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Kitro A, Imad HA, Pisutsan P, Matsee W, Sirikul W, Sapbamrer R, Rapheal E, Fernandez S, Cotrone TS, Farmer AR, Hunsawong T, Silachamroon U, Chatapat L, Olanwijitwong J, Salee P, Anderson KB, Piyaphanee W. Seroprevalence of dengue, Japanese encephalitis and Zika among long-term expatriates in Thailand. J Travel Med 2024; 31:taae022. [PMID: 38335250 DOI: 10.1093/jtm/taae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Travel to Southeast Asia increases the likelihood of acquiring mosquito-borne Flavivirus infections such as dengue (DENV), Japanese encephalitis (JEV) and Zika viruses (ZIKV). Expatriates are long-term travellers who have a higher risk of mosquito-borne illness at their destination country. The purpose of this study was to evaluate the seroprevalence of DENV, JEV and ZIKV infections and the determinants contributing to seropositivity among expatriates living in Thailand. METHODS A cross-sectional study was performed from December 2017 to February 2020. Expatriates from non-Flavivirus endemic countries were recruited. 5 mL of blood was collected for DENV 1-4, JEV and ZIKV antibody testing by plaque reduction neutralization test (PRNT50). Individuals with vaccination histories or diagnoses for dengue, Japanese encephalitis, yellow fever and tick-borne encephalitis were excluded. RESULTS Among 254 participants, most participants (83.1%) were male, the mean age was 65 years and the median duration of stay in Thailand was 6 years. Seroprevalence rate of any Flavivirus, non-specific DENV, DENV1-4, JEV and ZIKV were 34.3, 30.7, 20.5, 18.1, 18.9, 10.6, 4.7 and 2.8%, respectively. The presence of neutralizing antibodies against DENV1-4 positively correlates with the duration of stay in Thailand. DENV seropositivity was associated with living in urban areas (aOR 2.75, 95% CI 1.36-5.57). Expatriates were unlikely to have detectable anti-JEV antibodies regardless of time spent in a JEV-endemic area. No risk factors were identified that were significantly associated with JEV or ZIKV seropositivity. Only 48.4% received pre-travel counselling services, while only 18.9% visited a travel medicine specialist. CONCLUSIONS A high proportion (34.3%) of long-term expatriates living in Thailand were seropositive for flavivirus, mainly from dengue (30.7%). To minimize risk, travel medicine practitioners should provide adequate pre-travel health risk information on mosquito-borne flavivirus infection and offer advice on mosquito bite prevention strategies. Dengue vaccine might be considered in high-risk travellers such as long-term expatriate.
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Affiliation(s)
- Amornphat Kitro
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Environmental and Occupational Medicine Excellence Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Hisham Ahmed Imad
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Center for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Suita 565-0871, Japan
| | - Phimphan Pisutsan
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wasin Matsee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wachiranun Sirikul
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center of Data Analytics and Knowledge Synthesis for Health Care, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Environmental and Occupational Medicine Excellence Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Erica Rapheal
- School of Public Health, University of Minnesota, Minnesota, MN 55414, USA
| | - Stefan Fernandez
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Thomas S Cotrone
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Aaron R Farmer
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Taweewun Hunsawong
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Udomsak Silachamroon
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Lapakorn Chatapat
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Jutarmas Olanwijitwong
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Parichat Salee
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Kathryn B Anderson
- Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Watcharapong Piyaphanee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Bauer IL. The oral repellent - science fiction or common sense? Insects, vector-borne diseases, failing strategies, and a bold proposition. Trop Dis Travel Med Vaccines 2023; 9:7. [PMID: 37381000 DOI: 10.1186/s40794-023-00195-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/09/2023] [Indexed: 06/30/2023] Open
Abstract
Over the last decades, unimaginable amounts of money have gone into research and development of vector control measures, repellents, treatment, and vaccines for vector borne diseases. Technological progress and scientific breakthroughs allowed for ever more sophisticated and futuristic strategies. Yet, each year, millions of people still die or suffer from potentially serious consequences of malaria or dengue to more recent infections, such as zika or chikungunya, or of debilitating consequences of neglected tropical diseases. This does not seem value for money. In addition, all current vector control strategies and personal protection methods have shortcomings, some serious, that are either destructive to non-target species or unsatisfactory in their effectiveness. On the other hand, the rapid decline in insect populations and their predators reflects decades-long aggressive and indiscriminate vector control. This major disruption of biodiversity has an impact on human life not anticipated by the well-meaning killing of invertebrates. The objective of this paper is to re-examine current control methods, their effectiveness, their impact on biodiversity, human and animal health, and to call for scientific courage in the pursuit of fresh ideas. This paper brings together topics that are usually presented in isolation, thereby missing important links that offer potential solutions to long-standing problems in global health. First, it serves as a reminder of the importance of insects to human life and discusses the few that play a role in transmitting disease. Next, it examines critically the many currently employed vector control strategies and personal protection methods. Finally, based on new insights into insect chemo-sensation and attractants, this perspective makes a case for revisiting a previously abandoned idea, the oral repellent, and its use via currently successful methods of mass-application. The call is out for focused research to provide a powerful tool for public health, tropical medicine, and travel medicine.
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Affiliation(s)
- Irmgard L Bauer
- College of Healthcare Sciences, Academy - Tropical Health and Medicine, James Cook University, Townsville, QLD, 4811, Australia.
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Ogbusu VO, Onyido AE, Okechukwu CE, Okwelogu IS. Knowledge, attitudes and control practices regarding venomous arthropods among staff and students in a Nigerian public university campus. Trans R Soc Trop Med Hyg 2021; 116:278-280. [PMID: 34791483 DOI: 10.1093/trstmh/trab171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/24/2021] [Accepted: 10/22/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The objectives of this study were to assess the knowledge, attitudes and control practices among the staff and students of Nnamdi Azikiwe University (NAU), Awka, Anambra State, Nigeria, regarding venomous arthropods. METHODS The knowledge, attitudes and control practices regarding venomous arthropods were assessed in 350 participants. RESULTS The respondents were aware of the presence of venomous arthropods at NAU and they had seen them on campus, with spiders (40.44%) being the most common and electric ants (1.39%) being the least common. The control practices applied to limit the activities of these arthropods included keeping the environment clean (40.80%), the use of insecticides (37.33%), the use of repellents (8.68%), spraying houses with kerosene (7.81%), spraying of fuel on the arthropods (3.47%), screening of houses (1.39%) and the use of bed nets (0.52%). CONCLUSIONS An assessment and determination of knowledge, attitudes and control practices regarding venomous arthropods among the staff and students of NAU is necessary in order to improve the preventive measures to reduce injuries caused by venomous arthropod encounters, which are some of the most underestimated health hazards in tropical regions, including southeastern Nigeria, affecting primarily rural communities. According to the findings of our study, students and staff at NAU are rarely involved in life-threatening incidents as a result of their encounters with venomous arthropods and most apply several globally accepted standard practices for the control of venomous arthropods.
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NO TIME TO DIE ? Could pre-travel health advice help Bond to live another day? Travel Med Infect Dis 2021; 44:102198. [PMID: 34748987 DOI: 10.1016/j.tmaid.2021.102198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Graumans W, Stone WJR, Bousema T. No time to die: An in-depth analysis of James Bond's exposure to infectious agents. Travel Med Infect Dis 2021; 44:102175. [PMID: 34662727 DOI: 10.1016/j.tmaid.2021.102175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/08/2021] [Accepted: 10/12/2021] [Indexed: 01/29/2023]
Abstract
Global travelers, whether tourists or secret agents, are exposed to a smörgåsbord of infectious agents. We hypothesized that agents pre-occupied with espionage and counterterrorism may, at their peril, fail to correctly prioritize travel medicine. To examine our hypothesis, we examined adherence to international travel advice during the 86 international journeys that James Bond was observed to undertake in feature films spanning 1962-2021. Scrutinizing these missions involved ∼3113 min of evening hours per author that could easily have been spent on more pressing societal issues. We uncovered above-average sexual activity, often without sufficient time for an exchange of sexual history, with a remarkably high mortality among Bond's sexual partners (27.1; 95% confidence interval 16.4-40.3). Given how inopportune a bout of diarrhea would be in the midst of world-saving action, it is striking that Bond is seen washing his hands on only two occasions, despite numerous exposures to foodborne pathogens. We hypothesize that his foolhardy courage, sometimes purposefully eliciting life-threatening situations, might even be a consequence of Toxoplasmosis. Bond's approach to vector-borne diseases and neglected tropical diseases is erratic, sometimes following travel advice to the letter, but more often dwelling on the side of complete ignorance. Given the limited time Bond receives to prepare for missions, we urgently ask his employer MI6 to take its responsibility seriously. We only live once.
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Affiliation(s)
- Wouter Graumans
- Department of Medical Microbiology & Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - William J R Stone
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Teun Bousema
- Department of Medical Microbiology & Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
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Pires LC, Dantas LR, Witkin SS, Bertozzi APAP, Dezena RDCAB, Rodrigues MMD, Gazeta RE, Passos SD. Knowledge of Zika Virus Transmission and Its Prevention among High-Risk Pregnant Women in Brazil. Viruses 2021; 13:v13020242. [PMID: 33557048 PMCID: PMC7913803 DOI: 10.3390/v13020242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 12/12/2022] Open
Abstract
Recent outbreaks of Zika virus (ZIKV) infection highlight the urgent need to evaluate the efficacy of current public health measures to educate susceptible groups about how to prevent infection, modes of viral transmission, and consequences of infection. We performed a cross-sectional study in the city of Jundiaí, São-Paulo, from March 2016 to August 2017. In 315 high-risk pregnant women we evaluated the rate of ZIKV infection, knowledge of pathways of ZIKV transmission, and the use of protective measures. Data were analyzed and correlated with sociodemographic variables. The rate of ZIKV infection was 10.8%. ZIKV transmission by mosquitoes was the best-known means of virus acquisition, while transmission of ZIKV by sexual intercourse as well as mother–fetus transmission was known by less than half of the women. The use of insect repellent, reported by 53% of participants, was correlated with higher education and personal directives from health professionals. Condom use was reported by 19.5% of subjects. Improved strategies to increase awareness of ZIKV infection and its consequences, designed to appeal to specific, targeted populations, are clearly necessary to more accurately prevent the spread of this infection and diminish adverse consequences in the pregnant population.
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Affiliation(s)
- Lucas C. Pires
- Faculty of Medicine, Jundiaí School of Medicine, Jundiaí, São Paulo 13202-550, Brazil;
- Correspondence: ; Tel.: +55-119-8785-0707
| | - Luiza R. Dantas
- Faculty of Medicine, Jundiaí School of Medicine, Jundiaí, São Paulo 13202-550, Brazil;
| | - Steven S. Witkin
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY 10065, USA;
- Laboratory of Virology, Institute of Tropical Medicine, University of São Paulo, São Paulo 05403-000, Brazil
| | - Ana Paula A. P. Bertozzi
- Department of Pediatrics, Jundiaí School of Medicine, Jundiaí, São Paulo 13207-450, Brazil; (A.P.A.P.B.); (R.d.C.A.B.D.); (M.M.D.R.); (R.E.G.); (S.D.P.)
| | - Rita de Cássia A. B. Dezena
- Department of Pediatrics, Jundiaí School of Medicine, Jundiaí, São Paulo 13207-450, Brazil; (A.P.A.P.B.); (R.d.C.A.B.D.); (M.M.D.R.); (R.E.G.); (S.D.P.)
| | - Maria M. D. Rodrigues
- Department of Pediatrics, Jundiaí School of Medicine, Jundiaí, São Paulo 13207-450, Brazil; (A.P.A.P.B.); (R.d.C.A.B.D.); (M.M.D.R.); (R.E.G.); (S.D.P.)
| | - Rosa Estela Gazeta
- Department of Pediatrics, Jundiaí School of Medicine, Jundiaí, São Paulo 13207-450, Brazil; (A.P.A.P.B.); (R.d.C.A.B.D.); (M.M.D.R.); (R.E.G.); (S.D.P.)
| | - Saulo D. Passos
- Department of Pediatrics, Jundiaí School of Medicine, Jundiaí, São Paulo 13207-450, Brazil; (A.P.A.P.B.); (R.d.C.A.B.D.); (M.M.D.R.); (R.E.G.); (S.D.P.)
- Laboratory of Pediatric Infectious Disease, Jundiaí School of Medicine, Jundiaí, São Paulo 13202-550, Brazil
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Travel-related infections presenting in Europe: A 20-year analysis of EuroTravNet surveillance data. LANCET REGIONAL HEALTH-EUROPE 2021; 1:100001. [PMID: 35081179 PMCID: PMC8454853 DOI: 10.1016/j.lanepe.2020.100001] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Disease epidemiology of (re-)emerging infectious diseases is changing rapidly, rendering surveillance of travel-associated illness important. Methods We evaluated travel-related illness encountered at EuroTravNet clinics, the European surveillance sub-network of GeoSentinel, between March 1, 1998 and March 31, 2018. Findings 103,739 ill travellers were evaluated, including 11,239 (10.8%) migrants, 89,620 (86.4%) patients seen post-travel, and 2,880 (2.8%) during and after travel. Despite increasing numbers of patient encounters over 20 years, the regions of exposure by year of clinic visits have remained stable. In 5-year increments, greater proportions of patients were migrants or visiting friends and relatives (VFR); business travel-associated illness remained stable; tourism-related illness decreased. Falciparum malaria was amongst the most-frequently diagnosed illnesses with 5,254 cases (5.1% of all patients) and the most-frequent cause of death (risk ratio versus all other illnesses 2.5:1). Animal exposures requiring rabies post-exposure prophylaxis increased from 0.7% (1998–2002) to 3.6% (2013–2018). The proportion of patients with seasonal influenza increased from zero in 1998–2002 to 0.9% in 2013–2018. There were 44 cases of viral haemorrhagic fever, most during the past five years. Arboviral infection numbers increased significantly as did the range of presenting arboviral diseases, dengue and chikungunya diagnoses increased by 2.6% and 1%, respectively. Interpretation Travel medicine must adapt to serve the changing profile of travellers, with an increase in migrants and persons visiting relatives and friends and the strong emergence of vector-borne diseases, with potential for further local transmission in Europe. Funding This project was supported by a cooperative agreement (U50CK00189) between the Centers for Disease Control and Prevention to the International Society of Travel Medicine (ISTM) and funding from the ISTM and the Public Health Agency of Canada.
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Goodyer L, Grootveld M, Deobhankar K, Debboun M, Philip M. Characterisation of actions of p-menthane-3,8-diol repellent formulations against Aedes aegypti mosquitoes. Trans R Soc Trop Med Hyg 2020; 114:687-692. [PMID: 32542324 DOI: 10.1093/trstmh/traa045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 05/06/2020] [Accepted: 05/19/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Characterisation of mosquito repellents using arm-in-cage tests are performed by assessing the 95% effective dose (ED95), half-life and complete protection time (CPT). This study fully characterizes these properties for p-menthane-3,8-diol (PMD), which has not been widely studied, and a long-acting formulation containing a PMD-vanillin composite. METHODS A series of arm-in-cage tests against Aedes aegypti (Diptera: Culicidae) mosquitoes were devised using 6 volunteers to estimate CPT or 10 to estimate the ED95 and half-lives for three repellents: 20% N,N-diethyl-3-methylbenzamide (DEET), 30% PMD and a novel 30% PMD-vanillin formulation. Non-linear regression analysis was used to characterize the relationship between applied dose and CPT. RESULTS PMD and DEET showed a very similar log dose relationship to CPT; however, the PMD-vanillin formulation exhibited a sigmoidal 'S-shaped' relationship. This resulted in a 1.5-fold higher CPT for PMD-vanillin compared with that of 20% DEET when applied at a dose of 1.6 mg/cm2, but little difference was observed at lower doses of 0.8-1 mg/cm2. The ED95 value for the 30% PMD and PMD-vanillin formulations were 0.25 and 0.24 mg/cm2, respectively, these being higher than that for 20% DEET (0.09 mg/cm2). The half-lives for 30% PMD and 20% DEET were similar (2.23 vs. 2.74 h), but longer for the PMD-vanillin formulations (3.8 h). CONCLUSIONS A full characterisation for other repellent formulations, particularly those claiming extended longevity, should be conducted in order to identify differences at various applied doses.
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Affiliation(s)
| | | | - Kedar Deobhankar
- Ross Lifescience Private Limited, Plot No. 96, Sector No. 10, PCNTDA, Bhosari, Pune - 411026. Maharashtra, India
| | - Mustapha Debboun
- Global Mosquito & Vector Control Solutions, Sugar Land, TX, USA.,Delta Vector Control District (DVCD) 1737 W. Houston Ave PO Box 310, Visalia, CA 93279-0310
| | - Manju Philip
- Ross Lifescience Private Limited, Plot No. 96, Sector No. 10, PCNTDA, Bhosari, Pune - 411026. Maharashtra, India
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Murray HW. The Pretravel Consultation: Recent Updates. Am J Med 2020; 133:916-923.e2. [PMID: 32179056 DOI: 10.1016/j.amjmed.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 10/24/2022]
Abstract
Estimates suggest that 43%-79% of international travelers may develop travel-related illnesses. Most such illnesses are considered mild and self-limited; however, some are life-threatening. The pretravel consultation is aimed at assessing risks for a range of illnesses, communicating these risks, and then providing individualized recommendations and interventions to minimize or manage such risks. The effective consultation is predicated on a well-prepared clinician and motivated traveler, understanding the traveler's perception of, and tolerance for, risk, and providing education applicable to the actual itinerary. Integral to the clinician's preparation is regular review of up-to-date trip-specific recommendations; country-specific information and recommendations are readily available and can now be efficiently accessed. From the infectious diseases perspective, immunizations, malaria chemoprophylaxis, insect repellent use, and travelers' diarrhea and its self-management are cornerstones of the consultation. This review focuses primarily on updating these 4 topics with recently published information relevant to adult travelers.
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Affiliation(s)
- Henry W Murray
- Department of Medicine, Division of Infectious Diseases, Weill Cornell Medical College, New York, NY.
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Mäkelä HMM, Cristea V, Sane JA. Lack of perception regarding risk of dengue and day-active mosquitoes in Finnish travellers. Infect Dis (Lond) 2020; 52:651-658. [PMID: 32538285 DOI: 10.1080/23744235.2020.1775883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Background: An increasing number of international travellers are at risk for dengue infection. We analysed the characteristics of Finnish travellers with recently acquired dengue infections.Methods: Notified dengue infections from 2016 to 2019 were obtained from the Finnish National Infectious Disease Register. We developed a questionnaire and invited individuals diagnosed with dengue to provide information on countries and areas of infection, travel characteristics, risk perception and use of protective measures.Results: Almost all infections (94%, 127/135) were acquired in Asian countries, most in Thailand (78/135, 58%). The Maldives had the highest crude risk after adjusting for the number of travellers (55.6/100,000). Most trips were pre-booked holidays (93/111, 84%) and 62% (69/111) had a duration of 14-21 days with time spent mostly on the beach (78/111, 70%). The majority of travellers were not aware of the risk of dengue infection before travelling (67/111, 60%) and had not sought pre-travel advice (72/111, 65%). The majority applied some protective measures (71/111, 64%) but mainly after sunset (64/111, 58%).Conclusions: Most dengue infections in Finnish travellers were acquired at popular destinations in Southeast Asia, especially Thailand. Our study showed that there was low awareness regarding the risk of contracting the infection. In addition, many travellers reported inadequate use of protective measures. This calls for further public health actions, such as raising awareness of day-active mosquitoes, of risk at popular travelling destinations and the correct way of applying anti-vectorial measures.
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Affiliation(s)
- Henna M M Mäkelä
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Veronica Cristea
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Jussi A Sane
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
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