Program Schedule

Imported Exotic Infectious Diseases in Columbia, Missouri

Session: Poster Abstract Session: Infectious Diseases in Travelers, Immigrants, and Refugees
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
  • Exotic Infectious Disease Database - Columbia, MO.pdf (301.6 kB)
  • Background: The variety and number of imported exotic infections acquired by Midwest travelers and immigrants is not well known. Midwest physicians, particularly in rural settings, may not consider a foreign exotic infection as the cause of illness among patients who were also travelers or immigrants. We reviewed our past experience in patients diagnosed with a foreign exotic infection at the University of Missouri, in Columbia, Missouri.

    Methods: From the Geo-sentinel master list, we created a sublist of exotic infections acquired outside of the United States of America (USA) and performed a retrospective chart review  for patients with one or more of these diagnoses. Inclusion criteria: Patients seen by the Division of Infectious Diseases from Jan 2001 to Jan 2014, who had a diagnosis of an imported exotic infection and 18 years or older.  We abstracted demographic data, travel history, clinical findings, and laboratory results.

    Results: We recorded 38 cases of exotic infections. Tuberculosis (TB) was seen in 17 patients with one or more of the following: 4 lymphadenopathy, 4 gastrointestinal, 7 pulmonary, 2 each disseminated and latent TB, and 1 each of genitourinary and spine TB. There was no specific geographical trend: 3 Central America (CA), 4 Asia, 4 Africa, 2 Oceania and 1 Europe; 3 TB cases also had HIV and 1 had Echinococcosis. The remaining cases were diverse in diagnoses and origins: Africa: 4 cases of malaria (3 Africa, 1 Sri Lanka) and 1 each of typhoid (Ghana), paratyphoid (Sierra Leone), giardiasis (Sudan), loa loa (Gabon) and schistosomiasis (West Africa); Asia: 1 each of typhoid (Nepal), Leprosy (Sri Lanka), viral hepatitis A (Bangladesh), Japanese encephalitis (Thailand) and chronic Q fever (Iraq); CA: 2 cases each of neuro-cysticercosis (Mexico) and HTLV-1 (Mexico); 1 each of giardiasis (Ecuador), Chagas disease (El Salvador) and brucellosis (Mexico).

    Conclusion: Like travelers and immigrants from coastal and urban USA settings, rural Midwest travelers and immigrants can present with a wide variety of foreign exotic infections. Knowledge of the variety and types of such infections is important for the education and training of health care providers; evaluation of ill patients; and preventive medicine for travelers.

    Hariharan Regunath, MD1, William Salzer, MD1, Umme Aiman Halai, MD2, Deepa Sirigeere Prabhakar, MD1, William Roland, MD1,3, Nicholas Havens, MD1,3 and Gordon Christensen, MD1, (1)Division of Infectious Diseases, University of Missouri, Columbia, MO, (2)Department of Medicine, University of Missouri, Columbia, MO, (3)Harry S. Truman Memorial Veterans Hospital, Columbia, MO


    H. Regunath, None

    W. Salzer, None

    U. A. Halai, None

    D. Sirigeere Prabhakar, None

    W. Roland, None

    N. Havens, None

    G. Christensen, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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