicine, Emory University, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4700-1495","authenticated-orcid":false,"given":"Davidson H","family":"Hamer","sequence":"additional","affiliation":[{"name":"Department of Global Health, Boston University School of Public Health, Boston, MA, USA"},{"name":"Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin P","family":"Grobusch","sequence":"additional","affiliation":[{"name":"Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Effrossyni","family":"Gkrania-Klotsas","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Cambridge University Hospitals, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Libman","sequence":"additional","affiliation":[{"name":"J.D. 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