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Background: Zika virus has spread rapidly in the Americas and has been imported into many nonendemic countries by travelers.Objective: To describe clinical manifestations and epidemiology of Zika virus disease in travelers exposed in the Americas.Design: Descriptive, using GeoSentinel records.Setting: 63 travel and tropical medicine clinics in 30 countries.Patients: Ill returned travelers with a confirmed, probable, or clinically suspected diagnosis of Zika virus disease seen between January 2013 and 29 February 2016.Measurements: Frequencies of demographic, trip, and clinical characteristics and complications.Results: Starting in May 2015, 93 cases of Zika virus disease were reported. Common symptoms included exanthema (88%), fever (76%), and arthralgia (72%). Fifty-nine percent of patients were exposed in South America; 71% were diagnosed in Europe. Case status was established most commonly by polymerase chain reaction (PCR) testing of blood and less often by PCR testing of other body fluids or serology and plaque-reduction neutralization testing. Two patients developed Guillain-Barré syndrome, and 3 of 4 pregnancies had adverse outcomes (microcephaly, major fetal neurologic abnormalities, and intrauterine fetal death).Limitation: Surveillance data collected by specialized clinics may not be representative of all ill returned travelers, and denominator data are unavailable.Conclusion: These surveillance data help characterize the clinical manifestations and adverse outcomes of Zika virus disease among travelers infected in the Americas and show a need for global standardization of diagnostic testing. The serious fetal complications observed in this study highlight the importance of travel advisories and prevention measures for pregnant women and their partners. Travelers are sentinels for global Zika virus circulation and may facilitate further transmission.Primary Funding Source: Centers for Disease Control and Prevention, International Society of Travel Medicine, and Public Health Agency of Canada. [ABSTRACT FROM AUTHOR]

Background: International travel continues to increase, particularly to Asia and Africa. Clinicians are increasingly likely to be consulted for advice before travel or by ill returned travelers. Objective: To describe typical diseases in returned travelers accord-ing to region, travel reason, and patient demographic characteris-tics; describe the pattern of low-frequency travel-associated dis-eases; and refine key messages for care before and after travel. Design: Descriptive, using GeoSentinel records. Setting: 53 tropical or travel disease units in 24 countries. Patients: 42 173 ill returned travelers seen between 2007 and 2011. Measurements: Frequencies of demographic characteristics, regions visited, and illnesses reported. Results: Asia (32.6%) and sub-Saharan Africa (26.7%) were the most common regions where illnesses were acquired. Three quar-ters of travel-related illness was due to gastrointestinal (34.0%), febrile (23.3%), and dermatologie (19.5%) diseases. Only 40.5% of all ill travelers reported pretravel medical visits. The relative frequency of many diseases varied with both travel destination and reason for travel, with travelers visiting friends and relatives in their country of origin having both a disproportionately high burden of serious febrile illness and very low rates of advice before travel (18.3%). Life-threatening diseases, such as Plasmodium falciparum malaria, melioidosis, and African trypanosomiasis, were reported. Limitations: Sentinel surveillance data collected by specialist clinics do not reflect healthy returning travelers or those with mild or self-limited illness. Data cannot be used to infer quantitative risk for illness. Conclusion: Many illnesses may have been preventable with ap-propriate advice, chemoprophylaxis, or vaccination. Clinicians can use these 5-year GeoSentinel data to help tailor more efficient pretravel preparation strategies and evaluate possible differential diagnoses of ill returned travelers according to destination and reason for travel. Primary Funding Source: Centers for Disease Control and Prevention. [ABSTRACT FROM AUTHOR]