Characteristics and Spectrum of Disease Among Ill Returned Travelers from Pre- and Post-Earthquake Haiti: The GeoSentinel Experience

Abstract

To describe patient characteristics and disease spectrum among foreign visitors to Haiti before and after the 2010 earthquake, we used GeoSentinel Global Surveillance Network data and compared 1 year post-earthquake versus 3 years pre-earthquake. Post-earthquake travelers were younger, predominantly from the United States, more frequently international assistance workers, and more often medically counseled before their trip than pre-earthquake travelers. Work-related stress and upper respiratory tract infections were more frequent post-earthquake; acute diarrhea, dengue, and Plasmodium falciparum malaria were important contributors of morbidity both pre- and post-earthquake. These data highlight the importance of providing destination- and disaster-specific pre-travel counseling and post-travel evaluation and medical management to persons traveling to or returning from a disaster location, and evaluations should include attention to the psychological wellbeing of these travelers. For travel to Haiti, focus should be on mosquito-borne illnesses (dengue and P. falciparum malaria) and travelers' diarrhea.

Pre-Travel Preparation of US Travelers Going Abroad to Provide Humanitarian Service, Global TravEpiNet 2009–2011

“…HSWs were predominately female (63%), and missionaries were significantly older than other HSWs. The most common destination was Haiti, likely attributable to relief efforts after the 2010 earthquake near Port au Prince 8. Overall, HSWs attended the pre-travel consultation a median of 4 weeks in advance of their trip, and most HSWs were vaccinated for MMR, Td/Tdap, hepatitis A, typhoid, and YF.…”

“…An accurate percentage of HSWs seeking pre-travel preparations is not known, and previous studies of ill HSW travelers vary greatly in their estimates (15–71%) 7,8,11. Furthermore, travelers who do access health resources before departure may not always receive the most up-to-date recommendations 12.…”

VFR Travel: A Viable Market for Tourism Crisis and Disaster Recovery?

“…Visiting Friends and Relatives travellers and disease risk Visiting Friends and Relatives are regarded as a group of travellers who have a significantly higher risk of contracting travel-related infectious diseases (Angell & Cetron, 2005;Arnáez et al, 2010;Bacaner et al, 2004;Behrens et al, 2010;Esposito et al, 2012;Gibney et al, 2014;Hendel-Paterson & Swanson, 2011;Heywood et al, 2015;Leder et al, 2011;Leder et al, 2006;Ma et al, 2015;Ma et al, 2016;Monge-Maillo et al, 2014;Navarro et al, 2012;Neave et al, 2014;Pavli et al, 2009;Pavli & Maltezou, 2010;Swancutt, 2010). Studies have been done in various countries to consistently point to the high-risk factor for VFRs.…”

“…This risk was seen in Haiti, after the 2010 earthquake. Only two (6%) of the 31 VFR travellers had received pre-travel medical advice (Esposito et al, 2012) resulting in a significantly higher proportion of VFRs being ill. The proportion of people who were medically counselled before travelling to Haiti was significantly higher after the earthquake (71% versus 37% p < 0.001).…”

Disasters and Public Heath — An Updated Review of the Role of Infectious Disease in the Post-Disaster Environment

“…There were documented outbreaks of dengue and Plasmodium falciparum malaria amongst international travelers, as well as acute diarrhea and upper respiratory infections. The latter was specifically noted to occur at higher rates in post-earthquake travelers than in the population of pre-earthquake travelers [14]. In one group of American missionaries, 25% were infected with the dengue virus [15].…”