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Surveillance Open Access
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Abstract

Background

Travellers are generally considered good sentinels for infectious disease surveillance.

Aim

To investigate whether health data from travellers arriving from Africa to Europe could provide evidence to support surveillance systems in Africa.

Methods

We examined disease occurrence and estimated risk of infection among travellers arriving from Africa to Europe from 2015 to 2019 using surveillance data of arthropod-borne disease cases collected through The European Surveillance System (TESSy) and flight passenger volumes from the International Air Transport Association.

Results

Malaria was the most common arthropod-borne disease reported among travellers from Africa, with 34,235 cases. The malaria travellers’ infection rate (TIR) was 28.8 cases per 100,000 travellers, which is 36 and 144 times higher than the TIR for dengue and chikungunya, respectively. The malaria TIR was highest among travellers arriving from Central and Western Africa. There were 956 and 161 diagnosed imported cases of dengue and chikungunya, respectively. The highest TIR was among travellers arriving from Central, Eastern and Western Africa for dengue and from Central Africa for chikungunya in this period. Limited numbers of cases of Zika virus disease, West Nile virus infection, Rift Valley fever and yellow fever were reported.

Conclusions

Despite some limitations, travellers’ health data can efficiently complement local surveillance data in Africa, particularly when the country or region has a sub-optimal surveillance system. The sharing of anonymised traveller health data between regions/continents should be encouraged.

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/content/10.2807/1560-7917.ES.2023.28.7.2200270
2023-02-16
2024-04-15
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.7.2200270
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References

  1. Neumayr A, Muñoz J, Schunk M, Bottieau E, Cramer J, Calleri G, et al. Sentinel surveillance of imported dengue via travellers to Europe 2012 to 2014: TropNet data from the DengueTools Research Initiative. Euro Surveill. 2017;22(1):30433.  https://doi.org/10.2807/1560-7917.ES.2017.22.1.30433  PMID: 28080959 
  2. Leder K, Grobusch MP, Gautret P, Chen LH, Kuhn S, Lim PL, et al. Zika beyond the Americas: Travelers as sentinels of Zika virus transmission. A GeoSentinel analysis, 2012 to 2016. PLoS One. 2017;12(10):e0185689.  https://doi.org/10.1371/journal.pone.0185689  PMID: 28973011 
  3. Gossner CM, Fournet N, Dias JG, Martínez BF, Del Manso M, Young JJ, et al. Risks related to chikungunya infections among European Union travelers, 2012-2018. Emerg Infect Dis. 2020;26(6):1067-76.  https://doi.org/10.3201/eid2606.190490  PMID: 32441244 
  4. Grobusch MP, Weld L, Goorhuis A, Hamer DH, Schunk M, Jordan S, et al. Travel-related infections presenting in Europe: A 20-year analysis of EuroTravNet surveillance data. Lancet Reg Health Eur. 2020;1:100001.  https://doi.org/10.1016/j.lanepe.2020.100001  PMID: 35081179 
  5. United Nations (UN) Statistics Division. Standard country or area codes for statistical use (M49). Geneva: UN; 1999. [Accessed: 5 Feb 2022]. Available from: https://unstats.un.org/unsd/methodology/m49
  6. European Centre for Disease Prevention and Control (ECDC). The European Surveillance System (TESSy). Stockholm: ECDC. Available from: https://ecdc.europa.eu/en/publications-data/european-surveillance-system-tessy
  7. European Commission. Commission implementing decision 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions. Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 6.7.2018: L170/1. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32018D0945&from=EN#page=13
  8. Raafat N, Blacksell SD, Maude RJ. A review of dengue diagnostics and implications for surveillance and control. Trans R Soc Trop Med Hyg. 2019;113(11):653-60.  https://doi.org/10.1093/trstmh/trz068  PMID: 31365115 
  9. van Meer MPA, Mögling R, Klaasse J, Chandler FD, Pas SD, van der Eijk AA, et al. Re-evaluation of routine dengue virus serology in travelers in the era of Zika virus emergence. J Clin Virol. 2017;92:25-31.  https://doi.org/10.1016/j.jcv.2017.05.001  PMID: 28505571 
  10. World Health Organization (WHO). World malaria report. Geneva: WHO; 2020. Available from: https://www.who.int/publications/i/item/9789240015791
  11. Mayxay M, Pukrittayakamee S, Newton PN, White NJ. Mixed-species malaria infections in humans. Trends Parasitol. 2004;20(5):233-40.  https://doi.org/10.1016/j.pt.2004.03.006  PMID: 15105024 
  12. Sitali L, Chipeta J, Miller JM, Moonga HB, Kumar N, Moss WJ, et al. Patterns of mixed Plasmodium species infections among children six years and under in selected malaria hyper-endemic communities of Zambia: population-based survey observations. BMC Infect Dis. 2015;15(1):204.  https://doi.org/10.1186/s12879-015-0935-7  PMID: 25930101 
  13. Im J, Balasubramanian R, Ouedraogo M, Wandji Nana LR, Mogeni OD, Jeon HJ, et al. The epidemiology of dengue outbreaks in 2016 and 2017 in Ouagadougou, Burkina Faso. Heliyon. 2020;6(7):e04389.  https://doi.org/10.1016/j.heliyon.2020.e04389  PMID: 32695907 
  14. World Health Organization (WHO) Regional Office for Africa. Weekly bulletin on outbreaks and other emergencies, Week 50: 10 - 15 December 2017. Brazzaville: WHO Africa; 2017. Available at: https://apps.who.int/iris/bitstream/handle/10665/259709/OEW50-1015122017.pdf;jsessionid=7896E67A60CF790CB9115F0BCB784EF7?sequence=1
  15. World Health Organization (WHO) Regional Office for Africa. Weekly bulletin on outbreaks and other emergencies, Week 23: 3 - 9 June 2019. Brazzaville: WHO Africa; 2019. Available from: https://apps.who.int/iris/bitstream/handle/10665/325162/OEW23-0309062019.pdf
  16. European Centre for Disease Prevention and Control (ECDC). Dengue outbreak in Réunion, France, and associated risk of autochthonous outbreak in the EU/EEA, 18 June. Stockholm: ECDC; 2019. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/RRA-dengue-Reunion-18-June-2019.pdf
  17. World Health Organization (WHO)Regional Office for Africa. Weekly bulletin on outbreaks and other emergencies, Week 52: 23 - 29 December 2019. Brazzaville: WHO Africa, 2019. Available from: https://apps.who.int/iris/bitstream/handle/10665/330351/OEW52-31122019.pdf?sequence=1&isAllowed=y
  18. World Health Organization (WHO). Countries and territories with current or previous Zika virus transmission, 2 Jul 2019. Geneva: WHO, 2019. Available from: https://www.who.int/emergencies/diseases/zika/countries-with-zika-and-vectors-table.pdf?ua=1
  19. Public Health England. Zika virus: country specific risk. London: gov.uk. [Accessed: 05 Mar 2022]. Available from: https://www.gov.uk/guidance/zika-virus-country-specific-risk
  20. Hunsperger E, Odhiambo D, Makio A, Alando M, Ochieng M, Omballa V, et al. Zika Virus Detection with 2013 Serosurvey, Mombasa, Kenya. Emerg Infect Dis. 2020;26(7):1603-5.  https://doi.org/10.3201/eid2607.191363  PMID: 32568041 
  21. Gobillot TA, Kikawa C, Lehman DA, Kinuthia J, Drake AL, Jaoko W, et al. Zika Virus Circulates at Low Levels in Western and Coastal Kenya. J Infect Dis. 2020;222(5):847-52.  https://doi.org/10.1093/infdis/jiaa158  PMID: 32242626 
  22. Chepkorir E, Tchouassi DP, Konongoi SL, Lutomiah J, Tigoi C, Irura Z, et al. Serological evidence of Flavivirus circulation in human populations in Northern Kenya: an assessment of disease risk 2016-2017. Virol J. 2019;16(1):65.  https://doi.org/10.1186/s12985-019-1176-y  PMID: 31101058 
  23. World Health Organization (WHO). Zika epidemiology update, February 2022. Geneva: WHO; 2022. Available from: https://cdn.who.int/media/docs/default-source/documents/emergencies/zika/zika-epidemiology-update_february-2022_clean-version.pdf?sfvrsn=c4cec7b7_13&download=true
  24. World Health Organization (WHO). Countries and territories with current or previous Zika virus transmission. Geneva: WHO. Available from: https://cdn.who.int/media/docs/default-source/documents/emergencies/zika/zika-countries-with-zika-and-vectors-table-july2019.pdf?sfvrsn=591689c1_2
  25. Giron S, Franke F, Decoppet A, Cadiou B, Travaglini T, Thirion L, et al. Vector-borne transmission of Zika virus in Europe, southern France, August 2019. Euro Surveill. 2019;24(45):1900655.  https://doi.org/10.2807/1560-7917.ES.2019.24.45.1900655  PMID: 31718742 
  26. Musso D, Ko AI, Baud D. Zika virus infection - after the pandemic. N Engl J Med. 2019;381(15):1444-57.  https://doi.org/10.1056/NEJMra1808246  PMID: 31597021 
  27. Sule WF, Oluwayelu DO, Hernández-Triana LM, Fooks AR, Venter M, Johnson N. Epidemiology and ecology of West Nile virus in sub-Saharan Africa. Parasit Vectors. 2018;11(1):414.  https://doi.org/10.1186/s13071-018-2998-y  PMID: 30005653 
  28. Steyn J, Botha E, Stivaktas VI, Buss P, Beechler BR, Myburgh JG, et al. West nile virus in wildlife and nonequine domestic animals, South Africa, 2010-2018. Emerg Infect Dis. 2019;25(12):2290-4.  https://doi.org/10.3201/eid2512.190572  PMID: 31742510 
  29. Young JJ, Haussig JM, Aberle SW, Pervanidou D, Riccardo F, Sekulić N, et al. Epidemiology of human West Nile virus infections in the European Union and European Union enlargement countries, 2010 to 2018. Euro Surveill. 2021;26(19):2001095.  https://doi.org/10.2807/1560-7917.ES.2021.26.19.2001095  PMID: 33988124 
  30. Tong C, Javelle E, Grard G, Dia A, Lacrosse C, Fourié T, et al. Tracking Rift Valley fever: From Mali to Europe and other countries, 2016. Euro Surveill. 2019;24(8):1800213.  https://doi.org/10.2807/1560-7917.ES.2019.24.8.1800213  PMID: 30808441 
  31. Durand JP, Bouloy M, Richecoeur L, Peyrefitte CN, Tolou H. Rift Valley fever virus infection among French troops in Chad. Emerg Infect Dis. 2003;9(6):751-2.  https://doi.org/10.3201/eid0906.020647  PMID: 12781023 
  32. El-Gebaly MR. Epidemiological study of outbreak of Rift Valley fever among military personnel. J Egypt Public Health Assoc. 1978;53(3-4):137-46. PMID: 572394 
  33. Haneche F, Leparc-Goffart I, Simon F, Hentzien M, Martinez-Pourcher V, Caumes E, et al. Rift Valley fever in kidney transplant recipient returning from Mali with viral RNA detected in semen up to four months from symptom onset, France, autumn 2015. Euro Surveill. 2016;21(18).  https://doi.org/10.2807/1560-7917.ES.2016.21.18.30222  PMID: 27172608 
  34. Hardcastle AN, Osborne JCP, Ramshaw RE, Hulland EN, Morgan JD, Miller-Petrie MK, et al. Informing Rift Valley Fever preparedness by mapping seasonally varying environmental suitability. Int J Infect Dis. 2020;99:362-72.  https://doi.org/10.1016/j.ijid.2020.07.043  PMID: 32738486 
  35. Phan MV, Murad SD, van der Eijk AA, Metselaar HJ, Hartog H, Harinck F, et al. Genomic sequence of yellow fever virus from a Dutch traveller returning from the Gambia-Senegal region, the Netherlands, November 2018. Euro Surveill. 2019;24(4):1800684.  https://doi.org/10.2807/1560-7917.ES.2019.24.4.1800684  PMID: 30696531 
  36. Gershman MD, Erin Staples JE. Centers for Disease Control and Prevention Yellow book, Chapter 4. Travel-Related Infectious Diseases, Yellow Fever. Atlanta: CDC. Available from: https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/yellow-fever
  37. World Health Organization (WHO). Vaccination requirements and recommendations for international travellers; and malaria situation per country, 1 July 2019. Geneva: WHO; 2019. Available from: https://cdn.who.int/media/docs/default-source/documents/emergencies/travel-advice/yellow-fever-vaccination-requirements-country-list-2019-en.pdf?sfvrsn=eee5bf3_12&download=true
  38. World Health Organization (WHO). Yellow fever outbreak Angola, Democratic Republic of the Congo and Uganda 2016-2017. Geneva: WHO. [Accessed: 02 Feb 2022]. Available from: https://www.who.int/emergencies/yellow-fever/en
  39. United States Centers for Disease Control and Prevention (US CDC). Tick-borne encephalitis geographical distribution. Updated 30 Nov 2022. Atlanta: US CDC. [Accessed: 30 Jan 2023]. Available from: https://www.cdc.gov/tick-borne-encephalitis/geographic-distribution/index.html
  40. Africa Centres for Disease Control and Prevention. Crimean-Congo haemorrhagic fever. Addis Ababa: Africa CDC. [Accessed: 10 Feb 2022]. Available from: https://africacdc.org/disease/crimean-congo-haemorrhagic-fever
  41. Africa Centers for Disease Control and Prevention. Plague. Addis Ababa: Africa CDC. [Accessed: 05 Jan 2022]. Available from: https://africacdc.org/disease/plague
  42. European Centre for Disease Prevention and Control (ECDC). Outbreak of plague in Madagascar, 9 Oct 2017. Stockholm: ECDC; 2017. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/First%20version%20of%20RRA%20dated%209%20October%202017%20-%20with%20erratum%2010%20Nov%202017.pdf
  43. European Centre for Disease Prevention and Control (ECDC). Lassa fever in Nigeria, Benin, Togo, Germany and USA, 23 Mar 2016. Stockholm: ECDC; 2016. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/RRA-Lassa-fever-Germany-march-2016.pdf
  44. Amoako N, Duodu S, Dennis FE, Bonney JHK, Asante KP, Ameh J, et al. Detection of Dengue Virus among Children with Suspected Malaria, Accra, Ghana. Emerg Infect Dis. 2018;24(8):1544-7.  https://doi.org/10.3201/eid2408.180341  PMID: 30015610 
  45. International Society of Travel Medicine (ISTM). Geosentinel. Alpharetta, Georgia, United States: ISTM. Available from: https://www.istm.org/geosentinel
  46. European Centre for Disease Prevention and Control. EpiPulse - the European surveillance portal for infectious diseases. Stockholm: ECDC; 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/epipulse-european-surveillance-portal-infectious-diseases
  47. European Centre for Disease Prevention and Control (ECDC). Surveillance atlas of infectious diseases. Stockholm: ECDC; 2019. Available from: http://atlas.ecdc.europa.eu/public/index.aspx?Dataset=27&HealthTopic=16
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