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Morbidity and Mortality Weekly Report

1. Public Health Surveillance Using Emergency Medical Service Logs — U.S.–Mexico Land Border, El Paso, Texas, 2009

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Electronic notification systems for emergency transports can enhance infectious disease detection at ports of entry but require further evaluation. Identifying communicable diseases in the more than 500,000 travelers who enter the United States across the U.S.–Mexico border each day presents a challenge. CDC used a commercial software program to screen the records of 50,779 patients transported by emergency medical services in El Paso, Texas, in 2009 to evaluate the usefulness of EMS data for identifying ill travelers. Eighty-six patients required further evaluation by CDC and nine patients had previously unreported infectious diseases. While this process enhanced detection of travelers with serious infections at the U.S.-Mexico border, it required substantial additional resources and follow-up by CDC and needs further evaluation.

2. Dengue Fever Among U.S. Travelers Returning from the Dominican Republic — Minnesota and Iowa, 2008

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Dengue fever, a potentially severe mosquito-borne viral illness, represents a serious risk to travelers to the Caribbean and other endemic areas. This report describes a group of U.S. missionaries who became ill with dengue after traveling to the Dominican Republic for ~1 week. Interviews with these ill travelers suggest that most did not seek pre-travel medical advice and their awareness of dengue and use of prevention tools such as repellent was very limited. These cases indicate a need to increase awareness among US travelers by pre-travel education in the use of prevention measures to avoid mosquito bites. U. S. residents and organizations providing missionary and humanitarian services, as well as vacationers traveling to tropical and subtropical counties, should seek pre-travel medical advice about dengue and other travel-related risks, and need to increase their use of prevention measures such as mosquito repellents, protective clothing and appropriate insecticides to avoid mosquito bites. Importantly, travelers who return ill with dengue also present an ongoing risk for reintroduction of dengue virus to the U.S. mainland.





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