Syndromic approach to arboviral diagnostics for global travelers as a basis for infectious disease surveillance
Autor(es): Cleton Natalie B, Reusken Chantal B E M, Wagenaar Jiri F P, van der Vaart Elske E, Reimerink Johan, van der Eijk Annemiek A, Koopmans Marion P G
Resumo: Arboviruses have overlapping geographical distributions - can cause symptoms that coincide with more common infections. Therefore, arbovirus infections are often neglected by travel diagnostics. Here, we assessed the potential of syndrome-based approaches for diagnosis - surveillance of neglected arboviral diseases in returning travelers. To map the patients high at risk of missed clinical arboviral infections we compared the quantity of all arboviral diagnostic requests by physicians in the Netherl-s, from 2009 through 2013, with a literature-based assessment of the travelers' likely exposure to an arbovirus. 2153 patients, with travel - clinical history were evaluated. The diagnostic assay for dengue virus (DENV) was the most commonly requested (86%). Of travelers returning from Southeast Asia with symptoms compatible with chikungunya virus (CHIKV), only 55% were tested. For travelers in Europe, arbovirus diagnostics were rarely requested. Over all, diagnostics for most arboviruses were requested only on severe clinical presentation. Travel destination - syndrome were used inconsistently for triage of diagnostics, likely resulting in vast under-diagnosis of arboviral infections of public health significance. This study shows the need for more awareness among physicians - st-ardization of syndromic diagnostic algorithms.
Imprenta: PLoS Neglected Tropical Diseases, v. 9, n. 9, p. e0004073, 2015
Identificador do objeto digital: 10.1371/journal.pntd.0004073
Descritores: Chikungunya virus - Arbovirus ; Chikungunya virus - Infectious diseases ; Chikungunya virus - Viral infections ; Chikungunya Virus - Virus ; Chikungunya virus - Dengue ; Chikungunya virus - Public health
Data de publicação: 2015
