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Illness in Canadian travellers and migrants from Brazil: CanTravNet surveillance data, 2013-2016
A K Boggild1,2, J Geduld3, M Libman4
1Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University Health Network and the University of Toronto, Toronto, ON.
Insights
Canadian travellers returning from Brazil frequently contract vector-borne illnesses like dengue, chikungunya, and Zika virus. Health practitioners should be aware of these risks, especially with the Olympic games approaching.
Area of Science:
- Travel Medicine
- Infectious Diseases
- Epidemiology
Background:
- Canadian practitioners need information on illnesses affecting travellers returning from Brazil, particularly before the 2016 Olympic Games.
- Understanding travel-related health risks is crucial for public health preparedness.
Purpose of the Study:
- To identify demographic and travel factors associated with illnesses in Canadian travellers and migrants returning from Brazil.
- To provide data for healthcare providers managing patients with travel-related diseases.
Main Methods:
- Analysis of data from returned Canadian travellers and migrants presenting with illness at CanTravNet clinics (June 2013-June 2016).
- Focus on illnesses acquired in Brazil and their characteristics.
Main Results:
- 89 (0.01%) of 7,707 ill travellers acquired illnesses in Brazil; tourists and "visit friends and relatives" travellers were most common.
- Arboviruses (dengue, chikungunya, Zika) and Zika-like syndromes were diagnosed in 9% and 14.6% of ill travellers from Brazil, respectively.
- Ill travellers returning from Brazil had a higher likelihood of arboviral or Zika-like illness compared to other South America travellers (p=0.0024).
Conclusions:
- Epidemiological data on illnesses in travellers returning from Brazil informs Canadian practitioners about potential risks, including vector-borne diseases.
- Dengue, chikungunya, and Zika virus are significant concerns for travellers to Brazil.
- Educating travellers on mosquito-avoidance measures is critical for preventing illness.
Background:
In light of the 2016 summer Olympic games it is anticipated that Canadian practitioners will require information about common illnesses that may affect travellers returning from Brazil.
Objective:
To identify the demographic and travel correlates of illness among recent Canadian travellers and migrants from Brazil attending a network of travel health clinics across Canada.
Methods:
Data was analyzed on returned Canadian travellers and migrants presenting to a CanTravNet site for care of an illness between June 2013 and June 2016.
Results:
During the study period, 7,707 ill travellers and migrants presented to a CanTravNet site and 89 (0.01%) acquired their illness in Brazil. Tourists were most well represented (n=45, 50.6%), followed by those travelling to "visit friends and relatives" (n=14, 15.7%). The median age was 37 years (range <1-78 years), 49 travellers were men (55.1%) and 40 were women (44.9%). Of the 40 women, 26 (65%) were of childbearing age. Nine percent (n=8) of travellers were diagnosed with arboviruses including dengue (n=6), chikungunya (n=1) and Zika virus (n=1), while another 14.6% (n=13) presented for care of non-specific viral syndrome (n=7), non-specific febrile illness (n=1), peripheral neuropathy (n=1) and non-specific rash (n=4), which are four syndromes that may be indicative of Zika virus infection. Ill returned travellers to Brazil were more likely to present for care of arboviral or Zika-like illness than other ill returned travellers to South America (23.6 per 100 travellers versus 10.5 per 100 travellers, respectively [p=0.0024]).
Interpretation:
An epidemiologic approach to illness among returned Canadian travellers to Brazil can inform Canadian practitioners encountering both prospective and returned travellers to the Olympic games. Analysis showed that vector-borne illnesses such as dengue are common and even in this small group of travellers, both chikungunya and Zika virus were represented. It is extremely important to educate travellers about mosquito-avoidance measures in advance of travel to Brazil.
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