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Maldonado-Barrueco A, Utrilla C, Hernández-González A, Perteguer MJ, Díaz-Pollán B, Untoria-Tabares Y, Díaz-Menéndez M, Falces-Romero I, Gutiérrez-Arroyo A, García-Rodríguez J, Montero-Vega D. Intraventricular neurocysticercosis in a migrant from Honduras. J Travel Med 2024; 31:taad090. [PMID: 37406005 DOI: 10.1093/jtm/taad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 07/07/2023]
Abstract
We report in Madrid (Spain) a case of intraventricular neurocysticercosis in a migrant from Choluteca (Honduras), which was confirmed by epidemiological, radiological and microbiological criteria.
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Affiliation(s)
| | - Cristina Utrilla
- Radiology Department, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Ana Hernández-González
- Helminth Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid 28016, Spain
| | - María J Perteguer
- Helminth Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid 28016, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
| | - Beatriz Díaz-Pollán
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Yeray Untoria-Tabares
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Marta Díaz-Menéndez
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
- Imported Pathology and International Health Unit, CSUR for Adult and Pediatric Imported Tropical Pathology, High Level Isolation Unit, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Iker Falces-Romero
- Clinical Microbiology Department, Hospital Universitario La Paz, Madrid 28016, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
| | | | | | - Dolores Montero-Vega
- Clinical Microbiology Department, Hospital Universitario La Paz, Madrid 28016, Spain
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2
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Diallo S, Borentain P, Motte A, Gautret P, Colson P. Liver transplantation due to fulminant hepatitis A in a traveller visiting friends and relatives in Comoros. J Travel Med 2024; 31:taad153. [PMID: 38079524 DOI: 10.1093/jtm/taad153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 04/07/2024]
Abstract
An unvaccinated adult migrant from Comoros to France presented with fulminant hepatitis A after a 5-month-stay in Comoros visiting friends and relatives. People who have lived in hepatitis A endemic areas should be tested for hepatitis A virus (HAV) IgG before travelling to an HAV hyperendemic country to assess the benefit of vaccination.
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Affiliation(s)
- Safiétou Diallo
- Laboratory and Infectious Diseases Departments, IHU-Méditerranée Infection, 19-21, boulevard Jean Moulin, 13005 Marseille, France
| | - Patrick Borentain
- Assistance Publique des Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Service d'Hépato-Gastro-Entérologie, 264, rue Saint-Pierre, 13005 Marseille, France
| | - Anne Motte
- Laboratory and Infectious Diseases Departments, IHU-Méditerranée Infection, 19-21, boulevard Jean Moulin, 13005 Marseille, France
| | - Philippe Gautret
- Laboratory and Infectious Diseases Departments, IHU-Méditerranée Infection, 19-21, boulevard Jean Moulin, 13005 Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, 19-21, boulevard Jean Moulin, 13005 Marseille, France
| | - Philippe Colson
- Laboratory and Infectious Diseases Departments, IHU-Méditerranée Infection, 19-21, boulevard Jean Moulin, 13005 Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, MEPHI, 19-21, boulevard Jean Moulin, 13005 Marseille, France
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3
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Halsey ES, Plucinski MM. Out of Africa: Increasing reports of artemether-lumefantrine treatment failures of uncomplicated Plasmodium falciparum infection. J Travel Med 2023; 30:taad159. [PMID: 38109778 PMCID: PMC10893888 DOI: 10.1093/jtm/taad159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/20/2023]
Abstract
Studies of travellers returning from Africa with uncomplicated Plasmodium falciparum infection are starting to provide signals of failure of artemether-lumefantrine, a first-line treatment of uncomplicated malaria. Traveller-based reports offer an important adjunct to antimalarial efficacy studies performed in endemic regions.
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Affiliation(s)
- Eric S Halsey
- Division of Global Migration Health, Travelers' Health Branch, Centers for Disease Control and Prevention, Atlanta 30329-4027, USA
| | - Mateusz M Plucinski
- Division of Parasitic Diseases and Malaria, Malaria Branch, Centers for Disease Control and Prevention, Atlanta 30329-4027, USA
- U.S. President's Malaria Initiative, Centers for Disease Control and Prevention, Atlanta 30329-4027, USA
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4
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Norman FF, Diaz J, Martin-Davila P, Tato M, García-San Miguel L, Gil E, Casas I, Gonzalez-Sanz M. Bilateral pulmonary infiltrates in a traveller from Saudi Arabia with probable electronic cigarette or vaping associated lung injury (EVALI). J Travel Med 2023; 30:taad133. [PMID: 37856529 DOI: 10.1093/jtm/taad133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/21/2023]
Abstract
A Saudi traveller presented with fever and pulmonary infiltrates. Principal causes of infectious pneumonia were ruled out (including MERS-coronavirus) and a diagnosis of probable drug-induced pneumonitis due to vaping/electronic cigarettes was established. Professionals should be aware of international epidemiological alerts but also consider non-infectious causes of pneumonia in travellers.
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Affiliation(s)
- Francesca F Norman
- Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Jorge Diaz
- Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Pilar Martin-Davila
- Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Marta Tato
- Microbiology Department, Ramón y Cajal University Hospital, IRYCIS, CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Lucía García-San Miguel
- Centro de Coordinación de Alertas y Emergencias Sanitarias (CCAES), Ministerio de Sanidad, Madrid, Spain
| | - Elisa Gil
- Servicio de Alertas en Salud Pública, Subdirección General de Vigilancia en Salud Pública, Dirección General de Salud Pública, Consejería de Sanidad, Madrid, Spain
| | - Inmaculada Casas
- Laboratorio de Referencia e Investigación en Virus Respiratorios, Centro Nacional de Microbiologia, Instituto de Salud Carlos III, CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | - Marta Gonzalez-Sanz
- Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid, Spain
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5
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Wirawan IMA, Matsee W, Astuti PAS, Sutarsa IN. Enhancing rabies prevention in tourist destinations such as Indonesia. J Travel Med 2023; 30:taad103. [PMID: 37552057 DOI: 10.1093/jtm/taad103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/09/2023]
Affiliation(s)
- I Made Ady Wirawan
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Bali 80232, Indonesia
- Travel Medicine Unit, Faculty of Medicine, Udayana University, Bali 80232, Indonesia
| | - Wasin Matsee
- Faculty of Tropical Medicine, Thai Travel Clinic, Hospital for Tropical Diseases, Mahidol University, Bangkok 10400, Thailand
- Travel Medicine Research Unit, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Putu Ayu Swandewi Astuti
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Bali 80232, Indonesia
| | - I Nyoman Sutarsa
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Bali 80232, Indonesia
- Rural Clinical School, ANU Medical School, The Australian National University, Canberra 2601, Australia
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6
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Ronzoni N, Galizzi N, Tamarozzi F. Cystic echinococcosis in the abdominal wall. J Travel Med 2023; 30:taad094. [PMID: 37462529 PMCID: PMC10628767 DOI: 10.1093/jtm/taad094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Niccolò Ronzoni
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Nadia Galizzi
- Infectious Diseases Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
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7
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Desmoulin A, Melzani A, Dard C, Nacher M, Djossou F, Alsibai MKD, Epelboin L. First report of a possible abdominal Angiostrongylus costaricensis in a French expatriate in the French Amazon. J Travel Med 2023; 30:6887155. [PMID: 36495184 DOI: 10.1093/jtm/taac146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022]
Abstract
Abdominal angiostrongyliasis is a parasitic disease caused by Angiostrongylus costaricensis. Cases have been reported from Texas to southern Argentina but not in the eastern part of the Amazon. We present the case of a 34-year-old French man living in French Guiana who had travelled to the Caribbean.
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Affiliation(s)
- Anissa Desmoulin
- Unité des Maladies Infectieuses et Tropicales, CH de Cayenne, Cayenne 97300, French Guiana
| | - Alessia Melzani
- Unité des Maladies Infectieuses et Tropicales, CH de Cayenne, Cayenne 97300, French Guiana
| | - Céline Dard
- Human Leukocyte Antigen (HLA) Laboratory, Etablissement Français du Sang (EFS), La Tronche, France
| | - Mathieu Nacher
- CIC Antilles Guyane - Inserm 1424 CH de Cayenne, Cayenne 97300, French Guiana
| | - Félix Djossou
- Unité des Maladies Infectieuses et Tropicales, CH de Cayenne, Cayenne 97300, French Guiana
| | | | - Loïc Epelboin
- Unité des Maladies Infectieuses et Tropicales, CH de Cayenne, Cayenne 97300, French Guiana
- CIC Antilles Guyane - Inserm 1424 CH de Cayenne, Cayenne 97300, French Guiana
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8
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Maltezou HC, Pavli A. Pausanias, the first travel writer: a historical perspective. J Travel Med 2022; 29:taac066. [PMID: 35639762 DOI: 10.1093/jtm/taac066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies, and Documentation, National Public Health Organization, 3-5 Agrafon Street, Athens 15123, Greece
| | - Androula Pavli
- Department of Travel Medicine, National Public Health Organization, Athens15123, Greece
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Madsalae K, Ngamprasertchai T, Lawpoolsri S, Sirijatuphat R, Ratanasuwan W, Piyaphanee W, Pitisuttithum P. Adherence and Health Problems in Thai Travellers Living with HIV. Trop Med Infect Dis 2022; 7:tropicalmed7070128. [PMID: 35878140 PMCID: PMC9319754 DOI: 10.3390/tropicalmed7070128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/02/2022] [Accepted: 07/03/2022] [Indexed: 11/16/2022] Open
Abstract
It is important to focus on adherence to antiretroviral therapy (ART) and health problems of travellers living with HIV (TLWHIV) during travel. This study was conducted to investigate factors related to adherence and health problems among TLWHIV. This multicentre, cross-sectional observational study was conducted among TLWHIV in university hospitals from August 2019 to July 2020. Factors associated with adherence to ART were evaluated using a logistic regression model. Health problems and risk exposure were also examined among participants during travel. Of 321 TLWHIV, 20 (6.23%) showed moderate-to-poor adherence, among whom 3 (15%) had viral rebound after travelling. Travellers frequently missed ART during the first 3 days of their trip. International destination was associated with moderate-to-poor adherence. In total, 237 (73.8%) travellers reported health problems during travel, among whom 36 required medical attention. Sexual or sharp exposure was found in <5% of travellers during travel. Approximately 95% of Thai TLWHIV had good ART adherence. International destination was the major factor determining adherence. TLWHIV should be encouraged to seek pretravel consultation. Healthcare providers should discuss health risk prevention and teach about ART dosing during travel to enhance adherence and minimise toxicity.
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Affiliation(s)
- Krit Madsalae
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (K.M.); (W.P.); (P.P.)
- Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Thundon Ngamprasertchai
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (K.M.); (W.P.); (P.P.)
- Correspondence:
| | - Saranath Lawpoolsri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Rujipas Sirijatuphat
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Winai Ratanasuwan
- Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Watcharapong Piyaphanee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (K.M.); (W.P.); (P.P.)
| | - Punnee Pitisuttithum
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (K.M.); (W.P.); (P.P.)
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Hills SL, Broussard KR, Broyhill JC, Shastry LG, Cossaboom CM, White JL, Machesky KD, Kosoy O, Girone K, Klena JD, Backenson BP, Gould CV, Lind L, Hieronimus A, Gaines DN, Wong SJ, Choi MJ, Laven JJ, Staples JE, Fischer M. Tick-borne encephalitis among US travellers, 2010-20. J Travel Med 2022; 29:6421950. [PMID: 34741518 DOI: 10.1093/jtm/taab167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/08/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Tick-borne encephalitis (TBE) is an arboviral disease that is focally endemic in parts of Europe and Asia. TBE cases among US travellers are rare, with previous reports of only six cases among civilian travellers through 2009 and nine military-related cases through 2020. A TBE vaccine was licenced in the USA in August 2021. Understanding TBE epidemiology and risks among US travellers can help with the counselling of travellers going to TBE-endemic areas. METHODS Diagnostic testing for TBE in the USA is typically performed at the Centers for Disease Control and Prevention (CDC) because no commercial testing is available. Diagnostic testing for TBE at CDC since 2010 was reviewed. For individuals with evidence of TBE virus infection, information was gathered on demographics, clinical presentations and risk factors for infection. RESULTS From 2010-20, six patients with TBE were identified. Cases occurred among both paediatric and adult travellers and all were male. Patients were diagnosed with meningitis (n = 2) or encephalitis (n = 4); none died. Cases had travelled to various countries in Europe or Russia. Three cases reported visiting friends or relatives. Activities reported included hiking, camping, trail running, or working outdoors, and two cases had a recognized tick bite. CONCLUSIONS TBE cases among US travellers are uncommon, with these six cases being the only known TBE cases among civilian travellers during this 11-year period. Nonetheless, given potential disease severity, pre-travel counselling for travellers to TBE-endemic areas should include information on measures to reduce the risk for TBE and other tick-borne diseases, including possible TBE vaccine use if a traveller's itinerary puts them at higher risk for infection. Clinicians should consider the diagnosis of TBE in a patient with a neurologic or febrile illness recently returned from a TBE-endemic country, particularly if a tick bite or possible tick exposure is reported.
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Affiliation(s)
- Susan L Hills
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA
| | - Kelly R Broussard
- Zoonosis Control Branch, Texas Department of State Health Services, Austin, TX 78714, USA
| | - James C Broyhill
- Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA 23218, USA
| | - Lalita G Shastry
- Division of Infectious Diseases, Lehigh Valley Health Network, Allentown, PA 18103
| | - Caitlin M Cossaboom
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Jennifer L White
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY 12237, USA
| | - Kimberly D Machesky
- Bureau of Infectious Diseases, Ohio Department of Health, Columbus, OH 43215, USA
| | - Olga Kosoy
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA
| | - Kyle Girone
- Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA 23218, USA
| | - John D Klena
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Bryon P Backenson
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY 12237, USA
| | - Carolyn V Gould
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA
| | - Leah Lind
- Division of Infectious Disease Epidemiology, Pennsylvania Department of Health, Harrisburg, PA 17120, USA
| | - Arielle Hieronimus
- Disease Control and Response Unit, Delaware Public Health District, Delaware, OH 43015-0570, USA
| | - David N Gaines
- Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA 23218, USA
| | - Susan J Wong
- Division of Infectious Diseases, Wadsworth Center, New York State Department of Health, Albany, NY 12237, USA
| | - Mary J Choi
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Janeen J Laven
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA
| | - J Erin Staples
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA
| | - Marc Fischer
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA
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Schwan CL, Dallman TJ, Cook PW, Vipham J. A case report of Salmonella enterica serovar Corvallis from environmental isolates from Cambodia and clinical isolates in the UK. Access Microbiol 2022; 4:000315. [PMID: 35252753 PMCID: PMC8895601 DOI: 10.1099/acmi.0.000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/23/2021] [Accepted: 12/10/2021] [Indexed: 11/18/2022] Open
Abstract
Salmonella enterica subspecies enterica serovar Corvallis (S. Corvallis) has been identified as a human pathogen and as a food contaminant. Diarrhoeal disease is a common diagnosis in tourists visiting Southeast Asia, often with unknown aetiology. However, numerous public health institutes have identified Salmonella as a common causative agent when consuming contaminated food and water. Genomic data from environmental isolates from a Cambodian informal market were uploaded to the National Center for Biotechnology Information (NCBI) platform, allowing the novel sequences to be compared to global whole-genome sequence archives. The comparison revealed that two human clinical isolates from England and four of the environmental isolates were closely related, with an average single nucleotide polymorphism (SNP) difference of 1 (0-3 SNPs). A maximum-likelihood tree based on core SNPs was generated comparing the 4 isolates recovered from a Cambodian informal market with 239 isolates of S. Corvallis received from routine surveillance of human salmonellosis in England and confirmed the close relationship. In addition, the environmental isolates clustered into a broader phylogenetic group within the S. Corvallis population containing 68 additional human isolates, of which 42 were from patients who reported recent international travel, almost exclusively to Southeast Asia. The environmental isolates of S. Corvallis isolated from an informal market in Cambodia are concerning for public health due to their genetic similarity to isolates (e.g. clinical isolates from the UK) with known human virulence and pathogenicity. This study emphasizes the benefits of global and public data sharing of pathogen genomes.
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Affiliation(s)
- Carla L. Schwan
- Department of Nutritional Sciences, University of Georgia, 300 Carlton St., Athens, GA 30602, USA
| | | | - Peter W. Cook
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessie Vipham
- Department of Animal Sciences and Industry, Food Science Institute, Kansas State University, Manhattan, KS, USA
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12
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Ellsbury G, Campling J, Madhava H, Slack M. Identifying UK travellers at increased risk of developing pneumococcal infection: a novel algorithm. J Travel Med 2021; 28:6274293. [PMID: 33978186 PMCID: PMC8393689 DOI: 10.1093/jtm/taab063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND In 2016, the travel subcommittee of the UK Joint Committee on Vaccination and Immunisation (JCVI) recommended that 13-valent PCV (PCV13) could be offered to travellers aged over 65 years, visiting countries without infant PCV immunization programmes. This study aimed to identify, collate and review the available evidence to identify specific countries where UK travellers might be at an increased risk of developing pneumococcal infection. The data were then used to develop an algorithm, which could be used to facilitate implementation of the JCVI recommendation. METHODS We conducted a systematic search of the published data available for pneumococcal disease, PCV vaccine implementation, coverage data and programme duration by country. The primary data sources used were World Health Organization databases and the International Vaccine Access Centre Vaccine Information and Epidemiology Window-hub database. Based on the algorithm, the countries were classified into 'high overall risk', 'intermediate overall risk' and 'low overall risk' from an adult traveller perspective. This could determine whether PCV13 should be recommended for UK adult travellers. RESULTS A data search for a total of 228 countries was performed, with risk scores calculated for 188 countries. Overall, 45 countries were classified as 'high overall risk', 86 countries as 'intermediate overall risk', 57 countries as 'low overall risk' and 40 countries as 'unknown'. CONCLUSION To our knowledge this is the first attempt to categorize the risk to UK adult travellers of contracting pneumococcal infection in each country, globally. These findings could be used by national travel advisory bodies and providers of travel vaccines to identify travellers at increased risk of pneumococcal infection, who could be offered PCV immunization.
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Affiliation(s)
| | - James Campling
- Vaccines Medical Affairs, Pfizer Ltd, Tadworth, KT20 7NS, UK
| | - Harish Madhava
- Vaccines Medical Affairs, Pfizer Ltd, Tadworth, KT20 7NS, UK
| | - Mary Slack
- School of Medicine & Dentistry, Gfiffith University Gold Coast campus, Queensland 4222, Australia
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13
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Islam N, Wright S, Lau CL, Doi SAR, Mills DJ, Clark J, Clements ACA, Furuya-Kanamori L. Efficacy of a 3-day pretravel schedule of tafenoquine for malaria chemoprophylaxis: a network meta-analysis. J Travel Med 2021; 28:6217513. [PMID: 33834208 DOI: 10.1093/jtm/taab057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Chemoprophylaxis with weekly doses of tafenoquine (200 mg/day for 3 days before departure [loading dose], 200 mg/week during travel and 1-week post-travel [maintenance doses]) is effective in preventing malaria. Effectiveness of malaria chemoprophylaxis drugs in travellers is often compromised by poor compliance. Shorter schedules that can be completed before travel, allowing 'drug-free holidays', could increase compliance and thus reduce travel-related malaria. In this meta-analysis, we examined if a loading dose of tafenoquine alone is effective in preventing malaria in short-term travellers. METHODS Four databases were searched in November 2020 for randomized controlled trials (RCTs) that assessed efficacy and/or safety of tafenoquine for chemoprophylaxis. Network meta-analysis using the generalized pair-wise modelling framework was utilized to estimate the odds ratio (OR) of malaria infection in long-term (>28 days) and short-term (≤28 days) travellers, as well as adverse events (AEs) associated with receiving loading dose of tafenoquine alone, loading dose of tafenoquine followed by maintenance doses, loading dose of mefloquine followed by maintenance doses, or placebo. RESULTS Nine RCTs (1714 participants) were included. In long-term travellers, compared to mefloquine, tafenoquine with maintenance doses (OR = 1.05; 95% confidence interval [CI]: 0.44-2.46) was equally effective in preventing malaria, while there was an increased risk of infection with the loading dose of tafenoquine alone (OR = 2.89; 95% CI: 0.78-10.68) and placebo (OR = 62.91; 95% CI: 8.53-463.88). In short-term travellers, loading dose of tafenoquine alone (OR = 0.98; 95% CI: 0.04-22.42) and tafenoquine with maintenance doses (OR = 1.00; 95% CI: 0.06-16.10) were as effective as mefloquine. The risk of AEs with tafenoquine with maintenance doses (OR = 1.03; 95% CI: 0.67-1.60) was similar to mefloquine, while loading dose of tafenoquine alone (OR = 0.58; 95% CI: 0.20-1.66) was associated with lower risk of AEs, although the difference was not statistically significant. CONCLUSIONS For short-term travellers, loading dose of tafenoquine alone was equally effective, had possibly lower rate of AEs, and likely better compliance than standard tafenoquine or mefloquine chemoprophylaxis schedules with maintenance doses. Studies are needed to confirm if short-term travellers remain free of infection after long-term follow-up. REGISTRATION The meta-analysis was registered in PROSPERO (CRD42021223756). HIGHLIGHT Tafenoquine is the latest approved drug for malaria chemoprophylaxis. A loading dose of tafenoquine (200 mg/day for 3 days before departure) is as effective in preventing malaria in short-term (≤28 days) travellers as chemoprophylaxis schedules of tafenoquine or mefloquine with maintenance doses, allowing travellers to have a 'drug-free holiday'.
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Affiliation(s)
- Nazmul Islam
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, PO BOX 2713, Qatar
| | - Sophie Wright
- ANU Medical School, Australian National University, Canberra, ACT 2601, Australia
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD 4000, Australia
| | - Suhail A R Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, PO BOX 2713, Qatar
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD 4000, Australia
- Research School of Population Health, Australian National University, Canberra, ACT 2601, Australia
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Robina, QLD 4226, Australia
| | | | - Luis Furuya-Kanamori
- Research School of Population Health, Australian National University, Canberra, ACT 2601, Australia
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
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14
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Lim K, McShane L, Rees M, Muhi S. Cerebral melioidosis in an immunocompromised traveller: an argument for prevention. J Travel Med 2021; 28:5920558. [PMID: 33156336 DOI: 10.1093/jtm/taaa187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 11/13/2022]
Abstract
Melioidosis is a bacterial infection caused by Burkholderia pseudomalleleipseudomallei. This report discusses the case of an immunocompromised traveller who was found to haveacquired cerebral melioidosis during a visit to Thailand, and highlights the need for such travellers to seek specialised travel medicine review prior to travelling to melioidosis endemic regions to discuss preventative strategies.
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Affiliation(s)
- Kara Lim
- Department of General Medicine, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia
| | - Lauren McShane
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia
| | - Megan Rees
- Department of General Medicine, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia
| | - Stephen Muhi
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia
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15
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Abstract
Teaser Our review found the average reproductive number R0 for yellow fever to be 4.81 with a median of 4.21.
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Affiliation(s)
- Ying Liu
- School of International Business, Xiamen University Tan Kah Kee College, Zhangzhou 363105, China
| | - Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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16
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Foch E, Allou N, Vitry T, Masse L, Allyn J, Andre M, Allou N. Pulmonary embolism in a returning traveller with COVID-19 pneumonia. J Travel Med 2020; 27:5824830. [PMID: 32330267 PMCID: PMC7188122 DOI: 10.1093/jtm/taaa063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022]
Abstract
Pulmonary embolism and COVID-19 pneumonia
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Affiliation(s)
- Emilie Foch
- Pneumologie, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, 97400 Saint Denis, France
| | - Nathalie Allou
- Pneumologie, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, 97400 Saint Denis, France
| | - Thierry Vitry
- Radiologie, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, 97400 Saint Denis, France
| | - Laurie Masse
- Pneumologie, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, 97400 Saint Denis, France
| | - Jérôme Allyn
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, 97400 Saint Denis, France.,Département d'Informatique Clinique, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, 97400 Saint Denis, France
| | - Michel Andre
- Pneumologie, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, 97400 Saint Denis, France
| | - Nicolas Allou
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, 97400 Saint Denis, France.,Département d'Informatique Clinique, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, 97400 Saint Denis, France
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17
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Wolf T, Ellwanger R, Goetsch U, Wetzstein N, Gottschalk R. Fifty years of imported Lassa fever: a systematic review of primary and secondary cases. J Travel Med 2020; 27:5808990. [PMID: 32219400 DOI: 10.1093/jtm/taaa035] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 03/08/2020] [Indexed: 01/15/2023]
Abstract
RATIONALE FOR SYSTEMATIC REVIEW Lassa fever is the most common cause of imported haemorrhagic fevers cases in non-endemic countries. As a disease with a high case fatality rate that has regularly caused clusters of nosocomial transmission in endemic areas, prompt diagnosis is vital. We conducted a systematic review of imported cases of the last 50 years with the aim of defining the clinical and epidemiological characteristics that will enhance early diagnosis, prompt initiation of treatment and an appropriate public health response to Lassa fever cases. METHODS We performed a retrospective, systematic review of 36 primary and two secondary cases of Lassa fever in non-endemic countries outside West Africa by searching the PubMed database. This yielded 56 relevant publications that were included in our analysis. RESULTS The case fatality rate of 35.1% for imported cases was higher than that reported for endemic countries. The majority of patients showed clinical features consistent with Lassa fever and had a typical exposure. There was a considerable delay in diagnosis in imported cases with high associated numbers of contacts. Ribavirin was rarely used for post-exposure prophylaxis. Only two secondary transmissions occurred. Thirty-one percent of patients received Lassa fever-specific treatment and five required intensive care. CONCLUSIONS Although importation of Lassa fever to non-endemic countries is a rare event, it has repeatedly happened over five decades. Suspicion of Lassa fever should be based on careful consideration of clinical features and exposure history in order to assist early diagnosis in returning travellers from West Africa.
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Affiliation(s)
- Timo Wolf
- Department of Internal Medicine II-Infectious Diseases, University Hospital Frankfurtxs, Frankfurt, Germany
| | - Regina Ellwanger
- Department of Internal Medicine II-Infectious Diseases, University Hospital Frankfurtxs, Frankfurt, Germany.,Health Protection Authority, Municipality of Frankfurt am Main, Frankfurt, Germany
| | - Udo Goetsch
- Health Protection Authority, Municipality of Frankfurt am Main, Frankfurt, Germany
| | - Nils Wetzstein
- Department of Internal Medicine II-Infectious Diseases, University Hospital Frankfurtxs, Frankfurt, Germany
| | - Rene Gottschalk
- Health Protection Authority, Municipality of Frankfurt am Main, Frankfurt, Germany.,Institute of Medical Virology, University Hospital Frankfurt, Frankfurt, Germany
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18
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Abstract
In January 2019, five of 11 travellers to Koh Lanta, Thailand, contracted chikungunya, symptoms starting 4 days after presumed transmission. Four cases were hospitalised, one child treated in intensive care; 6 weeks after disease onset, all three adults have persistent arthralgias/arthritis, incapacitating for two. Together with a recent report of eight chikungunya cases among travellers to various destinations in Thailand, the high attack rate in our cluster points to an ongoing outbreak in the country.
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Affiliation(s)
- Anu Kantele
- Inflammation Center, Department of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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19
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Okada P, Buathong R, Phuygun S, Thanadachakul T, Parnmen S, Wongboot W, Waicharoen S, Wacharapluesadee S, Uttayamakul S, Vachiraphan A, Chittaganpitch M, Mekha N, Janejai N, Iamsirithaworn S, Lee RT, Maurer-Stroh S. Early transmission patterns of coronavirus disease 2019 (COVID-19) in travellers from Wuhan to Thailand, January 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32127124 PMCID: PMC7055038 DOI: 10.2807/1560-7917.es.2020.25.8.2000097] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We report two cases of coronavirus disease 2019 (COVID-19) in travellers from Wuhan, China to Thailand. Both were independent introductions on separate flights, discovered with thermoscanners and confirmed with RT-PCR and genome sequencing. Both cases do not seem directly linked to the Huanan Seafood Market in Hubei but the viral genomes are identical to four other sequences from Wuhan, suggesting early spread within the city already in the first week of January.
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Affiliation(s)
- Pilailuk Okada
- Department of Medical Sciences, Ministry of Public Health, Thailand
| | - Rome Buathong
- Department of Disease Control, Ministry of Public Health, Thailand
| | | | | | | | - Warawan Wongboot
- Department of Medical Sciences, Ministry of Public Health, Thailand
| | | | - Supaporn Wacharapluesadee
- Thai Red Cross Emerging Infectious Diseases - Health Science Centre, Chulalongkorn University, Thailand
| | | | | | | | - Nanthawan Mekha
- Department of Medical Sciences, Ministry of Public Health, Thailand
| | - Noppavan Janejai
- Department of Medical Sciences, Ministry of Public Health, Thailand
| | | | - Raphael Tc Lee
- Bioinformatics Institute, Agency for Science Technology and Research, Singapore
| | - Sebastian Maurer-Stroh
- Department of Biological Sciences, National University of Singapore, Singapore.,Bioinformatics Institute, Agency for Science Technology and Research, Singapore
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20
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Mendoza-Palomar N, Sulleiro E, Perez-Garcia I, Espiau M, Soriano-Arandes A, Martín-Nalda A, Espasa M, Zarzuela F, Soler-Palacin P. Schistosomiasis in children: review of 51 imported cases in Spain. J Travel Med 2020; 27:5671715. [PMID: 31821494 DOI: 10.1093/jtm/taz099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/02/2019] [Accepted: 12/02/2019] [Indexed: 11/14/2022]
Affiliation(s)
- N Mendoza-Palomar
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - E Sulleiro
- Microbiology Department, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - I Perez-Garcia
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - M Espiau
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - A Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - A Martín-Nalda
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - M Espasa
- Microbiology Department, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - F Zarzuela
- Microbiology Department, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - P Soler-Palacin
- Microbiology Department, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
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21
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Crone CG, Helleberg M. Cutaneous leishmaniasis with secondary mucosal disease in a traveller due to Leishmania (Viannia) braziliensis. J Travel Med 2020; 27:5644626. [PMID: 31776570 DOI: 10.1093/jtm/taz093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/09/2019] [Accepted: 11/15/2019] [Indexed: 11/12/2022]
Abstract
We describe the case of a Russian child with persistent mild eosinophilia in whom intestinal parasitism by Dibothriocephalus latus is finally diagnosed. This cestode is prevalent in circumpolar regions and, therefore, an uncommon finding in International Health units, where care for patients from tropical and subtropical areas is usually provided.
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Affiliation(s)
- Cornelia Geisler Crone
- Department of Infectious Diseases, Rigshospitalet - University of Copenhagen, 8632 København, Denmark
| | - Marie Helleberg
- Department of Infectious Diseases, Rigshospitalet - University of Copenhagen, 8632 København, Denmark
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22
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Affiliation(s)
- Kevin C Kain
- Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Canada.,SAR Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, University of Toronto, Toronto, Canada
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23
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Tan R, Elmers J, Genton B. Malaria standby emergency treatment (SBET) for travellers visiting malaria endemic areas: a systematic review and meta-analysis. J Travel Med 2019; 26:5475009. [PMID: 30995308 DOI: 10.1093/jtm/taz027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/11/2019] [Accepted: 04/11/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Malaria prevention methods for travellers to low or moderate malaria risk areas vary and remain controversial. Standby emergency treatment (SBET) for malaria is one possible strategy increasingly recommended since 1988 with little evidence on its effectiveness or how it is truly being used. METHODS A systematic review and meta-analysis were performed based on a structured search in Embase, Medline, PubMed, Cochrane and Web of Science on 7 September 2018. The primary outcome was the overall prevalence of SBET use in travellers, and secondary outcomes were the proportion carrying SBET, the response to fever [use of SBET, health facility attendance and use of malaria rapid diagnostic test (mRDT)], adverse events to SBET and the proportion using SBET incorrectly (incorrect dosage/duration). The pooled SBET use prevalence was analysed using a random effects model. A descriptive summary was done to present secondary outcomes. The study protocol was registered with PROSPERO CRD42018103703. RESULTS A total of 11 studies were eligible for inclusion among the 1027 titles identified by our search. The studies included 7/11 prospective cohort studies that recruited pre-travel clinic attendees in Europe and 4/11 cross-sectional studies, of which 3 recruited travellers at airports before their return home from Southeast Asia and Africa and 1 from an employee registry including long-term travellers. The overall pooled prevalence of SBET use among the 26 403 travellers was 2.5% (95% confidence interval, 1.1-4.3%; range, 0.4-10.8%). There was significant variation in the proportion of travellers carrying SBET medication (40-100%), the proportion of travellers with appropriate response to fever (23-100%), adverse events (0-33%) and incorrect dosage/duration of SBET (0-100%). CONCLUSION Adherence to the proposed recommendations for SBET use, notably the response to fever, was poor. If the use of SBET is to be pursued, modifications to the current SBET strategy should be considered, such as better selection of travellers at higher risk for malaria and the potential addition of mRDTs.
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Affiliation(s)
- Rainer Tan
- Travel Clinic, Department of Research, Innovation and Training, Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Jolanda Elmers
- Medical Library, Research and Education Department, Lausanne University Hospital, Rue du Bugnon 46, Lausanne, Switzerland
| | - Blaise Genton
- Travel Clinic, Department of Research, Innovation and Training, Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
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24
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Honce R, Schultz-Cherry S. Influenza in obese travellers: increased risk and complications, decreased vaccine effectiveness. J Travel Med 2019; 26:taz020. [PMID: 30924873 PMCID: PMC6509472 DOI: 10.1093/jtm/taz020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/11/2019] [Accepted: 03/13/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Obesity is a worldwide epidemic and was empirically shown to increase the risk of developing severe influenza virus infection. As international travel becomes more common and obesity is now prevalent even in low- and middle-income countries, travellers may have an increased risk of contracting influenza virus especially during peak influenza season. METHODS An analysis of the literature, centred on publications from 2014-19, was performed, with an emphasis on human epidemiological data, human studies ex vivo and studies in mouse models of obesity. Our search efforts focused on influenza disease severity, pathogenesis, evolutionary dynamics and measures of infection control in the obese and overweight host. RESULTS Obesity is associated with an increased risk of infection, as well as a greater chance for hospitalization and severe complications. Studies in mouse models of obesity have uncovered that obese hosts suffer increased viral spread, delayed viral clearance and heightened damage to the respiratory epithelium. Innate and adaptive immune responses are delayed, thus increasing morbidity and mortality. Further, infection control measures, including vaccination and antivirals, prove less effective in obese hosts. Finally, the obese microenvironment allows for increased duration and amount of viral shedding and potentially increases the chance for emergence of virulent minor variants in the viral population. Together, obese hosts are at high risk of influenza infection, as well as severe sequelae following infection. CONCLUSION Obese travellers should be aware of influenza activity in the regions visited, as well as take protective measures prior to travel. Vaccination is highly recommended for all travellers, but especially highly susceptible obese travellers.
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Affiliation(s)
- Rebekah Honce
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Stacey Schultz-Cherry
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA
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25
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Nakakubo S, Nagaoka K, Suzuki M, Konno S, Shibue Y, Ikeda T, Nishimura M. A case of primary bacteraemia caused by Salmonella enterica serovar Corvallis in an immunocompetent adult after travel to Southeast Asia. Access Microbiol 2019; 1:e000009. [PMID: 32974493 PMCID: PMC7470353 DOI: 10.1099/acmi.0.000009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction Non-typhoidal Salmonella (NTS) that typically causes diarrhoeal disease in humans has a dramatically more severe and more invasive presentation than typhoid fever in immunocompromised adults. However, the incidence and significance of NTS primary bacteraemia in immunocompetent adults have been unclear. Case presentation A 24-year-old man presented to our hospital with a high fever 14 days after travelling to Vietnam and Cambodia for 14 days. His past medical history, family history and social history were unremarkable, except for his dietary intake history during his stay in Southeast Asia. He did not have any abdominal pain, diarrhoea, enterocolitis, arthritis, or abscesses, as determined by multiple examinations, which included computed tomography. The initial blood cultures identified the presence of Gram-negative bacilli, which were finally identified as the Salmonella enterica subspecies serovar Corvallis. Thus, S. enterica serovar Corvallis was the most likely primary bacteria in this patient. Since domestic outbreaks of NTS infections are extremely rare, our case patient was diagnosed with travel-related bacteraemia. The patient had an uneventful recovery after antibiotic administration. Conclusion We report a rare case of bacteraemia caused by S. enterica serovar Corvallis in an immunocompetent adult after travelling through Vietnam and Cambodia. From the experience of our case, we suggest that more caution is necessary when diagnosing the unique clinical features of travel-related NTS infections.
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Affiliation(s)
- Sho Nakakubo
- First Department of Internal Medicine, Hokkaido University Hospital, Hokkaido, Japan
| | - Kentaro Nagaoka
- First Department of Internal Medicine, Hokkaido University Hospital, Hokkaido, Japan
| | - Masaru Suzuki
- First Department of Internal Medicine, Hokkaido University Hospital, Hokkaido, Japan
| | - Satoshi Konno
- First Department of Internal Medicine, Hokkaido University Hospital, Hokkaido, Japan
| | - Yasushi Shibue
- Division of Infectious Disease, Tokyo Takanawa Hospital, Tokyo, Japan
| | - Tetsuya Ikeda
- Hokkaido Instititute of Public Health, Hokkaido, Japan
| | - Masaharu Nishimura
- First Department of Internal Medicine, Hokkaido University Hospital, Hokkaido, Japan
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26
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Marano C, Moodley M, Melander E, De Moerlooze L, Nothdurft HD. Perceptions of tick-borne encephalitis risk: a survey of travellers and travel clinics from Canada, Germany, Sweden and the UK. J Travel Med 2019; 26:S10-S16. [PMID: 30476160 PMCID: PMC6377183 DOI: 10.1093/jtm/tay063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND While the worldwide endemicity of tick-borne encephalitis (TBE) has been increasing, a lack of awareness of the risks of this life-threatening disease may be leading to an underutilization of preventive measures among travellers to TBE-endemic regions. This study's objectives were to assess travellers' awareness of TBE and advice-seeking attitudes, and to evaluate practices of travel clinics regarding pre-travel advice. METHODS We used an online questionnaire to identify individuals aged 18-65 years residing in the UK, Germany, Canada and Sweden, who had travelled to TBE-endemic countries between 2013 and 2016. This sample was defined as the visit-risk sample. Of these, the first 375 respondents who reported that they had engaged in pre-defined at-risk activities (e.g. hiking in forests) were asked to complete an additional online survey and were included in the activity-risk sub-sample. We also used an online/phone questionnaire to interview travel clinic personnel. RESULTS The TBE visit-risk sample included 4375 individuals; 69% had heard of the disease and 32% had heard of a TBE vaccine. Before travelling, travellers most commonly sought information online (26%); fewer travellers consulted family doctors (8%) or travel clinics (5%). In the activity-risk sample, 79% of the travellers were aware of at least one correct TBE prevention measure; however, only 15% reported being vaccinated within the past 3 years, with 11% of vaccinated travellers doing so following a clinic's recommendation. One hundred and eighty travel clinic representatives responded and reported that TBE vaccination was recommended to an average of 61% of travellers to endemic regions. Vaccination-reminder services such as follow-up appointments, e-mail and text reminders were offered by 50% of the clinics. CONCLUSIONS There is a need to increase awareness of the risk and prevention of TBE among travellers to endemic countries, and travel clinics could play an important role in this process. 5975671594001tay062media15975671594001.
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Affiliation(s)
| | | | | | | | - Hans D Nothdurft
- Department of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
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Marano C, Moodley M, Melander E, De Moerlooze L, Nothdurft HD. Perceptions of rabies risk: a survey of travellers and travel clinics from Canada, Germany, Sweden and the UK. J Travel Med 2019; 26:S3-S9. [PMID: 30476212 PMCID: PMC6377182 DOI: 10.1093/jtm/tay062] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Extensive global experience shows that rabies pre-exposure prophylaxis (PrEP) through vaccination is effective and well tolerated, yet many travellers opt not to be vaccinated when travelling to rabies-endemic countries. Previous research has identified several factors influencing the choices travellers make to reduce the risk of rabies, including cost, time constraint and perspective on the importance of vaccination. The objectives of this study were to assess travellers' awareness of rabies and advice-seeking attitudes and to evaluate travel clinics practices regarding rabies pre-travel advice. METHODS We surveyed individuals aged 18-65 years residing in the UK, Germany, Canada and Sweden who had travelled to rabies-endemic countries between 2013 and 2016 and defined this as the rabies visit-risk sample. The first 850 respondents from the visit-risk sample who had undertaken pre-defined at-risk activities (e.g. contact with animals during the trip) completed an additional 15-min online questionnaire and were included in the activity-risk subsample. We also interviewed travel clinic personnel using a 25-min online or phone questionnaire. RESULTS The visit-risk sample included 4678 individuals. Many sought pre-travel health information online (33%) or talked to a family doctor (24%). Within the activity-risk subsample, 83% of travellers were aware of at least a few basic facts about rabies, and 84% could identify at least one correct rabies prevention measure; 49% were aware of a rabies vaccine, however, only 8% reported receiving PrEP vaccination within the past 3 years. Among 180 travel clinic respondents, 21% reported recommending PrEP against rabies to all travellers to rabies-endemic countries. Travel clinics estimated that 81% of travellers complete their travel vaccination schedules and reported sending reminders by e-mails (38%), text (38%), phone calls (37%) or by using vaccination cards (37%). CONCLUSIONS These findings suggest that although travellers had frequently heard of rabies, awareness of the risks of this serious infectious disease was relatively low. 5975671594001tay062media15975671594001.
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Affiliation(s)
| | | | | | | | - Hans D Nothdurft
- Department of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
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Romero-Alegría Á, Cabrera MH, Velasco-Tirado V, Pisos Álamo E, Pardo-Lledías J, Sánchez NJ, Belhassen-García M, Arellano JLP. Fake imported tropical diseases: A retrospective study. Rev Esp Quimioter 2018; 31:528-531. [PMID: 30364924 PMCID: PMC6254473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE When we evaluate a patient with a suspected imported disease we cannot forget to include any autochthonous causes that may mimic imported pathologies to avoid misdiagnosis and therapeutic delay. METHODS A descriptive longitudinal retrospective study was designed with patients in whom an imported disease was suspected but who were finally diagnosed with autochthonous processes. The patients were selected from two internal medicine practices specializing in tropical diseases between 2008-2017 in Spain. RESULTS We report 16 patients, 11 (68.7%) were males, and the mean age was 43.4 ± 13.7 years old. Thirteen patients (81.2%) were travellers. Half of the patients were from Latin America, 7 (43.5%) were from Africa, and 1 (6.2%) was from Asia. The time from trip to evaluation ranged between 1 week and 20 years (median, 4 weeks), and the mean time from evaluation to diagnosis was 58.4 ± 100.9 days. There were 5 (31.2%) cases of autochthonous infection, 5 (31.2%) cases of cancer, 2 (12.5%) cases of inflammatory disease, and 2 (12.5%) cases of vascular disease. CONCLUSIONS Travel or migration by a patient can sometimes be a confusing factor if an imported disease is suspected and may cause delays in the diagnosis and treatment of an autochthonous disease. We highlight that 1/3 of the patients with autochthonous diseases in this study had cancer. The evaluation of imported diseases requires a comprehensive approach by the internist, especially if he specializes in infectious and/or tropical diseases and is, therefore, the best qualified to make an accurate diagnosis.
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Affiliation(s)
- Ángela Romero-Alegría
- Servicio de Medicina Interna. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de investigación Biomédica de Salamanca (IBSAL). Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS). Universidad de Salamanca
| | - Michele Hernandez Cabrera
- Departamento de Ciencias Médicas y Quirúrgicas e Instituto de Biomedicina. Universidad de Las Palmas de Gran Canaria. Unidad de Enfermedades Infecciosas y Medicina Tropical. Complejo Hospitalario Materno Insular Las Palmas de Gran Canaria
| | | | - Elena Pisos Álamo
- Departamento de Ciencias Médicas y Quirúrgicas e Instituto de Biomedicina. Universidad de Las Palmas de Gran Canaria. Unidad de Enfermedades Infecciosas y Medicina Tropical. Complejo Hospitalario Materno Insular Las Palmas de Gran Canaria
| | - Javier Pardo-Lledías
- Servicio de Medicina Interna, Hospital General de Palencia “Río Carrión”, C/ Donantes de Sangre, Palencia, Spain
| | - Nieves Jaén Sánchez
- Departamento de Ciencias Médicas y Quirúrgicas e Instituto de Biomedicina. Universidad de Las Palmas de Gran Canaria. Unidad de Enfermedades Infecciosas y Medicina Tropical. Complejo Hospitalario Materno Insular Las Palmas de Gran Canaria
| | - Moncef Belhassen-García
- Servicio de Medicina Interna. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de investigación Biomédica de Salamanca (IBSAL). Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS). Universidad de Salamanca
| | - José Luis Pérez Arellano
- Departamento de Ciencias Médicas y Quirúrgicas e Instituto de Biomedicina. Universidad de Las Palmas de Gran Canaria. Unidad de Enfermedades Infecciosas y Medicina Tropical. Complejo Hospitalario Materno Insular Las Palmas de Gran Canaria
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Salzer HJF, Stoney RJ, Angelo KM, Rolling T, Grobusch MP, Libman M, López-Vélez R, Duvignaud A, Ásgeirsson H, Crespillo-Andújar C, Schwartz E, Gautret P, Bottieau E, Jordan S, Lange C, Hamer DH. Epidemiological aspects of travel-related systemic endemic mycoses: a GeoSentinel analysis, 1997-2017. J Travel Med 2018; 25:5067362. [PMID: 30085265 PMCID: PMC6628256 DOI: 10.1093/jtm/tay055] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 07/15/2018] [Indexed: 11/13/2022]
Abstract
Background International travel has increased in the past few decades, placing more travellers at risk of acquiring systemic endemic mycoses. There are limited published data on systemic endemic mycoses among international travellers. We report epidemiological characteristics of non-migrant, international travellers who acquired systemic endemic mycoses during travel. Methods We analysed records of non-migrant international travellers with a confirmed diagnosis of histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, blastomycosis or talaromycosis reported from 1997 through 2017 to GeoSentinel, a global surveillance network now consisting of 70 travel or tropical medicine centres in 31 countries. Results Sixty-nine records met the inclusion criteria. Histoplasmosis was most frequently reported; the 51 travellers with histoplasmosis had the lowest median age (30 years; range: 8-85) and shortest median duration of travel (12 days; range: 5-154). Coccidioidomycosis was reported in 14 travellers; travellers with coccidioidomycosis were older (median 62 years; range: 22-78) and had the longest median number of days between return from travel and presentation to a GeoSentinel site (55 days; range: 17-273). Almost all travellers with coccidioidomycosis were exposed in the USA. Other systemic endemic mycoses were less frequently reported, including blastomycosis (three travellers) and talaromycosis (one traveller). Conclusions Although relatively rare, systemic endemic mycoses should be considered as potential travel-related infections in non-migrant international travellers. Epidemiological exposures should be used to guide diagnostic evaluations and treatment.
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Affiliation(s)
- Helmut J. F. Salzer
- Division of Clinical Infectious Diseases and German Center for Infection Research Tuberculosis Unit, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Rhett J. Stoney
- Travelers’ Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Kristina M. Angelo
- Travelers’ Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Thierry Rolling
- Section of Infectious Diseases and Tropical Medicine, 1st Department of Internal Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Clinical Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Martin P. Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Michael Libman
- J. D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Canada
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramon y Cajal University Hospital, Madrid, Spain
| | | | - Hilmir Ásgeirsson
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Clara Crespillo-Andújar
- National Referral Unit for Tropical and Travel Medicine, Department of Internal Medicine, Hospital Universitario La Paz-Carlos III, Madrid, Spain
| | - Eli Schwartz
- The Center for Geographic Medicine and Internal Medicine ‘C’ Chaim Sheba Medical Center, Tel HaShomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Philippe Gautret
- Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sabine Jordan
- Section of Infectious Diseases and Tropical Medicine, 1st Department of Internal Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Lange
- Division of Clinical Infectious Diseases and German Center for Infection Research Tuberculosis Unit, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
- International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Davidson H. Hamer
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA, USA
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30
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Olanwijitwong J, Lawpoolsri S, Ponam T, Puengpholpool P, Sharma C, Chatapat L, Pawan V, Kittitrakul C, Piyaphanee W. Incidence and spectrum of health problems among travellers to Myanmar. J Travel Med 2018; 25:4711110. [PMID: 29232462 DOI: 10.1093/jtm/tax077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/31/2017] [Indexed: 11/13/2022]
Abstract
BACKGROUND The number of international travellers visiting Myanmar increases each year. However, information about pre-travel preparation and incidence of health problems among these travellers is limited. METHODS This cross-sectional study was conducted at three international airports in Thailand. Travellers returning from Myanmar completed questionnaires querying demographic profile, pre-travel health preparations and health problems during their stay in Myanmar. RESULTS From March 2015 to May 2017, we collected and analysed questionnaires completed by 397 Thai and 467 non-Thai travellers (total: 50.1% men, median age 37 years). Non-Thai travellers were from Europe (59%), Northern America (21.4%), Asia (16.5%) and Australia or New Zealand (3.0%). Approximately 74% of non-Thais sought pre-travel health information; only 36% of Thais did so. Tourism was the main purpose for travel among both Thais (58.4%) and non-Thais (85.2%). Non-Thais were more likely than Thais to travel as backpackers and perform outdoor activities such as trekking, cycling or swimming. The average length of stay in Myanmar among non-Thais was significantly longer than that of Thais (26.58 days vs 7.08 days, P < 0.001). Health problems were reported by 22.9% of non-Thais; the most common was diarrhoea (21.0%) followed by upper respiratory tract symptoms (9.2%), fever (3.4%) and skin problems (3.0%). Only 12.6% of Thais reported health problems, the most common being upper respiratory tract symptoms (7.6%), followed by diarrhoea (3.1%), fever (2.8%) and skin problems (2.0%). Most health problems were mild and self-limited in both groups. Only one Thai and eight non-Thai travellers required a doctor's visit during their trip to Myanmar, and two non-Thais required hospitalization. CONCLUSIONS Health problems are not very common among travellers to Myanmar. Overall, health problems were reported among 18.2% of travellers in our study. Most problems were mild, with spontaneous recovery. Only two foreign travellers required hospitalization.
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Affiliation(s)
- Jutarmas Olanwijitwong
- Faculty of Tropical Medicine, Hospital for Tropical Diseases, Mahidol University, Bangkok, Thailand
| | - Saranath Lawpoolsri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Thitiya Ponam
- Faculty of Tropical Medicine, Hospital for Tropical Diseases, Mahidol University, Bangkok, Thailand
| | | | | | - Lapakorn Chatapat
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Chatporn Kittitrakul
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Watcharapong Piyaphanee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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31
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Ellis J, Hearn P, Johnston V. Assessment of returning travellers with fever. ACTA ACUST UNITED AC 2017; 46:2-9. [PMID: 32288585 PMCID: PMC7108237 DOI: 10.1016/j.mpmed.2017.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Millions of people travel to the tropics each year and a significant minority of them become ill, either during their stay or shortly after their return. Most have mild, self-limiting illnesses, but a few have a life-threatening condition. This article outlines how to evaluate fever in the returning traveller and discusses important infection control and public health measures. A detailed travel history, which takes into account travel destinations, specific activities and risk factors in relation to the onset of symptoms, is essential for constructing a comprehensive list of differential diagnoses and guiding appropriate investigations. Importantly, all travellers returning from the tropics with a fever should be investigated for malaria.
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Affiliation(s)
- Jayne Ellis
- is a Registrar in Infectious Diseases at the Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, UK. Competing interests: none declared.,is a Registrar in Microbiology at the Royal Free London NHS Foundation Trust, UK. Competing interests: none-declared.,is an Associate Professor at the London School of Hygiene and Tropical Medicine, London, UK and a Consultant Physician at the Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, UK. Competing interests: none declared
| | - Pasco Hearn
- is a Registrar in Infectious Diseases at the Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, UK. Competing interests: none declared.,is a Registrar in Microbiology at the Royal Free London NHS Foundation Trust, UK. Competing interests: none-declared.,is an Associate Professor at the London School of Hygiene and Tropical Medicine, London, UK and a Consultant Physician at the Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, UK. Competing interests: none declared
| | - Victoria Johnston
- is a Registrar in Infectious Diseases at the Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, UK. Competing interests: none declared.,is a Registrar in Microbiology at the Royal Free London NHS Foundation Trust, UK. Competing interests: none-declared.,is an Associate Professor at the London School of Hygiene and Tropical Medicine, London, UK and a Consultant Physician at the Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, UK. Competing interests: none declared
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Abstract
OBJECTIVES The aim of this study is to analyse the relationship between smoking and altitude mountain sickness in a cohort of travellers to 2500 metres above sea level (masl) or higher. SETTING Travel Health Clinic at the Hospital Universitari de Bellvitge, in Barcelona, Spain. PARTICIPANTS A total of 302 adults seeking medical advice at the travel clinic, between July 2012 and August 2014, before travelling to 2500 masl or above, who agreed to participate in the study and to be contacted after the trip were included. Individuals who met the following criteria were excluded: younger than 18 years old, taking carbonic anhydrase inhibitors for chronic use, undergoing treatment with systemic corticosteroids and taking any medication that might prevent or treat altitude mountain sickness (AMS) prior to or during the trip. The majority of participants were women (n=156, 51.7%). The mean age was 37.7 years (SD 12.3). The studied cohort included 74 smokers (24.5%), 158 (52.3%) non-smokers and 70 (23.2%) ex-smokers. No statistical differences were observed between different sociodemographic characteristics, constitutional symptoms or drug use and smoking status. OUTCOMES The main outcome was the development of AMS, which was defined according to the Lake Louise AMS criteria. RESULTS AMS, according to the Lake Louise score, was significantly lower in smokers; the value was 14.9%, 95% CI (6.8 to 23.0%) in smokers and 29.4%, 95% CI (23.5 to 35.3%) in non-smokers with an adjusted OR of 0.54, 95% CI (0.31 to 0.97) independent of gender, age and maximum altitude reached. CONCLUSIONS These results suggest that smoking could reduce the risk of AMS in non-acclimated individuals. Further studies should be performed in larger cohorts of travellers to confirm these results. Despite the results, smoking must be strongly discouraged because it greatly increases the risk of cardiorespiratory diseases, cancer and other diseases.
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Affiliation(s)
- Alba Sánchez-Mascuñano
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
| | - Cristina Masuet-Aumatell
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
| | - Sergio Morchón-Ramos
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
| | - Josep M Ramon
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
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Eldin C, Gautret P, Nougairede A, Sentis M, Ninove L, Saidani N, Million M, Brouqui P, Charrel R, Parola P. Identification of dengue type 2 virus in febrile travellers returning from Burkina Faso to France, related to an ongoing outbreak, October to November 2016. ACTA ACUST UNITED AC 2017; 21:30425. [PMID: 28006651 PMCID: PMC5291134 DOI: 10.2807/1560-7917.es.2016.21.50.30425] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 12/15/2016] [Indexed: 12/17/2022]
Abstract
Dengue fever is rarely reported in travellers returning from Africa. We report two cases of dengue fever in travellers returning from Burkina Faso to France. One of them presented a severe dengue fever with ALT > 1,000 IU/L and pericarditis. Serotype 2 was identified. The cases reflect a large ongoing outbreak with over 1,000 reported cases between August and November in the capital city. Clinicians should consider dengue fever in malaria-negative febrile travellers returning from Africa.
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Affiliation(s)
- Carole Eldin
- URMITE, Aix Marseille Université (UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection), Marseille, France
| | - Philippe Gautret
- URMITE, Aix Marseille Université (UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection), Marseille, France
| | - Antoine Nougairede
- UMR 'Emergence des Pathologies Virales' (EPV: Aix-Marseille Univ - IRD 190 - Inserm 1207 - EHESP), Marseille, France
| | - Mélanie Sentis
- URMITE, Aix Marseille Université (UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection), Marseille, France
| | - Laetitia Ninove
- UMR 'Emergence des Pathologies Virales' (EPV: Aix-Marseille Univ - IRD 190 - Inserm 1207 - EHESP), Marseille, France
| | - Nadia Saidani
- URMITE, Aix Marseille Université (UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection), Marseille, France
| | - Matthieu Million
- URMITE, Aix Marseille Université (UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection), Marseille, France
| | - Philippe Brouqui
- URMITE, Aix Marseille Université (UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection), Marseille, France
| | - Remi Charrel
- UMR 'Emergence des Pathologies Virales' (EPV: Aix-Marseille Univ - IRD 190 - Inserm 1207 - EHESP), Marseille, France
| | - Philippe Parola
- URMITE, Aix Marseille Université (UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection), Marseille, France
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Woerther PL, Andremont A, Kantele A. Travel-acquired ESBL-producing Enterobacteriaceae: impact of colonization at individual and community level. J Travel Med 2017; 24:S29-S34. [PMID: 28520999 PMCID: PMC5441303 DOI: 10.1093/jtm/taw101] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Antibiotic resistance is a rapidly increasing global emergency that calls for action from all of society. Intestinal multidrugresistant (MDR) bacteria have spread worldwide with extended-spectrum beta-lactamase (ESBL) -producing Enterobacteriaceae (ESBL-PE) as the most prevalent type. The millions of travelers annually visiting regions with poor hygiene contribute substantially to this spread. Our review explores the underlying data and discusses the consequences of the colonization. METHODS PubMed was searched for relevant literature between January 2010 and August 2016. We focused on articles reporting (1) the rate of ESBL-PE acquisition in a group of travelers recruited before/after international travel, (2) fecal carriage of ESBL-PE as explored by culture and, for part of the studies, (3) analysis of factors predisposing to colonization. RESULTS We reviewed a total of 16 studies focusing on travel-acquired ESBL-PE. The acquisition rates reveal that 2070% of visitors to (sub)tropical regions get colonized by ESBL-PE. The main risk factors predisposing to colonization during travel are destination, travelers diarrhea, and antibiotic use. CONCLUSIONS While most of those colonized remain asymptomatic, acquisition of ESBL-PE may have consequences both at individual and community level. We discuss current efforts to restrict the spread.
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Affiliation(s)
- Paul-Louis Woerther
- Laboratory of Medical Microbiology, Institut Gustave-Roussy, Villejuif, France
| | - Antoine Andremont
- INSERM, IAME, UMR 1137, and Université Paris Diderot, Sorbonne Paris Cité, Paris, France APHP, Laboratory of Bacteriology, Hôpital Bichat-Claude Bernard, Paris, France
| | - Anu Kantele
- Department of Clinical Medicine, University of Helsinki, Helsinki, Finland.,Division of Infectious Diseases, Helsinki University Hospital, Inflammation Center, POB 348, FIN-00029, Helsinki, Finland.,Unit of Infectious Diseases, Karolinska Institutet, Solna, Stockholm, Sweden
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Korhonen EM, Huhtamo E, Smura T, Kallio-Kokko H, Raassina M, Vapalahti O. Zika virus infection in a traveller returning from the Maldives, June 2015. ACTA ACUST UNITED AC 2016; 21:30107. [PMID: 26794427 DOI: 10.2807/1560-7917.es.2016.21.2.30107] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 01/14/2016] [Indexed: 11/20/2022]
Abstract
We report a Zika virus (ZIKV) infection in a patient with fever and rash after returning to Finland from Maldives, June 2015. The patient had dengue virus (DENV) IgG and IgM antibodies but pan-flavivirus RT-PCR and subsequent sequencing showed presence of ZIKV RNA in urine. Recent association of ZIKV with microcephaly highlights the need for laboratory differentiation of ZIKV from DENV infection and the circulation of ZIKV in areas outside its currently known distribution range.
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Affiliation(s)
- Essi Marjana Korhonen
- Department of Virology, Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Tanizaki R, Ujiie M, Hori N, Kanagawa S, Kutsuna S, Takeshita N, Hayakawa K, Kato Y, Ohmagari N. Comparative study of adverse events after yellow fever vaccination between elderly and non-elderly travellers: questionnaire survey in Japan over a 1-year period. J Travel Med 2016; 23:taw012. [PMID: 27021495 DOI: 10.1093/jtm/taw012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2016] [Indexed: 11/14/2022]
Abstract
BACKGROUND A live attenuated yellow fever (YF) vaccination is required of all travellers visiting countries where YF virus is endemic. Although the risk of serious adverse events (AEs) after YF vaccination is known to be greater in elderly people than in younger people, information about other AEs among elderly travellers is lacking. METHODS A prospective observational questionnaire study was conducted to investigate the occurrence of AEs after YF vaccination in travellers who attended a designated YF vaccination centre in Tokyo, Japan, from 1 November 2011 to 31 October 2012. A questionnaire enquiring about any AEs experienced in the 2 weeks following YF vaccination was distributed to all vaccinees enrolled in this study, and responses were collected subsequently by mail or phone. For child vaccinees, their parents were allowed to respond in their stead. RESULTS Of the 1298 vaccinees who received the YF vaccine, 1044 (80.4%) were enrolled in the present study and 666 (63.8%) responded to the questionnaire. Of these 666 respondents, 370 (55.6%) reported AEs, of which 258 (38.7%) were systemic and 230 (34.5%) were local. No severe AEs associated with YF vaccination were reported. Elderly vaccinees (aged ≥60 years) reported fewer total AEs than those aged <60 years (42.9% vs 60.3%;P < 0.001). CONCLUSION Our study showed that fewer general AEs after yellow vaccination reported among elderly vaccinees than among non-elderly vaccinees. These results could provide supplementary information for judging the adaptation of vaccination in elderly travellers.
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Affiliation(s)
- Ryutaro Tanizaki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mugen Ujiie
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Narumi Hori
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shuzo Kanagawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nozomi Takeshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuyuki Kato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Barreto Miranda I, Ignatius R, Pfüller R, Friedrich-Jänicke B, Steiner F, Paland M, Dieckmann S, Schaufler K, Wieler LH, Guenther S, Mockenhaupt FP. High carriage rate of ESBL-producing Enterobacteriaceae at presentation and follow-up among travellers with gastrointestinal complaints returning from India and Southeast Asia. J Travel Med 2016; 23:tav024. [PMID: 26858272 DOI: 10.1093/jtm/tav024] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND International travel contributes to the spread of multidrug-resistant microorganisms including extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). We assessed the proportion of faecal carriers of ESBL-PE among 211 patients with gastrointestinal symptoms who returned to Berlin, Germany, after international travel. METHODS ESBL-PE were screened for on chromogenic agar, antimicrobial susceptibility testing was performed, and ESBL-genes were genotyped. Travel-related data were assessed by questionnaire. RESULTS Diarrhoea, abdominal pain and nausea were the main symptoms. Half of the travellers carried ESBL-PE (97% Escherichia coli); the proportion was highest for returnees from India (72%) and mainland Southeast Asia (59%), and comparatively lower for Africa (33%) and Central America (20%). Co-resistance to fluoroquinolones (particularly in isolates from India), gentamicin and cotrimoxazole was frequent but all isolates were carbapenem-susceptible. ESBL-PE carriage decreased with increasing timespan from return to presentation, and with age. At revisit of initially ESBL-PE positive patients half a year later, 28% (17/61) of the individuals were still carriers, CTX-M groups being congruent with the initial isolates. CTX-M groups 9 and 1/9, vegetarian diet and cat ownership tended to be associated with ESBL-PE carriage upon revisit. CONCLUSIONS Travellers, particularly those returning from India and Southeast Asia, constitute a relevant source of potential spread of ESBL-PE. Carriage declines over time but ESBL-PE persist for at least 6 months in a substantial proportion of individuals. Both genetic characteristics of the bacteria and lifestyle factors seem to contribute to persistent carriage of ESBL-PE. A recent, extra-European travel history argues for ESBL-PE screening and contact precautions for patients admitted to hospital.
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Affiliation(s)
- Isabel Barreto Miranda
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany, Department of Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ralf Ignatius
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany, Laboratory Enders and Partners, Stuttgart, Germany
| | - Roland Pfüller
- Medizinisch-Diagnostische Institute Laboratorien, Berlin, Germany
| | - Barbara Friedrich-Jänicke
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Steiner
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany, Division of Infectiology and Pneumonology, Medical Department, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Paland
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany, Division of Infectiology and Pneumonology, Medical Department, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sebastian Dieckmann
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Katharina Schaufler
- Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany and
| | - Lothar H Wieler
- Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany and Robert Koch-Institute, Berlin, Germany
| | - Sebastian Guenther
- Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany and
| | - Frank P Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany,
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Abstract
BACKGROUND In the past two decades, more and more Germans decided to spend their holidays on a passenger vessel. This study examined the frequencies and causes of deaths of German travellers aboard passenger vessels of all flags. METHODS The shipboard deaths of all German travellers within the time period from 1998 to 2008 were counted using the German civil central register in Berlin. The available documentation in this register provides information on frequencies, circumstances and causes of deaths on ships. In the above-mentioned period of time, the total cohort of German travellers on cruise ships is estimated to be 5.97 million persons. RESULTS During the 11-year examination period, 135 shipboard deaths of German passengers [102 males (75.6%) and 33 females (24.4%)] were recorded. Out of these travellers, 110 died on cruise ships. When considering only the passengers on cruise ships (without those on ferries) an average crude mortality rate of 1.8 per 100,000 German passengers was calculated. The crude mortality rate of shipboard death for males and females was 2.5 and 0.8 per 100,000 German passengers with a mean age of 71.2 years [standard deviation (SD) 16.0 years] and 73.3 years (SD 16.0 years), respectively. Significantly, more deceased travellers older than 70 years were observed on traditional cruise ships and resort vessels than on passenger ferries (P = 0.001). The causes of death were documented in 85 cases (63.0%). Out of these documented deaths, 82 (96.5%) cases were regarded to be natural causes (particularly circulatory diseases) and 3 (3.5%) as unnatural causes (twice drowning and once an accidental fall). CONCLUSIONS In spite of the large proportion of unknown causes of death, this study argues for a high significance of internal causes of deaths among German passengers. Thus, ship's doctors-particularly those on traditional cruise ships-should be well experienced in internal and geriatric medicines.
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Affiliation(s)
- Marcus Oldenburg
- Department of Martime Medicine, Institute for Occupational and Maritime Medicine Hamburg (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany and
| | - Jan Herzog
- Department of Martime Medicine, Institute for Occupational and Maritime Medicine Hamburg (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany and
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Volker Harth
- Department of Martime Medicine, Institute for Occupational and Maritime Medicine Hamburg (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany and
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Jackson C, Bedford H, Condon L, Crocker A, Emslie C, Dyson L, Gallagher B, Kerr S, Lewis HJ, Mytton J, Redsell SA, Schicker F, Shepherd C, Smith L, Vousden L, Cheater FM. UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): protocol for an exploratory, qualitative study. BMJ Open 2015; 5:e008564. [PMID: 26056124 PMCID: PMC4466610 DOI: 10.1136/bmjopen-2015-008564] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 05/22/2015] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Gypsies, Travellers and Roma (referred to here as Travellers) experience significantly poorer health and have shorter life expectancy than the general population. They are also less likely to access health services including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. This study has two aims: (1) Investigate the barriers and facilitators to acceptability and uptake of immunisations among six Traveller communities in the UK; (2) Identify potential interventions to increase uptake in these Traveller communities. METHODS AND ANALYSIS A three-phase qualitative study with six Traveller communities. PHASE 1: In each community, we will explore up to 45 Travellers' views about the influences on their immunisation behaviours and ideas for improving uptake in their community. PHASE 2: In each community, we will investigate 6-8 service providers' perspectives on barriers and facilitators to childhood and adult immunisations for Traveller communities with whom they work, and ideas to improve uptake. Interview data will be analysed using the Framework approach. PHASE 3: The findings will be discussed and interventions prioritised in six workshops, each with 10-12 phase 1 and 3-4 phase 2 participants. ETHICS AND DISSEMINATION This research received approval from NRES Committee Yorkshire and The Humber-Leeds East (Ref. 13/YH/02). It will produce (1) findings on the barriers and facilitators to uptake of immunisations in six Traveller communities; (2) a prioritised list of potentially feasible and acceptable interventions for increasing uptake in these communities; and (3) methodological development in undertaking research with diverse Traveller communities. The study has the potential to inform new ways of delivering services to ensure high immunisation uptake. Findings will be disseminated to participants, relevant UK organisations with responsibility for the implementation of immunisation policy and Traveller health/welfare; and submitted for publication in academic journals. TRIAL REGISTRATION NUMBER ISRCTN20019630.
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Affiliation(s)
- Cath Jackson
- Department of Health Sciences, University of York, York, UK
| | | | - Louise Condon
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Annie Crocker
- Formerly in the Gypsy and Traveller Team, Bristol City Council, Bristol, UK
| | - Carol Emslie
- Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Lisa Dyson
- Department of Health Sciences, University of York, York, UK
| | - Bridget Gallagher
- Formerly at South Glasgow Community Health Partnership, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - Susan Kerr
- Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Helen J Lewis
- Department of Health Sciences, University of York, York, UK
| | - Julie Mytton
- Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
| | - Sarah A Redsell
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge, UK
| | | | | | | | - Linda Vousden
- Women and Children's Directorate, North Bristol NHS Trust, Bristol, UK
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Bargain P. [Medical services at Paris-Charles-de-Gaulle airport]. Rev Infirm 2015; 64:20-21. [PMID: 26145994 DOI: 10.1016/j.revinf.2015.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Charles-de-Gaulle airport in Roissy, a 3 400 hectare citadel, contains a multitude of airlines, service companies, businesses, retailers and public services, including firefighters, police officers, customs officers, ministers and medical teams. This article presents its missions, notably with regard to health services.
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Affiliation(s)
- Philippe Bargain
- Service médical d'urgence et soins de l'aéroport de Paris-Charles-de-Gaulle, ADP, Aéroport Paris-Charles-de- Gaulle, 95700 Roissy-en-France, France.
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Tanizaki R, Kato Y, Iwagami M, Kutsuna S, Ujiie M, Takeshita N, Hayakawa K, Kanagawa S, Kano S, Ohmagari N. Performance of Rapid Diagnostic Tests for Plasmodium ovale Malaria in Japanese Travellers. Trop Med Health 2014; 42:149-53. [PMID: 25473374 PMCID: PMC4229013 DOI: 10.2149/tmh.2014-07] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 08/21/2014] [Indexed: 01/24/2023] Open
Abstract
Background: Rapid diagnostic tests (RDTs) are used widely in the diagnosis of malaria. Although the effectiveness of RDTs for malaria has been described in many previous studies, the low performance of RDT particularly for Plasmodium ovale malaria in traveller has rarely been reported. Methods: This was a retrospective cohort study conducted on Japanese travellers diagnosed with malaria at the National Center for Global Health and Medicine between January 2004 and June 2013. The diagnosis of malaria was confirmed by microscopic examination, RDT, and polymerase chain reaction in all patients. The RDTs used in our study were Binax NOW Malaria (Binax Inc., Scarborough, Maine, USA) (BN) and SD Malaria Antigen Pf/Pan (Standard Diagnostics Inc., Korea) (SDMA). We compared the sensitivity of the RDTs to P. ovale malaria and Plasmodium vivax malaria. Results: A total of 153 cases of malaria were observed, 113 of which were found among Japanese travellers. Nine patients with P. ovale malaria and 17 patients with P. vivax malaria undergoing RDTs were evaluated. The overall sensitivity of RDTs for P. ovale malaria and P. vivax malaria was 22.2% and 94.1%, respectively (P < 0.001). The sensitivity of SDMA for P. ovale malaria and P. vivax malaria was 50% and 100%, respectively. The sensitivity of BN for P. vivax malaria was 90.0%, but it was ineffective in detecting the cases of P. ovale malaria. Conclusions: The sensitivity of RDTs was not high enough to diagnose P. ovale malaria in our study. In order not to overlook P. ovale malaria, therefore, microscopic examination is indispensable.
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Affiliation(s)
- Ryutaro Tanizaki
- Disease Control and Prevention Center, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JAPAN
| | - Yasuyuki Kato
- Disease Control and Prevention Center, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JAPAN
| | - Moritoshi Iwagami
- Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JAPAN
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JAPAN
| | - Mugen Ujiie
- Disease Control and Prevention Center, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JAPAN
| | - Nozomi Takeshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JAPAN
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JAPAN
| | - Shuzo Kanagawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JAPAN
| | - Shigeyuki Kano
- Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JAPAN
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JAPAN
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Abstract
OBJECTIVE Neuropsychiatric presentation in paratyphoid fever is not a well-known entity. In countries such as Australia, where the prevalence of enteric fever is one of the lowest, this presentation seems to be unlikely. METHOD We present a case that demonstrates the importance of considering this possibility in Australian context in returned travellers. RESULTS A young male, who recently returned to Australia from his home country in South East Asia, presented with abnormal behaviour in the context of febrile illness. His behaviour was characterised by grandiosity, aggression, hallucinatory behaviour and paranoia, along with disturbed biological functions. Detailed inpatient assessment revealed him to be suffering from Salmonella Paratyphi A infection and psychotic illness because of his general medical condition. Although his fever and inflammatory markers responded to antibiotics, antipsychotics were required for treatment of his mental health problems. CONCLUSION This case demonstrates that paratyphoid fever, which is considered to be a less common variant of enteric fever, can present with neuropsychiatric manifestations.
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Affiliation(s)
- Raja Sadhu
- Department of Psychiatry, Werribee Mercy Hospital, Werribee, VIC, Australia
| | | | - Marc Lanteri
- Department of Medicine, Werribee Mercy Hospital, Werribee, VIC, Australia
| | - Manoj Kumar
- Department of Psychiatry, Werribee Mercy Hospital, Werribee, VIC, Australia
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Senn H, Alattas N, Boggild AK, Morris SK. Mixed-species Plasmodium falciparum and Plasmodium ovale malaria in a paediatric returned traveller. Malar J 2014; 13:78. [PMID: 24593188 PMCID: PMC3975726 DOI: 10.1186/1475-2875-13-78] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 02/26/2014] [Indexed: 12/02/2022] Open
Abstract
Malaria is a common and potentially fatal cause of febrile illness in returned travellers. Endemic areas for different malaria parasites overlap, but mixed species infections are rare. An adolescent male returned from a trip to Ghana in late summer 2013. He subsequently presented with blood smears positive for two species of malaria parasite, Plasmodium falciparum and Plasmodium ovale, on two isolated hospital visits within a six-week period. The epidemiology of mixed infections, likely pathophysiology of his presentation, and the implications for malaria testing and treatment in returned travellers are discussed.
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Affiliation(s)
- Heather Senn
- University of Toronto Faculty of Medicine, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Nadia Alattas
- Division of Infectious Diseases, Hospital for Sick Children, 555 University Ave., Toronto, ON M5G 1X8, Canada
| | - Andrea K Boggild
- Tropical Disease Unit, Division of Infectious Diseases, University Health Network-Toronto General Hospital, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada
- Department of Medicine, University of Toronto, Suite RFE 3–805, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada
- Public Health Ontario Laboratories, 81 Resources Road, Etobicoke, ON M9P 3T1, Canada
| | - Shaun K Morris
- Division of Infectious Diseases, Hospital for Sick Children, 555 University Ave., Toronto, ON M5G 1X8, Canada
- Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada
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Abstract
Millions of people travel to the tropics each year and a significant minority of them become ill, either during their stay, or shortly after their return. Most have mild, self-limiting illnesses, but a few will have a life-threatening condition. This article outlines how to evaluate fever in the returning traveller and discusses important infection control and public health measures. A detailed travel history, which takes into account travel destinations, specific activities and risk factors in relation to the onset of symptoms, is essential for constructing a comprehensive list of differential diagnoses and guiding appropriate investigations. Importantly, all travellers returning from the tropics with a fever should be investigated for malaria, even if their return was 3 months ago or longer.
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Affiliation(s)
- Pasco Hearn
- is a Registrar in Infectious Diseases at the Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK. Competing interests: none-declared.,is a Senior Lecturer at the London School of Hygiene and Tropical Medicine, London, UK and a Consultant Physician at the Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK and North Middlesex University Hospital NHS Trust, London, UK. Competing interests: none declared
| | - Victoria Johnston
- is a Registrar in Infectious Diseases at the Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK. Competing interests: none-declared.,is a Senior Lecturer at the London School of Hygiene and Tropical Medicine, London, UK and a Consultant Physician at the Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK and North Middlesex University Hospital NHS Trust, London, UK. Competing interests: none declared
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Schultze D, Müller B, Bruderer T, Dollenmaier G, Riehm JM, Boggian K. A traveller presenting with severe melioidosis complicated by a pericardial effusion: a case report. BMC Infect Dis 2012; 12:242. [PMID: 23035948 PMCID: PMC3532095 DOI: 10.1186/1471-2334-12-242] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Accepted: 10/01/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Burkholderia pseudomallei, the etiologic agent of melioidosis, is endemic to tropic regions, mainly in Southeast Asia and northern Australia. Melioidosis occurs only sporadically in travellers returning from disease-endemic areas. Severe clinical disease is seen mostly in patients with alteration of immune status. In particular, pericardial effusion occurs in 1-3% of patients with melioidosis, confined to endemic regions. To our best knowledge, this is the first reported case of melioidosis in a traveller complicated by a hemodynamically significant pericardial effusion without predisposing disease. CASE PRESENTATION A 44-year-old Caucasian man developed pneumonia, with bilateral pleural effusions and complicated by a hemodynamically significant pericardial effusion, soon after his return from Thailand to Switzerland. Cultures from different specimens including blood cultures turned out negative. Diagnosis was only accomplished by isolation of Burkholderia pseudomallei from the pericardial aspirate, thus finally enabling the adequate antibiotic treatment. CONCLUSIONS Melioidosis is a great mimicker and physicians in non-endemic countries should be aware of its varied manifestations. In particular, melioidosis should be considered in differential diagnosis of pericardial effusion in travellers , even without risk factors predisposing to severe disease.
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Affiliation(s)
- Detlev Schultze
- Center of Laboratory Medicine, Frohbergstrasse 3, CH-9001 St. Gallen, Switzerland
| | - Brigitt Müller
- Department of Internal Medicine, Cantonal Hospital, Rorschacherstrasse 95, CH-9007 St Gallen, Switzerland
| | - Thomas Bruderer
- Center of Laboratory Medicine, Frohbergstrasse 3, CH-9001 St. Gallen, Switzerland
| | - Günter Dollenmaier
- Center of Laboratory Medicine, Frohbergstrasse 3, CH-9001 St. Gallen, Switzerland
| | - Julia M Riehm
- Bundeswehr Institute of Microbiology, Neuherbergstr 11, D-80937, Munich, Germany
| | - Katia Boggian
- Department of Internal Medicine, Division of Infectious Diseases, Cantonal Hospital, Rorschacherstrasse 95, CH-9007 St Gallen, Switzerland
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Godineau N, Hamane S, Chaplain C, Blondel P. Diarrhées infectieuses d'importation : diagnostic étiologique. Revue Française des Laboratoires 2000. [PMCID: PMC7148762 DOI: 10.1016/s0338-9898(00)80432-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Les diarrhées infectieuses d'importation sont très bien connues des voyageurs puisque c'est la pathologie la plus fréquente au retour d'un pays tropical [41]. La contamination oro-fécale est le principal mode de transmission. Les agents responsables sont le plus souvent d'origine bactérienne (Escherichia coli entérotoxinogènes (40 %), salmonelles (15 %) par exemple), alors que les virus et les parasites ne représentent que 15 à 20 % des étiologies. Une revue de la littérature retrace les mécanismes physiopathologiques, les manifestations cliniques et les techniques biologiques les plus courantes pour aboutir au diagnostic étiologique.
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Affiliation(s)
- Nadine Godineau
- Unité de parasitologie-mycologie Laboratoire de microbiologie Hôpital Delafontaine 2,rue du Docteur-Delafontaine 93200 Saint-Denis, France
| | - Samia Hamane
- Unité de parasitologie-mycologie Laboratoire de microbiologie Hôpital Delafontaine 2,rue du Docteur-Delafontaine 93200 Saint-Denis, France
| | - Chantal Chaplain
- Unité de bactériologie-virologie Laboratoire de microbiologie Hôpital Delafontaine 2,rue du Docteur-Delafontaine 93200 Saint-Denis, France
| | - Patrice Blondel
- Unité de bactériologie-virologie Laboratoire de microbiologie Hôpital Delafontaine 2,rue du Docteur-Delafontaine 93200 Saint-Denis, France
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