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.

Interpretation: 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.

Figure 1: Regional exposure for the cohort of returned travellers (n = 1076) with a primary travel-related dermatologic diagnosis presenting to a CanTravNet site in Canada.