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Volume 24, Number 4—April 2018
Dispatch

Region-Specific, Life-Threatening Diseases among International Travelers from Israel, 2004–2015

Chen Avni, Shmuel Stienlauf, Eyal Meltzer, Yechezkel Sidi, Eli SchwartzComments to Author , and Eyal LeshemComments to Author 
Author affiliations: The Center for Travel Medicine and Tropical Diseases, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

Main Article

Table 1

Characteristics of travel-associated hospitalizations of citizens of Israel at Sheba Medical Center, Israel, 2004–2015*Category

Category Africa, 
n = 267 Asia, 
n = 330 South America, 
n = 43 Central America/ Caribbean, n = 30 North America/ Europe, 
n = 26 Other,† 
n = 26 Total, 
n = 722
Patient characteristics
Sex
M 226 (85) 219 (66) 28 (65) 20 (67) 21 (81) 16 (62) 530 (73)
F 41 (15) 111 (34) 15 (35) 10 (33) 5 (19) 10 (38) 192 (27)
Age, median (IQR) 41 (29–53) 29 (24–43) 24 (23–43) 29 (27–46) 55 (39–64) 27 (23–41) 33 (26–50)
Age ≥60 y
37 (14)
27 (8)
4 (9)
3 (10)
8 (31)
4 (15)
83 (11)
Category of travelers
Tourism 154 (58) 313 (95) 41 (95) 29 (97) 23 (88) 26 (100) 586 (81)
Business travelers 93 (35) 17 (5) 2 (5) 1 (3) 3 (12) 0 116 (16)
Visiting friends or relatives
19 (7)
1 (<1)
0
0
0
0
20 (3)
Type of illness
Potentially preventable
85 (32)
25 (8)
0
1 (3)
0
1 (4)
112 (16)
Febrile conditions
Malaria
Plasmodium falciparum 82 (30) 4 (1) 0 0 0 0 86 (12)
P. vivax 23 (9) 7 (2) 3 (7) 0 0 3 (12) 36 (5)
P. ovale 8 (3) 0 0 0 0 0 8 (1)
P. malariae 7 (3) 0 0 0 0 0 7 (<1)
Unidentified malaria 6 (2) 2 (<1) 0 0 0 0 8 (1)
Dengue fever 4 (1) 59 (18) 2 (5) 8 (27) 0 1 (4) 74 (10)
Enteric fever
Salmonella enterica serovar Typhi 2 (<1) 19 (6) 0 1 (3) 0 1 (4) 23 (3)
S. enterica ser. Paratyphi 0 36 (11) 0 0 0 0 36 (5)
Leptospirosis 1 (<1) 18 (5) 0 7 (23) 1 (4) 2 (8) 29 (4)
Pneumonia 10 (4) 11 (3) 0 1 (3) 5 (19) 1 (4) 28 (4)
Febrile diarrheal diseases 10 (4) 5 (2) 1 (2) 0 2 (8) 1 (4) 19 (3)
Acute schistosomiasis 16 (6) 3 (<1) 0 0 0 0 19 (3)
Influenza 0 7 (2) 0 0 0 1 (4) 8 (1)
Epstein–Barr virus 1 (<1) 6 (2) 1 (2) 0 0 0 8 (1)
Cytomegalovirus 4 (1) 2 (<1) 2 (5) 0 0 0 8 (1)
Amebic liver abscess 0 5 (2) 0 0 0 2 (8) 7 (<1)
Rickettsial diseases 3 (1) 3 (<1) 0 0 0 0 6 (<1)
Upper respiratory tract infection 4 (1) 1 (<1) 0 0 0 0 5 (<1)
Unspecified febrile illness 34 (13) 55 (17) 7 (16) 3 (10) 6 (23) 4 (15) 109 (15)
Other febrile conditions
15 (6)
29 (9)
8 (19)
2 (7)
3 (12)
2 (8)
59 (8)
Afebrile conditions
Afebrile diarrheal diseases 5 (2) 7 (2) 2 (5) 0 4 (15) 0 18 (2)
Afebrile eosinophilia 4 (1) 6 (2) 2 (5) 1 (3) 1 (4) 2 (8) 16 (2)
Skin disease 7 (3) 4 (1) 2 (5) 1 (3) 0 0 14 (2)
Afebrile nondiarrheal GI illness 3 (1) 8 (2) 2 (5) 0 0 0 13 (2)
Viral hepatitis 2 (<1) 8 (2) 0 2 (7) 0 0 12 (2)
Leishmaniasis 2 (<1) 0 9 (21) 0 0 0 11 (2)
Giardiasis 0 4 (1) 0 1 (3) 0 0 5 (<1)
Other afebrile
14 (5)
21 (6)
2 (5)
3 (10)
4 (15)
6 (23)
50 (7)
Outcome
Intensive care unit hospitalization 4 (1) 4 (1) 0 0 2 (8) 1 (4) 11 (2)
Death 1 (<1) 1 (<1) 0 0 0 0 2 (<1)

*Values are no. (%) patients except as indicated. Further details are available in online Technical Appendix Table 1 (https://wwwnc.cdc.gov/EID/article/24/4/17-1542-Techapp1.pdf). GI, gastrointestinal; IQR, interquartile range.
†Other comprises case-patients in Oceania (n = 6) and those for whom exact region of infection was undetermined (n = 26).
‡One patient returning from Asia with malaria had a coinfection with P. falciparum and P. vivax. In this table, we listed the patient under P. falciparum.

Main Article

Page created: June 01, 2018
Page updated: June 01, 2018
Page reviewed: June 01, 2018
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