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Arsuaga M, De Miguel Buckley R, De La Calle-Prieto F, Díaz-Menéndez M. Imported infectious diseases in migrants from Latin America: A retrospective study from a referral centre for tropical diseases in Spain, 2017-2022. Travel Med Infect Dis 2024; 59:102708. [PMID: 38467231 DOI: 10.1016/j.tmaid.2024.102708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/22/2023] [Accepted: 03/03/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Detecting imported diseases by migrants and individuals visiting friends and relatives (VFR) is key in the prevention and management of emergent infectious diseases acquired abroad. METHODS Retrospective descriptive study on migrants and VFR from Central and South America between 2017 and 2022 attended at a National Referral Centre for Tropical Diseases in Madrid, Spain. Demographic characteristics, syndromes and confirmed travel-related diagnoses were obtained from hospital patient medical records. RESULTS 1654 cases were registered, median age of 42 years, 69.1% were female, and 55.2% were migrants. Most cases came from Bolivia (49.6%), followed by Ecuador (12.9%). Health screening while asymptomatic (31.6%) was the main reason for consultation, followed by Chagas disease follow-up (31%). Of those asymptomatic at screening, 47,2% were finally diagnosed of any disease, mainly Chagas disease (19,7%) and strongyloidiasis (10,2%) CONCLUSION: Our study emphasizes the importance of proactive health screening to detect asymptomatic conditions in migrants and VFR, enabling timely intervention and improved health outcomes. By understanding the unique health profiles of immigrant populations, targeted public health interventions can be devised to safeguard the well-being of these vulnerable groups.
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Affiliation(s)
- Marta Arsuaga
- National Referral Unit for Imported Tropical Diseases, Tropical and Travel Medicine Unit, Hospital La Paz- Carlos III, Calle Sinesio Delgado, 10, 28029, Madrid, Spain; CIBERINFEC, Spain.
| | - Rosa De Miguel Buckley
- National Referral Unit for Imported Tropical Diseases, Tropical and Travel Medicine Unit, Hospital La Paz- Carlos III, Calle Sinesio Delgado, 10, 28029, Madrid, Spain; CIBERINFEC, Spain
| | - Fernando De La Calle-Prieto
- National Referral Unit for Imported Tropical Diseases, Tropical and Travel Medicine Unit, Hospital La Paz- Carlos III, Calle Sinesio Delgado, 10, 28029, Madrid, Spain; CIBERINFEC, Spain
| | - Marta Díaz-Menéndez
- National Referral Unit for Imported Tropical Diseases, Tropical and Travel Medicine Unit, Hospital La Paz- Carlos III, Calle Sinesio Delgado, 10, 28029, Madrid, Spain; CIBERINFEC, Spain
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Ali M, El Hafid M, Farrar DS, Kourdi H, Rea E, Waters V, Lam R, Morris SK, Kitai I. Travel-acquired paediatric tuberculosis in the Greater Toronto Area, Canada, 2002-2018. Eur Respir J 2024; 63:2301533. [PMID: 38212078 DOI: 10.1183/13993003.01533-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Affiliation(s)
- Mohsin Ali
- Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada
- These authors contributed equally to this work
| | - Melanie El Hafid
- Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada
- These authors contributed equally to this work
| | - Daniel S Farrar
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Haifa Kourdi
- Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada
| | - Elizabeth Rea
- Tuberculosis Program, Toronto Public Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Valerie Waters
- Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ray Lam
- Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Shaun K Morris
- Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ian Kitai
- Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Zhu P, Wu K, Zhang C, Batool SS, Li A, Yu Z, Huang J. Advances in new target molecules against schistosomiasis: A comprehensive discussion of physiological structure and nutrient intake. PLoS Pathog 2023; 19:e1011498. [PMID: 37498810 PMCID: PMC10374103 DOI: 10.1371/journal.ppat.1011498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
Schistosomiasis, a severe parasitic disease, is primarily caused by Schistosoma mansoni, Schistosoma japonicum, or Schistosoma haematobium. Currently, praziquantel is the only recommended drug for human schistosome infection. However, the lack of efficacy of praziquantel against juvenile worms and concerns about the emergence of drug resistance are driving forces behind the research for an alternative medication. Schistosomes are obligatory parasites that survive on nutrients obtained from their host. The ability of nutrient uptake depends on their physiological structure. In short, the formation and maintenance of the structure and nutrient supply are mutually reinforcing and interdependent. In this review, we focus on the structural features of the tegument, esophagus, and intestine of schistosomes and their roles in nutrient acquisition. Moreover, we introduce the significance and modes of glucose, lipids, proteins, and amino acids intake in schistosomes. We linked the schistosome structure and nutrient supply, introduced the currently emerging targets, and analyzed the current bottlenecks in the research and development of drugs and vaccines, in the hope of providing new strategies for the prevention and control of schistosomiasis.
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Affiliation(s)
- Peng Zhu
- Department of Parasitology, School of Basic Medical Science, Central South University, Changsha, China
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Kaijuan Wu
- Department of Parasitology, School of Basic Medical Science, Central South University, Changsha, China
| | - Chaobin Zhang
- Department of Parasitology, School of Basic Medical Science, Central South University, Changsha, China
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Syeda Sundas Batool
- Department of Microbiology, School of Basic Medical Science, Central South University, Changsha, Hunan, China
- China-Africa Research Center of Infectious Diseases, Central South University, Changsha, China
| | - Anqiao Li
- Department of Parasitology, School of Basic Medical Science, Central South University, Changsha, China
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Zheng Yu
- Department of Microbiology, School of Basic Medical Science, Central South University, Changsha, Hunan, China
- China-Africa Research Center of Infectious Diseases, Central South University, Changsha, China
| | - Jing Huang
- Department of Parasitology, School of Basic Medical Science, Central South University, Changsha, China
- China-Africa Research Center of Infectious Diseases, Central South University, Changsha, China
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Geographical Influence on Morphometric Variability of Genetically “Pure” Schistosoma haematobium Eggs from Sub-Saharan Migrants in Spain. Trop Med Infect Dis 2023; 8:tropicalmed8030144. [PMID: 36977146 PMCID: PMC10054267 DOI: 10.3390/tropicalmed8030144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 03/02/2023] Open
Abstract
Schistosome eggs play a key role in schistosomiasis diagnosis and research. The aim of this work is to morphogenetically study the eggs of Schistosoma haematobium found in sub-Saharan migrants present in Spain, analyzing their morphometric variation in relation to the geographical origin of the parasite (Mali, Mauritania and Senegal). Only eggs considered “pure” S. haematobium by genetic characterization (rDNA ITS-2 and mtDNA cox1) have been used. A total of 162 eggs obtained from 20 migrants from Mali, Mauritania and Senegal were included in the study. Analyses were made by the Computer Image Analysis System (CIAS). Following a previously standardized methodology, seventeen measurements were carried out on each egg. The morphometric analysis of the three morphotypes detected (round, elongated and spindle) and the biometric variations in relation to the country of origin of the parasite on the egg phenotype were carried out by canonical variate analysis. Mahalanobis distances, when all egg measurements were analyzed, showed differences between: (i) Mali-Mauritania, Mali-Senegal and Mauritania-Senegal in the round morphotype; (ii) Mali-Mauritania and Mauritania-Senegal in the elongated morphotype; and (iii) Mauritania-Senegal in the spindle morphotype. Mahalanobis distances, when spine variables were analyzed, showed differences between Mali-Senegal in the round morphotype. In conclusion, this is the first phenotypic study performed on individually genotyped “pure” S. haematobium eggs, allowing the assessment of the intraspecific morphological variations associated with the geographical origin of the schistosome eggs.
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Clinical Spectrum of Schistosomiasis: An Update. J Clin Med 2021; 10:jcm10235521. [PMID: 34884223 PMCID: PMC8672275 DOI: 10.3390/jcm10235521] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/17/2021] [Accepted: 11/25/2021] [Indexed: 11/18/2022] Open
Abstract
Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, particularly in poverty-stricken areas, especially those within the tropics and subtropics. It is estimated that at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.
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Commercial Simplex and Multiplex PCR Assays for the Detection of Intestinal Parasites Giardia intestinalis, Entamoeba spp., and Cryptosporidium spp.: Comparative Evaluation of Seven Commercial PCR Kits with Routine In-House Simplex PCR Assays. Microorganisms 2021; 9:microorganisms9112325. [PMID: 34835453 PMCID: PMC8623296 DOI: 10.3390/microorganisms9112325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 02/04/2023] Open
Abstract
Nowadays, many commercial kits allowing the detection of digestive parasites by DNA amplification methods have been developed, including simplex PCR assays (SimpPCRa) allowing the identification of a single parasite, and multiplex PCR assays (MultPCRa) allowing the identification of several parasites at once. Thus, aimed at improving the diagnosis of intestinal protozoal infections, it is essential to evaluate the performances of these new tools. A total of 174 DNA samples collected between 2007 and 2017 were retrospectively included in this study. Performances of four commercial SimpPCRa (i.e., CerTest-VIASURETM) and three MultPCRa (i.e., CerTest-VIASURETM, FAST-TRACK-Diagnostics-FTD-Stool-ParasiteTM and DIAGENODE-Gastroenteritis/Parasite-panel-ITM) were evaluated for the detection of Cryptosporidium spp., Entamoeba spp., and Giardia intestinalis in stool samples compared to our routinely used in-house SimpPCRa. Globally, the SimpPCRa showed better sensitivity/specificity for the detection of G. intestinalis, E. histolytica, E. dispar, and Cryptosporidium spp. (i.e., 96.9/93.6%; 100/100%; 95.5/100%; and 100/99.3%, respectively), compared to the three commercial MultPCRa tested. All in all, we showed that MultPCRa offer an interesting alternative for the detection of protozoans in stool samples depending on the clinical context.
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Wendt S, Beier D, Paquet D, Trawinski H, Fuchs A, Lübbert C. Medical Advice for Travelers. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:349–356. [PMID: 33597073 DOI: 10.3238/arztebl.m2021.0127] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND In 2019, 1.5 billion international tourist trips were counted worldwide. Germany, with 70.8 million vacations lasting ≥ 5 days, was one of the populations most willing to travel. These days, even elderly and multimorbid persons regularly travel long-distance, which can be associated with significant health risks. By advising travelers and implementing preventive measures, the risk of illness can be reduced significantly. METHODS A selective survey of PubMed was performed to identify publications on medical advice for travelers between 2000 and 2020. We included guidelines, studies, and recommendations that mainly deal with the preventive aspects of travel medicine and have a high level of practical relevance and the highest possible level of evidence. Previously published guidelines (based on the GRADE criteria) were adopted, and recommendations not based on the results of scientific studies were characterized as Good Clinical Practice (GCP). RESULTS Many medical recommendations for travelers still rely on individualized, experience-based, or consensus-based assessments. Apart from a review of medical history and vaccination status, a risk analysis is performed, travel fitness is evaluated individually, and a prevention plan is designed. Particular attention is devoted to malaria prophylaxis, vector protection, and traveler's diarrhea. Medical advice before travel is especially important for the elderly, children, pregnant women, the chronically ill, long-term and adventure travelers as well as migrants from malaria-endemic areas who are returning home. CONCLUSION The health risks associated with travel can be minimized by specialist medical advice. Many recommendations are empirical in nature and require further research.
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Diagne CT, Bengue M, Choumet V, Hamel R, Pompon J, Missé D. Mayaro Virus Pathogenesis and Transmission Mechanisms. Pathogens 2020; 9:pathogens9090738. [PMID: 32911824 PMCID: PMC7558846 DOI: 10.3390/pathogens9090738] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 12/19/2022] Open
Abstract
Mayaro virus (MAYV), isolated for the first time in Trinidad and Tobago, has captured the attention of public health authorities worldwide following recent outbreaks in the Americas. It has a propensity to be exported outside its original geographical range, because of the vast distribution of its vectors. Moreover, most of the world population is immunologically naïve with respect to infection with MAYV which makes this virus a true threat. The recent invasion of several countries by Aedesalbopictus underscores the risk of potential urban transmission of MAYV in both tropical and temperate regions. In humans, the clinical manifestations of MAYV disease range from mild fever, rash, and joint pain to arthralgia. In the absence of a licensed vaccine and clinically proven therapeutics against Mayaro fever, prevention focuses mainly on household mosquito control. However, as demonstrated for other arboviruses, mosquito control is rather inefficient for outbreak management and alternative approaches to contain the spread of MAYV are therefore necessary. Despite its strong epidemic potential, little is currently known about MAYV. This review addresses various aspects of MAYV, including its epidemiology, vector biology, mode of transmission, and clinical complications, as well as the latest developments in MAYV diagnosis.
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Affiliation(s)
- Cheikh Tidiane Diagne
- MIVEGEC, IRD, Univ. Montpellier, CNRS, 34394 Montpellier, France; (M.B.); (R.H.); (J.P.)
- Correspondence: (C.T.D.); (D.M.)
| | - Michèle Bengue
- MIVEGEC, IRD, Univ. Montpellier, CNRS, 34394 Montpellier, France; (M.B.); (R.H.); (J.P.)
| | - Valérie Choumet
- Unité Environnement Risques Infectieux Groupe Arbovirus, Institut Pasteur, 75724 Paris, France;
| | - Rodolphe Hamel
- MIVEGEC, IRD, Univ. Montpellier, CNRS, 34394 Montpellier, France; (M.B.); (R.H.); (J.P.)
| | - Julien Pompon
- MIVEGEC, IRD, Univ. Montpellier, CNRS, 34394 Montpellier, France; (M.B.); (R.H.); (J.P.)
| | - Dorothée Missé
- MIVEGEC, IRD, Univ. Montpellier, CNRS, 34394 Montpellier, France; (M.B.); (R.H.); (J.P.)
- Correspondence: (C.T.D.); (D.M.)
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Sondén K, Rolling T, Wångdahl A, Ydring E, Vygen-Bonnet S, Kobbe R, Douhan J, Hammar U, Duijster J, de Gier B, Freedman J, Gysin N, Stark K, Stevens F, Vestergaard LS, Tegnell A, Färnert A. Malaria in Eritrean migrants newly arrived in seven European countries, 2011 to 2016. ACTA ACUST UNITED AC 2020; 24. [PMID: 30722809 PMCID: PMC6386211 DOI: 10.2807/1560-7917.es.2019.24.5.1800139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Global migration has resulted in a large number of asylum applications in Europe. In 2014, clusters of Plasmodium vivax cases were reported among newly arrived Eritreans. This study aimed to assess malaria among Eritrean migrants in Europe from 2011 to 2016. We reviewed European migration numbers and malaria surveillance data for seven countries (Denmark, Germany, Netherlands, Norway, Sweden, Switzerland and the United Kingdom) which received 44,050 (94.3%) of 46,730 Eritreans seeking asylum in Europe in 2014. The overall number of malaria cases, predominantly P. vivax, increased significantly in 2014 compared to previous years, with the largest increases in Germany (44 P. vivax cases in 2013 vs 294 in 2014, p < 0.001) and Sweden (18 in 2013 vs 205 in 2014, p < 0.001). Overall, malaria incidence in Eritreans increased from 1-5 to 25 cases per 1,000, and was highest in male teenagers (50 cases/1,000). In conclusion, an exceptional increase of malaria cases occurred in Europe in 2014 and 2015, due to rising numbers of Eritreans with high incidence of P. vivax arriving in Europe. Our results demonstrate potential for rapid changes in imported malaria patterns, highlighting the need for improved awareness, surveillance efforts and timely healthcare in migrants.
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Affiliation(s)
- Klara Sondén
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Thierry Rolling
- Clinical Research Department, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.,Division of Infectious Diseases, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Wångdahl
- Department of Infectious Diseases, Västmanland Hospital, Västerås, Sweden.,Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Elsie Ydring
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | - Robert Kobbe
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johan Douhan
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Ulf Hammar
- Unit of Biostatistics, Department of Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Janneke Duijster
- Department for Early Warning and Surveillance Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Brechje de Gier
- Department for Early Warning and Surveillance Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Nicole Gysin
- Federal Office of Public Health, Bern, Switzerland
| | | | | | | | | | - Anna Färnert
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Vellere I, Mangano VD, Cagno MC, Gobbi F, Ragusa A, Bartoloni A, Biancofiore G, De Simone P, Campani D, Bruschi F, Zammarchi L. Imported human Schistosoma japonicum: A report on two cases in Filipino migrants present in Italy and a systematic review of literature. Travel Med Infect Dis 2019; 36:101496. [PMID: 31561021 DOI: 10.1016/j.tmaid.2019.101496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Schistosoma japonicum is endemic in the Philippines, China, and Indonesia, and is the third-most common schistosoma species. The infection can be asymptomatic for years but, if left untreated, can lead to irreversible complications. METHOD We report the results of a systematic review of the literature on imported S. japonicum infection and describe two previously unpublished cases diagnosed in Filipino migrants in Italy. RESULTS Twenty-five imported cases of S. japonicum schistosomiasis were retrieved. All patients but one were migrants. Most subjects acquired the infection in Philippines (n = 18, 72%). Median age at diagnosis was 46 years. Median period of residence in non-endemic countries before diagnosis was 14.5 years. Cases of prevalent hepatosplenic involvement were 10 (40%), those with prevalent intestinal involvement were 10 (40%), whereas five (20%) had overlapping manifestations. Ten patients suffered from cirrhosis; two underwent liver transplantation. Three patients presented with acute abdomen due to intestinal complications, leading to explorative laparotomy. In all cases, but one, the diagnosis was based on a histological examination of biopsy specimen, revealing S. japonicum ova. Seventeen patients were treated with praziquantel, and in three of them, possible treatment failures occurred. CONCLUSIONS S. japonicum infection is uncommonly reported in non-endemic areas, but is probably underestimated because of a low threshold awareness of clinicians and unavailability of specific diagnostic tools. Viable S. japonicum adults may persist for decades, indicating that migrants or travellers previously exposed in areas with high-risk areas can harbour viable worms and deserve treatment.
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Affiliation(s)
- Iacopo Vellere
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
| | | | | | - Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, I.R.C.C.S., Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
| | - Andrea Ragusa
- Department of Infectious-Tropical Diseases and Microbiology, I.R.C.C.S., Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Referral Center for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.
| | | | - Paolo De Simone
- Hepatobiliary Surgery and Liver Transplantation Unit, University of Pisa Medical School Hospital, Pisa, Italy.
| | - Daniela Campani
- Department of Surgical, Medical and Molecular Pathology, Pisa University Hospital, Pisa, Italy.
| | - Fabrizio Bruschi
- Department of Translational Research, University of Pisa, Pisa, Italy; Department of Laboratory Medicine, Pisa University Hospital, Pisa, Italy.
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Referral Center for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.
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11
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Low adherence with national travel medicine recommendations in Belgian expatriate children: A retrospective analysis. Travel Med Infect Dis 2019; 32:101424. [PMID: 31085332 DOI: 10.1016/j.tmaid.2019.05.010] [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: 11/08/2018] [Revised: 05/04/2019] [Accepted: 05/10/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Expatriates (expats) from European countries regularly migrate to low-income countries where infectious diseases are more prevalent. Little evidence exists however on pediatric expatriates' compliance with preventive measures related to infectious diseases. This study aims to evaluate compliance in Belgian expat-children. METHODS Data of 135 Belgian expat-children, visiting the Institute of Tropical Medicine (Antwerp, Belgium), were collected from clinical notes, laboratory results and from a web-based immunization-register. Information on routine vaccinations, yellow fever, hepatitis A, rabies, typhoid fever, meningococcal ACW135Y, Japanese encephalitis, BCG vaccine and anti-malaria chemoprophylaxis was collected. RESULTS Overall, 87% of expat-children were up-to-date with their routine vaccinations. Although all children were eligible for hepatitis A, typhoid and rabies vaccination, only 8-21% were fully vaccinated. Only 29 and 61% of eligible children were vaccinated against meningococcal (ACW135Y) or yellow fever respectively. Finally, only 10% of children who lived in malaria-endemic-areas, reported chemoprophylaxis-use. CONCLUSION Although routine vaccination coverage in expat-children seems adequate, additional preventive measures are often needed. Whether this is due to lack of high-quality health care-access, fear of side-effects or insufficient knowledge about the risks/available preventive measures, remains elusive. Nevertheless, expats seem to constitute a separate risk-group for infectious diseases and destination-related health issues.
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Overbosch FW, Elfrink F, Schinkel J, Sonder GJB. No chikungunya virus infections among Dutch long-term travellers to (sub)tropical countries: a prospective study 2008-2011. BMC Infect Dis 2019; 19:196. [PMID: 30808283 PMCID: PMC6390585 DOI: 10.1186/s12879-019-3819-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 02/13/2019] [Indexed: 11/20/2022] Open
Abstract
Background Chikungunya is an arthropod-borne viral disease now identified in over 60 countries in Asia, Africa, Europe, and the Americas. Chikungunya virus (CHIKV) has spread in the last 15 years to many countries, causing large local outbreaks. CHIKV infection can be clinically misdiagnosed in areas where dengue and/or Zika infections occur. Prospective studies are necessary to calculate the true incidence rate of CHIKV infection in travellers. The aim of this study was to obtain the attack and incidence rates of CHIKV infection among long-term travellers and identify associated risk factors. Methods A previously collected prospective cohort of Dutch long-term travellers (12–52 weeks) to subtropical and tropical countries was tested. From December 2008 to September 2011, participants were recruited at the travel clinic of the Public Health Service Amsterdam. A weekly diary was kept during travel in which participants recorded their itinerary, symptoms, and physician visits. On return, their pre- and post-travel blood samples were tested for the presence of IgG antibodies to CHIKV antigen. Seroconversions were confirmed by an in-house CHIKV neutralisation test. Results The median age of 603 participants was 25 years (interquartile range [IQR]: 23–29); 35.7% were male; median travel duration was 20 weeks (IQR: 15–25), and purpose of travel was predominantly tourism (62%). The presence of anti-CHIKV IgG in the pre-travel sample, suggestive of previous CHIKV infection, was found for 3/603 participants (0.5%); all three had been previously travelling in either Africa or Asia. In one traveler who visited Latin America, a seroconversion was found (0.2%) but the CHIKV neutralisation test was negative, making the incidence rate 0. Conclusion No chikungunya virus infections were found in this 2008–2011 prospective cohort of long-term travellers. We recommend the research be repeated, particularly as the sample size of our cohort might have been too small. Also, extensive spread of chikungunya virus has likely increased incidence rates among travellers since 2013.
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Affiliation(s)
- Femke W Overbosch
- Department of Infectious Diseases, Public Health Service (GGD), Amsterdam, The Netherlands. .,National Coordination Centre for Traveller's Health Advice (LCR), Amsterdam, The Netherlands.
| | - Floor Elfrink
- Department of Infectious Diseases, Public Health Service (GGD), Amsterdam, The Netherlands.,National Coordination Centre for Traveller's Health Advice (LCR), Amsterdam, The Netherlands
| | - Janke Schinkel
- Department of Medical Microbiology, Laboratory of Clinical Virology, Academic Medical Center, Amsterdam, the Netherlands
| | - Gerard J B Sonder
- Department of Infectious Diseases, Public Health Service (GGD), Amsterdam, The Netherlands.,National Coordination Centre for Traveller's Health Advice (LCR), Amsterdam, The Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, Amsterdam, The Netherlands
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Lindsay L, DuPont HL, Moe CL, Alberer M, Hatz C, Kirby AE, Wu HM, Verstraeten T, Steffen R. Estimating the incidence of norovirus acute gastroenteritis among US and European international travelers to areas of moderate to high risk of traveler's diarrhea: a prospective cohort study protocol. BMC Infect Dis 2018; 18:605. [PMID: 30509202 PMCID: PMC6276235 DOI: 10.1186/s12879-018-3461-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 10/31/2018] [Indexed: 12/31/2022] Open
Abstract
Background Acute gastroenteritis (AGE) is the leading cause of illness among returning travelers seeking medical care. Multiple types of enteric pathogens can cause travel-acquired AGE and, while bacterial pathogens have a predominant role, the importance of viruses, such as norovirus, is increasingly recognized. There is a lack of information on travel-acquired norovirus incidence among symptomatic and asymptomatic individuals irrespective of healthcare-seeking behavior. Our aim is to estimate the incidence of travel-acquired AGE due to norovirus and to characterize the burden of disease among international travelers from the United States and Europe. Methods We describe a prospective cohort study implemented in five US and European sites to estimate the role of AGE due to norovirus among adult international travelers. We enrolled individuals aged 18 years and older who are traveling to regions of moderate-high risk of AGE, or via cruise ship with an international port stop, with a trip duration of 3–15 days. The study will generate a wide range of health and travel-related data for pre-, during, and up to 6-months post-travel. We will identify laboratory-confirmed travel-acquired norovirus infections among both symptomatic and asymptomatic individuals from self-collected whole stool samples tested via quantitative RT-PCR. Coinfections will be identified in a subset of travelers with AGE using a multiplex molecular-based assay. Discussion This study is unique in design and breadth of data collected. The prospective collection of health and behavioral data, as well as biologic samples from travelers irrespective of symptoms, will provide useful data to better understand the importance of norovirus AGE among international travelers. This study will provide data to estimate the incidence of norovirus infections and AGE and the risk of post-infectious sequelae in the 6-month post-travel period serving as a baseline for future norovirus AGE vaccination studies. This study will contribute valuable information to better understand the role of norovirus in travel-acquired AGE risk and the impact of these infections on a broad set of outcomes.
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Affiliation(s)
- Lisa Lindsay
- P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001, Leuven, Belgium.
| | - Herbert L DuPont
- University of Texas McGovern Medical School and School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Christine L Moe
- Emory University, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Martin Alberer
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Leopoldstrasse 5, 80802, Munich, Germany
| | - Christoph Hatz
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4056, Basel, Switzerland.,University of Basel, Petersplatz 1, 4001, Basel, Switzerland.,University of Zurich; Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travellers' Health, Hirschengraben 84, 8001, Zurich, Switzerland
| | - Amy E Kirby
- Emory University, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Henry M Wu
- Emory University, Division of Infectious Diseases, Department of Medicine, 550 Peachtree Street NE MOT 7, Atlanta, GA, 30308, USA
| | - Thomas Verstraeten
- P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001, Leuven, Belgium
| | - Robert Steffen
- University of Texas McGovern Medical School and School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA.,University of Zurich; Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travellers' Health, Hirschengraben 84, 8001, Zurich, Switzerland
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14
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Obaidat MM. Seroprevalence and risk factors forCampylobacter jejuniseropositivity in Jordan. Infect Dis (Lond) 2018; 51:140-146. [DOI: 10.1080/23744235.2018.1540883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Mohammad M. Obaidat
- Department of Veterinary Pathology and Public Health, Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, Jordan
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15
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Gautret P, Pradines B, Memish ZA, Sokhna C, Parola P. Mobile populations across the Mediterranean Sea and beyond: travel medicine, mass gathering medicine and homeless health. New Microbes New Infect 2018; 26:S96-S99. [PMID: 30402250 PMCID: PMC6205569 DOI: 10.1016/j.nmni.2018.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/23/2018] [Accepted: 05/23/2018] [Indexed: 11/23/2022] Open
Abstract
The Méditerranée Infection institute is internationally recognized for its expertise in infectious diseases and tropical medicine, and is one of the most active research centres for infectious diseases in Europe. Surveillance and research addressing infectious diseases in globally mobile populations is one of the strong components of the research conducted at the institute. A significant amount of clinical, microbiologic and epidemiologic works have been conducted in international travellers, pilgrims participating in large international religious gatherings, economic migrants and homeless migrant people over the last decades by our group. Our strong anchoring in several countries around the Mediterranean Sea and beyond, as well as the pivotal role of Marseille in the EuroTravNet and GeoSentinel international networks that monitor travel-associated diseases, reinforce our leading position in the fields of travel and tropical medicine, mass gathering medicine and homeless health.
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Affiliation(s)
- P Gautret
- Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, France
| | - B Pradines
- Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, France.,Unité Parasitologie et Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, France.,Centre National de Référence du Paludisme, Institut Hospitalo-universitaire (IHU) Méditerranée Infection, Marseille, France
| | - Z A Memish
- Department of Medicine, College of Medicine, Alfaisal University & Infectious Diseases Division, 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
| | - C Sokhna
- Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, France
| | - P Parola
- Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, France
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16
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Norman FF, López-Polín A, Salvador F, Treviño B, Calabuig E, Torrús D, Soriano-Arandes A, Ruíz-Giardín JM, Monge-Maillo B, Pérez-Molina JA, Perez-Ayala A, García M, Rodríguez A, Martínez-Serrano M, Zubero M, López-Vélez R. Imported malaria in Spain (2009-2016): results from the +REDIVI Collaborative Network. Malar J 2017; 16:407. [PMID: 29017499 PMCID: PMC5635489 DOI: 10.1186/s12936-017-2057-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/06/2017] [Indexed: 11/15/2022] Open
Abstract
Background Imported malaria is a frequent diagnosis in travellers and migrants. The objective of this study was to describe the epidemiological and clinical characteristics of patients diagnosed with imported malaria within a Spanish collaborative network registering imported diseases (+REDIVI). In addition, the possible association between malaria and type of case, gender, age or area of exposure was explored. Methods Cases of imported malaria were identified among all cases registered in the +REDIVI database during the period October 2009–October 2016. Demographic, epidemiological and clinical characteristics were analysed. Results In total, 11,816 cases of imported infectious diseases were registered in +REDIVI’s database between October 2009 and October 2016. Immigrants seen for the first time after migration accounted for 60.2% of cases, 21.0% of patients were travellers, and 18.8% were travellers/immigrants visiting friends and relatives (VFRs). There were 850 cases of malaria (850/11,816, 7.2%). Malaria was significantly more frequent in men than in women (56.8% vs 43.2%) and in VFR-immigrants (52.6%) as compared to travellers (21.3%), immigrants (20.7%) and VFR-travellers (5.4%) (p < 0.001). Although this data was not available for most patients with malaria, only a minority (29/217, 13.4%) mentioned correct anti-malarial prophylaxis. Sub-Saharan Africa was found to be the most common region of acquisition of malaria. Most common reason for consultation after travel was a febrile syndrome although an important proportion of immigrants were asymptomatic and presented only for health screening (27.3%). Around 5% of travellers presented with severe malaria. The most prevalent species of Plasmodium diagnosed was Plasmodium falciparum (81.5%). Malaria due to Plasmodium ovale/Plasmodium vivax was frequent among travellers (17%) and nearly 5% of all malaria cases in immigrants were caused by Plasmodium malariae. Conclusions Malaria was among the five most frequent diagnoses registered in +REDIVI’s database. Some significant differences were found in the distribution of malaria according to gender, type of case, species. Among all malaria cases, the most frequent diagnosis was P. falciparum infection in VFR-immigrant men.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain.
| | - Ana López-Polín
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain
| | - Fernando Salvador
- Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Begoña Treviño
- Unitat Medicina Tropical i Salut Internacional Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain
| | - Eva Calabuig
- La Fe de Valencia University Hospital, Valencia, Spain
| | | | - Antonio Soriano-Arandes
- Unitat Medicina Tropical i Salut Internacional Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain
| | | | - Begoña Monge-Maillo
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain
| | - Jose-Antonio Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain
| | | | | | | | | | | | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain
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17
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Eiset AH, Wejse C. Review of infectious diseases in refugees and asylum seekers-current status and going forward. Public Health Rev 2017; 38:22. [PMID: 29450094 PMCID: PMC5810046 DOI: 10.1186/s40985-017-0065-4] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 08/21/2017] [Indexed: 12/18/2022] Open
Abstract
An unprecedented rise in the number of asylum seekers and refugees was seen in Europe in 2015, and it seems that numbers are not going to be reduced considerably in 2016. Several studies have tried to estimate risk of infectious diseases associated with migration but only very rarely these studies make a distinction on reason for migration. In these studies, workers, students, and refugees who have moved to a foreign country are all taken to have the same disease epidemiology. A common disease epidemiology across very different migrant groups is unlikely, so in this review of infectious diseases in asylum seekers and refugees, we describe infectious disease prevalence in various types of migrants. We identified 51 studies eligible for inclusion. The highest infectious disease prevalence in refugee and asylum seeker populations have been reported for latent tuberculosis (9-45%), active tuberculosis (up to 11%), and hepatitis B (up to 12%). The same population had low prevalence of malaria (7%) and hepatitis C (up to 5%). There have been recent case reports from European countries of cutaneous diphtheria, louse-born relapsing fever, and shigella in the asylum-seeking and refugee population. The increased risk that refugees and asylum seekers have for infection with specific diseases can largely be attributed to poor living conditions during and after migration. Even though we see high transmission in the refugee populations, there is very little risk of spread to the autochthonous population. These findings support the efforts towards creating a common European standard for the health reception and reporting of asylum seekers and refugees.
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Affiliation(s)
| | - Christian Wejse
- Department of Public Health, Aarhus University, Aarhus, Denmark
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18
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Lingscheid T, Kurth F, Clerinx J, Marocco S, Trevino B, Schunk M, Muñoz J, Gjørup IE, Jelinek T, Develoux M, Fry G, Jänisch T, Schmid ML, Bouchaud O, Puente S, Zammarchi L, Mørch K, Björkman A, Siikamäki H, Neumayr A, Nielsen H, Hellgren U, Paul M, Calleri G, Kosina P, Myrvang B, Ramos JM, Just-Nübling G, Beltrame A, Saraiva da Cunha J, Kern P, Rochat L, Stich A, Pongratz P, Grobusch MP, Suttorp N, Witzenrath M, Hatz C, Zoller T. Schistosomiasis in European Travelers and Migrants: Analysis of 14 Years TropNet Surveillance Data. Am J Trop Med Hyg 2017; 97:567-574. [PMID: 28722637 PMCID: PMC5544096 DOI: 10.4269/ajtmh.17-0034] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 03/30/2017] [Indexed: 02/05/2023] Open
Abstract
Schistosomiasis remains one of the most prevalent parasitic diseases worldwide and the infection is frequently found in travelers and migrants. The European Network for Tropical Medicine and Travel Health conducted a sentinel surveillance study on imported schistosomiasis between 1997 and 2010. This report summarizes epidemiological and clinical data from 1,465 cases of imported schistosomiasis. Direct pathogen detection and serology were the main diagnostic tools applied. Of these, 486 (33%) cases were identified among European travelers, 231 (16%) among long-term expatriates, and 748 (51%) among non-European immigrants. Overall, only 18.6% of travelers had received pretravel advice; 95% of infections were acquired in the African region. On species level, Schistosoma mansoni was identified in 570 (39%) and Schistosoma haematobium in 318 (22%) cases; 57.5% of patients were symptomatic. Acute symptoms were reported in 27% of patients leading to earlier presentation within 3 months. Praziquantel was used in all patients to treat schistosomiasis. Many infections were detected in asymptomatic patients. In 47.4% of asymptomatic patients infection was detected by microscopy and in 39% by serology or antigen testing. Schistosomiasis remains a frequent infection in travelers and migrants to Europe. Travelers should be made aware of the risk of schistosomiasis infection when traveling to sub-Saharan Africa. Posttravel consultations particularly for returning expatriates are useful given the high potential for detecting asymptomatic infections.
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Affiliation(s)
- Tilman Lingscheid
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Kurth
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Clerinx
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Stefania Marocco
- Centro per le Malattie Tropicali, Ospedale S. Cuore, Negrar, Verona, Italy
| | - Begoña Trevino
- Tropical Medicine and International Health Unit, Hospital Vall d’Hebron Drassanes, PROSICS Barcelona, Barcelona, Spain
| | - Mirjam Schunk
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the Ludwig-Maximilians-University (LMU), Munich, Germany
| | - José Muñoz
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Ida E. Gjørup
- Infectious Diseases Unit, Herlev University Hospital, Copenhagen, Denmark
| | - Tomas Jelinek
- Berlin Centre for Travel and Tropical Medicine, Berlin, Germany
| | - Michel Develoux
- Service de Parasitologie, Hôpital Saint-Antoine, Paris, France
| | - Graham Fry
- Tropical Medical Bureau, Dublin, Ireland
| | - Thomas Jänisch
- Department of Infectious Diseases, University Hospital Heideberg, Heidelberg, Germany
| | - Matthias L. Schmid
- Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Olivier Bouchaud
- Consultation de médecine tropicale, Hôpital Avicenne, Bobigny, France
| | | | - Lorenzo Zammarchi
- Infectious Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Kristine Mørch
- Department of Medicine, National Centre for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway
| | - Anders Björkman
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Heli Siikamäki
- Inflammation Centre, Clinic of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Henrik Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Urban Hellgren
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Malgorzata Paul
- Department and Clinic of Tropical and Parasitic Diseases, Karol Marcinkowski University of Medical Sciences, Poznan, Poland
| | - Guido Calleri
- Travel Medicine Unit, Department of Infectious Diseases, Amedeo di Savoia Hospital-ASLTO2, Turin, Italy
| | - Pavel Kosina
- Department of Infectious Diseases, University Hospital, Hradec Králové, Czech Republic
| | | | - José M. Ramos
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
| | - Gudrun Just-Nübling
- Department of Internal Medicine II, Section Infectious Diseases and Tropical Medicine, University Hospital Frankfurt, Main, Germany
| | - Anna Beltrame
- Centro per le Malattie Tropicali, Ospedale S. Cuore, Negrar, Verona, Italy
- Clinic of Infectious Diseases, University of Udine, Udine, Italy
| | | | - Peter Kern
- Department of Internal Medicine III, Comprehensive Infectious Diseases Center, Ulm University Hospital, Ulm, Germany
| | - Laurence Rochat
- Department of Ambulatory Care and Community Medicine, Travel Clinic, University Hospital, Lausanne, Switzerland
| | - August Stich
- Abteilung Tropenmedizin, Missionsärztliche Klinik, Würzburg, Germany
| | - Peter Pongratz
- Division of Tropical Medicine and Infectious Diseases, Rostock University Medical Center, Germany
| | - Martin P. Grobusch
- Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Norbert Suttorp
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Witzenrath
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Hatz
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Thomas Zoller
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - TropNet Schistosomiasis Investigator Group
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute of Tropical Medicine, Antwerp, Belgium
- Centro per le Malattie Tropicali, Ospedale S. Cuore, Negrar, Verona, Italy
- Tropical Medicine and International Health Unit, Hospital Vall d’Hebron Drassanes, PROSICS Barcelona, Barcelona, Spain
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the Ludwig-Maximilians-University (LMU), Munich, Germany
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Infectious Diseases Unit, Herlev University Hospital, Copenhagen, Denmark
- Berlin Centre for Travel and Tropical Medicine, Berlin, Germany
- Service de Parasitologie, Hôpital Saint-Antoine, Paris, France
- Tropical Medical Bureau, Dublin, Ireland
- Department of Infectious Diseases, University Hospital Heideberg, Heidelberg, Germany
- Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
- Consultation de médecine tropicale, Hôpital Avicenne, Bobigny, France
- Hospital Carlos III, Madrid, Spain
- Infectious Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Medicine, National Centre for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Inflammation Centre, Clinic of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department and Clinic of Tropical and Parasitic Diseases, Karol Marcinkowski University of Medical Sciences, Poznan, Poland
- Travel Medicine Unit, Department of Infectious Diseases, Amedeo di Savoia Hospital-ASLTO2, Turin, Italy
- Department of Infectious Diseases, University Hospital, Hradec Králové, Czech Republic
- Oslo University Hospital, Ullevål, Norway
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
- Department of Internal Medicine II, Section Infectious Diseases and Tropical Medicine, University Hospital Frankfurt, Main, Germany
- Clinic of Infectious Diseases, University of Udine, Udine, Italy
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Department of Internal Medicine III, Comprehensive Infectious Diseases Center, Ulm University Hospital, Ulm, Germany
- Department of Ambulatory Care and Community Medicine, Travel Clinic, University Hospital, Lausanne, Switzerland
- Abteilung Tropenmedizin, Missionsärztliche Klinik, Würzburg, Germany
- Division of Tropical Medicine and Infectious Diseases, Rostock University Medical Center, Germany
- Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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19
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Tomasini C, Moneghini L, Barbui AM. Chronic amastigote-negative cutaneous leishmaniasis: A clinical, histopathologic and molecular study of 27 cases with emphasis on atypical and pseudolymphomatous presentations. J Cutan Pathol 2017; 44:530-537. [DOI: 10.1111/cup.12927] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/23/2017] [Accepted: 03/01/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Carlo Tomasini
- Dermatopathology Unit; Azienda Ospedaliero-Universitaria Città della Salute e della Scienza; Turin Italy
| | - Laura Moneghini
- Division of Pathology, Department of Health Sciences; University of Milan, Hospital San Paolo; Milan Italy
| | - Anna M. Barbui
- Microbiology and Virology Unit; Azienda Ospedaliero Universitaria Città della Salute e della Scienza; Turin Italy
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20
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Cobo F, Salas-Coronas J, Cabezas-Fernández MT, Vázquez-Villegas J, Cabeza-Barrera MI, Soriano-Pérez MJ. Infectious Diseases in Immigrant Population Related to the Time of Residence in Spain. J Immigr Minor Health 2017; 18:8-15. [PMID: 25466580 DOI: 10.1007/s10903-014-0141-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The aim of this study was to evaluate the data on the main imported infectious diseases and public health issues arising from the risk of transmission of tropical and common diseases in the immigrant population. During the period of study, 2,426 immigrants were attended in the Tropical Medicine Unit of the Hospital of Poniente. For each patient, a complete screening for common and tropical diseases was performed. The prevalence and main features of intestinal and urinary parasites, microfilarias, Chagas disease, malaria, hepatitis B (HBV) and C (HCV) viruses, extrapulmonary tuberculosis and syphilis was investigated taking into account the length of stay in Spain. Sub-Saharan Africa patients who had lived for <3 years in Spain had a high significantly number of infections produced by hookworms, Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni, Giardia lamblia, Entamoeba histolytica/dispar and Plasmodium spp. In patients who had lived for more than 3 years, there were significantly high rates of HBV infections, although HBV rates in sub-Saharan African patients are high even if the patients have been in Spain for <3 years. However, patients with large stays in Spain had also an important number of parasitological diseases. The main objective of the diagnosis is to avoid important public health problems and further complications in patients. It is advisable to carry out a screening of the main transmissible infections in all immigrant population regardless of the time outside their country. This screening should be individualized according to the geographical area of origin.
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Affiliation(s)
- Fernando Cobo
- Tropical Medicine Unit, Hospital de Poniente, Ctra de Almerimar s/n, 04700, El Ejido, Almería, Spain.
| | - Joaquín Salas-Coronas
- Tropical Medicine Unit, Hospital de Poniente, Ctra de Almerimar s/n, 04700, El Ejido, Almería, Spain
| | | | - José Vázquez-Villegas
- Tropical Medicine Unit, Hospital de Poniente, Ctra de Almerimar s/n, 04700, El Ejido, Almería, Spain
| | - M Isabel Cabeza-Barrera
- Tropical Medicine Unit, Hospital de Poniente, Ctra de Almerimar s/n, 04700, El Ejido, Almería, Spain
| | - Manuel J Soriano-Pérez
- Tropical Medicine Unit, Hospital de Poniente, Ctra de Almerimar s/n, 04700, El Ejido, Almería, Spain
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21
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Aronson N, Herwaldt BL, Libman M, Pearson R, Lopez-Velez R, Weina P, Carvalho EM, Ephros M, Jeronimo S, Magill A. Diagnosis and Treatment of Leishmaniasis: Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 2016; 63:e202-e264. [PMID: 27941151 DOI: 10.1093/cid/ciw670] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 09/22/2016] [Indexed: 12/25/2022] Open
Abstract
It is important to realize that leishmaniasis guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. The IDSA and ASTMH consider adherence to these guidelines to be voluntary, with the ultimate determinations regarding their application to be made by the physician in the light of each patient's individual circumstances.
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Affiliation(s)
- Naomi Aronson
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Michael Libman
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | - Peter Weina
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | | | | | - Selma Jeronimo
- Federal University of Rio Grande do Norte, Natal, Brazil
| | - Alan Magill
- Bill and Melinda Gates Foundation, Seattle, Washington
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Tsiodras S. Irregular migrants: a critical care or a public health emergency. Intensive Care Med 2016; 42:252-5. [PMID: 26467708 DOI: 10.1007/s00134-015-4088-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 10/02/2015] [Indexed: 10/22/2022]
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Pinto-Almeida A, Mendes T, de Oliveira RN, Corrêa SDAP, Allegretti SM, Belo S, Tomás A, Anibal FDF, Carrilho E, Afonso A. Morphological Characteristics of Schistosoma mansoni PZQ-Resistant and -Susceptible Strains Are Different in Presence of Praziquantel. Front Microbiol 2016; 7:594. [PMID: 27199925 PMCID: PMC4844704 DOI: 10.3389/fmicb.2016.00594] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 04/11/2016] [Indexed: 01/18/2023] Open
Abstract
Schistosomiasis is one of the most common human parasitic diseases whose socioeconomic impact is only surpassed by malaria. Praziquantel (PZQ) is the only drug commercially available for the treatment of all schistosome species causing disease in humans. However, there has been stronger evidences of PZQ-resistance on Schistosoma mansoni and thus it is very important to study the phenotypic characteristics associated with it. The aim of this study was to evaluate morphological alterations in S. mansoni PZQ-resistant adult worms and eggs, by comparing a PZQ- resistant strain obtained under PZQ drug pressure with a PZQ-susceptible strain. For this, scanning electronic microscopy was used to assess tegumental responsiveness of both strains under PZQ exposure, and optical microscopy allowed the monitoring of worms and eggs in the presence of the drug. Those assays showed that PZQ-susceptible worms exposed to the drug had more severe tegumental damages than the resistant one, which had only minor alterations. Moreover, contrary to what occurred in the susceptible strain, resistant worms were viable after PZQ exposure and gradually regaining full motility after removal of the drug. Eggs from resistant strain parasites are considerably smaller than those from susceptible strain. Our results suggest that there might be a difference in the tegument composition of the resistant strain and that worms are less responsive to PZQ. Changes observed in egg morphology might imply alterations in the biology of schistosomes associated to PZQ-resistance, which could impact on transmission and pathology of the disease. Moreover, we propose a hypothetical scenario where there is a different egg tropism of the S. mansoni resistant strain. This study is the first comparing two strains that only differ in their resistance characteristics, which makes it a relevant step in the search for resistance determinants.
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Affiliation(s)
- António Pinto-Almeida
- Graduate Program in Areas of Basic and Applied Biology, Instituto de Ciências Biomédicas Abel Salazar, Universidade do PortoPorto, Portugal; Medical Parasitology Unit, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de LisboaLisbon, Portugal; Bioanalytical, Microfabrication, and Separations Group, Instituto de Química de São Carlos, Universidade de São PauloSão Carlos, Brazil
| | - Tiago Mendes
- Medical Parasitology Unit, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de LisboaLisbon, Portugal; Departamento De Biologia Animal, Instituto de Biologia, Universidade Estadual de CampinasCampinas, Brazil
| | | | | | - Silmara Marques Allegretti
- Departamento De Biologia Animal, Instituto de Biologia, Universidade Estadual de Campinas Campinas, Brazil
| | - Silvana Belo
- Medical Parasitology Unit, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa Lisbon, Portugal
| | - Ana Tomás
- Graduate Program in Areas of Basic and Applied Biology, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto Porto, Portugal
| | - Fernanda de Freitas Anibal
- Laboratory of Parasitology, Department of Morphology and Pathology, Universidade Federal de São Carlos São Carlos, Brazil
| | - Emanuel Carrilho
- Bioanalytical, Microfabrication, and Separations Group, Instituto de Química de São Carlos, Universidade de São Paulo São Carlos, Brazil
| | - Ana Afonso
- Medical Parasitology Unit, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de LisboaLisbon, Portugal; Bioanalytical, Microfabrication, and Separations Group, Instituto de Química de São Carlos, Universidade de São PauloSão Carlos, Brazil; Laboratory of Parasitology, Department of Morphology and Pathology, Universidade Federal de São CarlosSão Carlos, Brazil
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Herbinger KH, Alberer M, Berens-Riha N, Schunk M, Bretzel G, von Sonnenburg F, Nothdurft HD, Löscher T, Beissner M. Spectrum of Imported Infectious Diseases: A Comparative Prevalence Study of 16,817 German Travelers and 977 Immigrants from the Tropics and Subtropics. Am J Trop Med Hyg 2016; 94:757-66. [PMID: 26903611 DOI: 10.4269/ajtmh.15-0731] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 01/01/2016] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was to assess the spectrum of imported infectious diseases (IDs) among patients consulting the University of Munich, Germany, between 1999 and 2014 after being in the sub-/tropics. The analysis investigated complete data sets of 16,817 diseased German travelers (2,318 business travelers, 4,029 all-inclusive travelers, and 10,470 backpackers) returning from Latin America (3,225), Africa (4,865), or Asia (8,727), and 977 diseased immigrants, originating from the same regions (112, 654 and 211 respectively). The most frequent symptoms assessed were diarrhea (38%), fever (29%), and skin disorder (22%). The most frequent IDs detected were intestinal infections with species of Blastocystis(900),Giardia(730),Campylobacter(556),Shigella(209), and Salmonella(183). Also frequently observed were cutaneous larva migrans (379), dengue (257), and malaria (160). The number of IDs with significantly elevated proportions was higher among backpackers (18) and immigrants (17), especially among those from Africa (18) and Asia (17), whereas it was lower for business travelers (5), all-inclusive travelers (1), and those from Latin America (5). This study demonstrates a large spectrum of imported IDs among returning German travelers and immigrants, which varies greatly based not only on travel destination and origin of immigrants, but also on type of travel.
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Affiliation(s)
- Karl-Heinz Herbinger
- Department of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany
| | - Martin Alberer
- Department of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany
| | - Nicole Berens-Riha
- Department of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany
| | - Mirjam Schunk
- Department of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany
| | - Gisela Bretzel
- Department of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany
| | - Frank von Sonnenburg
- Department of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany
| | - Hans Dieter Nothdurft
- Department of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany
| | - Thomas Löscher
- Department of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany
| | - Marcus Beissner
- Department of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany
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Tavakolipoor P, Schmidt-Chanasit J, Burchard GD, Jordan S. Clinical features and laboratory findings of dengue fever in German travellers: A single-centre, retrospective analysis. Travel Med Infect Dis 2016; 14:39-44. [DOI: 10.1016/j.tmaid.2016.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 01/22/2023]
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Tafuri S, Guerra R, Gallone MS, Cappelli MG, Lanotte S, Quarto M, Germinario C. Effectiveness of pre-travel consultation in the prevention of travel-related diseases: a retrospective cohort study. Travel Med Infect Dis 2015; 12:745-9. [PMID: 25459434 DOI: 10.1016/j.tmaid.2014.10.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 10/09/2014] [Accepted: 10/13/2014] [Indexed: 01/26/2023]
Abstract
BACKGROUND This study aims to evaluate the effectiveness of pre-travel counselling carried out in Travel Clinics. METHODS This is a retrospective cohort. Three hundred international travellers were enrolled; 150 people were from users of Bari Travel Clinic, 150 were users of a travel agency. Enrolled subjects were interviewed using a questionnaire. RESULTS The average age of the enrolled subjects was 37.5 ± 13.9, without statistically significant differences between the two groups. 86% of cases and 19.3% of the controls reported the use of anti-malaria prophylaxis (p < 0.0001). Vaccination against cholera was given to 62% of cases and 7.3% of the controls (p < 0.001). Travel Clinic users, 6% reported diarrhoea and these figures were 27% in the control group (p < 0.0001). The proportion of those interviewed who reported fever (3.7) or insomnia (1.3) did not differ between the two groups. Mosquito bites were reported by 8% of cases and 20% of the controls (p = 0.003). Three cases of malaria were reported among the controls but no cases were detected among the cases (chi-square = 3.03; p = 0.08). CONCLUSIONS Our study demonstrated the effectiveness of pre-travel counselling; in the future, new studies must investigate the cost-effectiveness of pre-travel prevention measures.
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Twelve years of dengue surveillance in Belgian travellers and significant increases in the number of cases in 2010 and 2013. Clin Microbiol Infect 2015; 21:867-72. [DOI: 10.1016/j.cmi.2015.05.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/04/2015] [Accepted: 05/13/2015] [Indexed: 11/21/2022]
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Kaakoush NO, Castaño-Rodríguez N, Mitchell HM, Man SM. Global Epidemiology of Campylobacter Infection. Clin Microbiol Rev 2015; 28:687-720. [PMID: 26062576 PMCID: PMC4462680 DOI: 10.1128/cmr.00006-15] [Citation(s) in RCA: 846] [Impact Index Per Article: 94.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Campylobacter jejuni infection is one of the most widespread infectious diseases of the last century. The incidence and prevalence of campylobacteriosis have increased in both developed and developing countries over the last 10 years. The dramatic increase in North America, Europe, and Australia is alarming, and data from parts of Africa, Asia, and the Middle East indicate that campylobacteriosis is endemic in these areas, especially in children. In addition to C. jejuni, there is increasing recognition of the clinical importance of emerging Campylobacter species, including Campylobacter concisus and Campylobacter ureolyticus. Poultry is a major reservoir and source of transmission of campylobacteriosis to humans. Other risk factors include consumption of animal products and water, contact with animals, and international travel. Strategic implementation of multifaceted biocontrol measures to reduce the transmission of this group of pathogens is paramount for public health. Overall, campylobacteriosis is still one of the most important infectious diseases that is likely to challenge global health in the years to come. This review provides a comprehensive overview of the global epidemiology, transmission, and clinical relevance of Campylobacter infection.
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Affiliation(s)
- Nadeem O Kaakoush
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, NSW, Australia
| | - Natalia Castaño-Rodríguez
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, NSW, Australia
| | - Hazel M Mitchell
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, NSW, Australia
| | - Si Ming Man
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, NSW, Australia Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Valerio L, Roure S, Fernández-Rivas G, Ballesteros AL, Ruiz J, Moreno N, Bocanegra C, Sabrià M, Pérez-Quilez O, de Ory F, Molina I. Arboviral infections diagnosed in a European area colonized by Aedes albopictus (2009-2013, Catalonia, Spain). Travel Med Infect Dis 2015; 13:415-21. [PMID: 26169583 DOI: 10.1016/j.tmaid.2015.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 06/18/2015] [Accepted: 06/19/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND The invasive mosquito Aedes albopictus, with proven vectorial ability to transmit European autochthonous cycles of dengue and chikungunya virus, has currently colonized every coastal department of Eastern Spain. The main objective of the study was to define the epidemiological and clinical characteristics as well as the trends of these two arboviral diseases in a European area heavily colonized by Ae. albopictus. METHOD A voluntarily-based, prospective and multicenter surveillance study was performed in all medical units of the North Metropolitan area of Barcelona (406,000 inhabitants, Catalonia; Spain) with diagnostic capability from 2009 to 2013. Since any possible increase in arboviral cases could be justified by changes in traveling behaviors along the study period (especially longer trips) the trend showed by these two arboviral diseases was compared with that displayed by malaria cases during the same period. RESULTS 38 out of 52 (73.1%) suspected cases could be serologically confirmed (IgM+): dengue 34/38 (89.5%) and chikungunya 4/38 (11.5%). No autochthonous cases were identified. The overall incidence of both arboviruses was 0.19 cases/10,000 inhabitants-year (95% CI: 0.07-0.3); dengue = 0.17 cases/10,000 inhabitants-year (95% CI: 0.05-0.3), and chikungunya = 0.02 cases/10,000 inhabitants-year (95% CI: 0.001-0.03). The Incidence Relative Risk of arboviral disease between 2009 and 2013 shown a significant trend (IRR = 1.27. IC 95%: 1.01-1.59; p = 0.043) when compared with that displayed by malaria (IRR = 1.04. IC 95%: 0.924-1.192). If no unexpected circumstances concur, the arboviral disease incidence tax would equal that of malaria about 2021-2022. CONCLUSIONS The incidence of dengue and chikungunya is steadily increasing in the North Metropolitan area of Barcelona, a region densely colonized by Ae. albopictus, at the entire expense of imported cases (especially Visiting Friends and Relatives travelers). To date, no secondary autochthonous cases have been identified and, thus, they have not taken part in this rise.
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Affiliation(s)
- Lluís Valerio
- North Metropolitan International Health Unit, Universitat Autònoma de Barcelona, PROSICS - Institut Català de la Salut, Spain.
| | - Sílvia Roure
- Infectious Diseases Unit, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, PROSICS - Institut Català de la Salut, Spain.
| | - Gema Fernández-Rivas
- Microbiology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Institut Català de la Salut, Spain.
| | - Angel-Luis Ballesteros
- Internal Medicine Department, Hospital Municipal de Badalona, Badalona Serveis Assistencials, Spain.
| | - Jessica Ruiz
- Internal Medicine Department, Hospital de l'Esperit Sant, Spain.
| | - Nemesio Moreno
- Epidemiology Department, Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Spain.
| | - Cristina Bocanegra
- North Metropolitan International Health Unit, Universitat Autònoma de Barcelona, PROSICS - Institut Català de la Salut, Spain.
| | - Miquel Sabrià
- Infectious Diseases Unit, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, PROSICS - Institut Català de la Salut, Spain.
| | - Olga Pérez-Quilez
- North Metropolitan International Health Unit, Universitat Autònoma de Barcelona, PROSICS - Institut Català de la Salut, Spain.
| | - Fernando de Ory
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.
| | - Israel Molina
- Infectious Diseases Department, Hospital Universitari de la Vall d'Hebron, Universitat Autònoma de Barcelona, PROSICS - Institut Català de la Salut, Spain.
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Trojánek M, Maixner J, Sojková N, Kynčl J, Roháčová H, Marešová V, Stejskal F. Dengue fever in Czech travellers: A 10-year retrospective study in a tertiary care centre. Travel Med Infect Dis 2015; 14:32-38. [PMID: 26159629 DOI: 10.1016/j.tmaid.2015.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 06/10/2015] [Accepted: 06/12/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dengue fever is a frequent cause of morbidity in travellers. The objective was to describe the epidemiological and clinical characteristics of dengue fever in Czech travellers. METHOD This descriptive study includes patients with acute dengue fever diagnosed at Hospital Na Bulovce during 2004-2013. Data were collected and analysed retrospectively. RESULTS A total of 132 patients (83 males and 49 females) of median age 33 years (IQR 29-40) were included. Diagnosis was established by NS1 antigen detection in 87/107 cases (81.3%) and/or RT-PCR in 50/72 (69.4%) and by serology in 25 cases (18.9%). Dengue was acquired in South-East Asia in 69 cases (52.3%), followed by South Asia (48 cases; 36.3%), Latin America (14; 10.6%) and Sub-Saharan Africa (1; 0.8%). The most frequent symptoms included fever, rash and headache. Initial leukocyte and lymphocyte counts were lower in patients who presented in the early phase (0-4 days), however, platelet count was lower and AST, ALT and LDH activity higher in patients with a longer symptoms duration (≥5 days). The clinical course was mostly uncomplicated. CONCLUSIONS Dengue fever is becoming a frequent cause of fever in Czech travellers. Clinicians should be familiar with the typical clinical findings and novel diagnostic methods.
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Affiliation(s)
- Milan Trojánek
- 1st Department of Infectious Diseases, 2nd Medical Faculty, Charles University in Prague, Budínova 2, 180 81 Prague, Czech Republic; Department of Infectious, Parasitic and Tropical Diseases, Hospital Na Bulovce, Budínova 2, 180 81 Prague, Czech Republic.
| | - Jan Maixner
- Department of Virology, Institute of Public Health in Ústí nad Labem, Budínova 2, 180 81 Prague, Czech Republic
| | - Naděžda Sojková
- Department of Virology, Institute of Public Health in Ústí nad Labem, Budínova 2, 180 81 Prague, Czech Republic
| | - Jan Kynčl
- Department of Epidemiology of Infectious Diseases, National Institute of Public Health, Šrobárova 48, 100 42 Prague, Czech Republic; Department of Epidemiology, 3rd Medical Faculty, Charles University in Prague, Ruská 87, 100 00 Prague, Czech Republic
| | - Hana Roháčová
- 1st Department of Infectious Diseases, 2nd Medical Faculty, Charles University in Prague, Budínova 2, 180 81 Prague, Czech Republic; Department of Infectious, Parasitic and Tropical Diseases, Hospital Na Bulovce, Budínova 2, 180 81 Prague, Czech Republic
| | - Vilma Marešová
- 1st Department of Infectious Diseases, 2nd Medical Faculty, Charles University in Prague, Budínova 2, 180 81 Prague, Czech Republic; Department of Infectious, Parasitic and Tropical Diseases, Hospital Na Bulovce, Budínova 2, 180 81 Prague, Czech Republic
| | - František Stejskal
- 1st Department of Infectious Diseases, 2nd Medical Faculty, Charles University in Prague, Budínova 2, 180 81 Prague, Czech Republic; Department of Infectious, Parasitic and Tropical Diseases, Hospital Na Bulovce, Budínova 2, 180 81 Prague, Czech Republic; Institute of Immunology and Microbiology, 1st Medical Faculty, Charles University in Prague, Studničkova 7, 128 00 Prague, Czech Republic; Department of Infectious Diseases, Regional Hospital Liberec, Husova 10, 460 63 Liberec, Czech Republic
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Schistosomiasis in a migrating population in the lake region of China and its potential impact on control operation. Acta Trop 2015; 145:88-92. [PMID: 25700711 DOI: 10.1016/j.actatropica.2015.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 02/02/2015] [Accepted: 02/08/2015] [Indexed: 11/21/2022]
Abstract
Coverage of migrating people in schistosomiasis control program is a growing concern in China. Schistosomiasis caused by Schistosoma japonicum is still one of the major infectious diseases of public health importance in China though tremendous efforts have been made to control the transmission over the past decades. Along with the rapid social-economic development, migrant population has been remarkably increasing across the country. The infected migrants may introduce a new souse of infection to endemic areas or the areas where the transmission had been controlled or interrupted but the intermediate host Oncomelania snail is still present. Preliminary studies for surveillance on schistosomiasis prevalence in migrants were reported, but there is little basic information provided. We carried out an investigation on the prevalence in immigrants, emigrants and permanent residents in three villages of Hunan province located in the main endemic area of lake region, and analyzed the potential impact of migration on control practice. In the study villages, the migrant population accounts for 53.6% of the total. Schistosoma infection was detected by modified Kato-Katz method and miracidium hatching test. Questionnaire survey was conducted comprising knowledge of disease and its transmission, water contact, personal protective measures, and whether examined and treated after water contact. The survey indicated that the migrants and permanent residents had similar life style, and the majority of them experienced water contact in agricultural work or routine life activities. However, the infection rate in immigrants was significantly higher than that in permanent residents. It was also found that the migrants had significantly less knowledge about the disease than the permanent residents, and took no personal protective measures. This is due to that the control program could not cover the migrants when they were absent at the time the program being implemented. The present study suggested that the surveillance and intervention for migrants, immigrants in particular, should be included and strengthened in schistosomiasis control program and a feasible scheme be developed.
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Quam MB, Khan K, Sears J, Hu W, Rocklöv J, Wilder-Smith A. Estimating air travel-associated importations of dengue virus into Italy. J Travel Med 2015; 22:186-93. [PMID: 25756472 DOI: 10.1111/jtm.12192] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 11/24/2014] [Accepted: 12/01/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Southern Europe is increasingly at risk for dengue emergence, given the seasonal presence of relevant mosquito vectors and suitable climatic conditions. For example, Aedes mosquitoes, the main vector for both dengue and chikungunya, are abundant in Italy, and Italy experienced the first ever outbreak of chikungunya in Europe in 2007. We set out to estimate the extent of dengue virus importations into Italy via air travelers. METHODS We attempted to quantify the number of dengue virus importations based on modeling of published estimates on dengue incidence in the countries of disembarkation and analysis of data on comprehensive air travel from these countries into Italy's largest international airport in Rome. RESULTS From 2005 to 2012, more than 7.3 million air passengers departing from 100 dengue-endemic countries arrived in Rome. Our Importation Model, which included air traveler volume, estimated the incidence of dengue infections in the countries of disembarkation, and the probability of infection coinciding with travel accounted for an average of 2,320 (1,621-3,255) imported dengue virus infections per year, of which 572 (381-858) were "apparent" dengue infections and 1,747 (1,240-2,397) "inapparent." CONCLUSIONS Between 2005 and 2012, we found an increasing trend of dengue virus infections imported into Rome via air travel, which may pose a potential threat for future emergence of dengue in Italy, given that the reoccurring pattern of peak importations corresponds seasonally with periods of relevant mosquito vector activity. The observed increasing annual trends of dengue importation and the consistent peaks in late summer underpin the urgency in determining the threshold levels for the vector and infected human populations that could facilitate novel autochthonous transmission of dengue in Europe.
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Affiliation(s)
- Mikkel B Quam
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit, Umeå University, Umeå, Västerbotten, Sweden; Institute of Public Health, University of Heidelberg, Heidelberg, Germany
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Sergeyev B, Kazanets I, Ivanova L, Zhuravleva I, Isaeva N, Vasankari T, Nyberg A, Vauhkonnen M. Labor migrants in St Petersburg: disease awareness, behavioral risks and counseling by health professionals in building up prevention against TB, HIV and associated infections. J Public Health (Oxf) 2015. [DOI: 10.1007/s10389-015-0669-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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34
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Becker N, Krüger A, Kuhn C, Plenge-Bönig A, Thomas SM, Schmidt-Chanasit J, Tannich E. [Mosquitoes as vectors for exotic pathogens in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:531-40. [PMID: 24781910 DOI: 10.1007/s00103-013-1918-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
As a result of intensified globalization of international trade and of substantial travel activities, mosquito-borne exotic pathogens are becoming an increasing threat for Europe. In Germany some 50 different mosquito species are known, several of which have vector competence for pathogens. During the last few years a number of zoonotic arboviruses that are pathogenic for humans have been isolated from mosquitoes in Germany including Usutu, Sindbis and Batai viruses. In addition, filarial worms, such as Dirofilaria repens have been repeatedly detected in mosquitoes from the federal state of Brandenburg. Other pathogens, in particular West Nile virus, are expected to emerge sooner or later in Germany as the virus is already circulating in neighboring countries, e.g. France, Austria and the Czech Republic. In upcoming years the risk for arbovirus transmission might increase in Germany due to increased occurrence of new so-called "invasive" mosquito species, such as the Asian bush mosquito Ochlerotatus japonicus or the Asian tiger mosquito Aedes albopictus. These invasive species are characterized by high vector competence for a broad range of pathogens and a preference for human blood meals. For risk assessment, a number of mosquito and pathogen surveillance projects have been initiated in Germany during the last few years; however, mosquito control strategies and plans of action have to be developed and put into place to allow early and efficient action against possible vector-borne epidemics.
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Abstract
Schistosomiasis is one of the major parasitic diseases of the tropics, causing acute and long-term clinical syndromes. Almost all schistosomiasis is now imported from sub-Saharan Africa. This article summarises the aetiology, clinical presentation, diagnosis and management of schistosomiaisis for clinicians in non-endemic countries.
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Norman FF, Monge-Maillo B, Martínez-Pérez Á, Perez-Molina JA, López-Vélez R. Parasitic infections in travelers and immigrants: part I protozoa. Future Microbiol 2015; 10:69-86. [DOI: 10.2217/fmb.14.105] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
ABSTRACT The growth in international commerce, travel and migration contribute to the global emergence of certain parasitic infections. Importation of vectors and food products may contribute to the emergence of protozoan infections in nonendemic countries. Infections such as malaria are potentially fatal, especially in nonimmune patients, and outcome depends largely on timely diagnosis and treatment. Diagnosis/management of imported parasitic infections may be complex especially as some patients may have underlying immunosuppressive conditions such as HIV infection. Major challenges concern the development of improved diagnostic techniques, safer/more effective drug therapies and identification of biological markers of progression and response to treatment. Imported parasitic diseases which may be transmitted vertically or through blood transfusion/organ donation could become a public health priority in the near future. Climate change may affect arthropod distribution and facilitate the spread of protozoan vector-borne diseases. The first part of this review focuses on protozoan infections in travelers and immigrants.
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Affiliation(s)
- Francesca F Norman
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Begoña Monge-Maillo
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Ángela Martínez-Pérez
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Jose A Perez-Molina
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Rogelio López-Vélez
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
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Boggild AK, Lau R, Reynaud D, Kain KC, Gerson M. Failure of atovaquone-proguanil malaria chemoprophylaxis in a traveler to Ghana. Travel Med Infect Dis 2014; 13:89-93. [PMID: 25582377 DOI: 10.1016/j.tmaid.2014.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 12/18/2014] [Accepted: 12/23/2014] [Indexed: 11/18/2022]
Abstract
Clinical failure of Malarone™ chemoprophylaxis is extremely rare. We report a case of Plasmodium falciparum malaria in a returned traveler to Ghana who fully adhered to atovaquone-proguanil (Malarone™) chemoprophylaxis daily dosing, yet took the pills on an empty stomach. Screening of the P. falciparum isolate revealed triple codon mutation of Dhfr at positions 51, 59, and 108. Plasma drug levels of both atovaquone and proguanil revealed sub-therapeutic concentrations.
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Affiliation(s)
- Andrea K Boggild
- Tropical Disease Unit, Division of Infectious Diseases, University Health Network-Toronto General Hospital, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Public Health Ontario Laboratories, Public Health Ontario, Toronto, Canada.
| | - Rachel Lau
- Public Health Ontario Laboratories, Public Health Ontario, Toronto, Canada
| | - Denis Reynaud
- The Centre for the Study of Complex Childhood Diseases, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kevin C Kain
- Tropical Disease Unit, Division of Infectious Diseases, University Health Network-Toronto General Hospital, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Sandra A. Rotman Laboratories, Sandra Rotman Centre for Global Health, University of Toronto, Canada
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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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Belli A, Coppola MG, Petrullo L, Lettieri G, Palumbo C, Dell'Isola C, Smeraglia R, Triassi M, Spada E, Amoroso P. The current spectrum and prevalence of intestinal parasitosis in Campania (region of southern Italy) and their relationship with migration from endemic countries. Int J Infect Dis 2014; 29:42-7. [PMID: 25449234 DOI: 10.1016/j.ijid.2014.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 03/11/2014] [Accepted: 04/20/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND In Italy, the current clinical-epidemiological features of intestinal parasitosis and the impact of recent massive migration flows from endemic areas on their distribution are not very well known. METHODS An analysis was carried out involving 1766 patients (720 natives and 1046 immigrants) observed during the period 2009-2010 (the 'current group') and 771 native patients observed during the period 1996-1997 (the 'historical group'), a time at which immigration in the area was minimal. Patients were analyzed for intestinal parasitosis at four healthcare centres in Campania. RESULTS A wide variety of intestinal parasites was detected in the study subjects. Immigrants had a significantly higher prevalence of parasitosis and multiple simultaneous infections than natives in both groups. In both study groups of natives, the detection of at least one parasite was significantly associated with a history of travel to endemic areas. Among immigrants, we found an inverse correlation between the frequency of parasite detection and the amount of time spent in Italy. No circulation of parasites was found among contacts of parasitized patients. CONCLUSIONS Intestinal parasites are still a cause of intestinal infection in Campania. Although immigrants have a significantly higher prevalence of parasitosis than natives, this does not increase the risk of infection for that population. This is likely due to the lack of suitable biological conditions in our area.
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Affiliation(s)
- Alberta Belli
- Department of Preventive Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Maria Grazia Coppola
- Unit of Microbiology, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Luciana Petrullo
- Unit of Microbiology, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Gennaro Lettieri
- VI Division of Infectious Diseases, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Cristiana Palumbo
- VI Division of Infectious Diseases, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Chiara Dell'Isola
- VI Division of Infectious Diseases, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Riccardo Smeraglia
- Unit of Microbiology, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy
| | - Maria Triassi
- Department of Preventive Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Enea Spada
- Department of Infectious, Parasitic and Immuno-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Pietro Amoroso
- VI Division of Infectious Diseases, Cotugno Hospital, AORN "Ospedali dei Colli", Naples, Italy.
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Orlando G, Gubertini G, Negri C, Coen M, Ricci E, Galli M, Rizzardini G. Trends in hospital admissions at a Department for Infectious Diseases in Italy from 1995 to 2011 and implications for health policies. BMC Public Health 2014; 14:980. [PMID: 25239403 PMCID: PMC4180147 DOI: 10.1186/1471-2458-14-980] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 09/16/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interactions among several environmental, behavioral, social, and biological variables contribute to the epidemiology of infectious diseases (IDs) and have an impact on the healthcare system and hospitalizations. We evaluated trends in ID hospitalizations at our Department for Infectious Diseases in the last two decades to aid decision-makers in defining appropriate healthcare strategies. METHODS The discharge diagnoses of all patients admitted to the ID Department of L Sacco University Hospital between 1995 and 2011 were classified by the International Classification of Diseases (ICD-9) grouped in Major Diagnostic Categories (MDC). Linear regression was used to determine the trends in hospitalizations for each MDC. Estimates of the average annual change were based on the slope of the regression line. RESULTS A sharp decline in HIV/AIDS cases (-22.5 +/-6.0 cases per calendar year), and an increase in admissions for respiratory, cardiovascular, renal and musculoskeletal infections were recorded. The mean age of the patients increased by 1.2 years (+/-0.049) for each calendar year of observation (linear trend, p < 0.0001), increasing from 37.02 +/-11.91 years in 1995 to 56.02 +/-19.62 years in 2011 (p < 0.0001). The mean number of comorbidities per patient increased significantly over time (Mann-Whitney U test, p = 0.0153). From 1998/1999 to 2010/2011 the hospital length of stay (LOS) increased for cardiovascular, digestive system, musculoskeletal, and skin/subcutaneous infections, and infectious and parasitic diseases (p < 0.01). The rate of hospital stay over threshold (HSOT) increased in the last 5 years by 1.12% for every 10-year age group. CONCLUSIONS Older age, a higher number of comorbidities, a longer hospital LOS for certain conditions, and a higher rate of HSOT characterize the patients admitted to this ID department in recent years. Despite progress in treatment and management, infectious diseases continue to be a major threat to human health. The current challenge for ID departments is the treatment of complex cases, often associated with chronic diseases in elderly patients. Continuous monitoring at a local and national level will allow early identification of changes in the epidemiological patterns of IDs and provide information for healthcare system planning.
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Affiliation(s)
- Giovanna Orlando
- />Department of Infectious Disease I, L Sacco University Hospital, Milan, Italy
- />STD Unit, L Sacco University Hospital, Via GB Grassi, 74, 20157 Milan, Italy
| | - Guido Gubertini
- />Department of Infectious Disease I, L Sacco University Hospital, Milan, Italy
| | - Cristina Negri
- />Department of Infectious Disease III, L Sacco University Hospital, Milan, Italy
| | - Massimo Coen
- />Department of Infectious Disease I, L Sacco University Hospital, Milan, Italy
| | - Elena Ricci
- />Department of Infectious Disease I, L Sacco University Hospital, Milan, Italy
| | - Massimo Galli
- />Department of Infectious Disease III, L Sacco University Hospital, Milan, Italy
| | - Giuliano Rizzardini
- />Department of Infectious Disease I, L Sacco University Hospital, Milan, Italy
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Odolini S, Gautret P, Kain KC, Smith K, Leder K, Jensenius M, Coyle CM, Castelli F, Matteelli A. Imported Plasmodium vivax malaria ex Pakistan. J Travel Med 2014; 21:314-7. [PMID: 24889386 DOI: 10.1111/jtm.12134] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 02/25/2014] [Accepted: 03/06/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND According to WHO, 1.5 million cases of malaria are reported annually in Pakistan. Malaria distribution in Pakistan is heterogeneous, and some areas, including Punjab, are considered at low risk for malaria. The aim of this study is to describe the trend of imported malaria cases from Pakistan reported to the international surveillance systems from 2005 to 2012. METHODS Clinics reporting malaria cases acquired after a stay in Pakistan between January 1, 2005, and December 31, 2012, were identified from the GeoSentinel (http://www.geosentinel.org) and EuroTravNet (http://www.Eurotravnet.eu) networks. Demographic and travel-related information was retrieved from the database and further information such as areas of destination within Pakistan was obtained directly from the reporting sites. Standard linear regression models were used to assess the statistical significance of the time trend. RESULTS From January 2005 to December 2012, a total of 63 cases of malaria acquired in Pakistan were retrieved in six countries over three continents. A statistically significant increasing trend in imported Plasmodium vivax malaria cases acquired in Pakistan, particularly for those exposed in Punjab, was observed over time (p = 0.006). CONCLUSIONS Our observation may herald a variation in malaria incidence in the Punjab province of Pakistan. This is in contrast with the previously described decreasing incidence of malaria in travelers to the Indian subcontinent, and with reports that describe Punjab as a low risk area for malaria. Nevertheless, this event is considered plausible by international organizations. This has potential implications for changes in chemoprophylaxis options and reinforces the need for increased surveillance, also considering the risk of introduction of autochthonous P. vivax malaria in areas where competent vectors are present, such as Europe.
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Affiliation(s)
- Silvia Odolini
- University Division of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy
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Warne B, Weld LH, Cramer JP, Field VK, Grobusch MP, Caumes E, Jensenius M, Gautret P, Schlagenhauf P, Castelli F, Lalloo DG, Ursing J, Chappuis F, von Sonnenburg F, López-Vélez R, Rapp C, Smith KC, Parola P, Gkrania-Klotsas E. Travel-related infection in European travelers, EuroTravNet 2011. J Travel Med 2014; 21:248-54. [PMID: 24750378 DOI: 10.1111/jtm.12120] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 12/06/2013] [Accepted: 12/11/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Limited data exist on infectious diseases imported to various locations in Europe, particularly after travel within the continent. METHODS To investigate travel-related disease relevant to Europe that is potentially preventable through pre-travel intervention, we analyzed the EuroTravNet database of 5,965 ill travelers reported by 16 centers in "Western" Europe in 2011. RESULTS There were 54 cases of vaccine-preventable disease, mostly hepatitis A (n = 16), typhoid fever (n = 11), and measles (n = 8); 6 cases (including 3 measles cases) were associated with travel within "Western" Europe. Malaria was the most commonly diagnosed infection (n = 482, 8.1% of all travel-related morbidity). Among patients with malaria, the military most commonly received pre-travel advice (95%), followed by travelers for missionary, volunteer, research, or aid work (81%) but travelers visiting friends and relatives (VFRs) were least likely to receive pre-travel advice (21%). The vast majority (96%) of malaria patients were resident in "Western" Europe, but over half (56%) were born elsewhere. Other significant causes of morbidity, which could be reduced through advice and behavioral change, include Giardia (n = 221, 3.7%), dengue (n = 146, 2.4%), and schistosomiasis (n = 131, 2.2%). Of 206 (3.5%) travelers with exposure in "Western" Europe, 75% were tourists; the highest burden of disease was acute gastrointestinal infection (35% cases). Travel from "Eastern" Europe (n = 132, 2.2%) was largely associated with migration-related travel (53%); among chronic infectious diseases, tuberculosis was frequently diagnosed (n = 20). Travelers VFRs contributed the largest group of malaria patients (46%), but also had the lowest documented rate of pre-travel health advice in this subset (20%). Overall, 44% of nonimmigrant ill travelers did not receive pre-travel advice. CONCLUSION There is a burden of infectious diseases in travelers attending European health centers that is potentially preventable through comprehensive pre-travel advice, chemoprophylaxis, and vaccination. Targeted interventions for high-risk groups such as travelers VFRs and migration-associated travelers are of particular importance.
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Affiliation(s)
- Ben Warne
- Department of Infectious Diseases, Addenbrooke's Hospital, Cambridge, UK
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van Griensven J, Carrillo E, López-Vélez R, Lynen L, Moreno J. Leishmaniasis in immunosuppressed individuals. Clin Microbiol Infect 2014; 20:286-99. [DOI: 10.1111/1469-0691.12556] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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45
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Leishmaniasis acquired by travellers to endemic regions in Europe: A EuroTravNet multi-centre study. Travel Med Infect Dis 2014; 12:167-72. [DOI: 10.1016/j.tmaid.2013.12.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/02/2013] [Accepted: 12/03/2013] [Indexed: 01/09/2023]
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Lau C, Weinstein P, Slaney D. The Importance of Surveillance for Informing Pretravel Medical Advice: Imported Malaria in New Zealand 1997–2009. Vector Borne Zoonotic Dis 2014; 14:134-40. [DOI: 10.1089/vbz.2012.1261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Colleen Lau
- WHO Collaborating Centre for Children's Health and the Environment, Queensland Children's Medical Research Institute, The University of Queensland, Herston, Queensland, Australia
- Travel Medicine Alliance Clinics, Perth and Brisbane, Australia
| | - Philip Weinstein
- Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia
| | - David Slaney
- Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia
- Institute of Environmental Science and Research Ltd, Porirua, New Zealand
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Spanakos G, Alifrangis M, Schousboe ML, Patsoula E, Tegos N, Hansson HH, Bygbjerg IC, Vakalis NC, Tseroni M, Kremastinou J, Hadjichristodoulou C. Genotyping Plasmodium vivax isolates from the 2011 outbreak in Greece. Malar J 2013; 12:463. [PMID: 24373457 PMCID: PMC3877964 DOI: 10.1186/1475-2875-12-463] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 12/17/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Plasmodium vivax malaria was common in Greece until the 1950s with epidemics involving thousands of cases every year. Greece was declared free of malaria by the World Health Organization in 1974. From 1974 to 2010, an average of 39 cases per year were reported, which were mainly imported. However, in 2009 and 2010 six and one autochthonous cases were reported culminating with a total of 40 autochthonous cases reported in 2011, of which 34 originated from a single region: Laconia of Southern Peloponnese. In this study the genotypic complexity of the P. vivax infections from the outbreak in Greece during 2011 is described, to elucidate the possible origin and spread of the disease. METHODS Three polymorphic markers of P. vivax were used; Pvmsp-3α and the microsatellites m1501 and m3502 on P. vivax isolates sampled from individuals diagnosed in Greece. Thirty-nine isolates were available for this study (20 autochthonous and 19 imported), mostly from Evrotas municipality in Laconia region, in southern Greece, (n = 29), with the remaining representing sporadic cases originating from other areas of Greece. RESULTS Genotyping the Evrotas samples revealed seven different haplotypes where the majority of the P. vivax infections expressed two particular Pvmsp-3α-m1501-m3502 haplotypes, A10-128-151 (n = 14) and A10-121-142 (n = 7). These haplotypes appeared throughout the period in autochthonous and imported cases, indicating continuous transmission. In contrast, the P. vivax autochthonous cases from other parts of Greece were largely comprised of unique haplotypes, indicating limited transmission in these other areas. CONCLUSIONS The results indicate that several P. vivax strains were imported into various areas of Greece in 2011, thereby increasing the risk of re-introduction of malaria. In the region of Evrotas ongoing transmission occurred exemplifying that further control measures are urgently needed in this region of southern Europe. In circumstances where medical or travel history is scarce, methods of molecular epidemiology may prove highly useful for the correct classification of the cases.
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Affiliation(s)
- Gregory Spanakos
- Hellenic Centre for Diseases Control and Prevention, Marousi, Greece
- Department of Parasitology, Entomology and Tropical Diseases, National School of Public Health, Athens, Greece
| | - Michael Alifrangis
- Centre for Medical Parasitology, Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette L Schousboe
- Centre for Medical Parasitology, Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease, Copenhagen University Hospital, Copenhagen, Denmark
| | - Eleni Patsoula
- Department of Parasitology, Entomology and Tropical Diseases, National School of Public Health, Athens, Greece
| | - Nicholas Tegos
- Department of Parasitology, Entomology and Tropical Diseases, National School of Public Health, Athens, Greece
| | - Helle H Hansson
- Centre for Medical Parasitology, Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ib C Bygbjerg
- Centre for Medical Parasitology, Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease, Copenhagen University Hospital, Copenhagen, Denmark
| | - Nicholas C Vakalis
- Department of Parasitology, Entomology and Tropical Diseases, National School of Public Health, Athens, Greece
| | - Maria Tseroni
- Hellenic Centre for Diseases Control and Prevention, Marousi, Greece
| | - Jenny Kremastinou
- Hellenic Centre for Diseases Control and Prevention, Marousi, Greece
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Marchand E, Prat C, Jeannin C, Lafont E, Bergmann T, Flusin O, Rizzi J, Roux N, Busso V, Deniau J, Noel H, Vaillant V, Leparc-Goffart I, Six C, Paty MC. Autochthonous case of dengue in France, October 2013. ACTA ACUST UNITED AC 2013; 18:20661. [PMID: 24342514 DOI: 10.2807/1560-7917.es2013.18.50.20661] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In October 2013, autochthonous dengue fever was diagnosed in a laboratory technician in Bouches-du-Rhone, southern France, a department colonised by Aedes albopictus since 2010. After ruling out occupational contamination, we identified the likely chain of local vector-borne transmission from which the autochthonous case arose. Though limited, this second occurrence of autochthonous dengue transmission in France highlights that efforts should be continued to rapidly detect dengue virus introduction and prevent its further dissemination in France.
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Affiliation(s)
- E Marchand
- Regional office of the French Institute for Public Health Surveillance (Cire Sud), Marseille, France
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Fischer D, Thomas SM, Suk JE, Sudre B, Hess A, Tjaden NB, Beierkuhnlein C, Semenza JC. Climate change effects on Chikungunya transmission in Europe: geospatial analysis of vector's climatic suitability and virus' temperature requirements. Int J Health Geogr 2013; 12:51. [PMID: 24219507 PMCID: PMC3834102 DOI: 10.1186/1476-072x-12-51] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 07/10/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chikungunya was, from the European perspective, considered to be a travel-related tropical mosquito-borne disease prior to the first European outbreak in Northern Italy in 2007. This was followed by cases of autochthonous transmission reported in South-eastern France in 2010. Both events occurred after the introduction, establishment and expansion of the Chikungunya-competent and highly invasive disease vector Aedes albopictus (Asian tiger mosquito) in Europe. In order to assess whether these outbreaks are indicative of the beginning of a trend or one-off events, there is a need to further examine the factors driving the potential transmission of Chikungunya in Europe. The climatic suitability, both now and in the future, is an essential starting point for such an analysis. METHODS The climatic suitability for Chikungunya outbreaks was determined by using bioclimatic factors that influence, both vector and, pathogen. Climatic suitability for the European distribution of the vector Aedes albopictus was based upon previous correlative environmental niche models. Climatic risk classes were derived by combining climatic suitability for the vector with known temperature requirements for pathogen transmission, obtained from outbreak regions. In addition, the longest potential intra-annual season for Chikungunya transmission was estimated for regions with expected vector occurrences.In order to analyse spatio-temporal trends for risk exposure and season of transmission in Europe, climate change impacts are projected for three time-frames (2011-2040, 2041-2070 and 2071-2100) and two climate scenarios (A1B and B1) from the Intergovernmental Panel on Climate Change (IPCC). These climatic projections are based on regional climate model COSMO-CLM, which builds on the global model ECHAM5. RESULTS European areas with current and future climatic suitability of Chikungunya transmission are identified. An increase in risk is projected for Western Europe (e.g. France and Benelux-States) in the first half of the 21st century and from mid-century onwards for central parts of Europe (e.g. Germany). Interestingly, the southernmost parts of Europe do not generally provide suitable conditions in these projections. Nevertheless, many Mediterranean regions will persist to be climatically suitable for transmission. Overall, the highest risk of transmission by the end of the 21st century was projected for France, Northern Italy and the Pannonian Basin (East-Central Europe). This general tendency is depicted in both, the A1B and B1 climate change scenarios. CONCLUSION In order to guide preparedness for further outbreaks, it is crucial to anticipate risk as to identify areas where specific public health measures, such as surveillance and vector control, can be implemented. However, public health practitioners need to be aware that climate is only one factor driving the transmission of vector-borne disease.
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Affiliation(s)
- Dominik Fischer
- Department of Biogeography, University of Bayreuth, Bayreuth, Germany
- Present address: Technische Universität München (TUM), Munich, Germany
| | | | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Bertrand Sudre
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Andrea Hess
- Department of Biogeography, University of Bayreuth, Bayreuth, Germany
| | - Nils B Tjaden
- Department of Biogeography, University of Bayreuth, Bayreuth, Germany
| | | | - Jan C Semenza
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Theilacker C, Held J, Allering L, Emmerich P, Schmidt-Chanasit J, Kern WV, Panning M. Prolonged polyarthralgia in a German traveller with Mayaro virus infection without inflammatory correlates. BMC Infect Dis 2013; 13:369. [PMID: 23927600 PMCID: PMC3750572 DOI: 10.1186/1471-2334-13-369] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 08/06/2013] [Indexed: 01/18/2023] Open
Abstract
Background Mayaro virus is endemic in South America and sporadic outbreaks have been described. It causes a dengue-like febrile illness accompanied by severe and long-lasting polyarthralgias. Outside endemic regions, however, the disease is not well known and can be misdiagnosed as dengue. International travellers are at risk to acquire Mayaro virus and due to increased worldwide travel infectious disease specialists need to be aware of such rare clinical entities. Case presentation We report the first Mayaro virus infection imported into Germany. A 20-year-old woman developed fever, myalgia, maculopapular rash, and polyarthralgias following a 10-day trip in the Rurrenabaque region of Bolivia. Severe polyarthralgias persisted for 5 months and were treated with non-steroidal anti-inflammatory drugs. Serological analysis demonstrated Mayaro virus-specific-IgM and -IgG antibodies two months after onset of symptoms. Except for CXCL8/IL-8 other proinflammatory chemokines and cytokines were unremarkable at this time. Conclusions Dissemination of knowledge on rare disease might improve patient management. Understanding the inherent features of Mayaro virus infection and how the virus interacts with its host are essential for optimal patient care and therapy.
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