title: Dermatoses among returned Canadian travellers and immigrants: surveillance report based on CanTravNet data, 2009-2012.
abstract: BACKGROUND
  There is a lack of multicentre analyses of the spectrum of dermatologic illnesses acquired by Canadian travellers and immigrants. Our objective for this study was to provide a comprehensive, Canada-specific surveillance summary of travel-related dermatologic conditions in a cohort of returned Canadian travellers and immigrants.
  
  
  METHODS
  Data for Canadian travellers and immigrants with a primary dermatologic diagnosis presenting to CanTravNet sites between September 2009 and September 2012 were extracted and analyzed. Data were collected using the GeoSentinel data platform. This network comprises 56 specialized travel and tropical medicine clinics, including 6 Canadian sites (Vancouver, Calgary, Toronto, Ottawa and Montréal), that contribute anonymous, de-linked, clinician- and questionnaire-based travel surveillance data on all ill travellers examined to a centralized Structure Query Language database. Results were analyzed according to reason for most recent ravel: immigration (including refugee); tourism; business; missionary/volunteer/research and aid work; visiting friends and relatives; and other, which included students, military personnel and medical tourists.
  
  
  RESULTS
  During the study period, 6639 patients presented to CanTravNet sites across Canada and 1076 (16.2%) received a travel-related primary dermatologic diagnosis. Arthropod bites (n = 162, 21.5%), rash (n = 141, 18.7%), cutaneous larva migrans (n = 98, 13.0%), and skin and soft tissue infection (n = 92, 12.2%) were the most common dermatologic diagnoses or diagnostic bundles issued to returning Canadian tourists (n = 754, 70.1% of total sample). Patients travelling for the purpose of immigration (n = 63, 5.9%) were significantly more likely to require inpatient management of their dermatologic diagnoses (p < 0.001) than those travelling for other purposes.
  
  
  CONCLUSIONS
  This analysis of surveillance data details the spectrum of travel-related dermatological conditions among returning Canadian travellers in this cohort, and provides an epidemiologic framework for Canadian physicians encountering these patients.
authors.affiliation: Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ont.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Stevens
authors.affiliation: Travel and Migration Health Division, Infectious Disease Prevention and Control Branch, Public Health Agency of Canada, Ottawa, Ont.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Geduld
authors.affiliation: Division of Infectious Diseases, Department of Microbiology, and JD Maclean Centre for Tropical Diseases, McGill University Health Centre, Montréal, Que.
authors.forename: Michael
authors.initials: M
authors.lastname: Libman
authors.affiliation: Division of Infectious Diseases, Department of Microbiology, and JD Maclean Centre for Tropical Diseases, McGill University Health Centre, Montréal, Que.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Ward
authors.affiliation: Tropical Medicine and International Health Clinic, Division of Infectious Diseases, Ottawa Hospital and the University of Ottawa, Ottawa, Ont.
authors.forename: Anne E
authors.initials: AE
authors.lastname: McCarthy
authors.affiliation: Hôpital Saint-Luc du Centre Hospitalier de l'Université de Montréal, Montréal, Que.
authors.forename: Jean
authors.initials: J
authors.lastname: Vincelette
authors.affiliation: Infectious Diseases, Vancouver Island Health Authority, Department of Medicine, University of British Columbia, Victoria, BC.
authors.forename: Wayne
authors.initials: W
authors.lastname: Ghesquiere
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC.
authors.forename: Jan
authors.initials: J
authors.lastname: Hajek
authors.affiliation: Section of Pediatric Infectious Diseases, Departments of Pediatrics and Medicine, Alberta Children's Hospital and the University of Calgary, Calgary, Alta.
authors.forename: Susan
authors.initials: S
authors.lastname: Kuhn
authors.affiliation: UAB Travelers Health Clinic with the Gorgas Center for Geographic Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: David O
authors.initials: DO
authors.lastname: Freedman
authors.affiliation: SAR Laboratories, Sandra Rotman Centre for Global Health, Toronto, Ont. ; Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University Health Network and the University of Toronto, Toronto, Ont.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Kain
authors.affiliation: Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University Health Network and the University of Toronto, Toronto, Ont. ; Public Health Ontario Laboratories, Public Health Ontario, Toronto, Ont.
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Boggild
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