title: Dengue risk among visitors to Hawaii during an outbreak.
abstract: Despite the high rates of dengue in many tropical destinations frequented by tourists, limited information is available on the risk for infection among short-term visitors. We retrospectively surveyed 4,000 persons who arrived in Hawaii during the peak of the 2001-2002 dengue outbreak and collected follow-up serologic test results for those reporting denguelike illness. Of 3,064 visitors who responded, 94 (3%) experienced a denguelike illness either during their trip or within 14 days of departure; 34 of these persons were seen by a physician, and 2 were hospitalized. Twenty-seven visitors with denguelike illness provided a serum specimen; all specimens were negative for anti-dengue immunoglobulin G antibodies. The point estimate of dengue incidence was zero infections per 358 person-days of exposure with an upper 95% confidence limit of 3.0 cases per person-year. Thus, the risk for dengue infection for visitors to Hawaii during the outbreak was low.
authors.affiliation: Hawaii State Department of Health, Honolulu, Hawaii 96813, USA.
authors.forename: Carrie E
authors.initials: CE
authors.lastname: Smith
authors.forename: Tammy
authors.initials: T
authors.lastname: Tom
authors.forename: Jed
authors.initials: J
authors.lastname: Sasaki
authors.forename: Tracy
authors.initials: T
authors.lastname: Ayers
authors.forename: Paul V
authors.initials: PV
authors.lastname: Effler
mesh_terms: D003715:Dengue / Q000453:epidemiology* / Q000635:transmission*; D004196:Disease Outbreaks; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D013997:Time Factors; D014195:Travel