Travel-related zoonotic diseases associated with human exposure to rodents: a review of GeoSentinel Surveillance Data, 1996 - 2011 Open Access

Fitzpatrick, Jillian Leigh (2012)

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Current knowledge of the incidence and risk factors associated with rodent-borne
zoonoses in travelers is limited. Travelers and physicians alike must be properly
educated so that they are aware of the risks and the protective measures that should be
taken. This study investigated rodent-borne zoonoses in travelers and associated risk
factors using GeoSentinel, a multi-site global surveillance network established for the
surveillance of travel-related morbidity. 18 rodent-borne zoonoses were chosen for
analysis. This study analyzed only diseases that were either directly transmitted from
rodents to humans (including contact with infected urine or droppings) or indirectly
transmitted via an arthropod reservoir, where the rodent plays a major role in the life
cycle of the disease. Over a 15 year span there were 962 reports of illness associated
with one or more of these 18 rodent-borne zoonotic diseases. Ill travelers with rodent
zoonoses were found to be significantly more likely to be male and traveling as tourists
than those ill travelers with some other diagnosis. Adventure travel and risky behavior
may increase the risk of contact with rodent zoonoses for both groups, as males were
more likely to engage in adventure travel than females and tourists were also more likely
to engage in risk taking behavior. Further, when compared to all other ill travelers, those
with rodent zoonoses were 21 times more likely to have been exposed in South America,
12 times more likely to have been exposed in Sub-Saharan Africa, and 11 times more
likely to have been exposed in Central America. Travelers to these areas should be aware
of their increased risk of contracting a rodent-borne zoonosis and should take proper
preventative measures. Analysis of the GeoSentinel database can provide epidemiologic
information about rodent-borne zoonoses in travelers and ultimately decrease the disease
burden in this population.

Table of Contents

Background...1 Literature Review...4 Directly Transmitted Rodent Zoonoses...4

Indirectly Transmitted Rodent Zoonoses...6

Rodent Zoonoses in Travelers...11





Rodent Zoonoses Classification...14

Variable Descriptions...15

Comparison Groups...15

Analysis Plan (Specific Aims)...15

Sample Size and Power Calculations...16



Strengths and Limitations...25

Future Directions...26



Appendix 1...42

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