Background. Brazil will host the 2014 FIFA World Cup and the 2016 Olympic and Paralympic Games, events that are expected to attract hundreds of thousands of international travelers. Travelers to Brazil will encounter locally endemic infections as well as mass-event-specific risks. Methods. We describe 1586 ill returned travelers who had visited Brazil and were seen at a GeoSentinel Clinic from July 1997 through May 2013. Results. The most common travel-related illnesses were dermatologic conditions (40%), diarrheal syndromes (25%), and febrile systemic illness (19%). The most common specific dermatologic diagnoses were cutaneous larva migrans, myiasis, and tungiasis. Dengue and malaria, predominantly Plasmodium vivax, were the most frequently identified specific causes of fever and the most common reasons for hospitalization after travel. Dengue fever diagnoses displayed marked seasonality, although cases were seen throughout the year. Among the 28 ill returned travelers with HIV infection, 11 had newly diagnosed asymptomatic infection and 9 had acute symptomatic HIV. Conclusions. Our analysis primarily identified infectious diseases among travelers to Brazil. Knowledge of illness in travelers returning from Brazil can assist clinicians to advise prospective travelers and guide pre-travel preparation, including itinerary-tailored advice, vaccines and chemoprophylaxis; it can also help to focus post-travel evaluation of ill returned travelers. Travelers planning to attend mass events will encounter other risks that are not captured in our surveillance network.
Wilson M, Chen L, Han P, Keystone J, Cramer J, Segurado A, Hale D, Jensenius M, Schwartz E, von Sonnenburg F, Leder K; Clinical Infectious Diseases (Feb 2014)
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