Protracted rheumatic manifestations in travelers

ECDC comment

This paper describes a small retrospective observational study of Israeli travellers presenting to a tropical medicine clinic with a history of prolonged (>4 weeks), non-traumatic arthralgia or arthritis over a 5 year period.

Kivity S, Meltzer E, Bin H, Schwartz E. Journal of Clinical Rheumatology 2011;17: 55-58.

Description This paper describes a small retrospective observational study of Israeli travellers presenting to a tropical medicine clinic with a history of prolonged (>4 weeks), non-traumatic arthralgia or arthritis over a 5 year period. Fourteen out of 4,666 travellers corresponded to these criteria. Nine cases proved to have an Alphavirus infection (6 persons with chikungunya virus, 2 with Ross River virus and 1 with Sindbis virus), while the remaining 5 cases were diagnosed with reactive arthritis, all associated with a gastrointestinal infection prior to the development of rheumatic symptoms. The authors conclude that post-travel rheumatic disease manifestations may be associated with alphavirus or gastrointestinal infections. However, most cases are expected to recover without chronic debilitating effects.

Public Health significance Primary care physicians and rheumatology clinics should consider the possibility of a travel related illness when assessing patients with rheumatic disease manifestations. Further research into this area could prove beneficial for future treatment.

Link to the article: "Protracted rheumatic manifestations in travelers