title: Dengue Virus Seroconversion in Travelers to Dengue-Endemic Areas.
abstract: We conducted a prospective study to measure dengue virus (DENV) antibody seroconversion in travelers to dengue-endemic areas. Travelers seen in the Boston Area Travel Medicine Network planning to visit dengue-endemic countries for ≥ 2 weeks were enrolled from 2009 to 2010. Pre- and post-travel blood samples and questionnaires were collected. Post-travel sera were tested for anti-DENV IgG by indirect IgG enzyme-linked immunosorbent assay (ELISA) and anti-DENV IgM by capture IgM ELISA. Participants with positive post-travel anti-DENV IgG or IgM were tested for pre-travel anti-DENV IgG and IgM; they were excluded from the seroconversion calculation if either pre-travel anti-DENV IgG or IgM were positive. Paired sera and questionnaires were collected for 62% (589/955) of enrolled travelers. Most participants were 19-64 years of age, female, and white. The most common purposes of travel were tourism and visiting friends and relatives; most trips were to Asia or Africa. Median length of travel was 21 days. DENV antibody seroconversion by either anti-DENV IgM or IgG ELISA was 2.9-6.8%; lower range percent excluded potential false-positive anti-DENV IgG due to receipt of yellow fever or Japanese encephalitis vaccines at enrollment; upper range percent excluded proven false-positive anti-DENV IgM. Eighteen percent of those with seroconversion reported dengue-like symptoms. Seroconversion was documented for travel to Africa as well as countries and regions known to be highly dengue endemic (India, Brazil, southeast Asia). Given widespread risk of dengue, travel medicine counseling should include information on risk of dengue in endemic areas and advice on preventing insect bites and seeking prompt medical attention for febrile illness.
authors: Section of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
authors: Rosemary M
authors: RM
authors: Olivero
authors: Center for Global Health and Development, Boston University School of Public Health (BUSPH), Boston, Massachusetts.|Department of Global Health, Boston University School of Public Health (BUSPH), Boston, Massachusetts.|Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors: Davidson H
authors: DH
authors: Hamer
authors: Center for Global Health and Development, Boston University School of Public Health (BUSPH), Boston, Massachusetts.|Department of Global Health, Boston University School of Public Health (BUSPH), Boston, Massachusetts.
authors: William B
authors: WB
authors: MacLeod
authors: Section of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
authors: Christine M
authors: CM
authors: Benoit
authors: Division of Pediatric Infectious Diseases, Miami Children's Hospital, Miami, Florida.
authors: Carolina
authors: C
authors: Sanchez-Vegas
authors: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Emily S
authors: ES
authors: Jentes
authors: Travel Medicine Center, Mount Auburn Hospital, Cambridge, Massachusetts.|Harvard Medical School, Boston, Massachusetts.
authors: Lin H
authors: LH
authors: Chen
authors: Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors: Mary E
authors: ME
authors: Wilson
authors: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Nina
authors: N
authors: Marano
authors: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Emad A
authors: EA
authors: Yanni
authors: Department of Infectious Disease, Lahey Clinic Medical Center, Burlington, Massachusetts.
authors: Winnie W
authors: WW
authors: Ooi
authors: Harvard Medical School, Boston, Massachusetts.|Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors: Adolf W
authors: AW
authors: Karchmer
authors: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts.
authors: Laura
authors: L
authors: Kogelman
authors: Section of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts. ebarnett@bu.edu.
authors: Elizabeth D
authors: ED
authors: Barnett
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D001208:Asia; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000097:blood* / Q000276:immunology; D003716:Dengue Virus / Q000276:immunology* / Q000302:isolation & purification; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007194:India; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D000069078:Seroconversion; D011795:Surveys and Questionnaires; D014195:Travel; D014611:Vaccination; D015004:Yellow Fever / Q000097:blood / Q000276:immunology; D022341:Yellow Fever Vaccine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D022341:Yellow Fever Vaccine