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de Gier B, Suryapranata FST, Croughs M, van Genderen PJJ, Keuter M, Visser LG, van Vugt M, Sonder GJB. Increase in imported malaria in the Netherlands in asylum seekers and VFR travellers. Malar J 2017; 16:60. [PMID: 28148300 PMCID: PMC5288937 DOI: 10.1186/s12936-017-1711-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/25/2017] [Indexed: 01/12/2023] Open
Abstract
Background Malaria is a notifiable disease in the Netherlands, a non-endemic country. Imported malaria infections occur regularly among travellers, migrants and visitors. Surveillance data were analysed from 2008 to 2015. Trends in amounts of notifications among risk groups were analysed using Poisson regression. For asylum seekers, yearly incidence was calculated per region of origin, using national asylum request statistics as denominator data. For tourists, denominator data were used from travel statistics to estimate incidence per travel region up to 2012. Results A modest increase in overall imported malaria notifications occurred in 2008–2015 (from 222 in 2008 to 344 in 2015). Notably, in 2014 and 2015 sharp increases were seen in malaria among travellers visiting friends and relatives (VFR), and in asylum seekers. Of all Plasmodium falciparum infections, most (1254/1337; 93.8%) were imported from Africa; 1037/1337 (77.6%) were imported from Central and West Africa. Malaria in VFR was mostly caused by P. falciparum infection after visiting Ghana (22%) or Nigeria (19%). Malaria in asylum seekers was mostly caused by Plasmodium vivax infection from the Horn of Africa. The large number of notifications in asylum seekers resulted from both an increase in number of asylum seekers and a striking increase of malaria incidence in this group. Incidence of malaria in asylum seekers from the Horn of Africa ranged between 0.02 and 0.3% in 2008–2013, but rose to 1.6% in 2014 and 1.3% in 2015. In 2008–2012, incidence in tourists visiting Central and West Africa dropped markedly. Conclusions Imported malaria is on the rise again in the Netherlands, most notably since 2013. This is mostly due to immigration of asylum seekers from the Horn of Africa. The predominance of P. vivax infection among asylum seekers warrants vigilance in health workers when a migrant presents with fever, as relapses of this type of malaria can occur long after arrival in the Netherlands. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-1711-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- 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
| | - Franciska S T Suryapranata
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands. .,National Coordination Centre for Travellers' Health Advice (LCR), Nieuwe Achtergracht 100, PO Box 1008, 1000 BA, Amsterdam, The Netherlands.
| | - Mieke Croughs
- Department of Environment, Public Health Service (GGD) Hart voor Brabant, Ringbaan West 227, 5037 PC, Tilburg, The Netherlands.,Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Perry J J van Genderen
- Institute for Tropical Diseases, Harbour Hospital Rotterdam, Haringvliet 72, 3011 TG, Rotterdam, The Netherlands
| | - Monique Keuter
- Nijmegen Institute for International Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Leo G Visser
- Department of Infectious Diseases, Leiden University Medical Centre, C5P46, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Michele van Vugt
- Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Gerard J B Sonder
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands.,National Coordination Centre for Travellers' Health Advice (LCR), Nieuwe Achtergracht 100, PO Box 1008, 1000 BA, Amsterdam, The Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Suryapranata FST, Prins M, Sonder GJB. Low and declining attack rates of imported typhoid fever in the Netherlands 1997-2014, in spite of a restricted vaccination policy. BMC Infect Dis 2016; 16:731. [PMID: 27905890 PMCID: PMC5134084 DOI: 10.1186/s12879-016-2059-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/22/2016] [Indexed: 12/24/2022] Open
Abstract
Background Typhoid fever mainly occurs in (sub) tropical regions where sanitary conditions remain poor. In other regions it occurs mainly among returning travelers or their direct contacts. The aim of this study was to evaluate the current Dutch guidelines for typhoid vaccination. Method Crude annual attack rates (AR) per 100,000 Dutch travelers were calculated during the period 1997 to 2014 by dividing the number of typhoid fever cases by the estimated total number of travelers to a specific country or region. Regions of exposure and possible risk factors were evaluated. Results During the study period 607 cases of typhoid fever were reported. Most cases were imported from Asia (60%). Almost half of the cases were ethnically related to typhoid risk regions and 37% were cases visiting friends and relatives. The overall ARs for travelers to all regions declined significantly. Countries with the highest ARs were India (29 per 100,000), Indonesia (8 per 100,000), and Morocco (10 per 100,000). There was a significant decline in ARs among travelers to popular travel destinations such as Morocco, Turkey, and Indonesia. ARs among travelers to intermediate-risk areas according to the Dutch guidelines such as Latin America or Sub-Saharan Africa remained very low, despite the restricted vaccination policy for these areas compared to many other guidelines. Conclusion The overall AR of typhoid fever among travelers returning to the Netherlands is very low and has declined in the past 20 years. The Dutch vaccination policy not to vaccinate short-term travelers to Latin-America, Sub-Saharan Africa, Thailand and Malaysia seems to be justified, because the ARs for these destinations remain very low. These results suggest that further restriction of the Dutch vaccination policy is justified.
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Affiliation(s)
- F S T Suryapranata
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands. .,National Coordination Centre for Travellers' Health Advice (LCR), Nieuwe Achtergracht 100, PO Box 1008, 1000 BA, Amsterdam, The Netherlands.
| | - M Prins
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - G J B Sonder
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands.,National Coordination Centre for Travellers' Health Advice (LCR), Nieuwe Achtergracht 100, PO Box 1008, 1000 BA, Amsterdam, The Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Suryapranata FST, Ang CW, Chong LL, Murk JL, Falconi J, Huits RMHG. Epidemiology of Guillain-Barré Syndrome in Aruba. Am J Trop Med Hyg 2016; 94:1380-4. [PMID: 27022152 DOI: 10.4269/ajtmh.15-0070] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 01/05/2016] [Indexed: 11/07/2022] Open
Abstract
The epidemiology of Guillain-Barré syndrome (GBS) in tropical areas is different compared with developed countries. We investigated the epidemiology of GBS on the Caribbean island of Aruba. Data were collected retrospectively from all 36 patients hospitalized with GBS between 2003 and 2011 in Aruba. We observed a seasonal distribution of GBS cases with a peak in February. The incidence rate (IR) fluctuated heavily between individual years. The overall IR was 3.93/100,000, which is higher than that observed in developed countries. Serological studies indicated a possible relation of GBS cases with dengue virus infections. We also observed a relation between the annual number of dengue cases in Aruba and the number of GBS cases in the same year. We conclude that the epidemiology of GBS in tropical areas can be different from temperate climate regions and that dengue may be a trigger for developing GBS.
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Affiliation(s)
- Franciska S T Suryapranata
- Department of Medical Microbiology and Infection Control, VU University Medical Centre (VUMC), Amsterdam, The Netherlands; Department of Neurology, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Internal Medicine, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Microbiology, Landslaboratorium, Oranjestad, Aruba; Department of Virology, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands; Institute of Tropical Medicine, Antwerp, Belgium
| | - C Wim Ang
- Department of Medical Microbiology and Infection Control, VU University Medical Centre (VUMC), Amsterdam, The Netherlands; Department of Neurology, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Internal Medicine, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Microbiology, Landslaboratorium, Oranjestad, Aruba; Department of Virology, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands; Institute of Tropical Medicine, Antwerp, Belgium
| | - Luis L Chong
- Department of Medical Microbiology and Infection Control, VU University Medical Centre (VUMC), Amsterdam, The Netherlands; Department of Neurology, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Internal Medicine, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Microbiology, Landslaboratorium, Oranjestad, Aruba; Department of Virology, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands; Institute of Tropical Medicine, Antwerp, Belgium
| | - Jean-Luc Murk
- Department of Medical Microbiology and Infection Control, VU University Medical Centre (VUMC), Amsterdam, The Netherlands; Department of Neurology, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Internal Medicine, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Microbiology, Landslaboratorium, Oranjestad, Aruba; Department of Virology, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands; Institute of Tropical Medicine, Antwerp, Belgium
| | - Jaime Falconi
- Department of Medical Microbiology and Infection Control, VU University Medical Centre (VUMC), Amsterdam, The Netherlands; Department of Neurology, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Internal Medicine, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Microbiology, Landslaboratorium, Oranjestad, Aruba; Department of Virology, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands; Institute of Tropical Medicine, Antwerp, Belgium
| | - Ralph M H G Huits
- Department of Medical Microbiology and Infection Control, VU University Medical Centre (VUMC), Amsterdam, The Netherlands; Department of Neurology, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Internal Medicine, Dr Horacio E. Oduber Hospital, Oranjestad, Aruba; Department of Microbiology, Landslaboratorium, Oranjestad, Aruba; Department of Virology, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands; Institute of Tropical Medicine, Antwerp, Belgium
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