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Brosius I, Dijck CV, Coppens J, Vandenhove L, Bangwen E, Vanroye F, Verschueren J, Zange S, Bugert J, Michiels J, Bottieau E, Soentjens P, van Griensven J, Kenyon C, Ariën KK, Esbroeck MV, Vercauteren K, Liesenborghs L. Presymptomatic viral shedding in high-risk mpox contacts: A prospective cohort study. J Med Virol 2023; 95:e28769. [PMID: 37212312 DOI: 10.1002/jmv.28769] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/08/2023] [Indexed: 05/23/2023]
Abstract
The risk of infection after exposure to clade IIb mpox virus (MPXV) is unknown, and potential presymptomatic shedding of MPXV remains to be demonstrated. High-risk contacts of mpox patients were followed-up in a prospective longitudinal cohort study. Individuals reporting sexual contact, >15 min skin-to-skin contact, or living in the same household with an mpox patient were recruited in a sexual health clinic in Antwerp, Belgium. Participants kept a symptom diary, performed daily self-sampling (anorectal, genital, and saliva), and presented for weekly clinic visits for physical examination and sampling (blood and oropharyngeal). Samples were tested for MPXV by PCR. Between June 24 and July 31, 2022, 25 contacts were included, of which 12/18 (66.0%) sexual and 1/7 (14.0%) nonsexual contacts showed evidence of infection by MPXV-PCR. Six cases had typical mpox symptoms. Viral DNA was detected as early as 4 days before symptom onset in 5 of them. In 3 of these cases, replication-competent virus was demonstrated in the presymptomatic phase. These findings confirm the existence of presymptomatic shedding of replication-competent MPXV and emphasize the high risk of transmission during sexual contact. Sexual contacts of mpox cases should abstain from sex during the incubation period, irrespective of symptoms.
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Affiliation(s)
- Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Medical Microbiology, University of Antwerp, Antwerp, Belgium
| | - Jasmine Coppens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Leen Vandenhove
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Eugene Bangwen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Fien Vanroye
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jacob Verschueren
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sabine Zange
- Bundeswehr Institute of Microbiology, Munich, Germany
| | | | - Johan Michiels
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Johan van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa
| | - Kevin K Ariën
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Koen Vercauteren
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Laurens Liesenborghs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Berens-Riha N, Andries P, Aerssens A, Ledure Q, Vanderbeken Y, Heyndrickx L, Genbrugge E, Tsoumanis A, Van Herrewege Y, Ariën KK, Van Innis M, Vanbrabant P, Soentjens P. Five accelerated schedules for the tick-borne encephalitis vaccine FSME-Immun® in last-minute travellers: an open-label, single-Centre, randomized controlled pilot trial. J Travel Med 2023:7130284. [PMID: 37074147 DOI: 10.1093/jtm/taad053] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND The purpose of this exploratory study was to evaluate different accelerated tick-borne encephalitis (TBE) vaccine schedules for last-minute travellers. METHODS In a single-centre, open-label pilot study, 77 TBE-naïve Belgian soldiers were randomized to one of the following five schedules with FSME-Immun®: group 1 ('classical accelerated' schedule) received one intramuscular (IM) dose at day 0 and day 14, group 2 two IM doses at day 0, group 3 two intradermal (ID) doses at day 0, group 4 two ID doses at day 0 and day 7, group 5 two ID doses at day 0 and day 14. The last dose(s) of the primary vaccination scheme were given after one year: IM (1 dose) or ID (2 doses). TBE virus neutralizing antibodies were measured in a plaque reduction neutralization test (PRNT90 and 50) at day 0, 14, 21, 28, month 3, 6, 12, and 12 + 21 days. Seropositivity was defined as neutralizing antibody titres ≥10. RESULTS The median age was 19-19.5 years in each group. Median time-to-seropositivity up to day 28 was shortest for PRNT90 in ID-group 4 and for PRNT50 in all ID groups. Seroconversion until day 28 peaked highest for PRNT90 in ID-group 4 (79%) and for PRNT50 in ID-groups 4 and 5 (both 100%). Seropositivity after the last vaccination after 12 months was high in all groups. Previous yellow fever vaccination was reported in 16% and associated with lower GMTs of TBE-specific antibodies at all time points. The vaccine was generally well tolerated. However, mild to moderate local reactions occurred in 73-100% of ID compared to 0-38% of IM vaccinations, persistent discolouration was observed in nine ID vaccinated individuals. CONCLUSION The accelerated two-visit ID schedules might offer a better immunological alternative to the recommended classical accelerated IM schedule but an aluminium-free vaccine would preferable.
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Affiliation(s)
- Nicole Berens-Riha
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Petra Andries
- Centre for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
| | - Annelies Aerssens
- Department of Internal Medicine and Infectious Diseases, Ghent University Hospital, Belgium
| | - Quentin Ledure
- Hospital Pharmacy, Queen Astrid Military Hospital, Brussels, Belgium
| | | | - Leo Heyndrickx
- Virology Laboratory, Institute of Tropical Medicine, Antwerp, Belgium
| | - Els Genbrugge
- Clinical Trials Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Kevin K Ariën
- Virology Laboratory, Institute of Tropical Medicine, Antwerp, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Martine Van Innis
- Hospital Pharmacy, Queen Astrid Military Hospital, Brussels, Belgium
| | - Peter Vanbrabant
- Centre for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
| | - Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium, and Centre for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
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Van Dijck C, De Baetselier I, Kenyon C, Liesenborghs L, Vercauteren K, Van Esbroeck M, De Baetselier I, Kenyon C, Brosius I, Liesenborghs L, Van den Bossche D, Florence E, van Griensven J, Bottieau E, Soentjens P, Berens-Riha N, Vanbaelen T, Van Frankenhuijsen M, Vandenbruaene M, Huyst V, Wouters K, Apers L, Kint I, Caluwaerts S, Coppens J, Van Esbroeck M, Vercauteren K. Mpox screening in high-risk populations finds no asymptomatic cases. Lancet Microbe 2023; 4:e132-e133. [PMID: 36509096 PMCID: PMC9733947 DOI: 10.1016/s2666-5247(22)00357-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; Laboratory of Medical Microbiology, University of Antwerp, Antwerp, Belgium.
| | - Irith De Baetselier
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa
| | - Laurens Liesenborghs
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | | | - Koen Vercauteren
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
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Hens M, Brosius I, Berens-Riha N, Coppens J, Van Gestel L, Rutgers J, Kenyon C, Soentjens P, van Henten S, Bracke S, Vanbaelen T, Vandenhoven L, Bottieau E, Vercauteren K, Van Esbroeck M, Liesenborghs L, Van Dijck C, Van Esbroeck M, Brosius I, Liesenborghs L, Van Gestel L, Rutgers J, Kenyon C, De Baetselier I, Coppens J, Van den Bossche D, Florence E, Vercauteren K, van Griensven J, Bottieau E, Soentjens P, Berens-Riha N, van Henten S, Bracke S, Vanbaelen T, Vandenhoven L, Van Frankenhuijsen M, Vandenbruaene M, Huyst V, Wouters K, Apers L, Kint I, Caluwaerts S, Vanroye F, Verschueren J, Ariën K. Characteristics of confirmed mpox cases among clinical suspects: A prospective single-centre study in Belgium during the 2022 outbreak. New Microbes New Infect 2023; 52:101093. [PMID: 36874154 PMCID: PMC9982023 DOI: 10.1016/j.nmni.2023.101093] [Citation(s) in RCA: 1] [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: 01/04/2023] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
Background The presentation of mpox clade IIb during the 2022 outbreak overlaps with a range of other diseases. Understanding the factors associated with mpox is important for clinical decision making. Methods We described the characteristics of mpox patients who sought care at Belgian sexual health clinic. Furthermore we compared their characteristics to those of patients with a clinical suspicion of mpox but who tested negative on polymerase chain reaction. Results Between May 23 and September 20, 2022, 155 patients were diagnosed with mpox, and 51 patients with suspected symptoms tested negative. All mpox patients self-identified as men and 148/155 (95.5%) as gay or bisexual MSM. Systemic symptoms were present in 116/155 (74.8%) patients. All but 10 patients (145/155, 93.5%) presented with skin lesions. Other manifestations were lymphadenopathy (72/155, 46.5%), proctitis (50/155, 32.3%), urethritis (12/155, 7.7%), tonsillitis (2/155, 1.3%). Complications involved bacterial skin infection (13/155, 8.4%) and penile oedema with or without paraphimosis (4/155, 2.6%). In multivariable logistic regression models, the presence of lymphadenopathy (OR 3.79 95% CI 1.44-11.49), skin lesions (OR 4.35 95% CI 1.15-17.57) and proctitis (OR 9.41 95% CI 2.72-47.07) were associated with the diagnosis of mpox. There were no associations with age, HIV status, childhood smallpox vaccination, number of sexual partners and international travel. Conclusions The presence of proctitis, lymphadenopathies and skin lesions should increase clinical suspicion of mpox in patients with compatible symptoms.
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Affiliation(s)
- Matilde Hens
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Nicole Berens-Riha
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Jasmine Coppens
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Liesbeth Van Gestel
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Jojanneke Rutgers
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Saskia van Henten
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Stefanie Bracke
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Thibaut Vanbaelen
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Leen Vandenhoven
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Koen Vercauteren
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Laurens Liesenborghs
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium.,Laboratory of Medical Microbiology, University of Antwerp, Belgium
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5
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Berens-Riha N, Bracke S, Rutgers J, Burm C, Van Gestel L, Hens M, Kenyon C, Bottieau E, Soentjens P, Brosius I, Van Esbroeck M, Vercauteren K, van Griensven J, van Dijck C, Liesenborghs L. Persistent morbidity in Clade IIb mpox patients: interim results of a long-term follow-up study, Belgium, June to November 2022. Euro Surveill 2023; 28:2300072. [PMID: 36795501 PMCID: PMC9936596 DOI: 10.2807/1560-7917.es.2023.28.7.2300072] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
While mpox was well characterised during the 2022 global Clade IIb outbreak, little is known about persistent morbidity. We present interim results of a prospective cohort study of 95 mpox patients assessed 3-20 weeks post-symptom onset. Two-thirds of participants had residual morbidity, including 25 with persistent anorectal and 18 with genital symptoms. Loss of physical fitness, new-onset/worsened fatigue and mental health problems were reported in 36, 19 and 11 patients, respectively. These findings require attention by healthcare providers.
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Affiliation(s)
| | | | | | | | | | - Matilde Hens
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Chris Kenyon
- Institute of Tropical Medicine, Antwerp, Belgium,University of Cape Town, Cape Town, South Africa
| | | | | | | | | | | | | | - Christophe van Dijck
- Institute of Tropical Medicine, Antwerp, Belgium,These authors contributed equally to this work and share last authorship
| | - Laurens Liesenborghs
- Institute of Tropical Medicine, Antwerp, Belgium,These authors contributed equally to this work and share last authorship
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6
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Berens-Riha N, De Block T, Rutgers J, Michiels J, Van Gestel L, Hens M, Kenyon C, Bottieau E, Soentjens P, van Griensven J, Brosius I, Ariën KK, Van Esbroeck M, Rezende AM, Vercauteren K, Liesenborghs L. Severe mpox (formerly monkeypox) disease in five patients after recent vaccination with MVA-BN vaccine, Belgium, July to October 2022. Euro Surveill 2022; 27:2200894. [PMID: 36695462 PMCID: PMC9716643 DOI: 10.2807/1560-7917.es.2022.27.48.2200894] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Vaccination is important in containing the 2022 mpox (formerly monkeypox) epidemic. We describe five Belgian patients with localised severe symptoms of proctitis and penile oedema, occurring between 4 and 35 days after post-exposure preventive vaccination or after one- or two-dose off-label pre-exposure preventive vaccination with MVA-BN vaccine. Genome sequencing did not reveal evidence for immune escape variants. Healthcare workers and those at risk should be aware of possible infections occurring shortly after vaccination and the need for other preventive measures.
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Affiliation(s)
| | | | | | | | | | - Matilde Hens
- Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Chris Kenyon
- Institute of Tropical Medicine, Antwerp, Belgium,University of Cape Town, Cape Town, South Africa
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7
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Croughs M, Nyakunga GB, Sakita FM, Kilonzo K, Mmbaga BT, Soentjens P. Incidence and predictors of severe altitude illness symptoms in Mt. Kilimanjaro hikers: a prospective cohort study. J Travel Med 2022; 29:6554584. [PMID: 35348739 DOI: 10.1093/jtm/taac044] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Each year several Mt. Kilimanjaro hikers die due to altitude illness (AI) although urgent descent is technically easily possible. The objectives of this study were to determine the incidence and predictors of severe altitude illness (SAI) symptoms and of summit success in Mt. Kilimanjaro hikers, and the measures taken when AI symptoms develop. METHODS A prospective observational cohort study in Mt. Kilimanjaro hikers was conducted from December 2019 until March 2020. Participants were asked to complete a questionnaire at the entrance gate and one at the descend gate. A multivariate logistic regression was performed to study the relations between the variables. RESULTS A total of 1237 recreational hikers and 266 porters or guides were included. The incidence of severe symptoms was 8.6% in recreational hikers and 1.5% in porters and guides. One percent (1.1%) of hikers was hospitalized due to SAI. A history of SAI, young age, summit failure and lack of clear advice predicted the development of severe symptoms. Uhuru peak was reached by 87.9% of the hikers. Absence of severe symptoms, acetazolamide prophylaxis, climbing higher in daytime, young age and climbing in more days predicted summit success. The majority climbed further despite the presence of mild or severe symptoms. The only measure taken in case of mild symptoms that was associated with a lower incidence of severe symptoms was not climbing further. CONCLUSION The incidence of SAI symptoms in Mt. Kilimanjaro hikers was observed to be high. However, how hikers reacted during symptoms was not appropriate. Therefore, travel health counsellors should emphasize even more that hikers do not ascend higher until mild symptoms have resolved and that it is vital to descend immediately when severe symptoms develop. In addition, they can be informed on the measures, which improved summit success.
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Affiliation(s)
- Mieke Croughs
- Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp 2000, Belgium
| | - Gissela B Nyakunga
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi 3010, Tanzania.,Clinical Trial Unit, Kilimanjaro Clinical Research Institute (KCRI), Moshi 2236, Tanzania.,Faculty of Medicine, Kilimanjaro Christian Medical University College (KCMCUCO), Moshi 2240, Tanzania
| | - Francis M Sakita
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi 3010, Tanzania.,Clinical Trial Unit, Kilimanjaro Clinical Research Institute (KCRI), Moshi 2236, Tanzania.,Faculty of Medicine, Kilimanjaro Christian Medical University College (KCMCUCO), Moshi 2240, Tanzania
| | - Kajiru Kilonzo
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi 3010, Tanzania.,Clinical Trial Unit, Kilimanjaro Clinical Research Institute (KCRI), Moshi 2236, Tanzania.,Faculty of Medicine, Kilimanjaro Christian Medical University College (KCMCUCO), Moshi 2240, Tanzania
| | - Blandina T Mmbaga
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi 3010, Tanzania.,Clinical Trial Unit, Kilimanjaro Clinical Research Institute (KCRI), Moshi 2236, Tanzania.,Faculty of Medicine, Kilimanjaro Christian Medical University College (KCMCUCO), Moshi 2240, Tanzania
| | - Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp 2000, Belgium.,Department of Infectious Diseases, Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels 1120, Belgium
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Costescu Strachinaru DI, Gallez JL, Daras S, Paridaens MS, Engel H, François PM, Rose T, Vanbrabant P, Soentjens P. A case of Flavonifractor plautii blood stream infection in a severe burn patient and a review of the literature. Acta Clin Belg 2022; 77:693-697. [PMID: 34151750 DOI: 10.1080/17843286.2021.1944584] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Flavonifractor plautii is a strictly anaerobic rod shaped bacterium belonging to the family of Clostridiales. It is a commensal of the human intestinal microbiota which was seldom isolated from clinical samples, therefore clinical data are scarce. To date, only four cases of F. plautii infections were described, all occurring in immunosuppressed patients. CASE PRESENTATION We report a case where F. plautii was isolated from the blood culture of a severe burn victim and identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. DISCUSSION To the best of our knowledge, this is the first case of F. plautii blood stream infection described in a burn patient.
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Affiliation(s)
| | - Jean-Luc Gallez
- Department of Microbiology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Sonia Daras
- Department of Microbiology, Queen Astrid Military Hospital, Brussels, Belgium
| | | | - Harald Engel
- Burn Unit, Queen Astrid Military Hospital, Brussels, Belgium
| | | | - Thomas Rose
- Burn Unit, Queen Astrid Military Hospital, Brussels, Belgium
| | - Peter Vanbrabant
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
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Costescu Strachinaru DI, Gallez JL, François PM, Baekelandt D, Paridaens MS, Pirnay JP, De Vos D, Djebara S, Vanbrabant P, Strachinaru M, Soentjens P. Epidemiology and etiology of blood stream infections in a Belgian burn wound center. Acta Clin Belg 2022; 77:353-359. [PMID: 33432871 DOI: 10.1080/17843286.2021.1872309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Infections are a major cause of morbidity in burn patients. We aimed to investigate the epidemiology and antibiotic susceptibility of blood stream infections in order to gain a better understanding of their role and burden in our Burn Wound Center. METHODS This retrospective epidemiological investigation analyzed data derived from medical files of patients admitted to our Burn Wound Center having had at least one positive blood culture between 1 January and 31 December 2018. We focused on the prevalence of causative agents in blood stream infections in function of the time after injury and on their drug sensitivity. RESULTS Among the 363 patients admitted to our Burn Wound Center during the study period, 29 had at least one episode of blood stream infection. Gram-negative organisms accounted for 56,36% of the pathogens in blood stream infections, Gram-positives for 38,17%, and yeasts for 5,45%. Pseudomonas aeruginosa was the most common bacterium (20%), followed by Staphylococcus epidermidis (16.36%), Escherichia coli and Klebsiella pneumoniae (9,09% each). A third of the Gram-negative isolates were multidrug resistant. Gram-positive cocci were isolated from blood cultures at a median of 9 days after the injury, earlier than Gram-negative rods (median 15 days). The main sources of blood stream infections were the burn wounds, followed by infected catheters. CONCLUSIONS Multidrug resistant bacteria must be considered when selecting empirical antibiotic therapy in septic burn patients. In our center, we need to update our antibiotic guidelines, to review the hospital infection control measures and to introduce routine typing technology.
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Affiliation(s)
| | - Jean-Luc Gallez
- Microbiology Laboratory, Queen Astrid Military Hospital, Brussels, Belgium
| | | | | | | | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Sarah Djebara
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
| | - Peter Vanbrabant
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
- General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Mihai Strachinaru
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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10
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Costescu Strachinaru DI, Gallez JL, Paridaens MS, Djebara S, Soete O, Soentjens P. A case of Escherichia coli and Peptoniphilus species mixed osteomyelitis successfully identified by MALDI TOF-MS with a review of the literature. Acta Clin Belg 2022; 77:126-129. [PMID: 32552621 DOI: 10.1080/17843286.2020.1783908] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Peptoniphilus species are Gram-positive anaerobic cocci that are commensals of the human vagina and gut. METHODS AND RESULTS We describe a case of mixed Escherichia coli and Peptoniphilus spp. osteomyelitis identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry as Peptoniphilus harei and present a short literature review. CONCLUSION To our knowledge, only six cases of P. harei osteomyelitis have been reported to date.
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Affiliation(s)
| | - Jean-Luc Gallez
- Department of Microbiology, Queen Astrid Military Hospital, Brussels, Belgium
| | | | - Sarah Djebara
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
| | - Olivier Soete
- Burn Unit, Queen Astrid Military Hospital, Brussels, Belgium
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
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Bottieau E, Huits R, Van Den Broucke S, Maniewski U, Declercq S, Brosius I, Theunissen C, Feyens AM, Van Esbroeck M, van Griensven J, Clerinx J, Soentjens P. Human filariasis in travelers and migrants: a retrospective 25-year analysis at the Institute of Tropical Medicine, Antwerp, Belgium. Clin Infect Dis 2021; 74:1972-1978. [PMID: 34463732 DOI: 10.1093/cid/ciab751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/23/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Information on human filariasis in international travelers is scarce. We describe the epidemiology, clinical presentation and outcome of these infections in a reference travel clinic over the past decades. METHODS We reviewed all cases of filariasis diagnosed at the Institute of Tropical Medicine, Antwerp, Belgium, from 1994 to 2018. Diagnosis was obtained by either parasitological methods (confirmed) or strict clinical case definitions (probable). We assessed the characteristics of cases at diagnosis and response to therapy within three to 12 months. RESULTS A total of 320 patients (median age: 41 years; 71% males) were diagnosed with 327 filarial infections (Wuchereria bancrofti = 6; Onchocerca volvulus = 33, Loa loa = 150, Mansonella perstans = 130; unspecified species = 8). Diagnosis was confirmed in 213/320 (67%) patients. European long-term travelers accounted for 166 patients (52%) and visitors/migrants from tropical countries for another 110 (34%). Central Africa was the likely region of acquisition for 294 (92%) patients. The number of filariasis cases decreased from 21.5/year in average in the nineties to 6.3/year in the last decade, when loiasis became predominant. Cases reported symptoms in > 80% of all filarial infections but mansonellosis (45/123 single infections; 37%). Lymphatic filariasis and onchocerciasis cases responded well to conventional therapy. However, 30% of patients with loiasis and mansonellosis experienced treatment failure (with diethylcarbamazine and levamisole-mebendazole, respectively). CONCLUSIONS The burden and species distribution of filariasis in travelers evolved in the past decades. Most presentations were symptomatic. Case management would benefit from more effective therapies for loiasis and mansonellosis.
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Affiliation(s)
- Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ralph Huits
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Ula Maniewski
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Steven Declercq
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Caroline Theunissen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Anne-Marie Feyens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Johan van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jan Clerinx
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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12
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Pirnay JP, Selhorst P, Hong SL, Cochez C, Potter B, Maes P, Petrillo M, Dudas G, Claes V, Van der Beken Y, Verbeken G, Degueldre J, Dellicour S, Cuypers L, T’Sas F, Van den Eede G, Verhasselt B, Weuts W, Smets C, Mertens J, Geeraerts P, Ariën KK, André E, Neirinckx P, Soentjens P, Baele G. Variant Analysis of SARS-CoV-2 Genomes from Belgian Military Personnel Engaged in Overseas Missions and Operations. Viruses 2021; 13:1359. [PMID: 34372565 PMCID: PMC8310367 DOI: 10.3390/v13071359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023] Open
Abstract
More than a year after the first identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the causative agent of the 2019 coronavirus disease (COVID-19) in China, the emergence and spread of genomic variants of this virus through travel raise concerns regarding the introduction of lineages in previously unaffected regions, requiring adequate containment strategies. Concomitantly, such introductions fuel worries about a possible increase in transmissibility and disease severity, as well as a possible decrease in vaccine efficacy. Military personnel are frequently deployed on missions around the world. As part of a COVID-19 risk mitigation strategy, Belgian Armed Forces that engaged in missions and operations abroad were screened (7683 RT-qPCR tests), pre- and post-mission, for the presence of SARS-CoV-2, including the identification of viral lineages. Nine distinct viral genotypes were identified in soldiers returning from operations in Niger, the Democratic Republic of the Congo, Afghanistan, and Mali. The SARS-CoV-2 variants belonged to major clades 19B, 20A, and 20B (Nextstrain nomenclature), and included "variant of interest" B.1.525, "variant under monitoring" A.27, as well as lineages B.1.214, B.1, B.1.1.254, and A (pangolin nomenclature), some of which are internationally monitored due to the specific mutations they harbor. Through contact tracing and phylogenetic analysis, we show that isolation and testing policies implemented by the Belgian military command appear to have been successful in containing the influx and transmission of these distinct SARS-CoV-2 variants into military and civilian populations.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Philippe Selhorst
- Unit of Virology and Outbreak Research Team, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Samuel L. Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Christel Cochez
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Barney Potter
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Piet Maes
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Mauro Petrillo
- European Commission, Directorate-General Joint Research Centre (JRC), 21027 Ispra, Italy;
| | - Gytis Dudas
- Gothenburg Global Biodiversity Centre, 413 19 Gothenburg, Sweden;
- Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08410 Vilnius, Lithuania
| | - Vincent Claes
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Yolien Van der Beken
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Julie Degueldre
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, 1050 Bruxelles, Belgium
| | - Lize Cuypers
- Department of Laboratory Medicine, UZ Leuven Hospital, 3000 Leuven, Belgium; (L.C.); (E.A.)
| | - France T’Sas
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Guy Van den Eede
- European Commission, Directorate-General Joint Research Centre (JRC), 1050 Brussels, Belgium;
| | - Bruno Verhasselt
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium;
| | - Wouter Weuts
- Queen Astrid Military Hospital, 1120 Brussels, Belgium;
| | | | - Jan Mertens
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Philippe Geeraerts
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Kevin K. Ariën
- Unit of Virology, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
- Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Emmanuel André
- Department of Laboratory Medicine, UZ Leuven Hospital, 3000 Leuven, Belgium; (L.C.); (E.A.)
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Pierre Neirinckx
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium;
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
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13
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Costescu Strachinaru DI, Wauters A, Van Esbroeck M, Strachinaru M, Vanbrabant P, Soentjens P. A Cluster of Plasmodium ovale Infections in Belgian Military Personnel after Deployment in Kindu, Democratic Republic of Congo: A Retrospective Study. Trop Med Infect Dis 2021; 6:tropicalmed6030125. [PMID: 34287372 PMCID: PMC8293309 DOI: 10.3390/tropicalmed6030125] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 01/28/2023] Open
Abstract
Plasmodium ovale malaria is often neglected due to its less severe course compared to Plasmodium falciparum. In 2011–2012, Belgian Armed Forces identified a cluster of P. ovale cases among military personnel after deployment in the Democratic Republic of Congo (DRC). In this retrospective, monocentric, observational study, clinical and biological features of soldiers diagnosed with P. ovale after deployment in DRC were reviewed. Species diagnosis was based on polymerase chain reaction (PCR) and/or thick blood smear. Medical records of 149 soldiers screened at the Queen Astrid Military Hospital after deployment were reviewed. Eight cases (seven P. ovale infections and one P. ovale—falciparum coinfection) were identified. All had positive thick smears, and seven were confirmed by PCR. Chemoprophylaxis was mefloquine in all subjects. Median time of disease onset was 101 days after return from the endemic region. Median delay between return and diagnosis was 103 days. All P. ovale bouts were uncomplicated. None had relapses after primaquine treatment. This military cohort highlights a hotspot of P. ovale in Eastern DRC. Non-specific symptoms, the less severe presentation, the lack of sensitive parasitological tools in the field and long delays between infection and symptoms probably lead to underestimation of P. ovale cases.
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Affiliation(s)
- Diana Isabela Costescu Strachinaru
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (P.V.); (P.S.)
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (A.W.); (M.V.E.)
- Correspondence:
| | - An Wauters
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (A.W.); (M.V.E.)
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (A.W.); (M.V.E.)
| | - Mihai Strachinaru
- Department of Cardiology, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands;
| | - Peter Vanbrabant
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (P.V.); (P.S.)
- General Internal Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (P.V.); (P.S.)
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (A.W.); (M.V.E.)
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14
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Soentjens P, Berens-Riha N, Van Herrewege Y, Van Damme P, Bottieau E, Ravinetto R. Vaccinating children in high-endemic rabies regions: what are we waiting for? BMJ Glob Health 2021; 6:bmjgh-2020-004074. [PMID: 33568394 PMCID: PMC7878157 DOI: 10.1136/bmjgh-2020-004074] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/16/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium .,Centre for Infectious Diseases, MHKA, Brussel, Belgium
| | - Nicole Berens-Riha
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Yven Van Herrewege
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Raffaella Ravinetto
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
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15
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Soentjens P, Croughs M, Burm C, Declerq S, Clerinx J, Maniewski U, Van Den Broucke S, Theunissen C, Huits R, Brosius I, Florence E, Kenyon C, Van Griensven J, Van Ierssel S, Lynen L, Balliauw K, Van Gucht S, Van Esbroeck M, Vlieghe E, Bottieau E, Van Herrewege Y. Time of administration of rabies immunoglobulins and adequacy of antibody response upon post-exposure prophylaxis: a descriptive retrospective study in Belgium. Acta Clin Belg 2021; 76:91-97. [PMID: 31483218 DOI: 10.1080/17843286.2019.1662993] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Data on rabies post-exposure prophylaxis (PEP) and the use of human rabies immunoglobulins (HRIG) in Belgium are scarce. The main objective of this study was to evaluate the timely administration of HRIG after rabies exposure. The secondary objective was to evaluate the adequate antibody response following PEP.Methods: We reviewed all medical records from July 2017 to June 2018 of patients seeking care at, or referred to, the Institute of Tropical Medicine and the University Hospital, Antwerp for the administration of human rabies immunoglobulins following potential rabies exposure abroad or in Belgium.A timely response was defined as starting HRIG with a delay of ≤48 h and rabies vaccination in the first 7 days after exposure.Adequate antibody response was defined as a titer of >5.0 IU/mL in case of bat-related exposure and >3.0 IU/mL in case of exposure to other animals. Titers were measured 10 days after the last PEP vaccine dose, using the rapid fluorescent focus inhibition test (RFFIT).Results: Of the 92 cases treated with HRIG, 75 were evaluated.The majority of injuries were acquired in Asia (n = 26,34%) and in Western Europe (n = 18, 24%), of which 17 in Belgium. The five most frequently recorded countries overseas were Indonesia (n = 13), Thailand (n = 7), Morocco (n = 4), Peru (n = 3) and Costa Rica (n = 3). Administration of immunoglobulins was related to injuries by dogs (36%), monkeys (25%) or bats (22%).A timely response was observed in 16 (21,33%) and in 55 (73,33%) of subjects receiving HRIG (≤48 h) or rabies vaccine (<7days) respectively. The mean time between exposure and the first administered dose of rabies vaccine and HRIG was 7.7 and 8.7 days, respectively. The mean delay for HRIG administration was 9.6 days and 6 days for abroad and inland risks, respectively.In 15 of 16 (94%) bat-related cases the antibody titer after full PEP was >5.0 IU/ml. In 38 of 47 (81%) cases related to other animals the RFFIT titer was >3.0 IU/ml. All low-responders received additional rabies injections.Conclusion: This study showed a substantial time delay between the animal-related risk and the administration of HRIG, in particular when the injury occurred abroad. More targeted communication about the risks of rabies and preventable measures may reduce this delay.Furthermore, the antibody response was inadequate in some cases following full PEP administration according to the Belgian recommendation.
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Affiliation(s)
- Patrick Soentjens
- Centre for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Mieke Croughs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Christoph Burm
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Steven Declerq
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jan Clerinx
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ula Maniewski
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Caroline Theunissen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ralph Huits
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Eric Florence
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Johan Van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sabrina Van Ierssel
- Department of Infectious Diseases and Tropical Diseases, University Hospital Antwerp, Antwerp, Belgium
| | - Lut Lynen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Katleen Balliauw
- Hospital Pharmacy, University Hospital Antwerp, Antwerp, Belgium
| | - Steven Van Gucht
- Department of Infectious Diseases and Tropical Diseases, University Hospital Antwerp, Antwerp, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Erika Vlieghe
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Infectious Diseases and Tropical Diseases, University Hospital Antwerp, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Yven Van Herrewege
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- National Reference Centre for Rabies, Sciensano, Brussels, Belgium
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16
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Costescu Strachinaru DI, Vanbrabant P, Stinga P, Strachinaru M, Soentjens P. Diagnosis of Mycobacterium marinum Infection with Sporotrichoid Pattern. Acta Derm Venereol 2021; 101:adv00414. [PMID: 33686447 PMCID: PMC9366498 DOI: 10.2340/00015555-3777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Soentjens P, Croughs M. Simplified rabies pre-exposure prophylaxis in last-minute travellers. J Travel Med 2021; 28:5913448. [PMID: 33009803 DOI: 10.1093/jtm/taaa185] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 01/05/2023]
Abstract
Less can be more: simplified two-visit rabies pre-exposure prophylaxis once in a lifetime will certainly increase compliance in last-minute travellers and ease the post-exposure procedures after animal risks in endemic countries. Different arguments are being put forward to shorten this vaccination scheme even further into an effective one-day scheme.
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Affiliation(s)
- Patrick Soentjens
- Institute of Tropical Medicine, Dept of Clinical Sciences, Antwerp, Belgium.,Military Hospital, Center for infectious diseases, Brussels, Belgium
| | - Mieke Croughs
- Institute of Tropical Medicine, Dept of Clinical Sciences, Antwerp, Belgium
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18
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Vanbrabant P, Damanet B, Maussen C, Van Esbroeck M, Soentjens P. Screening the asymptomatic soldiers after a stay in sub-Saharan Africa. A retrospective observational study. Travel Med Infect Dis 2020; 39:101941. [PMID: 33278608 DOI: 10.1016/j.tmaid.2020.101941] [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] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Many tropical clinics offer post-travel screening for parasitic infections in asymptomatic travellers. However, literature on attack rates and incidence rates of parasitic infections is scarce. METHOD All military personnel returning from a tropical region during the year 2018 were tested for the presence of antibodies against Strongyloides stercoralis, Schistosoma and Entamoeba histolytica. Test results were compared with previous results if available to distinguish recent and old infection. RESULTS In total, 949 soldiers were included in the study. The median age was years 31 (IQR: 26-41), 96.3% were male. The median duration of stay in the tropics was 35 days (IQR: 14-90). The destination was predominantly central Africa. Serological tests were positive for S. stercoralis in 10 patients (1.1%), Schistosoma in 3 (0.3%), and E. histolytica in 16 (1.7%). The attack rates were 0.84, 0.32 and 1.69 respectively. The incidence rates were 3.99, 1.49 and 7.97 respectively. CONCLUSIONS The risk for parasitic infection in the asymptomatic returning soldiers is low. However, the potentially serious complications of unrecognised parasitic infection can legitimise systematic screening.
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Affiliation(s)
- Peter Vanbrabant
- Centre for Infectious Diseases, Polyclinic Department. Queen Astrid, Military Hospital, Brussels, Belgium; General Internal Medicine, University Hospitals Leuven, Leuven, Belgium.
| | - Benjamin Damanet
- Centre for Infectious Diseases, Polyclinic Department. Queen Astrid, Military Hospital, Brussels, Belgium; School of Public Health, Free University of Brussels, Brussels, Belgium
| | - Chris Maussen
- Centre for Infectious Diseases, Polyclinic Department. Queen Astrid, Military Hospital, Brussels, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Patrick Soentjens
- Centre for Infectious Diseases, Polyclinic Department. Queen Astrid, Military Hospital, Brussels, Belgium; Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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19
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Soentjens P, Damanet B. A randomized clinical trial to assess the immunogenicity of a single-visit four-dose intradermal booster rabies regimen with topical imiquimod. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Croughs M, Soentjens P. A risk scoring system to identify travellers who qualify for pre-exposure rabies vaccination. J Travel Med 2020; 27:5906302. [PMID: 33068005 DOI: 10.1093/jtm/taaa168] [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: 08/20/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 12/29/2022]
Abstract
We want to introduce a free online scoring system to identify high risk travellers who qualify for pre-travel rabies vaccination. The system uses evidence based risk predictors and the probable availability of HRIG at the destination.
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Affiliation(s)
- Mieke Croughs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Center for Infectious Diseases, Military Hospital, Brussels, Belgium
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21
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Soentjens P, Croughs M. Stock shortages of the rabies vaccine in Belgium: implications for pretravel advice. J Travel Med 2020; 27:5588083. [PMID: 31616950 DOI: 10.1093/jtm/taz076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 08/20/2019] [Accepted: 10/03/2019] [Indexed: 11/13/2022]
Affiliation(s)
- Patrick Soentjens
- Department of Clinical Sciences, Policlinic, Medical Services, Nationalestraat 155, 2000 Antwerp, Belgium; Center for Infectious Diseases, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
| | - Mieke Croughs
- Department of Clinical Sciences, Policlinic, Medical Services, Nationalestraat 155, 2000 Antwerp, Belgium; Center for Infectious Diseases, Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
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22
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Soentjens P, De Koninck K, Tsoumanis A, Herssens N, Van Den Bossche D, Terryn S, Van Gucht S, Van Damme P, Van Herrewege Y, Bottieau E. Comparative Immunogenicity and Safety Trial of 2 Different Schedules of Single-visit Intradermal Rabies Postexposure Vaccination. Clin Infect Dis 2020; 69:797-804. [PMID: 30566636 DOI: 10.1093/cid/ciy983] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 08/14/2018] [Accepted: 12/10/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Effective and safe single-visit rabies vaccination for pre- and postexposure prophylaxis (PrEP and PEP) could substantially simplify rabies prevention and therefore increase compliance. METHODS In a comparative trial, 303 healthy adults received a primary vaccination that consisted of 2 intradermal (ID) doses of 0.1 mL of the purified chicken embryo cell vaccine (PCEV) during a single visit. One year later, participants were randomly assigned to receive either 4 or 2 ID PEP booster doses of 0.1 mL PCEV during a single visit. The primary endpoint for immunogenicity was the percentage of participants with an adequate antibody level (>0.5 IU/mL) 7 days after the booster doses. The safety endpoint was the proportion of participants who developed adverse events (AEs) following primary and/or booster vaccination. RESULTS All participants, except 1 (99.3%) in each study group, had a rabies antibody titer >0.5 IU/mL on day 7 following the booster schedules. Participants exposed to the 4-dose PEP schedule had a geometric mean titer of 20 IU/mL vs 14 IU/mL for the 2-dose PEP schedule (P = .0228). Local reactions at the injection site following PrEP and PEP were mild and transient and only seen in 14.9% and 49.6%-53% of the participants, respectively. No serious AEs were reported. CONCLUSIONS In healthy adults, a 2-dose (2 × 0.1 mL) single-visit ID PEP schedule was as immunologically adequate and safe as a 4-dose (4 × 0.1 mL) single-visit PEP schedule 7 to 28 months following a 2-dose (2 × 0.1 mL) single-visit ID PREP. CLINICAL TRIALS REGISTRATION EudraCT 2014-00183612.
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Affiliation(s)
- Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels.,Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp
| | - Katrien De Koninck
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels
| | | | - Natacha Herssens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp
| | - Dorien Van Den Bossche
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels.,Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp
| | - Sanne Terryn
- National Reference Centre for Rabies, Sciensano, Brussels
| | | | - Pierre Van Damme
- Center for the Evaluation of Vaccination, University of Antwerp, Belgium
| | - Yven Van Herrewege
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp
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23
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Pirnay JP, Selhorst P, Cochez C, Petrillo M, Claes V, Van der Beken Y, Verbeken G, Degueldre J, T’Sas F, Van den Eede G, Weuts W, Smets C, Mertens J, Geeraerts P, Ariën KK, Neirinckx P, Soentjens P. Study of a SARS-CoV-2 Outbreak in a Belgian Military Education and Training Center in Maradi, Niger. Viruses 2020; 12:v12090949. [PMID: 32867108 PMCID: PMC7552053 DOI: 10.3390/v12090949] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 01/14/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compromises the ability of military forces to fulfill missions. At the beginning of May 2020, 22 out of 70 Belgian soldiers deployed to a military education and training center in Maradi, Niger, developed mild COVID-19 compatible symptoms. Immediately upon their return to Belgium, and two weeks later, all seventy soldiers were tested for SARS-CoV-2 RNA (RT-qPCR) and antibodies (two immunoassays). Nine soldiers had at least one positive COVID-19 diagnostic test result. Five of them exhibited COVID-19 symptoms (mainly anosmia, ageusia, and fever), while four were asymptomatic. In four soldiers, SARS-CoV-2 viral load was detected and the genomes were sequenced. Conventional and genomic epidemiological data suggest that these genomes have an African most recent common ancestor and that the Belgian military service men were infected through contact with locals. The medical military command implemented testing of all Belgian soldiers for SARS-CoV-2 viral load and antibodies, two to three days before their departure on a mission abroad or on the high seas, and for specific missions immediately upon their return in Belgium. Some military operational settings (e.g., training camps in austere environments and ships) were also equipped with mobile infectious disease (COVID-19) testing capacity.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
- Correspondence: ; Tel.: +32-244-32172
| | - Philippe Selhorst
- Unit of Virology, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Christel Cochez
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Mauro Petrillo
- European Commission, Directorate-General Joint Research Centre (JRC), 1050 Brussels, Belgium; (M.P.); (G.V.d.E.)
| | - Vincent Claes
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Yolien Van der Beken
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Julie Degueldre
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - France T’Sas
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Guy Van den Eede
- European Commission, Directorate-General Joint Research Centre (JRC), 1050 Brussels, Belgium; (M.P.); (G.V.d.E.)
| | - Wouter Weuts
- Queen Astrid Military Hospital, 1120 Brussels, Belgium;
| | | | - Jan Mertens
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Philippe Geeraerts
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Kevin K. Ariën
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
- Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Pierre Neirinckx
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium;
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
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24
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Van Nieuwenhove MDM, Damanet B, Soentjens P. Timing of Intradermal Rabies Pre-exposure Prophylaxis Injections: Immunological Effect on Vaccination Response. Mil Med 2020; 184:e515-e521. [PMID: 31004174 DOI: 10.1093/milmed/usz048] [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] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/08/2019] [Accepted: 02/25/2019] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Rabies remains a global threat, with annually over 59,000 deaths. Intradermal (ID) pre-exposure prophylaxis (PrEP) is very efficient and reduces the need for rabies immunoglobulins. Not much is known about factors that influence the immune response to ID administered rabies vaccine. The aim of this study is to determine if variations in timing of vaccine administration and serology determination, age and gender have an influence on the levels of rabies virus neutralizing antibody (RVNA) after ID rabies vaccination. MATERIALS AND METHODS This is a retrospective study based on electronic health record vaccination data of Belgian military personnel who received ID rabies PrEP with a three injections regimen during the period 2014-2017. Serology was determined by using the RFFIT method. Fischer's exacts tests were used to evaluate the effect of each independent variable on RVNA levels. RESULTS In this study, 2,112 subjects were included. All but one seroconverted with a RVNA level ≥0.5 IU/mL. About 48% of subjects developed an antibody titer of >10 IU/mL, 36% had antibody levels 3-10 IU/mL and 16% had an antibody level 0.5-2.99 IU/mL. Statistically significant (p = 0.0018) higher RVNA levels are observed in the groups that received vaccination doses later as planned. Timing of serology determination also influenced RVNA levels significantly (p = 0.000). Antibody levels were significantly higher in females than in males (p = 0.000). Age did influence RVNA levels significantly (p = 0.022). CONCLUSIONS Timing of vaccine dose administration, timing of serology testing, sex and age do significantly influence the humoral B-cell response to ID administered rabies vaccine.
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Affiliation(s)
- Mathias D M Van Nieuwenhove
- Belgian Military Medical Service, Royal Military Academy, Avenue de la Renaissance 30, 1000 Brussels, Belgium
| | - Benjamin Damanet
- Travel Clinic, Centre for Infectious Diseases, Military Hospital Queen Astrid, Rue Bruyn 1, 1120 Neder-Over-Heembeek, Belgium
| | - Patrick Soentjens
- Travel Clinic, Centre for Infectious Diseases, Military Hospital Queen Astrid, Rue Bruyn 1, 1120 Neder-Over-Heembeek, Belgium.,Policlinic, Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
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25
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Cnops L, Huyse T, Maniewski U, Soentjens P, Bottieau E, Van Esbroeck M, Clerinx J. Acute Schistosomiasis With a Schistosoma mattheei × Schistosoma haematobium Hybrid Species in a Cluster of 34 Travelers Infected in South Africa. Clin Infect Dis 2020; 72:1693-1698. [DOI: 10.1093/cid/ciaa312] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 03/25/2020] [Indexed: 12/19/2022] Open
Abstract
Abstract
Background
Diagnosis of schistosomiasis remains elusive soon after infection. We evaluated several diagnostic methods in a cluster of travelers with simultaneous freshwater exposure in South Africa.
Methods
Eosinophil count, schistosome antibody tests, stool and urine microscopy, and serum Dra1 PCR assays were performed at weeks 4–5 (early symptomatic phase), 7–8 (praziquantel treatment), and 13–14 (after treatment). Sequencing was done on serum samples from 3 patients to identify the species.
Results
Of the 34 travelers (16 adults and 18 children), 32 developed symptoms 2–6 weeks after exposure. A raised eosinophil count (>750/µL) was seen in 12 of 33 at weeks 4–5, and in 22 of 34 at weeks 7–8. Schistosoma antibodies were detected in 3 of 33 at weeks 4–5 and in 12 of 34 at weeks 7–8 and weeks 13–14. The Dra1 PCR result was positive in 24 of 33 travelers at weeks 4–5, in 31 of 34 at weeks 7–8, in 25 of 34 at weeks 13–14, and at least once in all. Ova were absent in all urine and stool samples obtained. Sequencing identified Schistosoma mattheei nuclear and Schistosoma haematobium mitochondrial DNA, indicative of a hybrid species.
Conclusions
The Dra1 PCR confirmed the diagnosis in all exposed travelers at a much earlier stage than conventional tests. The causative species is probably an S. mattheei × S. haematobium hybrid.
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Affiliation(s)
- Lieselotte Cnops
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Tine Huyse
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
- Department of Biology, Royal Museum for Central Africa, Tervuren, Belgium
| | - Ula Maniewski
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Joannes Clerinx
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
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26
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Soentjens P, Andries P, Aerssens A, Tsoumanis A, Ravinetto R, Heuninckx W, van Loen H, Brochier B, Van Gucht S, Van Damme P, Van Herrewege Y, Bottieau E. Preexposure Intradermal Rabies Vaccination: A Noninferiority Trial in Healthy Adults on Shortening the Vaccination Schedule From 28 to 7 Days. Clin Infect Dis 2020; 68:607-614. [PMID: 29939243 DOI: 10.1093/cid/ciy513] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/14/2018] [Indexed: 12/25/2022] Open
Abstract
Background The existing 4-week preexposure rabies vaccination schedule is costly and often not practicable. Shorter effective schedules would result in wider acceptance. Methods We conducted a noninferiority trial in 500 healthy adults comparing the safety and immunogenicity of a 2-visit (days 0 and 7) intradermal (ID) primary vaccination (2 doses of 0.1 mL ID of the human diploid cell culture rabies vaccine [HDCV] at days 0 and 7) vs a standard 3-visit schedule (single dose of 0.1 mL ID at days 0, 7, and 28). One year to 3 years after primary vaccination, a single booster dose of 0.1 mL ID of HDCV was given to evaluate the anamnestic rabies antibody response. The primary endpoint for immunogenicity was the percentage of subjects with an adequate antibody level >0.5 IU/mL 7 days after the booster injection. The safety endpoint was the proportion of participants developing adverse reactions following the primary vaccination and/or booster dose. Results All subjects in both study groups possessed a rabies antibody titer >0.5 IU/mL on day 7 following the booster dose. Following the booster dose, subjects exposed to the double-dose 2-visit ID schedule had a geometric mean titer of 37 IU/mL, compared with 25 IU/mL for the single-dose 3-visit schedule (P < .001). Local reactions at the injection site following primary vaccination were mild and transient. Conclusions In healthy adults, ID administration of a double dose of 0.1 mL of HDCV over 2 visits (days 0 and 7) was safe and not inferior to the single-dose 3-visit schedule. Clinical Trials Registration NCT01388985, EudraCT 2011-001612-62.
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Affiliation(s)
- Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels.,Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp
| | - Petra Andries
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels
| | - Annelies Aerssens
- Center for Vaccinology, Ghent University Hospital.,Department of Internal Medicine and Infectious Diseases, Ghent University Hospital
| | | | | | - Walter Heuninckx
- Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels
| | - Harry van Loen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp
| | | | | | - Pierre Van Damme
- Center for the Evaluation of Vaccination, University of Antwerp, Belgium
| | - Yven Van Herrewege
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp
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27
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Soentjens P. Improved information tools and measures are needed for the last-minute traveller. J Travel Med 2020; 27:5671716. [PMID: 31821496 DOI: 10.1093/jtm/taz097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/27/2019] [Accepted: 12/04/2019] [Indexed: 01/11/2023]
Affiliation(s)
- Patrick Soentjens
- Department of Clinical Sciences, Policlinic, Medical services, Nationalestraat 155, 2000 Antwerp, Belgium
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28
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Abstract
Background: A patient presenting with fever and purpura after a stay in the tropics tempts a physician to make a differential diagnosis mainly focusing on imported diseases. Although the importance of considering a tropical disease is obvious, the fact that cosmopolitan infections account for one third of the cases in a febrile returning traveler must not be overseen. Toxic Shock Syndrome is amongst the most notorious diseases due to the high mortality when inappropriately managed and the association with necrotizing fasciitis. Methods : We present a 60-year old female with fever, shock syndrome and progressive appearance of painful purpura on the lower legs after a 2-week holiday in Zanzibar. Results : The patient was diagnosed with Streptococcal Toxic Shock Syndrome. Treatment focusing on aggressive fluid resuscitation, prompt administration of antibiotics (ceftriaxon, doxycycline and one dose of amikacin) and adjunctive treatment by clindamycin and immunoglobulin was initiated. She was also immediately taken into surgery for a bilateral fasciotomy and surgical exploration of the lower legs. Histology appeared compatible with purpura fulminans, thereby excluding necrotizing fasciitis. No source of infection could be identified. Conclusion: Toxic Shock Syndrome remains a challenging diagnosis and even more in a returning traveler with an extensive differential diagnosis containing both tropical and cosmopolitan diseases. Cornerstones for the treatment of Streptococcal Toxic Shock Syndrome are abrupt administration of antimicrobial therapy comprising beta-lactam antibiotics and clindamycin and surgical exploration to apply source control when indicated.
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Affiliation(s)
- Stéphanie Note
- Medical Component, Royal Military Academy, Brussels, Belgium
- Emergency Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Patrick Soentjens
- Center for Infectious Diseases ID4C, Military Hospital Queen Astrid, Brussels, Belgium
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Marie Van Laer
- Emergency Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Philippe Meert
- Emergency Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Peter Vanbrabant
- Center for Infectious Diseases ID4C, Military Hospital Queen Astrid, Brussels, Belgium
- General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
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29
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Onsea J, Soentjens P, Djebara S, Merabishvili M, Depypere M, Spriet I, De Munter P, Debaveye Y, Nijs S, Vanderschot P, Wagemans J, Pirnay JP, Lavigne R, Metsemakers WJ. Bacteriophage Application for Difficult-to-treat Musculoskeletal Infections: Development of a Standardized Multidisciplinary Treatment Protocol. Viruses 2019; 11:v11100891. [PMID: 31548497 PMCID: PMC6832313 DOI: 10.3390/v11100891] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 12/19/2022] Open
Abstract
Bacteriophage therapy has recently attracted increased interest, particularly in difficult-to-treat infections. Although it is not a novel concept, standardized treatment guidelines are currently lacking. We present the first steps towards the establishment of a "multidisciplinary phage task force" (MPTF) and a standardized treatment pathway, based on our experience of four patients with severe musculoskeletal infections. After review of their medical history and current clinical status, a multidisciplinary team found four patients with musculoskeletal infections eligible for bacteriophage therapy within the scope of Article 37 of the Declaration of Helsinki. Treatment protocols were set up in collaboration with phage scientists and specialists. Based on the isolated pathogens, phage cocktails were selected and applied intraoperatively. A draining system allowed postoperative administration for a maximum of 10 days, 3 times per day. All patients received concomitant antibiotics and their clinical status was followed daily during phage therapy. No severe side-effects related to the phage application protocol were noted. After a single course of phage therapy with concomitant antibiotics, no recurrence of infection with the causative strains occurred, with follow-up periods ranging from 8 to 16 months. This study presents the successful outcome of bacteriophage therapy using a standardized treatment pathway for patients with severe musculoskeletal infection. A multidisciplinary team approach in the form of an MPTF is paramount in this process.
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Affiliation(s)
- Jolien Onsea
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium.
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Patrick Soentjens
- Centre for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium.
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium.
| | - Sarah Djebara
- Centre for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium.
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium.
| | - Melissa Depypere
- Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Isabel Spriet
- Pharmacy Department, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Paul De Munter
- Department of General Internal Medicine, University Hospitals Leuven, 3000 Leuven, Belgium.
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium.
| | - Yves Debaveye
- Department of Intensive Care Medicine, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Stefaan Nijs
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium.
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Paul Vanderschot
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium.
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Jeroen Wagemans
- Laboratory of Gene Technology, KU Leuven, 3001 Leuven, Belgium.
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium.
| | - Rob Lavigne
- Laboratory of Gene Technology, KU Leuven, 3001 Leuven, Belgium.
| | - Willem-Jan Metsemakers
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium.
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
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30
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Djebara S, Maussen C, De Vos D, Merabishvili M, Damanet B, Pang KW, De Leenheer P, Strachinaru I, Soentjens P, Pirnay JP. Processing Phage Therapy Requests in a Brussels Military Hospital: Lessons Identified. Viruses 2019; 11:v11030265. [PMID: 30884879 PMCID: PMC6466067 DOI: 10.3390/v11030265] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/10/2019] [Accepted: 03/14/2019] [Indexed: 12/18/2022] Open
Abstract
There is a growing interest in phage therapy as a complementary tool against antimicrobial resistant infections. Since 2007, phages have been used sporadically to treat bacterial infections in well-defined cases in the Queen Astrid military hospital (QAMH) in Brussels, Belgium. In the last two years, external requests for phage therapy have increased significantly. From April 2013 to April 2018, 260 phage therapy requests were addressed to the QAMH. Of these 260 requests, only 15 patients received phage therapy. In this paper, we analyze the phage therapy requests and outcomes in order to improve upon the overall capacity for phage therapy at the QAMH.
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Affiliation(s)
- Sarah Djebara
- Center for Infectious diseases ID4C, Queen Astrid military hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
| | - Christiane Maussen
- Center for Infectious diseases ID4C, Queen Astrid military hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
| | - Daniel De Vos
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
| | - Maya Merabishvili
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
| | - Benjamin Damanet
- Center for Infectious diseases ID4C, Queen Astrid military hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
| | - Kim Win Pang
- Center for Infectious diseases ID4C, Queen Astrid military hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
| | - Peggy De Leenheer
- Center for Infectious diseases ID4C, Queen Astrid military hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
| | - Isabella Strachinaru
- Center for Infectious diseases ID4C, Queen Astrid military hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
| | - Patrick Soentjens
- Center for Infectious diseases ID4C, Queen Astrid military hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
| | - Jean-Paul Pirnay
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
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31
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Jennes S, Merabishvili M, Soentjens P, Pang KW, Rose T, Keersebilck E, Soete O, François PM, Teodorescu S, Verween G, Verbeken G, De Vos D, Pirnay JP. Use of bacteriophages in the treatment of colistin-only-sensitive Pseudomonas aeruginosa septicaemia in a patient with acute kidney injury-a case report. Crit Care 2017; 21:129. [PMID: 28583189 PMCID: PMC5460490 DOI: 10.1186/s13054-017-1709-y] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Serge Jennes
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | - Maia Merabishvili
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Patrick Soentjens
- Phage therapy center, Queen Astrid military hospital, Brussels, Belgium
| | - Kim Win Pang
- Phage therapy center, Queen Astrid military hospital, Brussels, Belgium
| | - Thomas Rose
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | | | - Olivier Soete
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | | | - Simona Teodorescu
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | - Gunther Verween
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium.
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Huits R, Soentjens P, Maniewski-Kelner U, Theunissen C, Van Den Broucke S, Florence E, Clerinx J, Vlieghe E, Jacobs J, Cnops L, Van Den Bossche D, Van Esbroeck M, Bottieau E. Clinical Utility of the Nonstructural 1 Antigen Rapid Diagnostic Test in the Management of Dengue in Returning Travelers With Fever. Open Forum Infect Dis 2017; 4:ofw273. [PMID: 28480265 PMCID: PMC5414095 DOI: 10.1093/ofid/ofw273] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 12/29/2016] [Indexed: 11/17/2022] Open
Abstract
Background Rapid diagnostic test (RDT) detecting the nonstructural 1 (NS1) antigen is increasingly used for dengue diagnosis in endemic and nonendemic settings, but its clinical utility has not been studied in travel clinic practice. Methods From August 2012 to July 2016, travelers returning from the tropics with fever were evaluated in the Institute of Tropical Medicine (Antwerp, Belgium) with the routine use of NS1 antigen RDT that provided results within 1 hour. We determined the diagnostic performance, assessed the management of patients with a positive RDT result, and compared it with that of historical cases of dengue diagnosed from 2000 to 2006, when only antibody detection assays were available. Results Of 335 travelers evaluated for fever, 54 (16%) were diagnosed with dengue, including 1 severe case. Nonstructural 1 antigen RDT was performed in 308 patients. It was truly positive in 43 of 52 tested dengue cases and falsely positive in only 1 of the 256 nondengue cases; therefore, sensitivity was 82.7% (95% confidence interval [CI], 74.4%–93.0%) and specificity was 99.6% (95% CI, 98.8%–100%). Only 3 (7%) of the 43 febrile travelers “immediately” diagnosed by RDT were admitted, and only 2 (5%) were given empirical antibacterial treatment, without adverse outcome. Admission and antibiotic prescription rates were significantly higher in the historical cases (n = 43) diagnosed by antibody detection (33%, P = .006 and 26%, P = .014, respectively), although the frequency of severe dengue was similar. Conclusions In our practice, the diagnostic performance of NS1 antigen RDT substantially contributed in withholding unnecessary hospitalization and antibiotherapy in dengue patients.
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Affiliation(s)
- Ralph Huits
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ula Maniewski-Kelner
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Caroline Theunissen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Eric Florence
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jan Clerinx
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Erika Vlieghe
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Unit of Tropical Diseases, University Hospital of Antwerp, Belgium
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Microbiology and Immunology, University of Leuven, Belgium
| | - Lieselotte Cnops
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Note S, Vanbrabant P, Soentjens P. Perianal lesions after return from Togo: An isolated cutaneous manifestation of schistosomiasis. Acta Clin Belg 2016; 71:431-434. [PMID: 27075797 DOI: 10.1080/17843286.2016.1138591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Isolated perianal lesions in a returned traveller from Togo were observed. Eosinophilia was the lead to schistosomiasis, although no systemic symptoms were reported. This case report of cutaneous schistosomiasis demonstrates the importance of a travel history, especially geographic and exposure features, and treats the differential diagnosis of eosinophilia in a returned traveller with skin lesions.
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Soentjens P, Cnops L, Huyse T, Yansouni C, De Vos D, Bottieau E, Clerinx J, Van Esbroeck M. Diagnosis and Clinical Management of Schistosoma haematobium-Schistosoma bovis Hybrid Infection in a Cluster of Travelers Returning From Mali. Clin Infect Dis 2016; 63:1626-1629. [PMID: 27941144 DOI: 10.1093/cid/ciw493] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/13/2016] [Indexed: 11/12/2022] Open
Abstract
Ten Belgian travelers returned from Mali with a Schistosoma haematobium-Schistosoma bovis hybrid infection, confirmed by DNA sequencing from eggs. Clinical symptoms and laboratory findings resembled those of classic acute schistosomiasis, but the detected eggs were morphologically unusual.
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Affiliation(s)
- Patrick Soentjens
- Department of Clinical Sciences, Institute for Tropical Medicine, Antwerp.,Centre for Infectious Diseases, Polyclinic Department
| | - Lieselotte Cnops
- Department of Clinical Sciences, Institute for Tropical Medicine, Antwerp
| | - Tine Huyse
- Department of Biomedical Sciences, Institute for Tropical Medicine, Antwerp.,Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Belgium
| | - Cedric Yansouni
- J.D. MacLean Centre for Tropical Diseases.,Divisions of Infectious Diseases and Medical Microbiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid, Military Hospital, Brussels
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute for Tropical Medicine, Antwerp
| | - Jan Clerinx
- Department of Clinical Sciences, Institute for Tropical Medicine, Antwerp
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De Vos D, Pirnay JP, Bilocq F, Jennes S, Verbeken G, Rose T, Keersebilck E, Bosmans P, Pieters T, Hing M, Heuninckx W, De Pauw F, Soentjens P, Merabishvili M, Deschaght P, Vaneechoutte M, Bogaerts P, Glupczynski Y, Pot B, van der Reijden TJ, Dijkshoorn L. Molecular Epidemiology and Clinical Impact of Acinetobacter calcoaceticus-baumannii Complex in a Belgian Burn Wound Center. PLoS One 2016; 11:e0156237. [PMID: 27223476 PMCID: PMC4880317 DOI: 10.1371/journal.pone.0156237] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 05/11/2016] [Indexed: 12/21/2022] Open
Abstract
Multidrug resistant Acinetobacter baumannii and its closely related species A. pittii and A. nosocomialis, all members of the Acinetobacter calcoaceticus-baumannii (Acb) complex, are a major cause of hospital acquired infection. In the burn wound center of the Queen Astrid military hospital in Brussels, 48 patients were colonized or infected with Acb complex over a 52-month period. We report the molecular epidemiology of these organisms, their clinical impact and infection control measures taken. A representative set of 157 Acb complex isolates was analyzed using repetitive sequence-based PCR (rep-PCR) (DiversiLab) and a multiplex PCR targeting OXA-51-like and OXA-23-like genes. We identified 31 rep-PCR genotypes (strains). Representatives of each rep-type were identified to species by rpoB sequence analysis: 13 types to A. baumannii, 10 to A. pittii, and 3 to A. nosocomialis. It was assumed that isolates that belonged to the same rep-type also belonged to the same species. Thus, 83.4% of all isolates were identified to A. baumannii, 9.6% to A. pittii and 4.5% to A. nosocomialis. We observed 12 extensively drug resistant Acb strains (10 A. baumannii and 2 A. nosocomialis), all carbapenem-non-susceptible/colistin-susceptible and imported into the burn wound center through patients injured in North Africa. The two most prevalent rep-types 12 and 13 harbored an OXA-23-like gene. Multilocus sequence typing allocated them to clonal complex 1 corresponding to EU (international) clone I. Both strains caused consecutive outbreaks, interspersed with periods of apparent eradication. Patients infected with carbapenem resistant A. baumannii were successfully treated with colistin/rifampicin. Extensive infection control measures were required to eradicate the organisms. Acinetobacter infection and colonization was not associated with increased attributable mortality.
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Affiliation(s)
- Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- * E-mail:
| | - Florence Bilocq
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Serge Jennes
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Thomas Rose
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | | | - Petra Bosmans
- Hospital Hygiene and Infection Control Team, Queen Astrid Military Hospital, Brussels, Belgium
| | - Thierry Pieters
- Hospital Hygiene and Infection Control Team, Queen Astrid Military Hospital, Brussels, Belgium
| | - Mony Hing
- Clinical Laboratory, Queen Astrid Military Hospital, Brussels, Belgium
| | - Walter Heuninckx
- Clinical Laboratory, Queen Astrid Military Hospital, Brussels, Belgium
| | - Frank De Pauw
- Medical Communication and Information Systems, ACOS WB/Health Division, Queen Astrid Military Hospital, Brussels, Belgium
| | - Patrick Soentjens
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- Laboratory Bacteriology Research, University of Ghent, Ghent, Belgium
| | - Pieter Deschaght
- Laboratory Bacteriology Research, University of Ghent, Ghent, Belgium
| | | | - Pierre Bogaerts
- Laboratoire de Bactériologie, CHU Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Youri Glupczynski
- Laboratoire de Bactériologie, CHU Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Bruno Pot
- Applied Maths, Sint-Martens-Latem, Belgium
| | - Tanny J. van der Reijden
- Department of Infectious Diseases C5-P, Leiden University Medical Center, Leiden, The Netherlands
| | - Lenie Dijkshoorn
- Department of Infectious Diseases C5-P, Leiden University Medical Center, Leiden, The Netherlands
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Aerssens A, Cochez C, Niedrig M, Heyman P, Kühlmann-Rabens I, Soentjens P. Analysis of delayed TBE-vaccine booster after primary vaccination. J Travel Med 2016; 23:tav020. [PMID: 26858269 DOI: 10.1093/jtm/tav020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 11/10/2015] [Indexed: 11/14/2022]
Abstract
An open, uncontrolled single centre study was conducted in the Travel Clinic at the Military Hospital, Brussels. Eighty-eight subjects were recruited who had a primary series of tick-borne encephalitis (TBE) vaccine more than 5 years ago and who never received a booster dose afterwards. Response rate after booster vaccination was very high: 84 out of 88 subjects (95.5%) had neutralizing antibodies on plaque reduction neutralization test and all (100%) had IgG antibodies on ELISA, on Day 21-28 after booster vaccination. This study adds valuable information to the common situation of delayed booster interval. The results of our study indicate that in young healthy travellers (<50 years), one booster vaccination after a primary series of TBE vaccine in the past is sufficient to obtain protective antibodies, even if primary vaccination is much longer than the recommended booster interval of 5 years.
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Affiliation(s)
- Annelies Aerssens
- Centre for Vaccinology, Ghent University Hospital and Travel Clinic, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium,
| | - Christel Cochez
- Research Laboratory for Vector-Borne Diseases, Military Hospital, Brussels, Belgium
| | - Matthias Niedrig
- Centre for Biological Safety, Robert Koch Institute, Berlin, Germany
| | - Paul Heyman
- Research Laboratory for Vector-Borne Diseases, Military Hospital, Brussels, Belgium
| | | | - Patrick Soentjens
- Centre For Infectious Diseases, Military Hospital, Brussels, Belgium and Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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37
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Menten K, Soentjens P, Caenepeel P, Lemkens P. Mucocutaneous leishmaniasis of the nose: a case report. B-ENT 2015; 11:77-80. [PMID: 26513953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Mucocutaneous leishmaniasis of the nose: a case report. Leishmaniasis is a parasitic infection that is rarely seen in Belgium. The majority of new diagnoses are seen in patients living in or visiting endemic regions, which are mostly developing countries. Here we describe the case of a 60-year-old male patient who was referred to an ENT specialist because of an erythematous swelling of the left side of the nose tip, which had persisted for 3 months. Biopsies showed the presence of leishmaniasis. This case report alerts ENT physicians that leishmaniasis is part of the differential diagnosis in patients who present with an uncommon persistent lesion in the head and neck region and who have travelled to endemic regions or are immunodeficient.
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Kenyon C, Lynen L, Florence E, Caluwaerts S, Vandenbruaene M, Apers L, Soentjens P, Van Esbroeck M, Bottieau E. Syphilis reinfections pose problems for syphilis diagnosis in Antwerp, Belgium - 1992 to 2012. ACTA ACUST UNITED AC 2014; 19:20958. [PMID: 25411690 DOI: 10.2807/1560-7917.es2014.19.45.20958] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Persons with multiple syphilis reinfections may play an important role in syphilis transmission. We analysed all syphilis tests carried out for people attending the HIV/sexually transmitted infection (STI) clinic at the Institute of Tropical Medicine, Antwerp, Belgium, from 1992 to 2012 to evaluate the extent to which syphilis reinfections were contributing to the syphilis epidemic in Antwerp. We then characterised the features of the syphilis infections in individuals with five or more episodes of syphilis. A total of 729 syphilis episodes were diagnosed in 454 persons. The majority of syphilis episodes occurred in people who had more than one episode of syphilis (445/729; 61%). A total of 10 individuals had five or more episodes of syphilis diagnosed over this period. All were men who have sex with men, HIV positive and on antiretroviral therapy. They had a total of 52 episodes of syphilis diagnosed and treated. In 38/42 of the episodes of repeat syphilis in these 10 individuals, they presented without any signs or symptoms of syphilis. Given that the majority of cases of incident syphilis in our clinic were persons with reinfections and that they frequently presented without signs of symptoms of syphilis, there is a strong case for frequent and repeated screening in all persons with a diagnosis of syphilis.
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Affiliation(s)
- C Kenyon
- Institute for Tropical Medicine, Antwerp, Belgium
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Soentjens P, Ruyffelaert M, Collée A, Haverals S, Van Gompel A, Bottieau E. Follow-up of treatment response in imported acute schistosomiasis. J Travel Med 2014; 21:433-4. [PMID: 25345986 DOI: 10.1111/jtm.12148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Patrick Soentjens
- Centre for Infectious Diseases, Policlinic Department, Military Hospital, Brussels, Belgium; Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Affiliation(s)
- Patrick Soentjens
- Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium; Center for Infectious Diseases, Military Hospital, Brussels, Belgium
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Geeraerts P, Collee A, Soentjens P. A large single-center retrospective analysis of neutralizing antibodies after intradermal pre-exposure rabies vaccination. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.1325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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42
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Soentjens P, Ostyn B, Clerinx J, Van Gompel A, Colebunders R. A CASE OF MULTIPLE AMOEBIC LIVER ABSCESSES: CLINICAL IMPROVEMENT AFTER PERCUTANEOUS ASPIRATION. Acta Clin Belg 2014. [DOI: 10.1179/acb.2005.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Cnops L, Soentjens P, Clerinx J, Van Esbroeck M. A Schistosoma haematobium-specific real-time PCR for diagnosis of urogenital schistosomiasis in serum samples of international travelers and migrants. PLoS Negl Trop Dis 2013; 7:e2413. [PMID: 24009791 PMCID: PMC3757062 DOI: 10.1371/journal.pntd.0002413] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 07/27/2013] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Diagnosis of urogenital schistosomiasis by microscopy and serological tests may be elusive in travelers due to low egg load and the absence of seroconversion upon arrival. There is need for a more sensitive diagnostic test. Therefore, we developed a real-time PCR targeting the Schistosoma haematobium-specific Dra1 sequence. METHODOLOGY/PRINCIPAL FINDINGS The PCR was evaluated on urine (n = 111), stool (n = 84) and serum samples (n = 135), and one biopsy from travelers and migrants with confirmed or suspected schistosomiasis. PCR revealed a positive result in 7/7 urine samples, 11/11 stool samples and 1/1 biopsy containing S. haematobium eggs as demonstrated by microscopy and in 22/23 serum samples from patients with a parasitological confirmed S. haematobium infection. S. haematobium DNA was additionally detected by PCR in 7 urine, 3 stool and 5 serum samples of patients suspected of having schistosomiasis without egg excretion in urine and feces. None of these suspected patients demonstrated other parasitic infections except one with Blastocystis hominis and Entamoeba cyst in a fecal sample. The PCR was negative in all stool samples containing S. mansoni eggs (n = 21) and in all serum samples of patients with a microscopically confirmed S. mansoni (n = 22), Ascaris lumbricoides (n = 1), Ancylostomidae (n = 1), Strongyloides stercoralis (n = 1) or Trichuris trichuria infection (n = 1). The PCR demonstrated a high specificity, reproducibility and analytical sensitivity (0.5 eggs per gram of feces). CONCLUSION/SIGNIFICANCE The real-time PCR targeting the Dra1 sequence for S. haematobium-specific detection in urine, feces, and particularly serum, is a promising tool to confirm the diagnosis, also during the acute phase of urogenital schistosomiasis.
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Affiliation(s)
- Lieselotte Cnops
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
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Aerssens A, De Vos D, Pirnay JP, Yansouni C, Clerinx J, Van Gompel A, Soentjens P. Schistosomiasis in Belgian Military Personnel Returning From the Democratic Republic of Congo. Mil Med 2011; 176:1341-6. [DOI: 10.7205/milmed-d-11-00023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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46
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Eshun-Wilson I, Havers F, Nachega JB, Prozesky HW, Taljaard JJ, Zeier MD, Cotton M, Simon G, Soentjens P. Evaluation of paradoxical TB-associated IRIS with the use of standardized case definitions for resource-limited settings. ACTA ACUST UNITED AC 2010; 9:104-8. [PMID: 20160249 DOI: 10.1177/1545109710361537] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Standardized case definitions have recently been proposed by the International Network for the Study of HIV-associated immune reconstitution inflammatory syndrome (INSHI; [IRIS]) for use in resource-limited settings. We evaluated paradoxical tuberculosis (TB)-associated IRIS in a large cohort from a TB endemic setting with the use of these case definitions. DESIGN A retrospective cohort study. METHOD We reviewed records from 1250 South African patients who initiated antiretroviral therapy (ART) over a 5-year period. RESULTS A total of 333 (27%) of the patients in the cohort had prevalent TB at the initiation of ART. Of 54 possible paradoxical TB-associated IRIS cases, 35 fulfilled the INSHI case definitions (11% of TB cases). CONCLUSIONS INSHI-standardized case definitions were used successfully in identifying paradoxical TB-associated IRIS in this cohort and resulted in a similar proportion of TB IRIS cases (11%) as that reported in previous studies from resource-limited settings (8%-13%). This case definition should be evaluated prospectively.
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Affiliation(s)
- Ingrid Eshun-Wilson
- Division of Infectious Diseases, Department of Internal Medicine, Tygerberg Academic Hospital, Stellenbosch University, Cape Town, South Africa.
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Florence E, Bottieau E, Boer M, Vekemans M, Francque S, Vlieghe E, Soentjens P, Colebunders R. Acute hepatitis C infection in a cohort of HIV-infected patients in Belgium. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
Mefloquine is indicated as oral treatment and as prophylaxis for malaria in areas where chloroquine-resistant malaria is present. Gastrointestinal and neuropsychiatric side effects of mefloquine are well known. More severe neuropsychiatric disorders such as psychosis, depression, hallucinations, and seizures are also reported in the literature. We are reporting a case of drug-induced pneumonia due to mefloquine. This diagnosis was confirmed 4 months after the adverse event, after restarting the same malaria prophylaxis, which could be considered as an unintentional provocation test. This is the third case report in the literature of acute lung injury caused by mefloquine.
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Affiliation(s)
- Patrick Soentjens
- Department of Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium
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Soentjens P, Ostyn B, Van Outryve S, Ysebaert D, Vekemans M, Colebunders R. Portal vein thrombosis in a patient with HIV treated with a protease inhibitor-containing regimen. Acta Clin Belg 2006; 61:24-9. [PMID: 16673613 DOI: 10.1179/acb.2006.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We report a case of an HIV seropositive female patient treated with a protease inhibitor-containing regimen who developed recurrent severe life-threathening episodes of haematemesis over time, caused by ruptured oesophageal varices as a consequence of a portal vein thrombosis. Coagulation tests revealed a protein S deficiency, an elevated homocysteinemia and a constitutional elevated plasma factor VIII coagulant activity. These coagulopathies and the HIV infection are independent risk factors for developing venous thromboembolic events. The protease inhibitor treatment may have played a role in increasing the thromboembolic risk. The recurrent bleedings only stopped after invasive surgery. The invasive splenorenal shunt operation was in this case a life-saving procedure.
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Affiliation(s)
- P Soentjens
- Department of Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium
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Eshun-Wilson I, Soentjens P, Zeier M, Taljaard J. Symptomatic hyperlactataemia and lactic acidosis in the era of highly active antiretroviral therapy. S Afr Med J 2005; 95:929-30. [PMID: 16465351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
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