TY - JOUR
T1 - Cutaneous and mucocutaneous leishmaniasis in travellers and migrants: a 20-year GeoSentinel Surveillance Network analysis
AU - Boggild, Andrea K.
AU - Caumes, Eric
AU - Grobusch, Martin P.
AU - Schwartz, Eli
AU - Hynes, Noreen A.
AU - Libman, Michael
AU - Connor, Bradley A.
AU - Chakrabarti, Sumontra
AU - Parola, Philippe
AU - Keystone, Jay S.
AU - Nash, Theodore
AU - Showler, Adrienne J.
AU - Schunk, Mirjam
AU - Asgeirsson, Hilmir
AU - Hamer, Davidson H.
AU - Kain, Kevin C.
AU - GeoSentinel Surveillance Network
AU - von Sonnenburg, Frank
AU - Rothe, Camilla
AU - Jordan, Sabine
AU - Vinnemeier, Christof
AU - Yansouni, Cedric
AU - McCarthy, Anne
AU - Jensenius, Mogens
AU - Goorhuis, Abraham
AU - Coyle, Christina
AU - Mockenhaupt, Frank
AU - Harms-Zwingengerger, Gundel
AU - Leung, Daniel
AU - Benson, Scott
AU - Gautret, Philippe
AU - Javelle, Emilie
AU - Chappuis, Francois
AU - Rapp, Christophe
AU - Ficko, Cecile
AU - van Genderen, Perry
AU - Glans, Hedvig
AU - Beadsworth, Michael
AU - Beeching, Nicholas
AU - Castelli, Francesco
AU - Matteelli, Alberto
AU - Plewes, Katherine
AU - Mirzanejad, Yazdan
AU - Lopez-Velez, Rogelio
AU - Chamorro, Sandra
AU - Waggoner, Jesse
AU - Wu, Henry
AU - Leder, Karin
AU - Torresi, Joseph
AU - Bottieau, Emmanuel
AU - Huits, Ralph
PY - 2019
Y1 - 2019
N2 - BACKGROUND: Cutaneous leishmaniasis (CL) may be emerging among international travellers and migrants. Limited data exist on mucocutaneous leishmaniasis (MCL) in travellers. We describe the epidemiology of travel-associated CL and MCL among international travellers and immigrants over a 20-year period through descriptive analysis of GeoSentinel data. METHODS: Demographic and travel-related data on returned international travellers diagnosed with CL or MCL at a GeoSentinel Surveillance Network site between 1 September 1997 and 31 August 2017 were analysed. RESULTS: A total of 955 returned travellers or migrants were diagnosed with travel-acquired CL (n = 916) or MCL during the study period, of whom 10% (n = 97) were migrants. For the 858 non-migrant travellers, common source countries were Bolivia (n = 156, 18.2%) and Costa Rica (n = 97, 11.3%), while for migrants, they were Syria (n = 34, 35%) and Afghanistan (n = 22, 22.7%). A total of 99 travellers (10%) acquired their disease on trips of ≤ 2 weeks. Of 274 cases for which species identification was available, Leishmania Viannia braziliensis was the most well-represented strain (n = 117, 42.7%), followed by L. major (n = 40, 14.6%) and L. V. panamensis (n = 38, 13.9%). Forty cases of MCL occurred, most commonly in tourists (n = 29, 72.5%) and from Bolivia (n = 18, 45%). A total of 10% of MCL cases were acquired in the Old World. CONCLUSIONS: Among GeoSentinel reporting sites, CL is predominantly a disease of tourists travelling mostly to countries in Central and South America such as Bolivia where risk of acquiring L. V. braziliensis and subsequent MCL is high. The finding that some travellers acquired leishmaniasis on trips of short duration challenges the common notion that CL is a disease of prolonged travel. Migrants from areas of conflict and political instability, such as Afghanistan and Syria, were well represented, suggesting that as mass migration of refugees continues, CL will be increasingly encountered in intake countries.
AB - BACKGROUND: Cutaneous leishmaniasis (CL) may be emerging among international travellers and migrants. Limited data exist on mucocutaneous leishmaniasis (MCL) in travellers. We describe the epidemiology of travel-associated CL and MCL among international travellers and immigrants over a 20-year period through descriptive analysis of GeoSentinel data. METHODS: Demographic and travel-related data on returned international travellers diagnosed with CL or MCL at a GeoSentinel Surveillance Network site between 1 September 1997 and 31 August 2017 were analysed. RESULTS: A total of 955 returned travellers or migrants were diagnosed with travel-acquired CL (n = 916) or MCL during the study period, of whom 10% (n = 97) were migrants. For the 858 non-migrant travellers, common source countries were Bolivia (n = 156, 18.2%) and Costa Rica (n = 97, 11.3%), while for migrants, they were Syria (n = 34, 35%) and Afghanistan (n = 22, 22.7%). A total of 99 travellers (10%) acquired their disease on trips of ≤ 2 weeks. Of 274 cases for which species identification was available, Leishmania Viannia braziliensis was the most well-represented strain (n = 117, 42.7%), followed by L. major (n = 40, 14.6%) and L. V. panamensis (n = 38, 13.9%). Forty cases of MCL occurred, most commonly in tourists (n = 29, 72.5%) and from Bolivia (n = 18, 45%). A total of 10% of MCL cases were acquired in the Old World. CONCLUSIONS: Among GeoSentinel reporting sites, CL is predominantly a disease of tourists travelling mostly to countries in Central and South America such as Bolivia where risk of acquiring L. V. braziliensis and subsequent MCL is high. The finding that some travellers acquired leishmaniasis on trips of short duration challenges the common notion that CL is a disease of prolonged travel. Migrants from areas of conflict and political instability, such as Afghanistan and Syria, were well represented, suggesting that as mass migration of refugees continues, CL will be increasingly encountered in intake countries.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85075138179&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31553455
U2 - https://doi.org/10.1093/jtm/taz055
DO - https://doi.org/10.1093/jtm/taz055
M3 - Article
C2 - 31553455
SN - 1195-1982
VL - 26
JO - Journal of Travel Medicine
JF - Journal of Travel Medicine
IS - 8
ER -