Syndromic approach to arboviral diagnostics for global travelers as a basis for infectious disease surveillance

Cleton, N. B., Reusken, C. B. E. M., Wagenaar, J. F. P., van der Vaart, E. E., Reimerink, J., van der Eijk, A. A. and Koopmans, M. P. G. (2015) Syndromic approach to arboviral diagnostics for global travelers as a basis for infectious disease surveillance. PLoS Neglected Tropical Diseases, 9 (9). e0004073. ISSN 1935-2735 doi: 10.1371/journal.pntd.0004073

Abstract/Summary

Background Arboviruses have overlapping geographical distributions and 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 and surveillance of neglected arboviral diseases in returning travelers. Method 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 Netherlands, from 2009 through 2013, with a literature-based assessment of the travelers’ likely exposure to an arbovirus. Results 2153 patients, with travel and 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. Conclusion Travel destination and 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 and standardization of syndromic diagnostic algorithms

Item Type	Article
URI	https://reading-clone.eprints-hosting.org/id/eprint/46601
Identification Number/DOI	10.1371/journal.pntd.0004073
Refereed	Yes
Divisions	Life Sciences > School of Biological Sciences > Biomedical Sciences
Publisher	Public Library of Science
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