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Reference Manager
BibTeX
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1.
Wilder-Smith A , Ooi EE , Horstick O , Wills B , 2019. Dengue. Lancet 393: 350–363.
-
2.
Wilder-Smith A , Chang CR , Leong WY , 2018. Zika in travellers 1947-2017: a systematic review. J Travel Med 25: tay044.
-
3.
Cunha RVD , Trinta KS , 2017. Chikungunya virus: clinical aspects and treatment – a review. Mem Inst Oswaldo Cruz 112: 523–531.
-
4.
Thompson R , Martin Del Campo J , Constenla D , 2020. A review of the economic evidence of Aedes-borne arboviruses and Aedes-borne arboviral disease prevention and control strategies. Expert Rev Vaccines 19: 143–162.
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Leder K et al., 2013. GeoSentinel Surveillance Network. GeoSentinel surveillance of illness in returned travelers, 2007–2011. Ann Intern Med 158: 456–468.
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Stanaway JD et al., 2016. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. Lancet Infect Dis 16: 712–723.
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7.
Labeaud AD , Bashir F , King CH , 2011. Measuring the burden of arboviral diseases: the spectrum of morbidity and mortality from four prevalent infections. Popul Health Metr 9: 1.
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8.
World Tourism Organization (UNWTO) , 2022. Tourism Grows 4% in 2021 but Remains Far Below Pre-Pandemic Levels. Available at: https://www.unwto.org/news/tourism-grows-4-in-2021-but-remains-far-below-pre-pandemic-levels. Accessed January 18, 2022.
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9.
Zemke JN , Sanchez JL , Pang J , Gray GC , 2019. The double-edged sword of military response to societal disruptions: a systematic review of the evidence for military personnel as pathogen transmitters. J Infect Dis 220: 1873–1884.
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10.
Lindholm DA et al., 2017. Mosquito exposure and chikungunya and dengue infection among travelers during the chikungunya outbreak in the Americas. Am J Trop Med Hyg 96: 903–912.
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11.
Lalani T et al., 2016. A comparison of compliance rates with anti-vectorial protective measures during travel to regions with dengue or chikungunya activity, and regions endemic for Plasmodium falciparum malaria. J Travel Med 23: taw043.
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12.
Mølle I , Christensen KL , Hansen PS , Dragsted UB , Aarup M , Buhl MR , 2000. Use of medical chemoprophylaxis and antimosquito precautions in Danish malaria patients and their traveling companions. J Travel Med 7: 253–258.
-
13.
Armed Forces Health Surveillance Branch (AFHSB), Defense Health Agent , 2020. Armed Forces Reportable Medical Events (ARFME): Guidelines and Case Definitions. Available at: https://health.mil/Reference-Center/Publications/2020/01/01/Armed-Forces-Reportable-Medical-Events-Guidelines. Accessed January 18, 2022.
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14.
O’Donnell FL , Stahlman S , Fan M , 2018. Surveillance for vector-borne diseases among active and reserve component service members, U.S. Armed Forces, 2010–2016. MSMR 25: 8–15.
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15.
Eick-Cost AA , Hu Z , Klein TA , Putnak RJ , Jarman RG , 2015. Seroconversion to Japanese encephalitis virus among U.S. infantry forces in Korea. Am J Trop Med Hyg 93: 1052–1054.
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16.
Hills SL , Walter EB , Atmar RL , Fischer M , 2019. Japanese encephalitis vaccine: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 68: 1–33.
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Quan H , Li B , Duncan Saunders L , Parsons GA , Nilsson CI , Alibhai A , Ghali WA , IMECCHI Investigators , 2008. Assessing validity of ICD-9-CM and ICD-10 administrative data in recording clinical conditions in a unique dually coded database. Health Serv Res 43: 1424–1441.
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18.
Military OneSource , 2020. 2020 Demographics: Profile of the Military Community. Available at: https://www.militaryonesource.mil/data-research-and-statistics/military-community-demographics/2020-demographics-profile/. Accessed March 11, 2022.
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19.
Undurraga EA , Edillo FE , Erasmo JN , Alera MT , Yoon IK , Largo FM , Shepard DS , 2017. Disease burden of dengue in the Philippines: adjusting for underreporting by comparing active and passive dengue surveillance in Punta Princesa, Cebu City. Am J Trop Med Hyg 96: 887–898.
-
20.
Woon YL , Lee KY , Mohd Anuar SF , Goh PP , Lim TO , 2018. Validity of International Classification of Diseases (ICD) coding for dengue infections in hospital discharge records in Malaysia. BMC Health Serv Res 18: 292.
-
21.
Carabali M , Jaramillo-Ramirez GI , Rivera VA , Mina Possu NJ , Restrepo BN , Zinszer K , 2021. Assessing the reporting of dengue, chikungunya and Zika to the National Surveillance System in Colombia from 2014–2017: a capture-recapture analysis accounting for misclassification of arboviral diagnostics. PLoS Negl Trop Dis 15: e0009014.
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22.
Leder K et al., GeoSentinel Surveillance Network , 2006. Illness in travelers visiting friends and relatives: a review of the GeoSentinel Surveillance Network. Clin Infect Dis 43: 1185–1193.
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Petersen LR , Jamieson DJ , Powers AM , Honein MA , 2016. Zika virus. N Engl J Med 374: 1552–1563.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1151 | 854 | 55 |
| Full Text Views | 2024 | 179 | 1 |
| PDF Downloads | 245 | 27 | 2 |
The Burden of Arboviral Infections in the Military Health System 2012–2019
Trevor Wellington
Trevor Wellington
Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland;
Clinical Trials Center, Walter Reed Army Institute of Research, Silver Spring, Maryland;
1 stArea Medical Laboratory, Aberdeen Proving Grounds, Maryland;
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Clinical Trials Center, Walter Reed Army Institute of Research, Silver Spring, Maryland;
1 stArea Medical Laboratory, Aberdeen Proving Grounds, Maryland;
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Jamie A. Fraser
Jamie A. Fraser
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of Health Sciences, Bethesda, Maryland;
Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland;
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Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland;
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Huai-Ching Kuo
Huai-Ching Kuo
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of Health Sciences, Bethesda, Maryland;
Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland;
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Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland;
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Patrick W. Hickey
Patrick W. Hickey
Department of Pediatrics, Uniformed Services University of Health Sciences, Bethesda, Maryland;
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David A. Lindholm
David A. Lindholm
Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland;
Infectious Disease Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas
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Infectious Disease Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas
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ABSTRACT.
Arboviral infections, including dengue (DNV), chikungunya (CHIKV), and Zika (ZIKV), impact both travelers and native populations of endemic regions. We sought to assess the disease burden of arboviral infections in the Military Health System, the validity of arboviral diagnostic codes, and the role of pretravel counseling on insect avoidance precautions. We searched for diagnostic codes consistent with arboviral infection and grouped them into DNV, CHIKV, ZIKV, Japanese encephalitis virus (JEV), and Other. Demographic data were evaluated. A subset of charts in each category were reviewed for diagnostic validity and travel characteristics. In all, 10,547 unique subjects carried 17,135 arboviral diagnostic codes, including 1,606 subjects (15.2%) coded for DNV, 230 (2.2%) for ZIKV, 65 (0.6%) for CHIKV, and 4,317 (40.9%) for JEV. A chart review was performed on 807 outpatient charts, yielding outpatient diagnostic code positive predictive values of 60.5% (DNV), 15.3% (ZIKV), and 64.5% (CHIKV); there were no valid cases of JEV. Dengue represented the greatest burden of arboviral infections with 2.2 cases per 100,000 military healthcare enrollees over the 2012–2019 fiscal years. More than 80% of subjects with arboviral infection did not have documented pretravel counseling. Arboviral infections represent a significant disease burden in young travelers to endemic regions. After adjustment for diagnostic validity, DNV represented the greatest burden. Diagnostic codes for ZIKV and JEV overestimate the burden of these diseases. Low rates of pretravel visits represent an opportunity for increased emphasis on insect exposure precautions.
- Supplemental Materials (PDF 631 KB)
Author Notes
Disclosure: The contents of this publication are the sole responsibility of the author(s) and do not necessarily reflect the views, opinions or policies of Uniformed Services University of the Health Sciences, Walter Reed Army Institute of Research, the 1st Area Medical Laboratory, the Department of Defense, the Departments of the Army or Air Force, Brooke Army Medical Center, the Defense Health Agency, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, or the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government. The investigators have adhered to the policies for protection of human subjects as prescribed in 45 CFR 46.
Disclaimer: This work was previously presented as a poster at IDWeek 2020 (virtual) and a podium presentation at Triservice ACP 2020 (virtual).
Authors’ addresses: Trevor Wellington, Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, Clinical Trials Center, Walter Reed Army Institute of Research, Silver Spring, MD, and 1st Area Medical Laboratory, Aberdeen Proving Grounds, MD, E-mail: wellington.trevor@gmail.com. Jamie A. Fraser and Huai-Ching Kuo, Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of Health Sciences, Bethesda, MD, and Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, E-mails: jamiefras@gmail.com and ckuo@idcrp.org. Patrick W. Hickey, Department of Pediatrics, Uniformed Services University of Health Sciences, Bethesda, MD, E-mail: patrick.hickey@usuhs.edu. David A. Lindholm, Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, and Infectious Disease Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, E-mail: david.lindholm@usuhs.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Wilder-Smith A , Ooi EE , Horstick O , Wills B , 2019. Dengue. Lancet 393: 350–363.
-
2.
Wilder-Smith A , Chang CR , Leong WY , 2018. Zika in travellers 1947-2017: a systematic review. J Travel Med 25: tay044.
-
3.
Cunha RVD , Trinta KS , 2017. Chikungunya virus: clinical aspects and treatment – a review. Mem Inst Oswaldo Cruz 112: 523–531.
-
4.
Thompson R , Martin Del Campo J , Constenla D , 2020. A review of the economic evidence of Aedes-borne arboviruses and Aedes-borne arboviral disease prevention and control strategies. Expert Rev Vaccines 19: 143–162.
-
5.
Leder K et al., 2013. GeoSentinel Surveillance Network. GeoSentinel surveillance of illness in returned travelers, 2007–2011. Ann Intern Med 158: 456–468.
-
6.
Stanaway JD et al., 2016. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. Lancet Infect Dis 16: 712–723.
-
7.
Labeaud AD , Bashir F , King CH , 2011. Measuring the burden of arboviral diseases: the spectrum of morbidity and mortality from four prevalent infections. Popul Health Metr 9: 1.
-
8.
World Tourism Organization (UNWTO) , 2022. Tourism Grows 4% in 2021 but Remains Far Below Pre-Pandemic Levels. Available at: https://www.unwto.org/news/tourism-grows-4-in-2021-but-remains-far-below-pre-pandemic-levels. Accessed January 18, 2022.
-
9.
Zemke JN , Sanchez JL , Pang J , Gray GC , 2019. The double-edged sword of military response to societal disruptions: a systematic review of the evidence for military personnel as pathogen transmitters. J Infect Dis 220: 1873–1884.
-
10.
Lindholm DA et al., 2017. Mosquito exposure and chikungunya and dengue infection among travelers during the chikungunya outbreak in the Americas. Am J Trop Med Hyg 96: 903–912.
-
11.
Lalani T et al., 2016. A comparison of compliance rates with anti-vectorial protective measures during travel to regions with dengue or chikungunya activity, and regions endemic for Plasmodium falciparum malaria. J Travel Med 23: taw043.
-
12.
Mølle I , Christensen KL , Hansen PS , Dragsted UB , Aarup M , Buhl MR , 2000. Use of medical chemoprophylaxis and antimosquito precautions in Danish malaria patients and their traveling companions. J Travel Med 7: 253–258.
-
13.
Armed Forces Health Surveillance Branch (AFHSB), Defense Health Agent , 2020. Armed Forces Reportable Medical Events (ARFME): Guidelines and Case Definitions. Available at: https://health.mil/Reference-Center/Publications/2020/01/01/Armed-Forces-Reportable-Medical-Events-Guidelines. Accessed January 18, 2022.
-
14.
O’Donnell FL , Stahlman S , Fan M , 2018. Surveillance for vector-borne diseases among active and reserve component service members, U.S. Armed Forces, 2010–2016. MSMR 25: 8–15.
-
15.
Eick-Cost AA , Hu Z , Klein TA , Putnak RJ , Jarman RG , 2015. Seroconversion to Japanese encephalitis virus among U.S. infantry forces in Korea. Am J Trop Med Hyg 93: 1052–1054.
-
16.
Hills SL , Walter EB , Atmar RL , Fischer M , 2019. Japanese encephalitis vaccine: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 68: 1–33.
-
17.
Quan H , Li B , Duncan Saunders L , Parsons GA , Nilsson CI , Alibhai A , Ghali WA , IMECCHI Investigators , 2008. Assessing validity of ICD-9-CM and ICD-10 administrative data in recording clinical conditions in a unique dually coded database. Health Serv Res 43: 1424–1441.
-
18.
Military OneSource , 2020. 2020 Demographics: Profile of the Military Community. Available at: https://www.militaryonesource.mil/data-research-and-statistics/military-community-demographics/2020-demographics-profile/. Accessed March 11, 2022.
-
19.
Undurraga EA , Edillo FE , Erasmo JN , Alera MT , Yoon IK , Largo FM , Shepard DS , 2017. Disease burden of dengue in the Philippines: adjusting for underreporting by comparing active and passive dengue surveillance in Punta Princesa, Cebu City. Am J Trop Med Hyg 96: 887–898.
-
20.
Woon YL , Lee KY , Mohd Anuar SF , Goh PP , Lim TO , 2018. Validity of International Classification of Diseases (ICD) coding for dengue infections in hospital discharge records in Malaysia. BMC Health Serv Res 18: 292.
-
21.
Carabali M , Jaramillo-Ramirez GI , Rivera VA , Mina Possu NJ , Restrepo BN , Zinszer K , 2021. Assessing the reporting of dengue, chikungunya and Zika to the National Surveillance System in Colombia from 2014–2017: a capture-recapture analysis accounting for misclassification of arboviral diagnostics. PLoS Negl Trop Dis 15: e0009014.
-
22.
Leder K et al., GeoSentinel Surveillance Network , 2006. Illness in travelers visiting friends and relatives: a review of the GeoSentinel Surveillance Network. Clin Infect Dis 43: 1185–1193.
-
23.
Granovsky MA , 2016. ICD’10 Diagnosis Codes to Use for Zika Virus Documentation. Available at: https://www.acepnow.com/article/icd-10-diagnosis-codes-use-zika-virus-documentation/. Accessed March 28, 2023.
-
24.
Petersen LR , Jamieson DJ , Powers AM , Honein MA , 2016. Zika virus. N Engl J Med 374: 1552–1563.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1151 | 854 | 55 |
| Full Text Views | 2024 | 179 | 1 |
| PDF Downloads | 245 | 27 | 2 |