Publications by authors named "Rhett J Stoney"

Article Synopsis
  • Dengue poses a significant health risk to international travelers, with 5,958 cases reported from 2007 to 2022 at GeoSentinel sites, where 81.6% were confirmed cases.
  • The study revealed that the median age of affected travelers was 33 years, with the majority traveling for tourism and acquiring the virus primarily in South East Asia.
  • Complicated cases of dengue were rare, with only 1.6% of travelers experiencing complications; however, there is a crucial need for awareness and preventive measures among travelers heading to endemic areas.
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Background: Chikungunya is an important travel-related disease because of its rapid geographical expansion and potential for prolonged morbidity. Improved understanding of the epidemiology of travel-related chikungunya infections may influence prevention strategies including education and vaccination.

Methods: We analysed data from travellers with confirmed or probable chikungunya reported to GeoSentinel sites from 2005 to 2020.

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Background: International travellers may seek care abroad to address health problems that arise during their trip or plan healthcare outside their country of residence as medical tourists.

Methods: Data were collected on travellers evaluated at GeoSentinel Network sites who reported healthcare during travel. Both unplanned and planned healthcare were analysed, including the reason and nature of healthcare sought, characteristics of the treatment provided and outcomes.

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Carbapenem-resistant Pseudomonas aeruginosa (CRPA) producing the Verona integron‒encoded metallo-β-lactamase (VIM) are highly antimicrobial drug-resistant pathogens that are uncommon in the United States. We investigated the source of VIM-CRPA among US medical tourists who underwent bariatric surgery in Tijuana, Mexico. Cases were defined as isolation of VIM-CRPA or CRPA from a patient who had an elective invasive medical procedure in Mexico during January 2018‒December 2019 and within 45 days before specimen collection.

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Objective: To describe medical tourism among a subset of US residents; identify possible indicators for medical tourism.

Methods: The US Centers for Disease Control and Prevention collaborated with 11 states and territories to ask 6 questions about medical tourism, using the Behavioral Risk Factor Surveillance System. Data collected from January 1, 2016, through December 31, 2016, included whether respondents traveled internationally for preplanned care, travel reasons and destinations, procedures received, and occurrence and treatment of complications.

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Background: Hepatitis E virus (HEV) is widely distributed worldwide and is endemic in developing countries. Travel-related HEV infection has been reported at national levels, but global data are missing. Moreover, the global availability of HEV diagnostic testing has not been explored so far.

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Introduction: International travellers contribute to the rapid spread of Zika virus (ZIKV) and its sentinel identification globally. We describe ZIKV infections among international travellers seen at GeoSentinel sites with a focus on ZIKV acquired in the Americas and the Caribbean, describe countries of exposure and traveller characteristics, and assess ZIKV diagnostic testing by site.

Methods: Records with an international travel-related diagnosis of confirmed or probable ZIKV from January 2012 through December 2019 reported to GeoSentinel with a recorded illness onset date were included to show reported cases over time.

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Background: Estimates of travel-related illness have focused predominantly on populations from highly developed countries visiting low- or middle-income countries, yet travel to and within high-income countries is very frequent. Despite being a top international tourist destination, few sources describe the spectrum of infectious diseases acquired among travellers to the USA.

Methods: We performed a descriptive analysis summarizing demographic and travel characteristics, and clinical diagnoses among non-US-resident international travellers seen during or after travel to the USA at a GeoSentinel clinic from 1 January 1997 through 31 December 2016.

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Article Synopsis
  • International travel has increased, raising the risk of systemic endemic mycoses among travellers, with limited data on the topic reported in studies.
  • A study analyzed cases of these infections among 69 international travellers diagnosed between 1997 and 2017, focusing on conditions like histoplasmosis and coccidioidomycosis.
  • Histoplasmosis was the most common infection, affecting younger travellers, while coccidioidomycosis primarily impacted older individuals who were often exposed in the USA, indicating the need for awareness of these infections in travel medicine.
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Leptospirosis is a potentially fatal emerging zoonosis with worldwide distribution and a broad range of clinical presentations and exposure risks. It typically affects vulnerable populations in (sub)tropical countries but is increasingly reported in travelers as well. Diagnostic methods are cumbersome and require further improvement.

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AbstractThis prospective cohort study describes travelers' diarrhea (TD) and non-TD gastrointestinal (GI) symptoms among international travelers from the Boston area, the association of TD with traveler characteristics and dietary practices, use of prescribed antidiarrheal medications, and the impact of TD and non-TD GI symptoms on planned activities during and after travel. We included adults who received a pre-travel consultation at three Boston-area travel clinics and who completed a three-part survey: pre-travel, during travel, and post-travel (2-4 weeks after return). TD was defined as self-reported diarrhea with or without nausea/vomiting, abdominal pain, or fever.

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Background: There is increasing recognition of the contribution of community-acquired cases to the global burden of Clostridium difficile infection (CDI). The epidemiology of CDI among international travellers is poorly understood, and factors associated with international travel, such as antibiotic use and changes in gut microbiota, could potentially put travellers at higher risk.

Methods: We summarized demographic, travel-associated and geographic characteristics of travellers with CDI in the GeoSentinel database from 1997 to 2015.

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Background: The Boston Area Travel Medicine Network surveyed travelers on travel-related health problems.

Methods: Travelers were recruited 2009-2011 during pre-travel consultation at three clinics. The investigation included pre-travel data, weekly during-travel diaries, and a post-travel questionnaire.

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Background: In 2011, the Centers for Disease Control and Prevention and the New Jersey Department of Health used the New Jersey Behavioral Risk Factor Survey (NJBRFS), a state component of the national Behavioral Risk Factor Surveillance System (BRFSS) to pilot a travel health module designed to collect population-based data on New Jersey residents travelling internationally. Our objective was to use this population-based travel health information to serve as a baseline to evaluate trends in US international travellers.

Methods: A representative sample of New Jersey residents was identified through a random-digit-dialing method and administered the travel health module, which asked five questions: travel outside of USA during the previous year; destination; purpose; if a healthcare provider was visited before travel and any travel-related illness.

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We conducted a prospective cohort study to assess adherence to malaria chemoprophylaxis, reasons for nonadherence, and use of other personal protective measures against malaria. We included adults traveling to malaria-endemic countries who were prescribed malaria chemoprophylaxis during a pre-travel consultation at three travel clinics in the Boston area and who completed three or more surveys: pre-travel, at least one weekly during travel, and post-travel (2-4 weeks after return). Of 370 participants, 335 (91%) took malaria chemoprophylaxis at least once and reported any missed doses; 265 (79%) reported completing all doses during travel.

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Importance: Travelers from around the globe will attend the 2014 Fédération Internationale de Football Association (FIFA) World Cup and the 2016 Olympic and Paralympic Games in Brazil. Travelers to these mass gathering events may be exposed to a range of health risks, including a variety of infectious diseases. Most travelers who become ill will present to their primary care physicians, and thus it is important that clinicians are aware of the risks their patients encountered.

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We analyzed characteristics of humanitarian service workers (HSWs) seen pre-travel at Global TravEpiNet (GTEN) practices during 2009-2011. Of 23,264 travelers, 3,663 (16%) travelers were classified as HSWs. Among HSWs, 1,269 (35%) travelers were medical workers, 1,298 (35%) travelers were non-medical service workers, and 990 (27%) travelers were missionaries.

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