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Shiferaw W, Martin BM, Dean JA, Mills D, Lau C, Paterson D, Koh K, Eriksson L, Furuya-Kanamori L. A systematic review and meta-analysis of sexually transmitted infections and blood-borne viruses in travellers. J Travel Med 2024; 31:taae038. [PMID: 38438164 PMCID: PMC11149723 DOI: 10.1093/jtm/taae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/18/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Sexually transmitted infections (STIs) and blood-borne viruses (BBVs) impose a global health and economic burden. International travellers facilitate the spread of infectious diseases, including STIs. Hence, this review assessed the prevalence/proportionate morbidity of travellers with STIs and sexually transmitted BBVs and factors associated with the infection in this population. METHODS PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Cochrane Library were searched from inception of the databases until November 2022. Published analytical observational studies reporting the prevalence/proportionate morbidity of travellers with STIs and factors associated with STIs by type of traveller [i.e. tourists, business travellers, students, visiting friends or relatives (VFRs), international truck drivers, backpackers, expatriates and men who have sex with men (MSM)] were included. The selection of articles, data extraction and risk of bias assessment were conducted by two independent reviewers. Meta-analyses were conducted for each STI by clinical presentation and type of traveller. RESULTS Thirty-two studies (n = 387 731 travellers) were included; 19 evaluated the proportionate morbidity of STIs among symptomatic travellers, while 13 examined the prevalence of STIs in asymptomatic travellers. The highest proportionate morbidity was found among VFRs (syphilis, 1.67%; 95% CI: 1.03-2.81%), backpackers (Chlamydia trachomatis, 6.58%; 95% CI: 5.96-7.25%) and MSM (HIV [2.50%;95% CI: 0.44-12.88%], gonorrhoea [4.17%; 95% CI: 1.1.5-13.98%], lymphogranuloma venereum [4.17%;95% CI: 1.1.5-13.98%] and HAV [20.0%; 95% CI: 14.99-26.17%]). The highest prevalence of STIs among asymptomatic were found in MSM (HIV [25.94%; 95% CI: 22.21-30.05%] and HBV [24.90%; 95% CI: 21.23-28.96%]) and backpackers (C. trachomatis, 3.92%; 95% CI: 2.72-5.32%). Short duration of the trip (<1 month), not having pre-travel consultation, travelling to Southeast Asia and being unvaccinated for HBV were identified as risk factors for STIs. CONCLUSION Strategies to prevent STIs and sexually transmitted BBVs should be discussed at pre-travel consultations, and recommendations should be prioritized in high-risk groups of travellers, such as backpackers, VFRs and MSMs. Additionally, healthcare providers should tailor recommendations for safe sex practices to individual travellers' unique needs.
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Affiliation(s)
- Wondimeneh Shiferaw
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Asrat Woldeyes Health Science Campus, Debre Berhan University, Ethiopia
| | - Beatris Mario Martin
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Judith A Dean
- UQ Poche Centre for Indigenous Health, Faculty of Health, and Behavioural Sciences, The University of Queensland, Toowong, Australia
| | - Deborah Mills
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Colleen Lau
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - David Paterson
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Kenneth Koh
- Gladstone Road Medical Centre, Brisbane, Australia
| | - Lars Eriksson
- Herston Health Sciences Library, The University of Queensland, Herston, Australia
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
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Silva Viana IP, Paulo Vieira C, Lima Santos Rosario I, Brizack Monteiro N, Sousa Vieira IR, Conte-Junior CA, Pereira Costa M. Typhoid Fever and Non-typhoidal Salmonella Outbreaks: A Portrait of Regional Socioeconomic Inequalities in Brazil. Curr Microbiol 2024; 81:57. [PMID: 38196058 DOI: 10.1007/s00284-023-03559-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/14/2023] [Indexed: 01/11/2024]
Abstract
Typhoid fever occurs in an endemic form in Brazil and is a serious public health problem in some regions. In this scenario, further research is urgently needed to identify the associations between socioeconomic factors and typhoid fever, contributing to guiding policy decisions in the country. We aimed to investigate the influence of socioeconomic disparities on the prevalence of typhoid fever and non-typhoidal Salmonella (NTS) in Brazil. A search for data from 2010 to 2019 was carried out with the national health and human development agencies. As milk and derivatives are the fourth food incriminated in food outbreaks in Brazil, analyses for detecting Salmonella spp. in commercial dairy products allowed us to assess whether the outbreaks associated with these foods are due to inadequacies in sanitary control in dairy establishments or whether they are mainly home-based outbreaks. Predictive models validated by the bootstrapping method demonstrate an association of NTS prevalence reduction with improvements in the Sanitation Service Index (Rv ≥ -8 0.686; p ≤ 0.01) and Municipal Human Development Index - MHDI - (Rv = -0.789; p ≤ 0.02). In the North, typhoid fever prevalence had seasonal variability with the rainfall, while sanitation services (Rv ≥-0.684; p ≤ 0.04) and MHDI (Rv ≥-0.949; p ≤ 0.003) directly influenced Northeast and South Brazil. Thus, the unequal distribution of investments in the sanitation sector contributed to disparities in typhoid fever prevalence among Brazilian regions. The absence of Salmonella spp. in commercial samples ratified the collected data that the outbreaks of Salmonella spp. in the Brazilian population occur mainly at residences. These findings show that implementing public health education and increasing investments in sanitation in regions with poor service can control outbreaks of Salmonella spp. in Brazilian endemic areas.
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Affiliation(s)
- Isabelle Pryscylla Silva Viana
- Graduate Program in Food Science (PGAli), Faculty of Pharmacy, Federal University of Bahia (UFBA), Salvador, BA, 40170-115, Brazil
- Laboratório de Inspeção e Tecnologia de Leite e Derivados (LaITLacteos), Federal University of Bahia (UFBA), Salvador, BA, 40170-110, Brazil
| | - Carla Paulo Vieira
- Laboratory of Advanced Analysis in Biochemistry and Molecular Biology (LAABBM), Department of Biochemistry, Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro, RJ, 21941-909, Brazil
- Center for Food Analysis (NAL), Technological Development Support Laboratory (LADETEC), Cidade Universitária, Rio de Janeiro, RJ, 21941-598, Brazil
| | - Iuri Lima Santos Rosario
- Laboratório de Inspeção e Tecnologia de Leite e Derivados (LaITLacteos), Federal University of Bahia (UFBA), Salvador, BA, 40170-110, Brazil
- Laboratory of Advanced Analysis in Biochemistry and Molecular Biology (LAABBM), Department of Biochemistry, Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro, RJ, 21941-909, Brazil
| | - Nathália Brizack Monteiro
- Graduate Program in Food Science (PGAli), Faculty of Pharmacy, Federal University of Bahia (UFBA), Salvador, BA, 40170-115, Brazil
- Laboratório de Inspeção e Tecnologia de Leite e Derivados (LaITLacteos), Federal University of Bahia (UFBA), Salvador, BA, 40170-110, Brazil
| | - Italo Rennan Sousa Vieira
- Laboratory of Advanced Analysis in Biochemistry and Molecular Biology (LAABBM), Department of Biochemistry, Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro, RJ, 21941-909, Brazil
- Center for Food Analysis (NAL), Technological Development Support Laboratory (LADETEC), Cidade Universitária, Rio de Janeiro, RJ, 21941-598, Brazil
| | - Carlos Adam Conte-Junior
- Laboratory of Advanced Analysis in Biochemistry and Molecular Biology (LAABBM), Department of Biochemistry, Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro, RJ, 21941-909, Brazil
- Center for Food Analysis (NAL), Technological Development Support Laboratory (LADETEC), Cidade Universitária, Rio de Janeiro, RJ, 21941-598, Brazil
| | - Marion Pereira Costa
- Graduate Program in Food Science (PGAli), Faculty of Pharmacy, Federal University of Bahia (UFBA), Salvador, BA, 40170-115, Brazil.
- Laboratório de Inspeção e Tecnologia de Leite e Derivados (LaITLacteos), Federal University of Bahia (UFBA), Salvador, BA, 40170-110, Brazil.
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Alhussaini NWZ, Elshaikh UAM, Hamad NA, Nazzal MA, Abuzayed M, Al-Jayyousi GF. A scoping review of the risk factors and strategies followed for the prevention of COVID-19 and other infectious diseases during sports mass gatherings: Recommendations for future FIFA World Cups. Front Public Health 2023; 10:1078834. [PMID: 36726622 PMCID: PMC9885104 DOI: 10.3389/fpubh.2022.1078834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
Objective Sports mass gatherings of people pose particular concerns and place an additional burden on the host countries and the countries of origin of the travelers. It is imperative to identify how countries dealt with various communicable diseases in the context of previous world cups and identify possible advice for protection from outbreaks. Methods A scoping review was employed in this study and a PRISMA extension for scoping reviews was employed to guide the reporting of this study. A systematic search was performed using PubMed, Embase, Web of Science, SCOPUS, SportDiscus, and Google scholar. The search strategy included two main strings viz "communicable disease" AND "sport" AND "setting" as keywords for each string. A total of 34 studies were included in this review. Results Information on risk factors for infectious diseases during FIFA, and recommendations for disease prevention in various stages of the event: pre-event, during, and post-event were charted. These strategies can be achieved with the empowerment of the public by enhancing their social responsibility and the coordination between the healthcare system, the ministry of public health, and other stakeholders. Conclusion The findings will support planning for protection strategies to prevent any outbreak while having the FIFA World Cup or any other sports gatherings. A model was constructed to present the findings and recommendations from this review.
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Affiliation(s)
| | | | - Noor Ahmed Hamad
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Maisa Ayman Nazzal
- Department of Infection Control Unit, Ibn Sina Specialized Hospital, West Bank, Palestine
| | - Manal Abuzayed
- Health Promotion Division, Department of Public Health, Ministry of Public Health, Doha, Qatar
| | - Ghadir Fakhri Al-Jayyousi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar,*Correspondence: Ghadir Fakhri Al-Jayyousi ✉
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Cunha Filho GARD, Arliani GG, Yamada AF, Cohen M, Ejnisman B, Andreoli CV. MEDICAL PLANNING FOR MASS GATHERING SPORTS EVENTS IN BRAZIL. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012021_0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Medical planning for mass gathering events is founded on the structuring of assistance to the population involved and the preservation of the response capacities of the local healthcare system. Large sporting events attended by crowds are increasingly common in society. These events have been shown to be dangerous, generating higher incidences of injuries and illnesses than usual. Thus, planning and the interaction among various public and private sectors are required for the prevention of and response to emergencies and incidents involving multiple victims. Methods: Recently published studies on medical planning for large sports events and current federal agency legislation were selected to conduct an updated review on the subject. Results: After reading titles and abstracts, 159 papers were chosen for a full reading, 50 of which met the eligibility criteria and were included as the basis for this review. The size of the audience, the weather, and the behavior of the crowd seem to contribute significantly to the estimated need for resources in sporting events. Conclusion: Mass events require planning for prevention and to strengthen the resilience of host communities. There is a still a lack of evidence that these events increase the risk of the mass spreading of disease. Level of Evidence: V; Expert opinion .
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Yan X, Fang Y, Li Y, Jia Z, Zhang B. Risks, Epidemics, and Prevention Measures of Infectious Diseases in Major Sports Events: Scoping Review. JMIR Public Health Surveill 2022; 8:e40042. [PMID: 36459401 PMCID: PMC9758642 DOI: 10.2196/40042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Major sports events are the focus of the world. However, the gathering of crowds during these events creates huge risks of infectious diseases transmission, posing a significant public health threat. OBJECTIVE The aim of this study was to systematically review the epidemiological characteristics and prevention measures of infectious diseases at major sports events. METHODS The procedure of this scoping review followed Arksey and O'Malley's five-step methodological framework. Electronic databases, including PubMed, Web of Science, Scopus, and Embase, were searched systematically. The general information (ie, publication year, study type) of each study, sports events' features (ie, date and host location), infectious diseases' epidemiological characteristics (ie, epidemics, risk factors), prevention measures, and surveillance paradigm were extracted, categorized, and summarized. RESULTS A total of 24,460 articles were retrieved from the databases and 358 studies were included in the final data synthesis based on selection criteria. A rapid growth of studies was found over recent years. The number of studies investigating epidemics and risk factors for sports events increased from 16/254 (6.3%) before 2000 to 201/254 (79.1%) after 2010. Studies focusing on prevention measures of infectious diseases accounted for 85.0% (238/280) of the articles published after 2010. A variety of infectious diseases have been reported, including respiratory tract infection, gastrointestinal infection, vector-borne infection, blood-borne infection, and water-contact infection. Among them, respiratory tract infections were the most concerning diseases (250/358, 69.8%). Besides some routine prevention measures targeted at risk factors of different diseases, strengthening surveillance was highlighted in the literature. The surveillance system appeared to have gone through three stages of development, including manual archiving, network-based systems, and automated intelligent platforms. CONCLUSIONS This critical summary and collation of previous empirical evidence is meaningful to provide references for holding major sports events. It is essential to improve the surveillance techniques for timely detection of the emergence of epidemics and to improve risk perception in future practice.
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Affiliation(s)
- Xiangyu Yan
- School of Public Health, Peking University, Beijing, China
| | - Yian Fang
- School of Public Health, Peking University, Beijing, China
| | - Yongjie Li
- School of Basic Medical Sciences, Peking University, Beijing, China
| | - Zhongwei Jia
- School of Public Health, Peking University, Beijing, China
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China
- Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China
| | - Bo Zhang
- School of Public Health, Peking University, Beijing, China
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Saboyá-Díaz MI, Nicholls RS, Castellanos LG, Feldmeier H. Current status of the knowledge on the epidemiology of tungiasis in the Americas. Rev Panam Salud Publica 2022; 46:e124. [PMID: 36060204 PMCID: PMC9426953 DOI: 10.26633/rpsp.2022.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/05/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives. To present the state-of-the-knowledge on the epidemiology of tungiasis in the Region of the Americas. Methods. A search of publications on the epidemiology of tungiasis in the Americas was performed in PubMed and LILACS databases from January 2007 to June 2021. In addition, a manual literature search on articles on the epidemiology of tungiasis was performed. Results. A total of 83 articles were analyzed which contained relevant information on tungiasis cases and their geographical distribution, prevalence and risk factors, life cycle, sites where transmission takes place, and zoonotic aspects. The on-host and off-host life cycles have been researched in detail. In certain contexts, the whole life cycle is completed indoors enabling transmission around the whole year. Cases were reported from 10 countries; 71% of them were from Brazil. In the general population, the prevalence varied between 1.0% and 82.6% according to the settings. Age-specific prevalence indicated that children and the elderly bear the highest disease burden. Risk factor studies indicate that tungiasis is associated with severe poverty. Conclusions. In the Americas, there are important gaps in information and knowledge of tungiasis. Understanding the burden, epidemiology, distribution, magnitude, related risk factors, and reservoirs, among others, is needed to develop and implement integrated control measures tailored to the context and patterns of transmission in the affected communities.
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Affiliation(s)
- Martha Idalí Saboyá-Díaz
- Pan American Health Organization Washington, DC United States of America Pan American Health Organization, Washington, DC, United States of America
| | - Rubén Santiago Nicholls
- Pan American Health Organization Washington, DC United States of America Pan American Health Organization, Washington, DC, United States of America
| | - Luis Gerardo Castellanos
- Pan American Health Organization Washington, DC United States of America Pan American Health Organization, Washington, DC, United States of America
| | - Hermann Feldmeier
- University Medicine Berlin Berlin Germany University Medicine Berlin, Berlin, Germany
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Pandey P, Lee K, Amatya B, Angelo KM, Shlim DR, Murphy H. Health problems in travellers to Nepal visiting CIWEC clinic in Kathmandu - A GeoSentinel analysis. Travel Med Infect Dis 2021; 40:101999. [PMID: 33639265 DOI: 10.1016/j.tmaid.2021.101999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/21/2020] [Accepted: 02/18/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Nepal has always been a popular international travel destination. There is limited published data, however, on the spectrum of illnesses acquired by travellers to Nepal. METHODS GeoSentinel is a global data collection network of travel and tropical medicine providers that monitors travel-related morbidity. Records for ill travellers with at least one confirmed or probable diagnosis, were extracted from the GeoSentinel database for the CIWEC Clinic Kathmandu site from January 1, 2009 to December 31, 2017. RESULTS A total of 24,271 records were included. The median age was 30 years (range: 0-91); 54% were female. The top 3 system-based diagnoses in travellers were: gastrointestinal (32%), pulmonary (16%), and dermatologic (9%). Altitude illness comprised 9% of all diagnoses. There were 278 vaccine-preventable diseases, most frequently influenza A (41%) and typhoid fever (19%; S. typhi 52 and S. paratyphi 62). Of 64 vector-borne illnesses, dengue was the most frequent (64%), followed by imported malaria (14%). There was a single traveller with Japanese encephalitis. Six deaths were reported. CONCLUSIONS Travellers to Nepal face a wide spectrum of illnesses, particularly diarrhoea, respiratory disease, and altitude illness. Pre-travel consultations for travellers to Nepal should focus on prevention and treatment of diarrhoea and altitude illness, along with appropriate immunizations and travel advice.
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Affiliation(s)
- Prativa Pandey
- CIWEC Hospital and Travel Medicine Center, Lainchaur, Kathmandu, Nepal.
| | - Keun Lee
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA, USA.
| | - Bhawana Amatya
- CIWEC Hospital and Travel Medicine Center, Lainchaur, Kathmandu, Nepal.
| | - Kristina M Angelo
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA, USA.
| | - David R Shlim
- Jackson Hole Travel and Tropical, Jackson Hole, WY, USA.
| | - Holly Murphy
- IHA Infectious Diseases Consultants, 5333 McAuley Dr., Ypsilanti, MI, USA.
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Hamer DH, Rizwan A, Freedman DO, Kozarsky P, Libman M. GeoSentinel: past, present and future†. J Travel Med 2020; 27:taaa219. [PMID: 33247586 PMCID: PMC7799014 DOI: 10.1093/jtm/taaa219] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022]
Abstract
RATIONALE FOR REVIEW In response to increased concerns about emerging infectious diseases, GeoSentinel, the Global Surveillance Network of the International Society of Travel Medicine in partnership with the US Centers for Disease Control and Prevention (CDC), was established in 1995 in order to serve as a global provider-based emerging infections sentinel network, conduct surveillance for travel-related infections and communicate and assist global public health responses. This review summarizes the history, past achievements and future directions of the GeoSentinel Network. KEY FINDINGS Funded by the US CDC in 1996, GeoSentinel has grown from a group of eight US-based travel and tropical medicine centers to a global network, which currently consists of 68 sites in 28 countries. GeoSentinel has provided important contributions that have enhanced the ability to use destination-specific differences to guide diagnosis and treatment of returning travelers, migrants and refugees. During the last two decades, GeoSentinel has identified a number of sentinel infectious disease events including previously unrecognized outbreaks and occurrence of diseases in locations thought not to harbor certain infectious agents. GeoSentinel has also provided useful insight into illnesses affecting different traveling populations such as migrants, business travelers and students, while characterizing in greater detail the epidemiology of infectious diseases such as typhoid fever, leishmaniasis and Zika virus disease. CONCLUSIONS Surveillance of travel- and migration-related infectious diseases has been the main focus of GeoSentinel for the last 25 years. However, GeoSentinel is now evolving into a network that will conduct both research and surveillance. The large number of participating sites and excellent geographic coverage for identification of both common and illnesses in individuals who have traversed international borders uniquely position GeoSentinel to make important contributions of travel-related infectious diseases in the years to come.
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Affiliation(s)
- Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Crosstown 308, 801 Massachusetts Avenue, Boston, MA 02118, USA
- Section of Infectious Disease, Department of Medicine, Boston University School of Medicine, Crosstown 308, 801 Massachusetts Avenue, Boston, MA 02118, USA
- National Emerging Infectious Disease Laboratory, Boston University, Crosstown 308, 801 Massachusetts Avenue, Boston, MA 02118, USA
| | - Aisha Rizwan
- GeoSentinel, International Society of Travel Medicine, 11720 Amber Park Drive, Suite 160, Alpharetta, GA 30009, USA
| | - David O Freedman
- Division of Infectious Diseases, University of Alabama at Birmingham, 1720 2nd Ave S, BBRB 201, Birmingham, AL 35294 2170, USA
| | - Phyllis Kozarsky
- Division of Infectious Diseases (Emerita), Department of Medicine, Emory University, 2500 Peachtree Road NW, Suite 505, Atlanta, GA 30305, USA
| | - Michael Libman
- J.D. MacLean Centre for Tropical Diseases, McGill University, Room E05.1830, 1001 Boulevard Décarie, Montréal, Québec H4A 3J1, Canada
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Osman S, Preet R. Dengue, chikungunya and Zika in GeoSentinel surveillance of international travellers: a literature review from 1995 to 2020. J Travel Med 2020; 27:6007546. [PMID: 33258476 DOI: 10.1093/jtm/taaa222] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION GeoSentinel is a global surveillance network of travel medicine providers seeing ill-returned travellers. Much of our knowledge on health problems and infectious encountered by international travellers has evolved as a result of GeoSentinel surveillance, providing geographic and temporal trends in morbidity among travellers while contributing to improved pre-travel advice. We set out to synthesize epidemiological information, clinical manifestations and time trends for dengue, chikungunya and Zika in travellers as captured by GeoSentinel. METHODS We conducted a systematic literature search in PubMed on international travellers who presented with dengue, chikungunya or Zika virus infections to GeoSentinel sites around the world from 1995 until 2020. RESULTS Of 107 GeoSentinel publications, 42 articles were related to dengue, chikungunya and/or Zika. The final analyses and synthesis of and results presented here are based on the findings from 27 original articles covering the three arboviral diseases. CONCLUSIONS Dengue is the most frequent arboviral disease encountered in travellers presenting to GeoSentinel sites, with increasing trends over the past two decades. In Southeast Asia, annual proportionate morbidity increased from 50 dengue cases per 1000 ill returned travellers in non-epidemic years to an average of 159 cases per 1000 travellers during epidemic years. The highest number of travellers with chikungunya virus infections was reported during the chikungunya outbreak in the Americas and the Caribbean in the years 2013-16. Zika was first reported by GeoSentinel already in 2012, but notifications peaked in the years 2016-17 reflecting the public health emergency in the Americas at the time.
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Affiliation(s)
- S Osman
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, 90185, Sweden
| | - R Preet
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, 90185, Sweden
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Ectoparasites. J Am Acad Dermatol 2020; 82:551-569. [DOI: 10.1016/j.jaad.2019.05.110] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/16/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022]
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Gallego V, Berberian G, Siu H, Verbanaz S, Rodríguez-Morales AJ, Gautret P, Schlagenhauf P, Lloveras S. The 2019 Pan American games: Communicable disease risks and travel medicine advice for visitors to Peru - Recommendations from the Latin American Society for Travel Medicine (SLAMVI). Travel Med Infect Dis 2019; 30:19-24. [PMID: 31238107 DOI: 10.1016/j.tmaid.2019.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 12/29/2022]
Abstract
The next Pan American Games will be held in Peru in the period July-August 2019. Around 6680 participants from 41 countries are expected to take part in the event. There will be a total of 62 sport disciplines. This event poses specific challenges, given its size and the diversity of attendees. Such gatherings also have potential for the transmission of imported or endemic communicable diseases, including measles in view of the global outbreak situation, but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations taking into consideration the epidemiology and risks of the main communicable diseases at potential destinations in Peru, recommended immunizations and other preventives measures. These recommendations can be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Although Lima is malaria free, travelers visiting Peruvian high-risk areas for malaria should be assessed regarding the need for chemoprophylaxis. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing vector-borne infections. Other important recommendations for travelers should focus on preventing water- and food-borne diseases including travelers' diarrhea. This paper addresses pre-travel, preventive strategies to reduce the risk of acquiring communicable diseases during the Pan American Games and also reviews the spectrum of endemic infections in Lima and Peru to facilitate the recognition and management of infectious diseases in travelers returning to their countries of origin.
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Affiliation(s)
- Viviana Gallego
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Griselda Berberian
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Hugo Siu
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Lima, Peru
| | - Sergio Verbanaz
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Alfonso J Rodríguez-Morales
- Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Pereira, Colombia; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, Institute for Epidemiology, Biostatistics and Prevention, Hirschengraben 84, 8001, Zürich, Switzerland
| | - Susana Lloveras
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina; Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Pereira, Colombia
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12
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Memish ZA, Steffen R, White P, Dar O, Azhar EI, Sharma A, Zumla A. Mass gatherings medicine: public health issues arising from mass gathering religious and sporting events. Lancet 2019; 393:2073-2084. [PMID: 31106753 PMCID: PMC7159069 DOI: 10.1016/s0140-6736(19)30501-x] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/19/2019] [Accepted: 02/27/2019] [Indexed: 12/14/2022]
Abstract
Mass gathering events are associated with major public health challenges. The 2014 Lancet Series on the new discipline of mass gatherings medicine was launched at the World Health Assembly of Ministers of Health in Geneva in May, 2014. The Series covered the planning and surveillance systems used to monitor public health risks, public health threats, and experiences of health-care providers from mass gathering events in 2012 and 2013. This follow-up Review focuses on the main public health issues arising from planned mass gathering events held between 2013 and 2018. We highlight public health and research data on transmission of infectious diseases and antibiotic-resistant bacteria, mass casualty incidents, and non-communicable diseases, including thermal disorders. In the events discussed in this Review, the combination of a large influx of people, many from countries with outbreak-prone infectious diseases, with a high degree of crowd interactions imposed substantial burdens on host countries' health systems. The detection and transmission of antibiotic-resistant bacteria in pilgrims attending the Kumbh Mela and the Hajj raise concern of possible globalisation from mass-gathering religious events. Priorities for further investments and opportunities for research into prevention, surveillance, and management of these public health issues are discussed.
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Affiliation(s)
- Ziad A Memish
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Infectious Diseases Division, Department of Medicine and Research, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travellers' Health, University of Zurich, Zurich, Switzerland; Division of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas School of Public Health, Houston, TX, USA
| | - Paul White
- Commonwealth of the Northern Mariana Islands, Epidemiology and Laboratory Capacity Program, Public Health & Hospital Emergency Preparedness Program, Commonwealth Health Care Corporation, Saipan, Northern Mariana Islands, USA
| | - Osman Dar
- Public Health England and Chatham House Centre on Global Health Security, Royal Institute of International Affairs, London, UK
| | - Esam I Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, Saudi Arabia; Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Avinash Sharma
- National Centre for Microbial Resource, Pune, Maharashtra, India; National Centre for Cell Science, Pune, Maharashtra, India
| | - Alimuddin Zumla
- Division of Infection, University College London, London, UK; NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
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13
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Seasonal variation and persistence of tungiasis infestation in dogs in an endemic community, Bahia State (Brazil): longitudinal study. Parasitol Res 2019; 118:1711-1718. [PMID: 30976966 DOI: 10.1007/s00436-019-06314-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 04/03/2019] [Indexed: 10/27/2022]
Abstract
Tungiasis is a zoonosis neglected by authorities, health professionals, and affected populations. Domestic, synanthropic, and sylvatic animals serve as reservoirs for human infestation, and dogs are usually considered a main reservoir in endemic communities. To describe the seasonal variation and the persistence of tungiasis in dogs, we performed quarterly surveys during a period of 2 years in a tourist village in the municipality of Ilhéus, Bahia State, known to be endemic for tungiasis. Prevalence in dogs ranged from 62.1% (43/66) in August 2013 to 82.2% (37/45) in November 2014, with no significant difference (p = 0.06). The prevalence of infestation remained high, regardless of rainfall patterns. Of the 31 dogs inspected at all surveys, period prevalence was 94% (29/31; 95% CI 79.3-98.2%) and persistence of infestation indicator [PII] was high (median PII = 6 surveys, q1 = 5, q3 = 7). Dogs < 1 year of age had a higher mean prevalence of 84.5%, as compared with 69.3% in the older dogs. No significant difference was found between the risk of infestation and age or sex (p = 0.61). Our data indicate that canine tungiasis persisted in the area during all periods of the year. The seasonal variation described in human studies from other endemic areas was not observed, most probably due to different rainfall patterns throughout the year. The study has important implications for the planning of integrated control measures in both humans and animal reservoirs, considering a One Health approach.
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14
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Heywood AE, López-Vélez R. Reducing infectious disease inequities among migrants. J Travel Med 2019; 26:5198602. [PMID: 30476162 DOI: 10.1093/jtm/tay131] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/13/2018] [Accepted: 11/20/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND migration has reached unprecedented levels, with 3.6% of the world's population living outside their country of birth. Migrants comprise a substantial proportion of high-income country populations, are at increased risk of a range of infectious diseases, compared to native-born populations and may experience worse health outcomes due to barriers accessing timely diagnoses and treatment. Poor access to essential healthcare services can be attributed to several factors, including language and cultural barriers and lack of specific inclusive health policies. METHODS This review draws on evidence from the immigrant health and travel medicine literature, with a focus on infectious disease risks. It presents strategies to reduce barriers to healthcare access through health promotion and screening programs both at the community and clinic level and the delivery of linguistically and culturally competent care. The Methods: Salud Entre Culturas (SEC) 'Health Between Cultures' project from the Tropical Medicine Unit at the Hospital Ramon y Cajal in Madrid is described as an effective model of care. RESULTS For those providing healthcare to migrant populations, the use of community-consulted approaches are considered best practice in the development of health education, health promotion and the delivery of targeted health services. At the clinic-level, strategies optimizing care for migrants include the use of bilingual healthcare professionals or community-based healthcare workers, cultural competence training of all clinic staff, the appropriate use of trained interpreters and the use of culturally appropriate health promotion materials. CONCLUSIONS Multifaceted strategies are needed to improve access, community knowledge, community engagement and healthcare provider training to provide appropriate care to migrant populations to reduce infectious disease disparities.
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Affiliation(s)
- Anita E Heywood
- Level 3, Samuels Building, School of Public Health and Community Medicine, UNSW Sydney, NSW, Australia
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Department of Infectious Diseases, Ramón y Cajal University Hospital, Madrid, Spain
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15
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Boggild AK, Geduld J, Libman M, Yansouni CP, McCarthy AE, Hajek J, Ghesquiere W, Mirzanejad Y, Vincelette J, Kuhn S, Plourde PJ, Chakrabarti S, Greenaway C, Hamer DH, Kain KC. Spectrum of illness in migrants to Canada: sentinel surveillance through CanTravNet. J Travel Med 2019; 26:5159662. [PMID: 30395252 DOI: 10.1093/jtm/tay117] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/29/2018] [Accepted: 11/02/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Due to ongoing political instability and conflict in many parts of the world, migrants are increasingly seeking asylum and refuge in Canada. METHODS We examined demographic and travel correlates of illnesses among migrants to Canada to establish a detailed epidemiologic framework of this population for Canadian practitioners. Data on ill-returned Canadian travellers presenting to a CanTravNet site between 1 January 2015 and 31 December 2015 were analyzed. RESULTS During the study period, 2415 ill travellers and migrants presented to a CanTravNet site, and of those, 519 (21.5%) travelled for the purpose of migration. Sub-Saharan Africa (n = 160, 30.8%), southeast Asia (n = 84, 16.2%) and south central Asia (n = 75, 14.5%) were the most common source regions for migrants, while the top specific source countries, of 98 represented, were the Philippines (n = 45, 8.7%), China (n = 36, 6.9%) and Vietnam (n = 31, 6.0%). Compared with non-migrant travellers, migrants were more likely to have a pre-existing immunocompromising medical condition, such as HIV or diabetes mellitus (P < 0.0001), and to require inpatient management of their illness (P < 0.0001). Diagnoses such as tuberculosis (n = 263, 50.7%), hepatitis B and C (n = 78, 15%) and HIV (n = 11, 2.1%) were over-represented in the migrant population compared with non-migrant travellers (P < 0.0001). Most cases of tuberculosis in the migrant population (n = 263) were latent (82% [n = 216]); only 18% (n = 47) were active. CONCLUSIONS Compared with non-migrant travellers, migrants were more likely to present with a communicable infectious disease, such as tuberculosis, potentially complicated by an underlying immunosuppressing condition such as HIV. These differences highlight the divergent healthcare needs in the migrant population, and underscore the importance of surveillance programmes to understand their burden of illness. Intake programming should be adequately resourced to accommodate the medical needs of this vulnerable population of new Canadians.
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Affiliation(s)
- Andrea K Boggild
- Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University Health Network and the University of Toronto, Toronto ON, Canada.,Public Health Ontario Laboratories, Public Health Ontario, Toronto, ON, Canada
| | - Jennifer Geduld
- Office of Border and Travel Health, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Michael Libman
- The J.D. MacLean Centre for Tropical Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Cedric P Yansouni
- The J.D. MacLean Centre for Tropical Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Anne E McCarthy
- Tropical Medicine and International Health Clinic, Division of Infectious Diseases, Ottawa Hospital and the University of Ottawa, Ottawa ON, Canada
| | - Jan Hajek
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver British Columbia, Canada
| | - Wayne Ghesquiere
- Infectious Diseases, Vancouver Island Health Authority, Department of Medicine, University of British Columbia, Victoria, British Columbia, Canada
| | - Yazdan Mirzanejad
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver British Columbia, Canada.,Fraser Health, Surrey, British Columbia, Canada
| | - Jean Vincelette
- Hôpital Saint-Luc du CHUM, Université de Montréal, Montréal, Quebec, Canada
| | - Susan Kuhn
- Section of Pediatric Infectious Diseases, Departments of Pediatrics and Medicine, Alberta Children's Hospital and the University of Calgary, Calgary, Alberta, Canada
| | - Pierre J Plourde
- Travel Health and Tropical Medicine Services, Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Sumontra Chakrabarti
- Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University Health Network and the University of Toronto, Toronto ON, Canada.,Trillium Health Partners, Mississauga, ON, Canada
| | - Christina Greenaway
- The J.D. MacLean Centre for Tropical Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada.,Division of Infectious Diseases, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA
| | - Kevin C Kain
- Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University Health Network and the University of Toronto, Toronto ON, Canada.,SAR Laboratories, Sandra Rotman Centre for Global Health, Toronto, ON Canada
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16
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Reichert F, Pilger D, Schuster A, Lesshafft H, Guedes de Oliveira S, Ignatius R, Feldmeier H. Epidemiology and morbidity of hookworm-related cutaneous larva migrans (HrCLM): Results of a cohort study over a period of six months in a resource-poor community in Manaus, Brazil. PLoS Negl Trop Dis 2018; 12:e0006662. [PMID: 30024875 PMCID: PMC6067763 DOI: 10.1371/journal.pntd.0006662] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/31/2018] [Accepted: 07/03/2018] [Indexed: 11/29/2022] Open
Abstract
Background Hookworm-related cutaneous larva migrans (HrCLM) is a neglected parasitic skin disease, widespread in resource-poor communities in tropical and subtropical countries. Incidence and risk factors have never been investigated in a cohort study. Methodology/Principal findings To understand the seasonal epidemiology of HrCLM, an open cohort of 476 children in a resource-poor community in Manaus, Brazil was examined for HrCLM monthly over a period of 6 months. Monthly prevalence and intensity of infection were correlated with the amount of monthly precipitation. Multivariable Cox regression analysis indicated male sex (hazard ratio [HR] 3.29; 95% confidence interval [CI] 1.95–5.56), walking barefoot on sandy ground (HR 2.30; 95% CI 1.03–5.16), poverty (HR 2.13; 95% CI 1.09–4.17) and age between 10 and 14 years (HR 1.87; 95% CI 1.01–3.46) as predictors of HrCLM. Monthly incidence rates ranged between 0.21 and 1.05 cases per person-year with an overall incidence of 0.52 per person-year. Conclusions/Significance HrCLM is a frequent parasitic skin disease in this resource-poor community. Every second child theoretically becomes infected during one year. Boys, 10 to 14 years old, belonging to the poorest households of the community, are the most vulnerable population group. Even in the tropical monsoonal climate of Amazonia there is a considerable seasonal variation with monthly incidence and number of lesions peaking in the rainy season. Hookworm-worm related cutaneous larva migrans (HrCLM) is a parasitic skin disease caused by hookworm larvae of cats and dogs occurring in many countries with a tropical or subtropical climate. Humans are a biological impasse for these helminths as the larvae cannot pass the basal membrane of the epidermis and hence migrate haphazardly in the skin causing local inflammation and intense itching. In scientific literature HrCLM is generally described as a disease of travellers returning from endemic areas. In contrast, epidemiological data is scanty. In a previous study, we had examined an entire resource-poor neighbourhood in Manaus (Brazil) and showed, that HrCLM is an important individual and public health problem, affecting up to 8% of the population, in particular children. In this study, we followed a cohort of children for six months. We found a significant seasonal variation in incidence and morbidity between dry and rainy season. Extrapolated, every second child in this population will be affected at least once within one year. The longitudinal study design enabled us to validate previously identified risk factors. Children aged 10–14 years, in particular boys, and those walking barefoot on sandy ground had the highest infection rates. Children from the poorest families in the resource-poor community were most vulnerable to HrCLM.
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Affiliation(s)
- Felix Reichert
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Microbiology and Infection Immunology, Berlin, Germany
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Neonatology, Berlin, Germany
- * E-mail:
| | - Daniel Pilger
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Ophthalmology, Berlin, Germany
| | - Angela Schuster
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Microbiology and Infection Immunology, Berlin, Germany
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of General Practice, Berlin, Germany
| | - Hannah Lesshafft
- University of Edinburgh, School of Social and Political Sciences, Edinburgh, United Kingdom
| | | | - Ralf Ignatius
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Microbiology and Infection Immunology, Berlin, Germany
- Labor 28 GmbH, Berlin, Germany
| | - Hermann Feldmeier
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Microbiology and Infection Immunology, Berlin, Germany
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17
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Vasquez V, Haddad E, Perignon A, Jaureguiberry S, Brichler S, Leparc-Goffart I, Caumes E. Dengue, chikungunya, and Zika virus infections imported to Paris between 2009 and 2016: Characteristics and correlation with outbreaks in the French overseas territories of Guadeloupe and Martinique. Int J Infect Dis 2018; 72:34-39. [PMID: 29782922 DOI: 10.1016/j.ijid.2018.05.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 05/10/2018] [Accepted: 05/11/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) infections are rapidly expanding across countries and are being diagnosed in returned travellers who represent epidemiological sentinels. The French Territories of America (FTA) such as Guadeloupe and Martinique see high levels of tourism and have experienced three consecutive outbreaks by these viruses in the last decade. OBJECTIVE This study was performed to evaluate how ill returned travellers could have represented epidemiological sentinels for these three expanding arboviral diseases over eight consecutive years. The degree of correlation between the cases of ill returned travellers arriving at a French tertiary hospital in Paris and the three outbreaks that occurred in the FTA during the study period was estimated. METHODS All consecutive ill returned travellers diagnosed at the hospital in Paris with imported DENV, CHIKV, or ZIKV infections from January 2009 to December 2016 were included. Epidemiological and clinical variables were evaluated. Data concerning the incidence of arboviruses in the FTA, as well as the temporal relationship between the occurrence of imported cases and outbreaks in the FTA, were analyzed. RESULTS Overall, 320 cases of arboviral infection were reported: 216 DENV, 68 CHIKV, and 36 ZIKV. Most of the patients presented with fever and exanthema. One hundred and fifteen patients were exposed in Guadeloupe or Martinique, which were the at-risk destinations in 25% of patients with DENV, 59% of patients with CHIKV, and 58% of patients with ZIKV. The occurrence of cases diagnosed in returning travellers followed the same time pattern as the outbreaks in these areas. CONCLUSIONS A temporal correlation was found between newly diagnosed imported cases of arboviruses and the three corresponding outbreaks that occurred in Martinique and Guadeloupe during 8 consecutive years. Thus, ill returned travellers act as epidemiological sentinels from the beginning up to the end of outbreaks occurring in touristic locations.
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Affiliation(s)
- Victor Vasquez
- Infectious Diseases and Tropical Medicine Department, Hôpital La Pitié-Salpêtrière, Paris, France
| | - Elie Haddad
- Infectious Diseases and Tropical Medicine Department, Hôpital La Pitié-Salpêtrière, Paris, France.
| | - Alice Perignon
- Infectious Diseases and Tropical Medicine Department, Hôpital La Pitié-Salpêtrière, Paris, France
| | - Stéphane Jaureguiberry
- Infectious Diseases and Tropical Medicine Department, Hôpital La Pitié-Salpêtrière, Paris, France
| | - Ségolène Brichler
- Laboratory of Virology and Infectious Diseases, Hôpital Avicenne, Bobigny, France
| | - Isabelle Leparc-Goffart
- National Arbovirus Reference Centre, Hôpital d'Instruction des Armées Laveran, Marseille, France
| | - Eric Caumes
- Infectious Diseases and Tropical Medicine Department, Hôpital La Pitié-Salpêtrière, Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), AP-HP, Hôpital Pitié Salpètriére, Services des maladies infectieuses et tropicales, Paris, France
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18
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Gautret P, Mockenhaupt F, Grobusch MP, Rothe C, von Sonnenburg F, van Genderen PJ, Chappuis F, Asgeirsson H, Caumes E, Bottieau E, Malvy D, Lopez-Vélez R, Jensenius M, Larsen CS, Castelli F, Rapp C, Field V, Molina I, Gkrania-Klotsas E, Florescu S, Lalloo D, Schlagenhauf P. Arboviral and other illnesses in travellers returning from Brazil, June 2013 to May 2016: implications for the 2016 Olympic and Paralympic Games. ACTA ACUST UNITED AC 2017; 21:30278. [PMID: 27416907 DOI: 10.2807/1560-7917.es.2016.21.27.30278] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 07/06/2016] [Indexed: 11/20/2022]
Abstract
We evaluated EuroTravNet (a GeoSentinel subnetwork) data from June 2013 to May 2016 on 508 ill travellers returning from Brazil, to inform a risk analysis for Europeans visiting the 2016 Olympic and Paralympic Games in Brazil. Few dengue fever cases (n = 3) and no cases of chikungunya were documented during the 2013-15 Brazilian winter months, August and September, the period when the Games will be held. The main diagnoses were dermatological (37%), gastrointestinal (30%), febrile systemic illness (29%) and respiratory (11%).
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Affiliation(s)
- Philippe Gautret
- University Hospital Institute for Infectious and Tropical Diseases, Aix-Marseille University, Marseille, France
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19
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Díaz-Menéndez M, Trigo E, de la Calle-Prieto F, Arsuaga M. Zika virus infection during the Olympic Games in Rio: A fear or an actual risk? Rev Clin Esp 2017. [DOI: 10.1016/j.rceng.2016.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Nontraditional infectious diseases surveillance systems. Infect Dis (Lond) 2017. [DOI: 10.1002/9781119085751.ch2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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21
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Díaz-Menéndez M, Trigo E, de la Calle-Prieto F, Arsuaga M. Zika virus infection during the Olympic Games in Rio: A fear or an actual risk? Rev Clin Esp 2016; 217:155-160. [PMID: 27865425 DOI: 10.1016/j.rce.2016.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/13/2016] [Accepted: 10/16/2016] [Indexed: 10/20/2022]
Abstract
The recent outbreak of Zika virus infection in Brazil has aroused considerable media interest due to its association with neurological malformations in children born from mothers infected by the virus and to its association with Guillain-Barre syndrome in adults. This relationship has led to the World Health Organisation declaring the current epidemic as a "Public Health Emergency of International Concern". Controversy also emerged on the advisability of delaying or changing the location of the Olympic and Paralympic Games, which were held in August at various locations in Brazil. In this article, we review the available evidence on the risk of Zika and dengue virus infection in individuals who travel to endemic countries, especially for multitudinous events.
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Affiliation(s)
- M Díaz-Menéndez
- Unidad de Medicina Tropical y del Viajero, Hospital Universitario La Paz-CarlosIII Madrid, España.
| | - E Trigo
- Unidad de Medicina Tropical y del Viajero, Hospital Universitario La Paz-CarlosIII Madrid, España
| | - F de la Calle-Prieto
- Unidad de Medicina Tropical y del Viajero, Hospital Universitario La Paz-CarlosIII Madrid, España
| | - M Arsuaga
- Unidad de Medicina Tropical y del Viajero, Hospital Universitario La Paz-CarlosIII Madrid, España
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22
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Abstract
Myiasis is defined as the infestation of live vertebrates, either humans or animals, with dipterous larvae. Many organs can be infested by these larvae with cutaneous myiasis being the most common form. Cutaneous myiasis can be divided into three categories: localized furuncular myiasis, migratory myiaisis and wound myiasis, which occurs when fly larvae infest the open wounds of the host. Human myiasis has worldwide distribution, with more species and a heavier burden in tropical and subtropical countries. In recent years with increased travel to the tropics, myiasis has become common in returning travelers from these regions, Furuncular myiasis, mainly Dermatobia homonis becomes the most common form seen among them. Treatment is based on full extraction of the larva and no antibiotic treatment is needed. Understanding the mode of transmission of each type of myiasis may help to prevent the infestation.
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23
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Vilkman K, Pakkanen SH, Lääveri T, Siikamäki H, Kantele A. Travelers' health problems and behavior: prospective study with post-travel follow-up. BMC Infect Dis 2016; 16:328. [PMID: 27412525 PMCID: PMC4944265 DOI: 10.1186/s12879-016-1682-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 06/20/2016] [Indexed: 11/17/2022] Open
Abstract
Background The annual number of international tourist arrivals has recently exceeded one billion, yet surprisingly few studies have characterized travelers’ behavior, illness, and risk factors in a prospective setting. Particularly scarce are surveys of data spanning travel, return, and follow-up of the same cohort. This study examines behavior and illness among travelers while abroad, after return home, and at follow-up. Patterns of behavior connected to type of travel and illness are characterized so as to identify risk factors and provide background data for pre-travel advice. Methods Volunteers to this prospective cohort study were recruited at visits to a travel clinic prior to departure. Data on the subjects’ health and behavior were collected by questionnaires before and after journeys and over a three-week follow-up. In addition, the subjects were asked to fill in health diaries while traveling. Results The final study population consisted of 460 subjects, 79 % of whom reported illness during travel or on arrival: 69 % had travelers’ diarrhea (TD), 17 % skin problems, 17 % fever, 12 % vomiting, 8 % respiratory tract infection, 4 % urinary tract infection, 2 % ear infection, 4 % gastrointestinal complaints other than TD or vomiting, and 4 % other symptoms. Of all subjects, 10 % consulted a doctor and 0.7 % were hospitalized; 18 % took antimicrobials, with TD as the most common indication (64 %). Ongoing symptoms were reported by 25 % of all travelers upon return home. During the three-week follow-up (return rate 51 %), 32 % of respondents developed new-onset symptoms, 20 % visited a doctor and 1.7 % were hospitalized. Factors predisposing to health problems were identified by multivariable analysis: certain regions (Southern Asia, South-Eastern Asia, and Eastern Africa), female gender, young age, and long travel duration. Conclusions Despite proper preventive measures like vaccinations, malaria prophylaxis, and travel advice, the majority of our subjects fell ill during or after travel. As the symptoms mostly remained mild, health care services were seldom needed. Typical traveler profiles were identified, thereby providing a tool for pre-travel advice. The finding that one third reported new-onset illness during follow-up attests to the importance of advising clients on potential post-travel health problems already during pre-travel visits. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1682-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katri Vilkman
- Department of Bacteriology and Immunology, University of Helsinki, Haartmaninkatu 3, (P.O. Box 21), 00014, Helsinki, Finland.,Inflammation Center, Clinic of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Aurora Hospital, Nordenskiöldinkatu 20, (P.O. Box 348), Helsinki, Finland
| | - Sari H Pakkanen
- Department of Bacteriology and Immunology, University of Helsinki, Haartmaninkatu 3, (P.O. Box 21), 00014, Helsinki, Finland
| | - Tinja Lääveri
- Inflammation Center, Clinic of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Aurora Hospital, Nordenskiöldinkatu 20, (P.O. Box 348), Helsinki, Finland
| | - Heli Siikamäki
- Inflammation Center, Clinic of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Aurora Hospital, Nordenskiöldinkatu 20, (P.O. Box 348), Helsinki, Finland
| | - Anu Kantele
- Inflammation Center, Clinic of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Aurora Hospital, Nordenskiöldinkatu 20, (P.O. Box 348), Helsinki, Finland. .,Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland. .,Aava Travel Clinic, Medical Centre Aava, Annankatu 32, 00100, Helsinki, Finland. .,Unit of Infectious Diseases, Solna, Karolinska Institutet, SE-171 76, Stockholm, Sweden.
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Eberhardt KA, Vinnemeier CD, Dehnerdt J, Rolling T, Steffen R, Cramer JP. Travelers to the FIFA world cup 2014 in Brazil: Health risks related to mass gatherings/sports events and implications for the Summer Olympic Games in Rio de Janeiro in 2016. Travel Med Infect Dis 2016; 14:212-20. [PMID: 27238909 DOI: 10.1016/j.tmaid.2016.05.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/19/2016] [Accepted: 05/19/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health threats during mass gatherings, such as the FIFA world cup 2014 differ from traditional health risks. The influence of event type, demographics of attendees and environmental conditions are still not fully understood. METHODS An observational, prospective case-control survey conducted at the Frankfurt international airport in Germany on 544 travelers to the FIFA world cup 2014 and 432 regular travelers to Brazil departing after the end of the world cup. RESULTS Travelers to the FIFA world cup 2014 were predominantly male whereas the gender distribution in the control group was more balanced. The majority in both groups obtained insect bites and sunburns as environmental risk factors. Every third traveler suffered from diarrheal complaints in both groups, whereas the proportion of travelers with flu-like symptoms was higher in the case group. Travelers to the FIFA world cup 2014 indicated alcohol intake and sexual contacts outside of a relationship more frequently than travelers in the control group. CONCLUSIONS The additional health risks of travelers to sporting events as the FIFA world cup 2014 should be addressed in addition to traditional health threats in pre-travel counseling for the Summer Olympic Games 2016 in Brazil.
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Affiliation(s)
| | - Christof David Vinnemeier
- Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Section Tropical Medicine, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johanna Dehnerdt
- Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Thierry Rolling
- Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Section Tropical Medicine, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Robert Steffen
- University of Zurich Centre for Travel Medicine, WHO Collaborating Centre for Travelers' Health, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - Jakob Peter Cramer
- Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
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Palicelli A, Boldorini R, Campisi P, Disanto MG, Gatti L, Portigliotti L, Tosoni A, Rivasi F. Tungiasis in Italy: An imported case of Tunga penetrans and review of the literature. Pathol Res Pract 2016; 212:475-83. [DOI: 10.1016/j.prp.2016.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 12/18/2015] [Accepted: 02/01/2016] [Indexed: 10/22/2022]
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Ximenes R, Amaku M, Lopez LF, Coutinho FAB, Burattini MN, Greenhalgh D, Wilder-Smith A, Struchiner CJ, Massad E. The risk of dengue for non-immune foreign visitors to the 2016 summer olympic games in Rio de Janeiro, Brazil. BMC Infect Dis 2016; 16:186. [PMID: 27129407 PMCID: PMC4850678 DOI: 10.1186/s12879-016-1517-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 04/15/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Rio de Janeiro in Brazil will host the Summer Olympic Games in 2016. About 400,000 non-immune foreign tourists are expected to attend the games. As Brazil is the country with the highest number of dengue cases worldwide, concern about the risk of dengue for travelers is justified. METHODS A mathematical model to calculate the risk of developing dengue for foreign tourists attending the Olympic Games in Rio de Janeiro in 2016 is proposed. A system of differential equation models the spread of dengue amongst the resident population and a stochastic approximation is used to assess the risk to tourists. Historical reported dengue time series in Rio de Janeiro for the years 2000-2015 is used to find out the time dependent force of infection, which is then used to estimate the potential risks to a large tourist cohort. The worst outbreak of dengue occurred in 2012 and this and the other years in the history of Dengue in Rio are used to discuss potential risks to tourists amongst visitors to the forthcoming Rio Olympics. RESULTS The individual risk to be infected by dengue is very much dependent on the ratio asymptomatic/symptomatic considered but independently of this the worst month of August in the period studied in terms of dengue transmission, occurred in 2007. CONCLUSIONS If dengue returns in 2016 with the pattern observed in the worst month of August in history (2007), the expected number of symptomatic and asymptomatic dengue cases among tourists will be 23 and 206 cases, respectively. This worst case scenario would have an incidence of 5.75 (symptomatic) and 51.5 (asymptomatic) per 100,000 individuals.
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Affiliation(s)
- Raphael Ximenes
- School of Medicine, University of São Paulo and LIM01-HCFMUSP, São Paulo, SP, Brazil
| | - Marcos Amaku
- School of Medicine, University of São Paulo and LIM01-HCFMUSP, São Paulo, SP, Brazil
| | - Luis Fernandez Lopez
- School of Medicine, University of São Paulo and LIM01-HCFMUSP, São Paulo, SP, Brazil.,Center for Internet Augmented Research &Assessment, Florida International University, Miami, FL, USA
| | | | - Marcelo Nascimento Burattini
- School of Medicine, University of São Paulo and LIM01-HCFMUSP, São Paulo, SP, Brazil.,Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Eduardo Massad
- School of Medicine, University of São Paulo and LIM01-HCFMUSP, São Paulo, SP, Brazil. .,London School of Hygiene and Tropical Medicine, London, UK.
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da Cunha DT, Saccol ALDF, Tondo EC, de Oliveira ABA, Ginani VC, Araújo CV, Lima TAS, de Castro AKF, Stedefeldt E. Inspection Score and Grading System for Food Services in Brazil: The Results of a Food Safety Strategy to Reduce the Risk of Foodborne Diseases during the 2014 FIFA World Cup. Front Microbiol 2016; 7:614. [PMID: 27199943 PMCID: PMC4847479 DOI: 10.3389/fmicb.2016.00614] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 04/13/2016] [Indexed: 11/13/2022] Open
Abstract
In 2014, Brazil hosted one of the most popular sport competitions in the world, the FIFA World Cup. Concerned about the intense migration of tourists, the Brazilian government decided to deploy a food safety strategy based on inspection scores and a grading system applied to food services. The present study aimed to evaluate the results of the food safety strategy deployed during the 2014 FIFA World Cup in Brazil. To assess food safety, an evaluation instrument was applied twice in 1927 food service establishments from 26 cities before the start of the competition. This instrument generated a food safety score for each establishment that ranged from 0.0 (no flaws observed) to 2565.95, with four possible grades: A (0.0-13.2); B (13.3-502.6); C (502.7-1152.2); and pending (more than 1152.3). Each food service received a stamp with the grade of the second evaluation. After the end of the World Cup, a study was conducted with different groups of the public to evaluate the acceptance of the strategy. To this end, 221 consumers, 998 food service owners or managers, 150 health surveillance auditors, and 27 health surveillance coordinators were enrolled. These participants completed a survey with positive and negative responses about the inspection score system through a 5-point Likert scale. A reduction in violation scores from 393.1 to 224.4 (p < 0.001) was observed between the first and second evaluation cycles. Of the food services evaluated, 38.7% received the A stamp, 41.4% the B stamp, and 13.9% the C stamp. All positive responses on "system reliability" presented a mean of 4.0 or more, indicating that the public believed this strategy is reliable for communicating risks and promoting food safety. The strategy showed positive results regarding food safety and public acceptance. The deployed strategy promoted improvements in the food safety of food services. The implementation of a permanent policy may be well accepted by the public and may greatly contribute to a reduction in foodborne diseases (FBDs).
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Affiliation(s)
- Diogo T da Cunha
- Faculdade de Ciências Aplicadas, Universidade de Campinas Limeira, Brazil
| | | | - Eduardo C Tondo
- Instituto de Ciência e Tecnologia dos Alimentos, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil
| | - Ana B A de Oliveira
- Departamento de Nutrição, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil
| | - Veronica C Ginani
- Departamento de Nutrição, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil
| | | | | | | | - Elke Stedefeldt
- Centro de Desenvolvimento do Ensino Superior em Saúde, Universidade Federal de São Paulo São Paulo, Brazil
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Prevalence and Risk Factors of Hookworm-Related Cutaneous Larva Migrans (HrCLM) in a Resource-Poor Community in Manaus, Brazil. PLoS Negl Trop Dis 2016; 10:e0004514. [PMID: 27010204 PMCID: PMC4807001 DOI: 10.1371/journal.pntd.0004514] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/14/2016] [Indexed: 11/19/2022] Open
Abstract
Background Hookworm-related cutaneous larva migrans (HrCLM) is a neglected tropical skin disease associated with significant clinical pathology. Little knowledge exists about prevalence and risk factors of HrCLM in endemic regions. Methodology/ Principal Findings To understand the epidemiology of HrCLM in Amazonia, we conducted a cross-sectional study in a resource-poor township in Manaus, Brazil. HrCLM was diagnosed in 8.2% (95% CI, 6.3–10.1%) of the study population (N = 806) with a peak prevalence of 18.2% (95% CI, 9.3–27.1%) in children aged 10–14. Most of the tracks (62.4%) were located on the feet, and 10.6% were superinfected. HrCLM was associated independently with age under 15, male sex, presence of animal faeces on the compound, walking barefoot on sandy ground and poverty. Conclusions/ Significance HrCLM is common in resource-poor communities in Amazonia and is related to poverty. To reduce the disease burden caused by HrCLM, living conditions have to be improved. Hookworm-related cutaneous larva migrans (HrCLM) is a parasitic skin disease caused by the penetration of animal hookworm larvae into the human skin. In this compartment the larvae cannot pass the basal membrane and reproduce, but migrate in the outer skin layer for several weeks, causing skin inflammation and intense itching. Thus, humans are a biological impasse. Although HrCLM is a common skin disease in tropical and subtropical regions, studies on prevalence and risk factors are scarce. We clinically examined the population of a resource-poor neighbourhood in Manaus, capital of Amazonas State, Brazil, and investigated HrCLM-associated risk factors. HrCLM was very common with an overall prevalence of 8.2%. Children in general, and boys in particular, were most frequently infected. We could confirm that walking barefoot on sandy ground is a significant risk factor, and we identified the presence of animal faeces on the compound as another important predictive factor. Clearly, HrCLM was associated with low income and poverty-related living conditions. The poorest of the poor were identified as the most vulnerable population group.
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Bowman LR, Donegan S, McCall PJ. Is Dengue Vector Control Deficient in Effectiveness or Evidence?: Systematic Review and Meta-analysis. PLoS Negl Trop Dis 2016; 10:e0004551. [PMID: 26986468 PMCID: PMC4795802 DOI: 10.1371/journal.pntd.0004551] [Citation(s) in RCA: 231] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 02/24/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Although a vaccine could be available as early as 2016, vector control remains the primary approach used to prevent dengue, the most common and widespread arbovirus of humans worldwide. We reviewed the evidence for effectiveness of vector control methods in reducing its transmission. METHODOLOGY/PRINCIPAL FINDINGS Studies of any design published since 1980 were included if they evaluated method(s) targeting Aedes aegypti or Ae. albopictus for at least 3 months. Primary outcome was dengue incidence. Following Cochrane and PRISMA Group guidelines, database searches yielded 960 reports, and 41 were eligible for inclusion, with 19 providing data for meta-analysis. Study duration ranged from 5 months to 10 years. Studies evaluating multiple tools/approaches (23 records) were more common than single methods, while environmental management was the most common method (19 studies). Only 9/41 reports were randomized controlled trials (RCTs). Two out of 19 studies evaluating dengue incidence were RCTs, and neither reported any statistically significant impact. No RCTs evaluated effectiveness of insecticide space-spraying (fogging) against dengue. Based on meta-analyses, house screening significantly reduced dengue risk, OR 0.22 (95% CI 0.05-0.93, p = 0.04), as did combining community-based environmental management and water container covers, OR 0.22 (95% CI 0.15-0.32, p<0.0001). Indoor residual spraying (IRS) did not impact significantly on infection risk (OR 0.67; 95% CI 0.22-2.11; p = 0.50). Skin repellents, insecticide-treated bed nets or traps had no effect (p>0.5), but insecticide aerosols (OR 2.03; 95% CI 1.44-2.86) and mosquito coils (OR 1.44; 95% CI 1.09-1.91) were associated with higher dengue risk (p = 0.01). Although 23/41 studies examined the impact of insecticide-based tools, only 9 evaluated the insecticide susceptibility status of the target vector population during the study. CONCLUSIONS/SIGNIFICANCE This review and meta-analysis demonstrate the remarkable paucity of reliable evidence for the effectiveness of any dengue vector control method. Standardised studies of higher quality to evaluate and compare methods must be prioritised to optimise cost-effective dengue prevention.
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Affiliation(s)
- Leigh R. Bowman
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Sarah Donegan
- Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom
| | - Philip J. McCall
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Petersen E, Wilson ME, Touch S, McCloskey B, Mwaba P, Bates M, Dar O, Mattes F, Kidd M, Ippolito G, Azhar EI, Zumla A. Rapid Spread of Zika Virus in The Americas--Implications for Public Health Preparedness for Mass Gatherings at the 2016 Brazil Olympic Games. Int J Infect Dis 2016; 44:11-5. [PMID: 26854199 DOI: 10.1016/j.ijid.2016.02.001] [Citation(s) in RCA: 236] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 02/02/2016] [Indexed: 11/26/2022] Open
Abstract
Mass gatherings at major international sporting events put millions of international travelers and local host-country residents at risk of acquiring infectious diseases, including locally endemic infectious diseases. The mosquito-borne Zika virus (ZIKV) has recently aroused global attention due to its rapid spread since its first detection in May 2015 in Brazil to 22 other countries and other territories in the Americas. The ZIKV outbreak in Brazil, has also been associated with a significant rise in the number of babies born with microcephaly and neurological disorders, and has been declared a 'Global Emergency by the World Health Organization. This explosive spread of ZIKV in Brazil poses challenges for public health preparedness and surveillance for the Olympics and Paralympics which are due to be held in Rio De Janeiro in August, 2016. We review the epidemiology and clinical features of the current ZIKV outbreak in Brazil, highlight knowledge gaps, and review the public health implications of the current ZIKV outbreak in the Americas. We highlight the urgent need for a coordinated collaborative response for prevention and spread of infectious diseases with epidemic potential at mass gatherings events.
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Affiliation(s)
- Eskild Petersen
- The Royal Hospital, Muscat, Oman, and Insititute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Mary E Wilson
- School of Medicine, University of California, San Francisco, USA; Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sok Touch
- Communicable Disease Control Department, Ministry of Health, Cambodia
| | - Brian McCloskey
- Global Health Department, Public Health England, London, United Kingdom
| | - Peter Mwaba
- UNZA-UCLMS Project, University Teaching Hospital, and Ministry of Health, Lusaka, Zambia
| | - Matthew Bates
- UNZA-UCLMS Project, University Teaching Hospital, and Ministry of Health, Lusaka, Zambia
| | - Osman Dar
- Global Health Department, Public Health England, London, United Kingdom
| | - Frank Mattes
- Dept of Virology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Mike Kidd
- Dept of Virology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Italy
| | - Esam I Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Alimuddin Zumla
- Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom
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Arbex AK, Bizarro VR, Paletti MT, Brandt OJ, de Jesus ALC, Werner I, Dantas LM, de Almeida MH. Zika Virus Controversies: Epidemics as a Legacy of Mega Events? Health (London) 2016. [DOI: 10.4236/health.2016.87074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Wilson ME, Schlagenhauf P. Aedes and the triple threat of DENV, CHIKV, ZIKV – Arboviral risks and prevention at the 2016 Rio Olympic games. Travel Med Infect Dis 2016; 14:1-4. [DOI: 10.1016/j.tmaid.2016.01.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 01/27/2016] [Indexed: 10/22/2022]
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Monsel G, Caumes E. What's New in Travel-Associated Dermatology? J Travel Med 2015; 22:221-4. [PMID: 26146819 DOI: 10.1111/jtm.12224] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 05/25/2015] [Accepted: 05/25/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Gentiane Monsel
- Département des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eric Caumes
- Département des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Paris, France
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Tabatabaei SM, Metanat M. Mass Gatherings and Infectious Diseases Epidemiology and Surveillance. ACTA ACUST UNITED AC 2015. [DOI: 10.17795/iji-22833] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Schlagenhauf P, Weld L, Goorhuis A, Gautret P, Weber R, von Sonnenburg F, Lopez-Vélez R, Jensenius M, Cramer JP, Field VK, Odolini S, Gkrania-Klotsas E, Chappuis F, Malvy D, van Genderen PJJ, Mockenhaupt F, Jauréguiberry S, Smith C, Beeching NJ, Ursing J, Rapp C, Parola P, Grobusch MP. Travel-associated infection presenting in Europe (2008-12): an analysis of EuroTravNet longitudinal, surveillance data, and evaluation of the effect of the pre-travel consultation. THE LANCET. INFECTIOUS DISEASES 2014; 15:55-64. [PMID: 25477022 DOI: 10.1016/s1473-3099(14)71000-x] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Travel is important in the acquisition and dissemination of infection. We aimed to assess European surveillance data for travel-related illness to profile imported infections, track trends, identify risk groups, and assess the usefulness of pre-travel advice. METHODS We analysed travel-associated morbidity in ill travellers presenting at EuroTravNet sites during the 5-year period of 2008-12. We calculated proportionate morbidity per 1000 ill travellers and made comparisons over time and between subgroups. We did 5-year trend analyses (2008-12) by testing differences in proportions between subgroups using Pearson's χ(2) test. We assessed the effect of the pre-travel consultation on infection acquisition and outcome by use of proportionate morbidity ratios. FINDINGS The top diagnoses in 32 136 patients, ranked by proportionate morbidity, were malaria and acute diarrhoea, both with high proportionate morbidity (>60). Dengue, giardiasis, and insect bites had high proportionate morbidity (>30) as well. 5-year analyses showed increases in vector borne infections with significant peaks in 2010; examples were increased Plasmodium falciparum malaria (χ(2)=37·57, p<0·001); increased dengue fever (χ(2)=135·9, p<0·001); and a widening geographic range of acquisition of chikungunya fever. The proportionate morbidity of dengue increased from 22 in 2008 to 36 in 2012. Five dengue cases acquired in Europe contributed to this increase. Dermatological diagnoses increased from 851 in 2008 to 1102 in 2012, especially insect bites and animal-related injuries. Respiratory infection trends were dominated by the influenza H1N1 pandemic in 2009. Illness acquired in Europe accounted for 1794 (6%) of all 32 136 cases-mainly, gastrointestinal (634) and respiratory (357) infections. Migration within Europe was associated with more serious infection such as hepatitis C, tuberculosis, hepatitis B, and HIV/AIDS. Pre-travel consultation was associated with significantly lower proportionate morbidity ratios for P falciparum malaria and also for acute hepatitis and HIV/AIDS. INTERPRETATION The pattern of travel-related infections presenting in Europe is complex. Trend analyses can inform on emerging infection threats. Pre-travel consultation is associated with reduced malaria proportionate morbidity ratios and less severe illness. These findings support the importance and effectiveness of pre-travel advice on malaria prevention, but cast doubt on the effectiveness of current strategies to prevent travel-related diarrhoea. FUNDING European Centre for Disease Prevention and Control, University Hospital Institute Méditerranée Infection, US Centers for Disease Control and Prevention, and the International Society of Travel Medicine.
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Affiliation(s)
- Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Epidemiology, Biostatistics, and Prevention Institute, Zürich, Switzerland.
| | | | - Abraham Goorhuis
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Philippe Gautret
- University Hospital Institute for Infectious and Tropical Diseases, Aix-Marseille University, Marseille, France
| | - Rainer Weber
- University Hospital, Department of Infectious Diseases, University of Zürich, Switzerland
| | - Frank von Sonnenburg
- Department of Infectious Diseases and Tropical Medicine, Ludwig-Maximilian's University of Munich, Munich, Germany
| | - Rogelio Lopez-Vélez
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
| | - Mogens Jensenius
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Jakob P Cramer
- University Medical Center Hamburg-Eppendorf, Department of Tropical Medicine and Infectious Diseases, Bernhard Nocht Clinic, Hamburg, Germany
| | - Vanessa K Field
- InterHealth Worldwide and National Travel Health Network and Centre (NaTHNaC), London, UK
| | - Silvia Odolini
- University Division of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Brescia, Italy
| | | | - Francois Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Denis Malvy
- Department of Internal Medicine and Tropical Disease, University Hospital Centre, Bordeaux, France
| | | | - Frank Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Germany
| | - Stéphane Jauréguiberry
- Service des Maladies Infectieuses et Tropicales (Department of Infectious and Tropical Diseases), Hôpital Pitié-Salpétrière, Paris, France
| | - Catherine Smith
- Travel Medicine and International Health Team, Health Protection Scotland, NHS National Services Scotland, Glasgow, UK
| | - Nicholas J Beeching
- Liverpool School of Tropical Medicine and National Institute for Health Research Unit in Emerging and Zoonotic Infections, Liverpool, UK
| | - Johan Ursing
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Philippe Parola
- University Hospital Institute for Infectious and Tropical Diseases, Aix-Marseille University, Marseille, France
| | - Martin P Grobusch
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Gaines J, Sotir MJ, Cunningham TJ, Harvey KA, Lee CV, Stoney RJ, Gershman MD, Brunette GW, Kozarsky PE. Health and safety issues for travelers attending the World Cup and Summer Olympic and Paralympic Games in Brazil, 2014 to 2016. JAMA Intern Med 2014; 174:1383-90. [PMID: 24887552 PMCID: PMC4655589 DOI: 10.1001/jamainternmed.2014.2227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
IMPORTANCE Travelers from around the globe will attend the 2014 Fédération Internationale de Football Association (FIFA) World Cup and the 2016 Olympic and Paralympic Games in Brazil. Travelers to these mass gathering events may be exposed to a range of health risks, including a variety of infectious diseases. Most travelers who become ill will present to their primary care physicians, and thus it is important that clinicians are aware of the risks their patients encountered. OBJECTIVE To highlight health and safety concerns for people traveling to these events in Brazil so that health care practitioners can better prepare travelers before they travel and more effectively diagnose and treat travelers after they return. EVIDENCE REVIEW We reviewed both peer-reviewed and gray literature to identify health outcomes associated with travel to Brazil and mass gatherings. Thirteen specific infectious diseases are described in terms of signs, symptoms, and treatment. Relevant safety and security concerns are also discussed. FINDINGS Travelers to Brazil for mass gathering events face unique health risks associated with their travel. CONCLUSIONS AND RELEVANCE Travelers should consult a health care practitioner 4 to 6 weeks before travel to Brazil and seek up-to-date information regarding their specific itineraries. For the most up-to-date information, health care practitioners can visit the Centers for Disease Control and Prevention (CDC) Travelers' Health website (http://wwwnc.cdc.gov/travel) or review CDC's Yellow Book online (http://wwwnc.cdc.gov/travel/page/yellowbook-home-2014).
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Affiliation(s)
- Joanna Gaines
- Geographic Medicine and Health Promotion Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Mark J Sotir
- Geographic Medicine and Health Promotion Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Timothy J Cunningham
- Epidemiology and Surveillance Branch, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Kira A Harvey
- Geographic Medicine and Health Promotion Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - C Virginia Lee
- Geographic Medicine and Health Promotion Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Rhett J Stoney
- Geographic Medicine and Health Promotion Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Mark D Gershman
- Geographic Medicine and Health Promotion Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Gary W Brunette
- Geographic Medicine and Health Promotion Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Phyllis E Kozarsky
- Geographic Medicine and Health Promotion Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia3Emory University School of Medi
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van Panhuis WG, Hyun S, Blaney K, Marques ETA, Coelho GE, Siqueira JB, Tibshirani R, da Silva JB, Rosenfeld R. Risk of dengue for tourists and teams during the World Cup 2014 in Brazil. PLoS Negl Trop Dis 2014; 8:e3063. [PMID: 25079960 PMCID: PMC4120682 DOI: 10.1371/journal.pntd.0003063] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 06/13/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This year, Brazil will host about 600,000 foreign visitors during the 2014 FIFA World Cup. The concern of possible dengue transmission during this event has been raised given the high transmission rates reported in the past by this country. METHODOLOGY/PRINCIPAL FINDINGS We used dengue incidence rates reported by each host city during previous years (2001-2013) to estimate the risk of dengue during the World Cup for tourists and teams. Two statistical models were used: a percentile rank (PR) and an Empirical Bayes (EB) model. Expected IR's during the games were generally low (<10/100,000) but predictions varied across locations and between models. Based on current ticket allocations, the mean number of expected symptomatic dengue cases ranged from 26 (PR, 10th-100th percentile: 5-334 cases) to 59 (EB, 95% credible interval: 30-77 cases) among foreign tourists but none are expected among teams. These numbers will highly depend on actual travel schedules and dengue immunity among visitors. Sensitivity analysis for both models indicated that the expected number of cases could be as low as 4 or 5 with 100,000 visitors and as high as 38 or 70 with 800,000 visitors (PR and EB, respectively). CONCLUSION/SIGNIFICANCE The risk of dengue among tourists during the World Cup is expected to be small due to immunity among the Brazil host population provided by last year's epidemic with the same DENV serotypes. Quantitative risk estimates by different groups and methodologies should be made routinely for mass gathering events.
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Affiliation(s)
- Willem G. van Panhuis
- University of Pittsburgh Graduate School of
Public Health, Pittsburgh, Pennsylvania, United States of
America
- * E-mail:
| | - Sangwon Hyun
- Carnegie Mellon University, Pittsburgh,
Pennsylvania, United States of America
| | - Kayleigh Blaney
- University of Pittsburgh Graduate School of
Public Health, Pittsburgh, Pennsylvania, United States of
America
| | - Ernesto T. A. Marques
- University of Pittsburgh Center for Vaccine
Research, Pittsburgh, Pennsylvania, United States of America
| | | | | | - Ryan Tibshirani
- Carnegie Mellon University, Pittsburgh,
Pennsylvania, United States of America
| | | | - Roni Rosenfeld
- Carnegie Mellon University, Pittsburgh,
Pennsylvania, United States of America
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Massad E, Burattini MN, Ximenes R, Amaku M, Wilder-Smith A. Dengue outlook for the World Cup in Brazil. THE LANCET. INFECTIOUS DISEASES 2014; 14:552-3. [PMID: 24929925 DOI: 10.1016/s1473-3099(14)70807-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Eduardo Massad
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil; London School of Hygiene and Tropical Medicine, London, UK
| | - Marcelo N Burattini
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil; Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Raphael Ximenes
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marcos Amaku
- Faculty of Veterinarian Medicine, University of São Paulo, São Paulo, Brazil
| | - Annelies Wilder-Smith
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, University of Umea, Umea, 901 85, Sweden; Lee Kong Chian School of Medicine, Nanyang University, Singapore.
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40
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Massad E, Wilder-Smith A, Ximenes R, Amaku M, Lopez LF, Coutinho FAB, Coelho GE, Silva JBD, Struchiner CJ, Burattini MN. Risk of symptomatic dengue for foreign visitors to the 2014 FIFA World Cup in Brazil. Mem Inst Oswaldo Cruz 2014; 109:394-7. [PMID: 24863976 PMCID: PMC4131799 DOI: 10.1590/0074-0276140133] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 04/17/2014] [Indexed: 01/24/2023] Open
Abstract
Brazil will host the FIFA World Cup™, the biggest single-event competition in the world, from June 12-July 13 2014 in 12 cities. This event will draw an estimated 600,000 international visitors. Brazil is endemic for dengue. Hence, attendees of the 2014 event are theoretically at risk for dengue. We calculated the risk of dengue acquisition to non-immune international travellers to Brazil, depending on the football match schedules, considering locations and dates of such matches for June and July 2014. We estimated the average per-capita risk and expected number of dengue cases for each host-city and each game schedule chosen based on reported dengue cases to the Brazilian Ministry of Health for the period between 2010-2013. On the average, the expected number of cases among the 600,000 foreigner tourists during the World Cup is 33, varying from 3-59. Such risk estimates will not only benefit individual travellers for adequate pre-travel preparations, but also provide valuable information for public health professionals and policy makers worldwide. Furthermore, estimates of dengue cases in international travellers during the World Cup can help to anticipate the theoretical risk for exportation of dengue into currently non-infected areas.
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Affiliation(s)
- Eduardo Massad
- LIM01, Hospital de Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Raphael Ximenes
- LIM01, Hospital de Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcos Amaku
- Faculdade de Medicina Veterinária, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luis Fernandez Lopez
- LIM01, Hospital de Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Iliaki E, Chen LH, Hamer DH, Macleod WB, Jentes ES, Barnett ED, Wilson ME. Travel to Brazil: analysis of data from the Boston Area Travel Medicine Network (BATMN) and relevance to travelers attending world cup and olympics. J Travel Med 2014; 21:214-7. [PMID: 24673916 DOI: 10.1111/jtm.12117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 02/09/2014] [Accepted: 02/17/2014] [Indexed: 11/30/2022]
Abstract
We describe travelers who were evaluated pre-travel to Brazil from March 2008 through July 2010 in the Boston area. Of 599 Brazil travelers, 71%, 58%, and 50% received vaccines for yellow fever (YF), typhoid, and hepatitis A, respectively. Fewer received influenza and hepatitis B vaccines (14%, 11%). A total of 60% traveled during Brazil's peak influenza season, and one fourth visited during peak dengue transmission. The 2014 World Cup and 2016 Olympics include events throughout Brazil. Travelers should seek pre-travel assessment including YF and malaria risk; travelers should be vaccinated against influenza, be up to date on other routine vaccines, and be prepared to protect themselves against mosquitoes.
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The 2014 FIFA World Cup: communicable disease risks and advice for visitors to Brazil--a review from the Latin American Society for Travel Medicine (SLAMVI). Travel Med Infect Dis 2014; 12:208-18. [PMID: 24821081 DOI: 10.1016/j.tmaid.2014.04.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 04/14/2014] [Accepted: 04/16/2014] [Indexed: 11/21/2022]
Abstract
The next FIFA World Cup will be held in Brazil in June-July 2014. Around 600,000 international visitors and participants (as well over 3 million domestic travelers) are expected. This event will take place in twelve cities. This event poses specific challenges, given its size and the diversity of attendees, including the potential for the transmission of imported or endemic communicable diseases, especially those that have an increased transmission rate as a result of close human proximity, eg, seasonal influenza, measles but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations regarding the epidemiology and risks of the main communicable diseases in the major potential destinations, recommended immunizations and other preventives measures to be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Dengue poses a significant risk in all states, including the host cities. Vaccination against yellow fever is recommended except for travelers who will only visit coastal areas. Travelers visiting high-risk areas for malaria (Amazon) should be assessed regarding the need for chemoprophylaxis. Chikunguya fever may be a threat for Brazil, given the presence of Aedes aegypti, vector of dengue, and the possibility of travelers bringing the virus with them when attending the event. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing these vector-borne infections. Other important recommendations for travelers should focus on preventing water and food-borne diseases such as hepatitis A, typhoid fever, giardiasis and traveler's diarrhea. Sexually transmitted diseases (STD) should be also mentioned and the use of condoms advocated. This review addresses pre-travel, preventive strategies to reduce the risk of acquiring communicable diseases during a mass gathering such as the World Cup and also reviews the spectrum of endemic infections in Brazil to facilitate the recognition and management of infectious diseases in travelers returning to their countries of origin.
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Wilson ME, Chen LH. Health risks among travelers to Brazil: implications for the 2014 FIFA World Cup and 2016 Olympic Games. Travel Med Infect Dis 2014; 12:205-7. [PMID: 24786668 PMCID: PMC7128226 DOI: 10.1016/j.tmaid.2014.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 04/04/2014] [Indexed: 11/18/2022]
Affiliation(s)
| | - Lin H Chen
- Mount Auburn Hospital, Cambridge, MA, USA; Harvard Medical School, Boston, MA, USA
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