학술논문
Mosquito Exposure and Chikungunya and Dengue Infection Among Travelers During the Chikungunya Outbreak in the Americas.
Document Type
Academic Journal
Author
Lindholm DA; San Antonio Military Medical Center, San Antonio, Texas.; Myers T; Naval Infectious Diseases Diagnostic Laboratory, Silver Spring, Maryland.; Widjaja S; Naval Infectious Diseases Diagnostic Laboratory, Silver Spring, Maryland.; Grant EM; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.; Telu K; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.; Lalani T; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.; Naval Medical Center, Portsmouth, Virginia.; Fraser J; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.; Fairchok M; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.; Madigan Army Medical Center, Tacoma, Washington.; Ganesan A; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.; Walter Reed National Military Medical Center, Bethesda, Maryland.; Johnson MD; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.; Naval Health Research Center, San Diego, California.; Kunz A; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.; Madigan Army Medical Center, Tacoma, Washington.; Tribble DR; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.; Yun HC; San Antonio Military Medical Center, San Antonio, Texas.; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Source
Publisher: American Society of Tropical Medicine and Hygiene Country of Publication: United States NLM ID: 0370507 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-1645 (Electronic) Linking ISSN: 00029637 NLM ISO Abbreviation: Am J Trop Med Hyg Subsets: MEDLINE
Subject
Language
English
Abstract
AbstractTravelers are at risk for arbovirus infection. We prospectively enrolled 267 Department of Defense beneficiaries traveling to chikungunya-outbreak regions in the Americas between December 2013 and May 2015 and assessed travel characteristics and serologic exposure to chikungunya virus (CHIKV) and dengue virus (DENV). Ten ill-returning travelers were also assessed retrospectively. Self-reported mosquito exposure was common (64% of 198 evaluable travelers saw mosquitoes; 53% of 201 reported ≥ 1 bite). Increased exposure was associated with active-duty travelers (odds ratio [OR] = 2.6 [1.3-5.4] for seeing mosquitoes) or travelers visiting friends and relatives (VFR) (OR = 3.5 [1.0-10.0] for high-intensity bite exposure). Arbovirus infection was defined as seroconversion on plaque reduction neutralization testing (PRNT) of pre- and posttravel sera. For ill subjects enrolled posttravel, infection was defined by a positive convalescent PRNT and/or a positive reverse transcription polymerase chain reaction for CHIKV or DENV. We identified seven cases of arbovirus infection: four with CHIKV, five with DENV, and two with both. The composite attack rate for CHIKV and DENV infection was 3.7% of 108 evaluable, immunologically naïve, prospectively assessed travelers; there was serologic and/or polymerase chain reaction evidence of arbovirus infection in three of four evaluable (three of 10 total) ill-returning travelers. We identified both symptomatic and asymptomatic cases. Military purpose of travel and VFR travel accounted for five of seven cases. Pretravel counseling is important and should target higher risk groups. Given a shared vector between CHIKV, DENV, and Zika virus (ZIKV), this study can also help guide counseling for travelers to ZIKV-outbreak regions.