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Zhu Y, Restrepo AC, Wang HB, Mills DJ, Liang RR, Liu ZB, Lau CL, Furuya-Kanamori L. Malaria cases in China acquired through international travel, 2013-2022. J Travel Med 2024:taae056. [PMID: 38591791 DOI: 10.1093/jtm/taae056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/27/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Despite the World Health Organisation certifying China malaria-free in 2021, the risk of local transmission caused by imported malaria cases remains a significant clinical and public health issue. It is necessary to present the changing trends of malaria in China and discuss the role of travel medicine services in consolidating malaria elimination. METHODS This study systematically reviewed articles and reports related to human malaria from 2013 to 2022 published in international and Chinese databases. Data on malaria (i.e. number of cases, Plasmodium spp., diagnostic method, country of acquisition, provinces with high risk of re-introduction and transmission) were collected and synthesised, then summarised using descriptive statistics. RESULTS Overall, 24 758 cases of malaria (>99.5% laboratory confirmed, > 99.2% imported, 0.5% fatal) were reported in China from 2013 to 2022, with a downward trend over the years (4128 cases in 2013 compared to 843 cases in 2022; χ2 trend p-value = 0.005). The last locally acquired case was reported in 2017. P. falciparum (65.5%) was the most common species identified, followed by P. vivax (20.9%) and P. ovale (10.0%). Two Pheidole knowlesi cases were also identified in 2014 and 2017 in returned travellers from Malaysia and Indonesia, respectively. The most common countries of malaria acquisition were Ghana, Angola, and Myanmar. P. vivax was mainly detected in returned travellers from Myanmar, while P. falciparum and P. ovale were detected in travellers from Sub-Saharan Africa. Imported cases were mainly reported in Yunnan, Jiangsu, Sichuan, Guangxi, Shandong, Zhejiang, and Henan provinces, where large numbers of Chinese people travel overseas for work. CONCLUSION Returned travellers from malaria-endemic countries pose a significant risk of malaria re-introduction to China. Travel medicine should be strengthened to improve the capacity and accessibility of both pre- and post-travel services, including malaria prophylaxis and prompt diagnosis of illness in returned travellers.
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Affiliation(s)
- Yan Zhu
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
- Zhuhai International Travel Healthcare Center of China Customs, Zhuhai, China
| | - Angela Cadavid Restrepo
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
| | - Hai-Bo Wang
- Zhuhai International Travel Healthcare Center of China Customs, Zhuhai, China
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Rong-Rong Liang
- Guangzhou International Travel Healthcare Center of China Customs, GuangZhou, China, and
| | - Zhi-Bin Liu
- Fangshan District Center for Disease Control and Prevention, Beijing, China
| | - Colleen L Lau
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
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2
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Grahn E, Picard J, Henning L. Yellow fever - An old foe with new developments. Aust J Rural Health 2024. [PMID: 38506501 DOI: 10.1111/ajr.13101] [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] [Received: 07/10/2023] [Revised: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Yellow fever is caused by an RNA flavivirus. Immunisation in conjunction with vector control is at the forefront of yellow fever control and elimination. OBJECTIVE This narrative review describes the impact and importance of yellow fever vaccinations for northern Australian health practitioners. DESIGN Selected key policies, studies and medical guidelines are reviewed and presented. FINDING Large yellow fever outbreaks, associated with vector spread, have occurred in the last decade in Africa and South America, increasing the risk of international spread of the virus. Mobile populations, like travellers or migrant workers, continue to be at risk of yellow fever. Quality assurance, including yellow fever centre accreditation and initiatives to decrease fraudulent yellow fever vaccination documentation, has evolved in the past few years. Fractional dosing of yellow fever vaccines has been shown to provide protection for 1 year in outbreak scenarios, but further studies are needed. DISCUSSION Although Australia is yellow fever-free, the disease could be introduced by viraemic persons as a competent Aedes mosquito vector is present in northern Australia. In addition to surveillance and vector control, health education and yellow fever vaccination remain the best lines of defence. In the event of an outbreak, a response via fractional dosing could prove to be effective in controlling the virus. CONCLUSION Health care providers in northern Australia should be aware of the risks of yellow fever and its introduction to northern Australia and be able to discuss vaccination status with their clients when needed.
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Affiliation(s)
- Emily Grahn
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Jacqueline Picard
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Lars Henning
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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3
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Wollet C, Milliron ML. A Rare Case of Cutaneous Leishmaniasis Presenting to the Emergency Department of a Large Community Hospital. Cureus 2024; 16:e56658. [PMID: 38646325 PMCID: PMC11032212 DOI: 10.7759/cureus.56658] [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] [Received: 12/12/2023] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Cutaneous leishmaniasis should be considered a possible cause of skin ulcers in a patient who has traveled abroad recently and comes to the emergency department (ED) for an assessment. Before getting an accurate diagnosis, ED assessment, and proper treatment with intravenous amphotericin B, the patient presented to several other healthcare providers. This case displays the importance of a multidisciplinary approach with consultation from infectious diseases to determine an accurate diagnosis and effective treatment plan for patients with cutaneous leishmaniasis.
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Affiliation(s)
- Cally Wollet
- Emergency Medicine, Allegheny Health Network, Saint Vincent Hospital, Erie, USA
| | - Melody L Milliron
- Emergency Medicine, Allegheny Health Network, Saint Vincent Hospital, Erie, USA
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Almogbel ES, Almutairi SM, Almuzaini AS, Alduraibi AA, Almutairi A, Almarshad AS, Altwaijri M, Alharbi S. The Knowledge, Attitudes, and Practices of Primary Healthcare Physicians in the Al Qassim Region, Saudi Arabia Regarding Travel Medicine: A Cross-Sectional Study. Cureus 2024; 16:e52772. [PMID: 38389614 PMCID: PMC10882419 DOI: 10.7759/cureus.52772] [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] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Background and objective In the age of globalization, diseases associated with travel have emerged as a focal point of public health interest. This has become particularly relevant in Saudi Arabia after the changes in tourism policy in recent years. Primary care physicians are expected to suspect diseases of importance in certain geographic areas. They should dispense pre- and post-travel advice. This study aimed to assess the knowledge, attitudes, and practices of primary care physicians in the Al Qassim region, Saudi Arabia regarding travel medicine. Methods This cross-sectional study was conducted in the Al Qassim region, Saudi Arabia between October and November 2023. We reached out to all primary care physicians in the region regardless of their gender, nationality, and years of experience. The data were collected using a self-administered questionnaire, which was designed based on the available literature and validated by experts. Results A total of 197 physicians participated in the study; 74% were male, 46% were general practitioners, and 48% had 5-10 years of experience. More than half (51%) of the participants reported a weekly patient load of 50-100, while 47% engaged with 5-10 travelers annually; 53% provided travel health advice and a quarter of primary healthcare physicians never attended travel update sessions or conferences. In the last six months, 48% and 43% of the physicians conducted pre- and post-travel consultations respectively. Approximately 49.2% demonstrated a fair knowledge of the topic. Factors associated with fair knowledge included non-Saudi nationality, age below 30 years, minimal traveler exposure, and infrequent conference attendance (p<0.05). A positive attitude was linked to being under 30 years old, having <5 years of experience, seeing <5 travelers yearly, and possessing a fair knowledge of the topic (p<0.05). Conclusions Overall, about half of the physicians in the Al Qassim region engage with travelers and demonstrate good attitudes and practices toward travel medicine. Opening Saudi borders to tourism necessitates the inclusion of travel medicine in continuing medical education programs to prepare primary care physicians to care for travelers more efficiently.
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Affiliation(s)
- Ebtehal S Almogbel
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraydah, SAU
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5
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Maier JD, Anagnostopoulos A, Gazzotti A, Bühler S, Baroutsou V, Hatz C, Puhan MA, Fehr J, Farnham A. The Ready-To-Go Questionnaire predicts health outcomes during travel: a smartphone application-based analysis. J Travel Med 2023; 30:taad117. [PMID: 37669125 PMCID: PMC10755167 DOI: 10.1093/jtm/taad117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/24/2023] [Accepted: 08/31/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND The Ready-To-Go (R2G) Questionnaire is a tool for rapid assessment of health risks for travel consultation. This study aims to assess the utility of the R2G Questionnaire in identifying high-risk travellers and predicting health events and behaviour during travel in the TOURIST2 prospective cohort. METHODS TOURIST2 data were used to calculate the R2G medical and travel risk scores and categorize each participant based on their risk. The TOURIST2 study enrolled 1000 participants from Switzerland's largest travel clinics between 2017 and 2019. Participants completed daily smartphone application surveys before, during and after travel on health events and behaviours. We used regression models to analyse incidence of overall health events and of similar health events grouped into health domains (e.g. respiratory, gastrointestinal, accident/injury). Incidence rate ratios (IRR) are displayed with 95% confidence intervals (95% CI). RESULTS R2G high-risk travellers experienced significantly greater incidence of health events compared to lower-risk travellers (IRR = 1.27, 95% CI: 1.22-1.33). Both the medical and travel scores showed significant positive associations with incidence of health events during travel (IRR = 1.11, 95% CI: 1.07-1.16; IRR = 1.07, 95% CI: 1.03-1.12, respectively), with significant increases in all health domains except skin disorders. Medical and travel risk scores were associated with different patterns in behaviour. Travellers with chronic health conditions accessed medical care during travel more often (IRR = 1.16, 95% CI: 1.03-1.31), had greater difficulty in carrying out planned activities (IRR = -0.04, 95% CI: -0.05, -0.02), and rated their travel experience lower (IRR = -0.04, 95% CI: -0.06, -0.02). Travellers with increased travel-related risks due to planned travel itinerary had more frequent animal contact (IRR = 1.09, 95% CI: 1.01-1.18) and accidents/injuries (IRR = 1.28, 95% CI: 1.15-1.44). CONCLUSIONS The R2G Questionnaire is a promising risk assessment tool that offers a timesaving and reliable means to identify high-risk travellers. Incorporated into travel medicine websites, it could serve as a pre-consultation triage to help travellers self-identify their risk level, direct them to the appropriate medical provider(s), and help practitioners in giving more tailored advice.
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Affiliation(s)
- Julian D Maier
- Department of Public & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Alexia Anagnostopoulos
- Department of Public & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Anna Gazzotti
- Department of Public & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Silja Bühler
- Division of Hygiene and Infectious Diseases, Institute of Hygiene and Environment, Hamburg, Germany
| | - Vasiliki Baroutsou
- Department of Public & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Christoph Hatz
- Department of Public & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Milo A Puhan
- Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Jan Fehr
- Department of Public & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Andrea Farnham
- Department of Public & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Jerome D, Stacey M, Newbigging J. Twinkle Artifact Observed During POCUS of a Human Myiasis Caused by the Dermatobia hominisBotfly. POCUS J 2023; 8:142-145. [PMID: 38099171 PMCID: PMC10721296 DOI: 10.24908/pocus.v8i2.16712] [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] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
An 81-year-old man presented to urgent care for assessment of an area of erythema and tenderness on his right thigh after recent travel to Belize. Point of care ultrasound (POCUS) revealed a hyperechoic structure with acoustic shadowing in the subcutaneous tissue. Colour Doppler assessment of the structure produced a twinkle artifact. The structure was removed and pathology identified the object as a Dermatobia hominis larva (human botfly). The use of POCUS helped identify and localize the subcutaneous foreign body. The use of colour Doppler produced the twinkle artifact, which has not been previously reported as a finding produced during ultrasonographic assessment of botfly larvae.
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Affiliation(s)
- David Jerome
- Northern Ontario School of Medicine UniversityThunder Bay, ONCanada
- Department of Medicine, Queen's UniversityKingston, ONCanada
| | - Matthew Stacey
- Department of Medicine, Queen's UniversityKingston, ONCanada
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Martins-Filho PR, Araújo FWC, Lima SVMA, Santiago BM, Damascena NP, Araújo APD, Silva MC, Machado CEP. Imported cases of malaria in Brazil from South American countries: a retrospective ecological study from 2009 to 2022. J Travel Med 2023; 30:taad078. [PMID: 37289500 DOI: 10.1093/jtm/taad078] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/09/2023]
Abstract
The Legal Amazon region serves as a hotspot for imported malaria from other South American countries, with over 75% of cases concentrated in municipalities that cover extensive Indigenous territories. These areas have witnessed substantial escalations in deforestation and illegal mining activities over the years.
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Affiliation(s)
| | | | | | - Bianca Marques Santiago
- Center for Forensic Medicine and Dentistry, Institute of Science Police of Paraiba, Paraiba, Brazil
- Federal University of Paraiba, Paraiba Brazil
| | - Nicole Prata Damascena
- Federal University of Sergipe, Sergipe, Brazil
- Technical Police Department, Bahia, Brazil
| | - Analany Pereira Dias Araújo
- National Center for the Dissemination of Forensic Sciences, Brazilian Federal Police, Distrito Federal, Brazil
- National Institute of Criminalistics, Brazilian Federal Police, Distrito Federal, Brazil
| | - Melina Calmon Silva
- National Center for the Dissemination of Forensic Sciences, Brazilian Federal Police, Distrito Federal, Brazil
| | - Carlos Eduardo Palhares Machado
- National Center for the Dissemination of Forensic Sciences, Brazilian Federal Police, Distrito Federal, Brazil
- National Institute of Criminalistics, Brazilian Federal Police, Distrito Federal, Brazil
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Riccò M, Corrado S, Marchesi F, Bottazzoli M. Tick-Borne Encephalitis Virus Vaccination among Tourists in a High-Prevalence Area (Italy, 2023): A Cross-Sectional Study. Trop Med Infect Dis 2023; 8:491. [PMID: 37999610 PMCID: PMC10674593 DOI: 10.3390/tropicalmed8110491] [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] [Received: 10/12/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023] Open
Abstract
Tick-borne encephalitis (TBE) represents a potential health threat for tourists in high-risk areas, including the Dolomite Mountains in northeastern Italy. The present questionnaire-based survey was, therefore, designed in order to assess knowledge, attitudes, and preventive practices (KAP) in a convenience sample of Italian tourists visiting the Dolomite Mountains, who were recruited through online discussion groups. A total of 942 participants (39.2% males, with 60.2% aged under 50) filled in the anonymous survey from 28 March 2023 to 20 June 2023. Overall, 24.1% of participants were vaccinated against TBE; 13.8% claimed to have previously had tick bites, but no cases of TBE were reported. The general understanding of TBE was relatively low; while 79.9% of participants acknowledged TBE as a potentially severe disease, its occurrence was acknowledged as high/rather high or very high in the Dolomites area by only 51.6% of respondents. Factors associated with the TBE vaccine were assessed by the calculation of adjusted odds ratios (aOR) and 95% confidence intervals through a logistic regression analysis model. Living in areas considered at high risk for TBE (aOR 3.010, 95%CI 2.062-4.394), better knowledge on tick-borne disorders (aOR 1.515, 95%CI 1.071-2.142), high risk perception regarding tick-borne infections (aOR 2.566, 95%CI 1.806-3.646), a favorable attitude toward vaccinations (aOR 3.824, 95%CI 1.774-8.224), and a tick bite(s) in a previous season (aOR 5.479, 95%CI 3.582-8.382) were characterized as being positively associated with TBE vaccination uptake. Conversely, being <50 years old (aOR 0.646, 95%CI, 0.458-0.913) and with a higher risk perception regarding the TBE vaccine (aOR 0.541, 95%CI 0.379-0.772) were identified as the main barriers to vaccination. In summary, tourists to the high-risk area of the Dolomites largely underestimate the potential occurrence of TBE. Even though the uptake of the TBE vaccine in this research was in line with European data, public health communication on TBE is required in order to improve acceptance of this effective preventive option.
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Affiliation(s)
- Matteo Riccò
- Occupational Health and Safety Service on the Workplace/Servizio di Prevenzione e Sicurezza Ambienti di Lavoro (SPSAL), Department of Public Health, AUSL–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Silvia Corrado
- ASST Rhodense, Dipartimento della donna e Area Materno-Infantile, UOC Pediatria, 20024 Garbagnate Milanese, Italy;
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy;
| | - Marco Bottazzoli
- Department of Otorhinolaryngology, APSS Trento, 31223 Trento, Italy;
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Tunali V, Korkmaz M. Emerging and Re-Emerging Parasitic Infections of the Central Nervous System (CNS) in Europe. Infect Dis Rep 2023; 15:679-699. [PMID: 37987400 PMCID: PMC10660548 DOI: 10.3390/idr15060062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/12/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023] Open
Abstract
In a rapidly evolving global landscape characterized by increased international travel, migration, and ecological shifts, this study sheds light on the emergence of protozoal and helminthic infections targeting the central nervous system (CNS) within Europe. Despite being traditionally associated with tropical regions, these infections are progressively becoming more prevalent in non-endemic areas. By scrutinizing the inherent risks, potential outcomes, and attendant challenges, this study underscores the intricate interplay between diagnostic limitations, susceptibility of specific population subsets, and the profound influence of climate fluctuations. The contemporary interconnectedness of societies serves as a conduit for introducing and establishing these infections, warranting comprehensive assessment. This study emphasizes the pivotal role of heightened clinician vigilance, judicious public health interventions, and synergistic research collaborations to mitigate the potential consequences of these infections. Though rare, their profound impact on morbidity and mortality underscores the collective urgency required to safeguard the neurological well-being of the European populace. Through this multifaceted approach, Europe can effectively navigate the complex terrain posed with these emergent infections.
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Affiliation(s)
- Varol Tunali
- Department of Parasitology, Faculty of Medicine, Manisa Celal Bayar University, 45030 Manisa, Turkey
- Department of Emergency Medicine, Izmir Metropolitan Municipality Eşrefpaşa Hospital, 35170 Izmir, Turkey
| | - Metin Korkmaz
- Department of Parasitology, Faculty of Medicine, Ege University, 35100 Izmir, Turkey;
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Milionis C, Ilias I, Tselebis A, Pachi A. Psychological and Social Aspects of Vaccination Hesitancy-Implications for Travel Medicine in the Aftermath of the COVID-19 Crisis: A Narrative Review. Medicina (Kaunas) 2023; 59:1744. [PMID: 37893462 PMCID: PMC10608755 DOI: 10.3390/medicina59101744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
Vaccines are an important tool of preventive medicine. Although organized vaccination programs have saved large populations from serious infectious diseases, there is a considerable part of the population who oppose vaccinations. In particular, anti-vaccination perceptions, among travelers to countries with endemic diseases, are a major public health concern. Although hesitancy towards vaccinations is not a novel phenomenon, it came back to the forefront during the fight against the COVID-19 pandemic. This review explores the etiology of anti-vaccination beliefs among travelers and draws conclusions about their impact on public health and society in general. For this purpose, a purposeful search for data on the causative factors of vaccine hesitancy and their impact on people's health was conducted. A descriptive analysis of the findings and conclusions regarding possible implications in health policy and clinical practice are presented. A fear of side effects, lack of credence in the necessity of vaccines, and mistrust of medical authorities are important causative factors. Their interplay shapes hesitancy towards vaccines. However, anti-vaccination beliefs can also be an aspect of a more general unconventional stance of life. Health care professionals and organizations must be ready to tackle vaccine hesitancy by making the necessary interventions. Correcting misconceptions about vaccinations is a prerequisite for ensuring personal and public health, especially in the context of a pandemic or epidemic. Moreover, ensuring the efficacy and safety of vaccines, especially in cases of modern technology applications, is a fundamental factor in addressing people's concerns about vaccines. For this purpose, medical authorities and organizations must provide accurate and clear information on vaccines so as to eliminate misinformation. Furthermore, clinicians should cultivate their communication skills in order to convey the appropriate messages to prospective recipients of vaccinations.
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Affiliation(s)
- Charalampos Milionis
- Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou General and Maternity Hospital, GR-11521 Athens, Greece;
| | - Ioannis Ilias
- Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou General and Maternity Hospital, GR-11521 Athens, Greece;
| | - Athanasios Tselebis
- Department of Psychiatry, Sotiria Thoracic Diseases Hospital of Athens, GR-11527 Athens, Greece; (A.T.); (A.P.)
| | - Argyro Pachi
- Department of Psychiatry, Sotiria Thoracic Diseases Hospital of Athens, GR-11527 Athens, Greece; (A.T.); (A.P.)
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11
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Chivinski J, Nathan K, Naeem F, Ekmekjian T, Libman MD, Barkati S. Intravenous Liposomal Amphotericin B Efficacy and Safety for Cutaneous and Mucosal Leishmaniasis: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2023; 10:ofad348. [PMID: 37520422 PMCID: PMC10372713 DOI: 10.1093/ofid/ofad348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/08/2023] [Indexed: 08/01/2023] Open
Abstract
Background Tegumentary leishmaniasis is often subject to limited funding, underpowered studies, and a paucity of high-quality interventional studies. Intravenous liposomal amphotericin B (L-AmB) has been increasingly used to treat cutaneous and mucosal leishmaniasis (CL and ML, respectively) despite the lack of well-conducted interventional studies. We conducted a systematic review to consolidate the descriptive evidence on the efficacy and safety of L-AmB in treating CL and ML. Methods Several online databases and the reference lists of included studies were searched to extract data from 132 studies comprising both case reports and case series. The population, intervention, comparison, outcome, and study design strategy and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. Results Of 132 studies included, 92 were case reports and 40 were case series. Of the 92 cases, 65 (82.3%) were considered cured after receiving L-AmB as part of their treatment regimen. Twenty-one of the 92 (22.8%) cases reported adverse reactions to L-AmB. A pooled cure rate of 87.0% (95% CI, 79.0%-92.0%) was reported for the 38 case series that reported on treatment efficacy; 40.7% of the cases were associated with an adverse reaction. Conclusions Observational data on cure rates using L-AmB suggest efficacy between 80% and 90%, similar to rates reported for other antileishmanial drugs. The highest efficacy rates were observed when a single cycle of L-AmB was administered to patients with mild-moderate CL and ML. The limitations of this study include the heterogeneity observed among the included studies and the increased likelihood of publication bias associated with the inclusion of case reports and case series. This systematic review further illustrates the need for high-quality comparative trials of intravenous L-AmB for the treatment of tegumentary leishmaniasis.
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Affiliation(s)
| | | | - Faheel Naeem
- J.D. MacLean Centre for Tropical Diseases at McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Taline Ekmekjian
- Medical Libraries, McGill University Health Centre, Montreal, Quebec, Canada
| | - Michael D Libman
- Correspondence: Sapha Barkati, MD, MSc, FRCPC, DTM&H, CTropMed, J.D. MacLean Centre for Tropical Diseases at McGill University, 1001 Boulevard Decarie, Montreal, Quebec, Canada, H4A 3J1 (); or Michael Libman, MD, J.D. MacLean Centre for Tropical Diseases at McGill University, 1001 Boulevard Decarie, Montreal, Quebec, Canada, H4A 3J1 ()
| | - Sapha Barkati
- Correspondence: Sapha Barkati, MD, MSc, FRCPC, DTM&H, CTropMed, J.D. MacLean Centre for Tropical Diseases at McGill University, 1001 Boulevard Decarie, Montreal, Quebec, Canada, H4A 3J1 (); or Michael Libman, MD, J.D. MacLean Centre for Tropical Diseases at McGill University, 1001 Boulevard Decarie, Montreal, Quebec, Canada, H4A 3J1 ()
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12
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Lim BWW, Flaherty GT. Journal author funding sources and conflict of interest disclosures in travel medicine. J Travel Med 2023; 30:taad046. [PMID: 37040343 DOI: 10.1093/jtm/taad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 04/12/2023]
Abstract
Highlight Failure to fully disclose conflicts of interest and funding sources in biomedical and clinical research erodes public confidence in the academic integrity of research publications. This study is the first of its kind to analyse the funding and conflict disclosures in a leading travel medicine journal.
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Affiliation(s)
- Bryan W W Lim
- School of Medicine, University of Galway, Galway, Ireland
| | - Gerard T Flaherty
- School of Medicine, University of Galway, Galway, Ireland
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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Itzkowitz E, Alpert EA, Farojeh AZ, Zimmerman DR, Schwartz E, Lachish T. Morbidity of Returning Travelers Seen in Community Urgent Care Centers throughout Israel. Trop Med Infect Dis 2023; 8:319. [PMID: 37368737 DOI: 10.3390/tropicalmed8060319] [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] [Received: 04/20/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Information regarding post-travel morbidity is usually reported via dedicated post-travel clinics and mainly relates to travelers returning from low-middle-income countries (LMIC), however, the spectrum of morbidity seen within the community setting is scarcely reported. This prospective observational study among visitors to 17 community Urgent Care Centers (UCC) was designed to evaluate the reasons for post-travel community clinic visits and to compare travelers returning from LMIC to high-income countries (HIC). All visitors within one-month post-travel to all destinations were included. A total of 1580 post-travel visits were analyzed during 25 months. Travelers to LMICs were younger (mean 36.8 years old vs. 41.4 in the HIC group) and stayed longer periods abroad (30.1 ± 41.2 vs. 10.0 ± 10.6 in the HIC group) but more of them had pre-travel vaccines (35.5% vs. 6.6%). Travel-related morbidity was significantly more common in the LMIC group 58.3% (253/434) vs. 34.1% (391/1146) in the HIC group, (p < 0.001). Acute diarrhea was the leading cause of morbidity after visiting LMIC (28.8%) and was significantly more common than in the HIC (6.6%, p < 0.001). Other common morbidities in the LMIC cohort were respiratory (23.3%), cutaneous (15.8%), and injuries (9.9%). In the HIC group, the common morbidities were respiratory (37.3%), and diarrhea composed only 6.6% of the complaints. Our study group represents a less biased sample of travelers to LMIC as well as HIC, therefore, data from the UCC setting and at the specialized travel clinics complete each other in understanding the true extent of morbidity in travelers.
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Affiliation(s)
- Eyal Itzkowitz
- Nephrology Unit, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
| | - Evan A Alpert
- Department of Emergency Medicine, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9101001, Israel
| | | | - Deena R Zimmerman
- TEREM Urgent Care Centers, Jerusalem 9439029, Israel
- Maternal Child and Adolescent Department, Public Health Division, Israel Ministry of Health, Jerusalem 9446724, Israel
| | - Eli Schwartz
- The Center for Geographic Medicine and Tropical Diseases, The Chaim Sheba Medical Center, Tel Hashomer 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Tamar Lachish
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9101001, Israel
- The Infectious Diseases Unit, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
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14
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Chuan BC, Zulkufli NS, Rajesvaran C, Yon R, Khee SL. Lessons from the Lab: SARS-CoV-2 Detection Rate amongst the Vaccinated Travel Lane and Non-Vaccinated Travel Lane Travellers into Malaysia. Malays J Med Sci 2023; 30:153-160. [PMID: 37102055 PMCID: PMC10125236 DOI: 10.21315/mjms2023.30.2.14] [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] [Received: 06/09/2022] [Accepted: 09/09/2022] [Indexed: 04/28/2023] Open
Abstract
Background The vaccinated travel lane (VTL) between Malaysia and Singapore was implemented to facilitate travelling between countries without the need for quarantine. Objectives i) Observe the rate of positive SARS-CoV-2 test results amongst inbound international travellers; ii) Explore possible factors associated with the outcome of test results between VTL and non-VTL travellers. Method This is a retrospective cross-sectional study involving air travellers arriving in Malaysia via the Kuala Lumpur International Airport (KLIA) or Kuala Lumpur International Airport 2 (KLIA2) who were tested for SARS-CoV-2 by reverse transcriptase polymerase chain reaction (RT-PCR) from 29 November 2021 to 15 March 2022. Subject demographics and RT-PCR results were retrieved from the laboratory information system and statistically analysed. Results Out of 118,902 travellers, mostly were Malaysian nationals (62.7%) and VTL travellers (68.2%) with a median age of 35 years old. A total of 699 (0.6%) of travellers tested positive on arrival, out of which 70.2% had cycle threshold (Ct) values > 30 (70.8% of VTL and 70.0% of non-VTL cohorts). Non-VTL travellers were 4.5 times more likely to test positive compared with VTL travellers (1.25% versus 0.28%; P < 0.001). Conclusion Tighter entry requirements including vaccination status and testing frequency, the use of sensitive detection methods on arrival and similar public health policies between countries may have contributed to the VTL being a safe and cost-effective mode of travel.
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Affiliation(s)
- Beh Chun Chuan
- BP Clinical Lab Sdn Bhd, Temasya@Glenmarie, Selangor, Malaysia
| | | | | | - Rohaizat Yon
- BP Clinical Lab Sdn Bhd, Temasya@Glenmarie, Selangor, Malaysia
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15
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Halani S, Bogoch II. Weight-related malaria treatment failure with artemether-lumefantrine. J Travel Med 2023; 30:7084880. [PMID: 36951994 DOI: 10.1093/jtm/taad036] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 03/24/2023]
Abstract
A 52-year-old male with no past medical history travelled from Canada to Nigeria for work. Eight days after returning to Canada he experienced fevers and night sweats, and self-tested with a BinaxNow malaria kit (Abbott, Chicago, IL) that was positive for Plasmodium falciparum. He self-initiated treatment with four tablets of combined artemether (20 mg) and lumefantrine (120 mg) (AL) twice daily for three days. He was adherent to this therapy. His fevers abated and he made a self-described complete clinical recovery within 5 days. His symptoms returned two and a half weeks after completing AL and he presented to the Emergency Department with a temperature of 40 degrees Celsius, chills, lethargy, non-bloody diarrhoea, and back pain, and was admitted to hospital. Two malaria thick and thin smears confirmed Plasmodium falciparum with parasitemia of 0.4%. He was diagnosed with uncomplicated malaria and initiated on a three-day course of combined atovaquone (250 mg) plus proguanil (100 mg), four tablets per day for three days. He rapidly defervesced within 24 hours, his parasitemia resolved two days after initiating therapy, and had an uneventful and full recovery.
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Affiliation(s)
- Sheliza Halani
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Isaac I Bogoch
- Department of Medicine, University of Toronto, Toronto, Canada
- Divisions of Infectious Diseases and General Internal Medicine, University Health Network, Toronto, Canada
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16
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Wilkinson EA, Newell BJ, Melton BL, Robertson AD. Community-Based Pharmacy Travel Health Service Pilot Impact on Participant Understanding and Satisfaction. J Pharm Pract 2023; 36:33-38. [PMID: 34096391 DOI: 10.1177/08971900211017093] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Increased rates of international travel have led to a higher demand for healthcare professionals to provide travel health services. Community-based pharmacists are capable of meeting this need. OBJECTIVE This study evaluates the impact of pharmacists providing travel health services in a community-based pharmacy on participant understanding and satisfaction of travel education and preparation. METHOD A trained pharmacist met with participants to review their medical history, travel itinerary, and provide education. Indicated immunizations were administered and the participant's primary care provider was contacted if prescription medications were warranted. A questionnaire was administered before and after the travel health consultation assessing participants perceived understanding of travel health information, satisfaction, and perceived monetary value of the service. Data were collected by 5-point Likert-scale responses, with 5 equivalent to strongly agree. Wilcoxon signed-rank test and descriptive statistics were used for evaluation. Participants were included if they had international travel planned within 12 weeks of the consultation. RESULTS A total of 12 participants were included. Participant understanding significantly increased for all 5 survey items relating to travel health information with a p value < 0.05 for each item. The largest change was for how to find medical help during international travel (medians and IQR were 3(2-3), and 5(5-5) for pre-and post-consultation, respectively, p = 0.003). Participant satisfaction questions received a median response of 5. Participants' perceived monetary value of the service was a median of $50 (IQR $50-50). CONCLUSION Pharmacist-led travel health consultations improved participant understanding of travel health information and was of perceived value.
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Affiliation(s)
- Erica A Wilkinson
- 24130Salina Regional Health Center Outpatient Pharmacy, Salina, KS, USA
| | - Bradley J Newell
- Department of Pharmacy Practice, 4202University of Kansas School of Pharmacy-Wichita Campus, Wichita, KS, USA
| | - Brittany L Melton
- Department of Pharmacy Practice, 4202University of Kansas School of Pharmacy, Lawrence, KS, USA
| | - Amy D Robertson
- Department of Pharmacy Practice, 4202University of Kansas School of Pharmacy-Wichita Campus, Wichita, KS, USA
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17
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Mastroianni A, Greco S, Vangeli V, Mauro MV, Greco F, Manfredi R. Lambliasis-associated Schönlein-Henoch purpura in an Italian traveller: first case report in Italy. Int Marit Health 2023; 74:89-91. [PMID: 37417841 DOI: 10.5603/imh.2023.0013] [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: 01/24/2023] [Revised: 04/05/2023] [Accepted: 05/02/2023] [Indexed: 07/08/2023] Open
Abstract
A unique report of Schönlein-Henoch purpura (SHP) associated with a recent Giardia lamblia enteric infection is described and discussed on the ground of the available literature. Tinidazole plus an appropriate probiotic therapy, including Lactobacillus reuteri and vitamin D, proved to be effective in the condition. SHP is an immunocomplex-mediated disorder characterised by a number of differently associated signs and symptoms, leading to the possible involvement of the skin, joints, abdomen and kidneys. Recent bacterial, viral, or protozoan infections may trigger the disease onset in patients of all ages. The paper describes the first case of SHP triggered by a giardiasis. Tinidazole plus an appropriate probiotic therapy, i.e. L. reuteri and vitamin D proved to be effective in this condition. To our knowledge, this is the first reported case of lambliasis-associated SHP described in an international traveller.
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Affiliation(s)
- Antonio Mastroianni
- Infectious and Tropical Diseases Unit, "Annunziata" Hub Hospital, Azienda Ospedaliera di Cosenza, Cosenza, Italy.
| | - Sonia Greco
- Infectious and Tropical Diseases Unit, "Annunziata" Hub Hospital, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - Valeria Vangeli
- Infectious and Tropical Diseases Unit, "Annunziata" Hub Hospital, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - Maria Vittoria Mauro
- Microbiology and Virology Unit, "Annunziata" Hub Hospital, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - Francesca Greco
- Microbiology and Virology Unit, "Annunziata" Hub Hospital, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - Roberto Manfredi
- Infectious Diseases Institute, Alma Mater Studiorum University of Bologna, Bologna, Italy
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18
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Riccò M, Zaniboni A, Satta E, Baldassarre A, Cerviere MP, Marchesi F, Peruzzi S. Management and Prevention of Traveler's Diarrhea: A Cross-Sectional Study on Knowledge, Attitudes, and Practices in Italian Occupational Physicians (2019 and 2022). Trop Med Infect Dis 2022; 7:370. [PMID: 36422921 PMCID: PMC9692574 DOI: 10.3390/tropicalmed7110370] [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] [Received: 10/17/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 07/29/2023] Open
Abstract
Even though Italian Occupational Physicians (OP) are increasingly involved in the managing of overseas workers, their knowledge, attitudes, and practices (KAP) in travel medicine are mostly undefined. We, therefore, permed a KAP study specifically targeting the management of travelers' diarrhea (TD) by OP. A total of 371 professionals (43.4% males; mean age 40.8 ± 10.9 years) completed in 2 rounds (2019 and 2022) a specifically designed web questionnaire that inquired participating OP on their knowledge status (KS), risk perception, and management of TD through pre- and post-travel advice and interventions. Multivariable odds ratios (aOR) for predictors of a better knowledge status were calculated through regression analysis. Eventually, the majority of participants (53.4%) had participated in the management of cases of TD in the previous months, but only 26.4% were reportedly involved in pre-travel consultations. The overall knowledge status was unsatisfying (potential range: 0-100%, actual average of the sample 59.6% ± 14.6), with substantial uncertainties in the management of antimicrobial treatment. Interestingly, only a small subset of participants had previously prescribed antimicrobial prophylaxis or treatment (3.5% and 1.9%, respectively). Main effectors of a better knowledge status were: having a background qualification in Hygiene and Public Health (aOR 14.769, 95%CI 5.582 to 39.073), having previously managed any case of (aOR 3.107, 95%CI 1.484 to 6.506), and having higher concern on TD, reported by acknowledging high frequency (aOR 8.579, 95%CI 3.383 to 21.756) and severity (aOR 3.386; 95%CI 1.741 to 6.585) of this disorder. As the adherence of participating OP to official recommendations for TD management was unsatisfying, continuous Education on Travel Medicine should be improved by sharing up-to-date official recommendations on appropriate treatment options for TD.
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Affiliation(s)
- Matteo Riccò
- Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Department of Public Health, AUSL-IRCCS di Reggio Emilia, I-42122 Reggio Emilia, Italy
| | - Alessandro Zaniboni
- Department of Medicine and Surgery, University of Parma, I-43126 Parma, Italy
| | - Elia Satta
- Department of Medicine and Surgery, University of Parma, I-43126 Parma, Italy
| | - Antonio Baldassarre
- Department of Experimental and Clinical Medicine, University of Florence, I-50134 Florence, Italy
| | | | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, I-43126 Parma, Italy
| | - Simona Peruzzi
- Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, AUSL-IRCCS di Reggio Emilia, I-42016 Guastalla, Italy
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19
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Dorji T, Lhendup K, Gyeltshen K. The Nairobi fly in the Himalayas. J Travel Med 2022; 29:6675647. [PMID: 36006838 DOI: 10.1093/jtm/taac097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022]
Abstract
The Nairobi fly has been sighted in the sub-Himalayan range with an outbreak of Paederus dermatitis in Nepal, Bhutan and north-eastern India in 2022. With increasing international travel and a warmer earth, tropical vectors in non-native regions are an emerging global health challenge.
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Affiliation(s)
- Thinley Dorji
- Department of Internal Medicine, Central Regional Referral Hospital, Gelegphu 31101, Bhutan
| | - Karma Lhendup
- Samtse General Hospital, Ministry of Health, Samtse 22001, Bhutan
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20
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Barkati S, Harrison LB. Monkeypox outbreak 2022: "See one, do one, teach one" no longer the rule. J Assoc Med Microbiol Infect Dis Can 2022; 7:157-158. [PMID: 36337609 PMCID: PMC9629735 DOI: 10.3138/jammi-2022-07-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Sapha Barkati
- Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
- J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Quebec, Canada
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Luke B Harrison
- Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
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21
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Potin M, Calmes JM, De Vallière S. Acute abdomen with haemorrhagic shock while cruising on a private sailboat in the Atlantic Ocean. J Travel Med 2022; 29:6588639. [PMID: 35587361 DOI: 10.1093/jtm/taac062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/14/2022]
Abstract
This case report demonstrates that even in an austere and remote environment (nearly the middle of the Atlantic Ocean), a severe medical case can be handled, but luck was probably part of the positive outcome.
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Affiliation(s)
- Mathieu Potin
- Internal Medicine Unit, Hirslanden Clinic Cecil, Lausanne 1003, Switzerland
| | - Jean-Marie Calmes
- Visceral Surgery Unit, Hirslanden Clinic Cecil, Lausanne 1003, Switzerland
| | - Serge De Vallière
- Hirslanden Clinic Cecil, Switzerland.,University Hospital of Lausanne, Switzerland
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22
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Costello V, Sowash M, Gaur A, Cardis M, Pasieka H, Wortmann G, Ramdeen S. Imported Monkeypox from International Traveler, Maryland, USA, 2021 (Response). Emerg Infect Dis 2022; 28:1739. [PMID: 35798003 PMCID: PMC9328932 DOI: 10.3201/eid2808.220830] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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23
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Shelomi M. Thiamine (vitamin B1) as an insect repellent: a scoping review. Bull Entomol Res 2022; 112:431-440. [PMID: 35199632 DOI: 10.1017/s0007485321001176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
While the desire for systemic repellents is high, ineffective repellents put one at risk of insect-vectored pathogens. Vitamin B1, or thiamine, has been touted as a systemic insect repellent since 1943, and denounced as an ineffective placebo for just as long. This paper presents a scoping review of 104 relevant case reports, research studies, and review articles to trace the evolution of this idea and identify an evidence-based, scientific consensus. Reports of thiamine's systemic repellency are primarily anecdotal and based on uncontrolled trials and/or used bite symptoms as a proxy for reduced biting. Controlled experiments on insect landing and feeding found no evidence of repellency. Of the 49 relevant review papers, 16 insect bite prevention guidelines, and 4 government documents, none after the 1990s claimed thiamine is a repellent. The findings of this review are that thiamine cannot repel arthropods in any dosage or route of administration. Due to limited available evidence, the possibility that thiamine reduces the subjective symptoms of insect bites cannot currently be ruled out. Unfortunately, many medical professionals and travelers today still believe thiamine may be effective despite the evidence stating otherwise. Continued promotion of debunked repellents on the commercial market poses a serious risk in countries with the endemic, mosquito-vectored disease.
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Affiliation(s)
- Matan Shelomi
- Department of Entomology, National Taiwan University, Taipei, Taiwan
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24
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Pender MA, Smith T, Brintz BJ, Pandey P, Shrestha SK, Anuras S, Demons S, Sornsakrin S, Bodhidatta L, Platts-Mills JA, Leung DT. Weather variables as important clinical predictors of bacterial diarrhoea among international travellers. J Travel Med 2022; 29:6520888. [PMID: 35134202 PMCID: PMC9282096 DOI: 10.1093/jtm/taac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/19/2022] [Accepted: 01/27/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Clinicians and travellers often have limited tools to differentiate bacterial from non-bacterial causes of travellers' diarrhoea (TD). Development of a clinical prediction rule assessing the aetiology of TD may help identify episodes of bacterial diarrhoea and limit inappropriate antibiotic use. We aimed to identify predictors of bacterial diarrhoea among clinical, demographic and weather variables, as well as to develop and cross-validate a parsimonious predictive model. METHODS We collected de-identified clinical data from 457 international travellers with acute diarrhoea presenting to two healthcare centres in Nepal and Thailand. We used conventional microbiologic and multiplex molecular methods to identify diarrheal aetiology from stool samples. We used random forest and logistic regression to determine predictors of bacterial diarrhoea. RESULTS We identified 195 cases of bacterial aetiology, 63 viral, 125 mixed pathogens, 6 protozoal/parasite and 68 cases without a detected pathogen. Random forest regression indicated that the strongest predictors of bacterial over viral or non-detected aetiologies were average location-specific environmental temperature and red blood cell on stool microscopy. In 5-fold cross-validation, the parsimonious model with the highest discriminative performance had an area under the receiver operator curve of 0.73 using 3 variables with calibration intercept -0.01 (standard deviation, SD 0.31) and slope 0.95 (SD 0.36). CONCLUSIONS We identified environmental temperature, a location-specific parameter, as an important predictor of bacterial TD, among traditional patient-specific parameters predictive of aetiology. Future work includes further validation and the development of a clinical decision-support tool to inform appropriate use of antibiotics in TD.
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Affiliation(s)
- Melissa A Pender
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Timothy Smith
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Ben J Brintz
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Prativa Pandey
- CIWEC Hospital Director, CIWEC Hospital, Kathmandu 44600, Nepal
| | - Sanjaya K Shrestha
- Department of Bacterial and Parasitic Diseases, Walter Reed/Armed Forces Research Institute of Medical Sciences Research Unit Nepal (WARUN), Kathmandu 44600, Nepal
| | - Sinn Anuras
- Department of Medicine, MedPark Hospital, Bangkok 10110, Thailand
| | - Samandra Demons
- Department of Bacterial and Parasitic Diseases, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand
| | - Siriporn Sornsakrin
- Department of Bacterial and Parasitic Diseases, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand
| | - Ladaporn Bodhidatta
- Department of Bacterial and Parasitic Diseases, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - Daniel T Leung
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
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Lieu A, Mah J, Desgagnés N, Pillai DR. The impact of the COVID-19 pandemic on malaria in returning travellers in Canada: a retrospective population-based cohort study. J Travel Med 2022; 29:6585752. [PMID: 35567486 PMCID: PMC9129210 DOI: 10.1093/jtm/taac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/16/2022] [Accepted: 04/14/2022] [Indexed: 11/28/2022]
Abstract
In high-income, low-prevalence settings, travel patterns largely govern malaria transmission; the COVID-19 pandemic has led to travel restrictions resulting in a decrease in malaria case incidence. The proportion of travellers seeking pre-travel has decreased; with the easing of borders, an increase in malaria cases may occur.
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Affiliation(s)
- Anthony Lieu
- Division of Infectious Diseases, Department of Medicine, Cummings School of Medicine, University of Calgary, Calgary, Canada
| | - Jordan Mah
- Division of Infectious Diseases, Department of Medicine, Cummings School of Medicine, University of Calgary, Calgary, Canada.,Internal Medicine, Department of Medicine, Cummings School of Medicine, University of Calgary, Calgary, Canada
| | - Noémie Desgagnés
- Division of Internal Medicine, Department of Medicine, Cummings School of Medicine, University of Calgary, Calgary, Canada
| | - Dylan R Pillai
- Division of Infectious Diseases, Department of Medicine, Cummings School of Medicine, University of Calgary, Calgary, Canada.,Department of Pathology and Laboratory Medicine, Cummings School of Medicine, University of Calgary, Calgary, Canada
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26
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Adegboye OA, Eugenia Castellanos M, Alele FO, Pak A, Ezechukwu HC, Hou K, Emeto TI. Travel-Related Monkeypox Outbreaks in the Era of COVID-19 Pandemic: Are We Prepared? Viruses 2022; 14:1283. [PMID: 35746754 PMCID: PMC9228578 DOI: 10.3390/v14061283] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 05/21/2022] [Revised: 06/02/2022] [Accepted: 06/10/2022] [Indexed: 02/01/2023] Open
Abstract
Several neglected infectious pathogens, such as the monkeypox virus (MPXV), have re-emerged in the last few decades, becoming a global health burden. Despite the incipient vaccine against MPXV infection, the global incidence of travel-related outbreaks continues to rise. About 472 confirmed cases have been reported in 27 countries as of 31 May 2022, the largest recorded number of cases outside Africa since the disease was discovered in the early 1970s.
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Affiliation(s)
- Oyelola A. Adegboye
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia; (M.E.C.); (F.O.A.); (T.I.E.)
- World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Maria Eugenia Castellanos
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia; (M.E.C.); (F.O.A.); (T.I.E.)
- World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Faith O. Alele
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia; (M.E.C.); (F.O.A.); (T.I.E.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Anton Pak
- Centre for the Business and Economics of Health, The University of Queensland, Brisbane, QLD 4067, Australia;
| | - Henry C. Ezechukwu
- Department of Medical Biochemistry, Eko University of Medicine and Health Sciences, Ijanikin 102004, Lagos State, Nigeria;
| | - Kay Hou
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia;
| | - Theophilus I. Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia; (M.E.C.); (F.O.A.); (T.I.E.)
- World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
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Abstract
A case of monkeypox was diagnosed in a returning traveler from Nigeria to Maryland, USA. Prompt infection control measures led to no secondary cases in 40 exposed healthcare workers. Given the global health implications, public health systems should be aware of effective strategies to mitigate the potential spread of monkeypox.
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Azadi B, Tantet C, Sylla F, Andro A. Women who have undergone female genital mutilation/cutting's perceptions and experiences with healthcare providers in Paris. Cult Health Sex 2022; 24:583-596. [PMID: 34751634 DOI: 10.1080/13691058.2021.1982010] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Female genital mutilation/cutting (FGM/C) is a health and human rights issue and a dangerous form of gender-based violence. Given migratory flows from the countries in which it is practised, FGM/C concerns a substantial number of women living in Western countries. In this study, we looked at women who had undergone FGM/C experiences with French medical practitioners. We also discussed with them the desirability of screening for, and prevention of, FGM/C in international travel medicine centres. A qualitative approach was used to collect and analyse the data. Focus groups and semi-structured interviews were held with 26 women (24 participants in focus groups and 2 individual interviews). Transcriptions were coded and analysed thematically. All the participants came from sub-Saharan Africa. Their median age was 32.9 years. Persistent silence about FGM/C in the host society following immigration resulted in dissatisfaction with healthcare providers. Participants expected professionals to address the subject of FGM/C, feeling professionals should bring up the subject first so as to put women at ease. International travel medicine centres were discussed by some as a possible means of prevention.
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Affiliation(s)
- Bahar Azadi
- INSERM, CRIDUP, University of Paris 1- Panthéon-Sorbonne, Paris, France
| | | | - Fatoumata Sylla
- INSERM, CRIDUP, University of Paris 1- Panthéon-Sorbonne, Paris, France
| | - Armelle Andro
- INSERM, CRIDUP, University of Paris 1- Panthéon-Sorbonne, Paris, France
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Bangs AC, Gastañaduy P, Neilan AM, Fiebelkorn AP, Walker AT, Rao SR, Ryan ET, LaRocque RC, Walensky RP, Hyle EP. The Clinical and Economic Impact of Measles-Mumps-Rubella Vaccinations to Prevent Measles Importations From US Pediatric Travelers Returning From Abroad. J Pediatric Infect Dis Soc 2022; 11:257-266. [PMID: 35333347 PMCID: PMC9214784 DOI: 10.1093/jpids/piac011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pediatric international travelers account for nearly half of measles importations in the United States. Over one third of pediatric international travelers depart the United States without the recommended measles-mumps-rubella (MMR) vaccinations: 2 doses for travelers ≥12 months and 1 dose for travelers 6 to <12 months. METHODS We developed a model to compare 2 strategies among a simulated cohort of international travelers (6 months to <6 years): (1) No pretravel health encounter (PHE): travelers depart with baseline MMR vaccination status; (2) PHE: MMR-eligible travelers are offered vaccination. All pediatric travelers experience a destination-specific risk of measles exposure (mean, 30 exposures/million travelers). If exposed to measles, travelers' age and MMR vaccination status determine the risk of infection (range, 3%-90%). We included costs of medical care, contact tracing, and lost wages from the societal perspective. We varied inputs in sensitivity analyses. Model outcomes included projected measles cases, costs, and incremental cost-effectiveness ratios ($/quality-adjusted life year [QALY], cost-effectiveness threshold ≤$100 000/QALY). RESULTS Compared with no PHE, PHE would avert 57 measles cases at $9.2 million/QALY among infant travelers and 7 measles cases at $15.0 million/QALY among preschool-aged travelers. Clinical benefits of PHE would be greatest for infants but cost-effective only for travelers to destinations with higher risk for measles exposure (ie, ≥160 exposures/million travelers) or if more US-acquired cases resulted from an infected traveler, such as in communities with limited MMR coverage. CONCLUSIONS Pretravel MMR vaccination provides the greatest clinical benefit for infant travelers and can be cost-effective before travel to destinations with high risk for measles exposure or from communities with low MMR vaccination coverage.
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Affiliation(s)
- Audrey C Bangs
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Paul Gastañaduy
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anne M Neilan
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA,Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA,Division of General Academic Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy Parker Fiebelkorn
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Allison Taylor Walker
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sowmya R Rao
- MGH Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Edward T Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA,Travelers' Advice and Immunization Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Regina C LaRocque
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA,Travelers' Advice and Immunization Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rochelle P Walensky
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA,Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Emily P Hyle
- Corresponding Author: Emily P. Hyle, MD, MSc, Division of Infectious Diseases, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114, USA. E-mail:
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van Gemert C, Tarivonda L, Tapo PS, Natuman S, Clark G, Mariasua J, Scott N, Craig A, Abel M, Cornish MJ, Hellard M, Sacks-Davis R. Mathematical Modeling for Removing Border Entry and Quarantine Requirements for COVID-19, Vanuatu. Emerg Infect Dis 2022; 28:1053-1055. [PMID: 35271791 PMCID: PMC9045451 DOI: 10.3201/eid2805.211757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The Pacific Island country of Vanuatu is considering strategies to remove border restrictions implemented during 2020 to prevent imported coronavirus disease. We performed mathematical modeling to estimate the number of infectious travelers who had different entry scenarios and testing strategies. Travel bubbles and testing on entry have the greatest importation risk reduction.
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Robinson PD, Vaughan S, Missaghi B, Meatherall B, Pattullo A, Kuhn S, Conly J. A case series of infectious complications in medical tourists requiring hospital admission or outpatient home parenteral therapy. J Assoc Med Microbiol Infect Dis Can 2022; 7:64-74. [PMID: 36340853 PMCID: PMC9603019 DOI: 10.3138/jammi-2021-0015] [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] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/09/2021] [Accepted: 09/24/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Travelling for medical care is increasing, and this medical tourism (MT) may have complications, notably infectious diseases (ID). We sought to identify MT-related infections (MTRIs) in a large Canadian health region and estimate resulting costs. METHODS Retrospective and prospective capture of post-MT cases requiring hospital admission or outpatient parenteral antimicrobial therapy was completed by canvassing ID physicians practising in Calgary, Alberta, from January 2017 to July 2019. Cost estimates for management were made with the Canadian Institute for Health Information's (CIHI's) patient cost estimator database tool applied to estimated rates of Canadians engaging in MT from a 2017 Fraser Institute report. RESULTS We identified 12 cases of MT-related infectious syndromes. Eight had microbial etiologies identified. MTs were young (mean 40.3 [SD 12.2] y) and female (n = 11) and pursued surgical treatment (n = 11). Destination countries and surgical procedures varied but were largely cosmetic (n = 5) and orthopaedic (n = 3). Duration to organism identification (mean 5.3 wk) and treatment courses (mean 19 wk) appeared lengthy. CIHI cost estimates for management of relevant infectious complications of our cases ranged from $6,288 to $20,741, with total cost for cases with matching codes (n = 8) totalling $94,290. CONCLUSIONS In our series of MTRIs, etiologic organisms often found in Canadian-performed post-procedural infections were identified, and prolonged treatment durations were noted. Young women pursuing cosmetic surgery may be a population to target with public health measures to reduce the incidence of MTRIs and burden of disease.
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Affiliation(s)
- Paul D Robinson
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Stephen Vaughan
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
- Synder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Bayan Missaghi
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Bonnie Meatherall
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Andrew Pattullo
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Susan Kuhn
- Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - John Conly
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
- Synder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
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32
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Riccò M, Peruzzi S, Balzarini F, Zaniboni A, Ranzieri S. Dengue Fever in Italy: The "Eternal Return" of an Emerging Arboviral Disease. Trop Med Infect Dis 2022; 7:10. [PMID: 35051126 DOI: 10.3390/tropicalmed7010010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/04/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
Enhanced surveillance for dengue virus (DENV) infections in Italy has been implemented since 2012, with annual reports from the National Health Institute. In this study, we summarize available evidence on the epidemiology of officially notified DENV infections from 2010–2021. In total, 1043 DENV infection cases were diagnosed, and most of them occurred in travelers, with only 11 autochthonous cases. The annual incidence rates of DENV infections peaked during 2019 with 0.277 cases per 100,000 (95% confidence interval [95% CI] 0.187–0.267), (age-adjusted incidence rate: 0.328, 95% CI 0.314–0.314). Cases of DENV were clustered during the summer months of July (11.4%), August (19.3%), and September (12.7%). The areas characterized by higher notification rates were north-western (29.0%), and mostly north-eastern Italy (41.3%). The risk for DENV infection in travelers increased in the time period 2015–2019 (risk ratio [RR] 1.808, 95% CI 1.594–2.051) and even during 2020–2021 (RR 1.771, 95% CI 1.238–2.543). Higher risk for DENV was additionally reported in male subjects compared with females subjects, and aged 25 to 44 years, and in individuals from northern and central Italy compared to southern regions and islands. In a multivariable Poisson regression model, the increased number of travelers per 100 inhabitants (incidence rate ratio [IRR] 1.065, 95% CI 1.036–1.096), the incidence in other countries (IRR 1.323, 95% CI 1.165–1.481), the share of individuals aged 25 to 44 years (IRR 1.622, 95% CI 1.338–1.968), and foreign-born residents (IRR 2.717, 95% CI 1.555–3.881), were identified as effectors of annual incidence. In summary, although the circulation of DENV remains clustered among travelers, enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.
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Ortiz-Martínez Y, Rodríguez-Morales AJ, Franco-Paredes C, Chastain DB, Gharamti AA, Vargas Barahona L, Henao-Martínez AF. Monkeypox - a description of the clinical progression of skin lesions: a case report from Colorado, USA. Ther Adv Infect Dis 2022; 9:20499361221117726. [PMID: 35910397 PMCID: PMC9335484 DOI: 10.1177/20499361221117726] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 07/08/2022] [Accepted: 07/19/2022] [Indexed: 12/16/2022] Open
Abstract
A rapidly emerging global outbreak of monkeypox virus infection (MPXV) in over 50 non-endemic countries was identified in May 2022. We report the case and images of a patient with MPXV presenting with genital lesions later complicated by superimposed cellulitis in Colorado, USA. MPXV lesions are susceptible to bacterial superinfection, and with the advent of new cases, the early identification of skin lesions and their evolution during MPXV are imperative for treating clinicians. Clinicians should consider MPXV in differential diagnoses of sexually transmitted diseases presenting with genital lesions.
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Affiliation(s)
- Yeimer Ortiz-Martínez
- Department of Internal Medicine, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Alfonso J Rodríguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | | | - Daniel B Chastain
- Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Albany, GA, USA
| | - Amal A Gharamti
- Department of Internal Medicine, Yale University, Waterbury, CT, USA
| | - Lilian Vargas Barahona
- Division of Infectious Diseases, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Andrés F Henao-Martínez
- Division of Infectious Diseases, School of Medicine, University of Colorado, Anschutz Medical Campus, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO 80045, USA
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Dewart CM, Almeida FA, Koval C, Nowicki S, Gee JE, Elrod MG, Gulvik CA, Salzer JS, de Fijter S, Liu L. Subclinical Burkholderia pseudomallei Infection Associated with Travel to the British Virgin Islands. Emerg Infect Dis 2021; 27:3182-3184. [PMID: 34808079 PMCID: PMC8632167 DOI: 10.3201/eid2712.211816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Phylogenetic analysis of a clinical isolate associated with subclinical Burkholderia pseudomallei infection revealed probable exposure in the British Virgin Islands, where reported infections are limited. Clinicians should consider this geographic distribution when evaluating possible infection among persons with compatible travel history.
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Gustafsson L, James S, Zhang Y, Thozhuthumparambil KP. Fatal case of delayed-onset haemolytic anaemia after oral artemether-lumefantrine. BMJ Case Rep 2021; 14:e245718. [PMID: 34799392 PMCID: PMC8606760 DOI: 10.1136/bcr-2021-245718] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 11/03/2022] Open
Abstract
Artemisinin derivatives are used globally in the management of falciparum malaria. Postartemisinin delayed haemolysis (PADH) is a recognised adverse event contributing to severe anaemia. To the best of our knowledge, we report the first recorded fatal case of PADH. A 60-year-old woman presented with two episodes of collapse at home and feeling generally unwell. She had recently been treated for uncomplicated falciparum malaria 1 month prior with artemether 80 mg/lumefantrine 480 mg in Congo. Her results on admission revealed an anaemia (haemoglobin 43 g/L), raised lactate dehydrogenase and positive direct antiglobulin test that suggested an intravascular haemolytic process. She made a capacitous decision to refuse blood products in line with her personal beliefs. Despite best supportive treatment, she did not survive. This case highlights the importance of postartemisinin follow-up and should encourage discussion and careful consideration of its use in the context of lack of access to/patient refusal of blood products.
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Affiliation(s)
- Lotta Gustafsson
- Department of Acute medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Sunil James
- Department of Acute medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Yimeng Zhang
- Department of Acute medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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Parize P, Poujol P, Conan PL, Kuhmel L, Lucet C, Jidar K, Gominet M, Bourhy H, Ficko C. COVID-19-related travel restrictions temporarily reduced the demand for rabies post-exposure prophylaxis in France. J Travel Med 2021; 28:6369020. [PMID: 34510213 PMCID: PMC8499958 DOI: 10.1093/jtm/taab127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 12/02/2022]
Abstract
Due to travel restrictions, a dramatic decrease of rabies post-exposure demand was observed in 2020 in the Ile-de-France region. The recovery of international travels may lead to a rebound in rabies exposures. This risk need to be anticipated and prevention messages delivered to people travelling to rabies-enzootic countries.
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Affiliation(s)
- Perrine Parize
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Centre for Rabies, WHO Collaborating Centre for Research on Rabies, Paris, France
| | - Philippe Poujol
- Institut Pasteur, Institut Pasteur Medical Center, Rabies Vaccination Clinic, Paris, France
| | - Pierre Louis Conan
- Ecole du Val-de-Grâce French Military Medical Academy, Paris, France.,Bégin Military Training Hospital, French Military Health Service, Rabies Vaccination Clinic, Saint-Mandé, France
| | - Lucie Kuhmel
- Institut Pasteur, Institut Pasteur Medical Center, Rabies Vaccination Clinic, Paris, France
| | - Cora Lucet
- Institut Pasteur, Institut Pasteur Medical Center, Rabies Vaccination Clinic, Paris, France
| | - Kaoutar Jidar
- Institut Pasteur, Institut Pasteur Medical Center, Rabies Vaccination Clinic, Paris, France
| | - Marie Gominet
- Ecole du Val-de-Grâce French Military Medical Academy, Paris, France.,Bégin Military Training Hospital, French Military Health Service, Rabies Vaccination Clinic, Saint-Mandé, France
| | - Hervé Bourhy
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Centre for Rabies, WHO Collaborating Centre for Research on Rabies, Paris, France
| | - Cécile Ficko
- Ecole du Val-de-Grâce French Military Medical Academy, Paris, France.,Bégin Military Training Hospital, French Military Health Service, Rabies Vaccination Clinic, Saint-Mandé, France
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Felkai PP, Flaherty G, Felkai T. International dental tourism in a post-COVID era: pre-travel advice. J Travel Med 2021; 28:6323174. [PMID: 34272850 DOI: 10.1093/jtm/taab108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/12/2022]
Abstract
The most significant risk of dental tourism is the timing of air travel after dental interventions in order to avoid the pain or injury caused by barotrauma. Usually the minimum waiting time should be 24 h, but in some cases, it can be up to 2 weeks.
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Affiliation(s)
- Peter P Felkai
- Travel Medicine Department, Medical School, Debrecen University, Debrecen 4032, Hungary
| | - Gerard Flaherty
- School of Medicine, National University of Ireland Galway, Galway H91, Ireland
| | - Thomas Felkai
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Semmelweis University, Budapest 1082, Hungary
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Sharahili AA, Al-Eanzi F, Ghzwany AA, Alazmi AM, Alhwsawi EA. Knowledge, attitude, and practice of travel medicine among primary health care physicians in the Cluster-1, Riyadh City, Saudi Arabia: A cross-sectional study. J Family Med Prim Care 2021; 10:2587-2593. [PMID: 34568140 PMCID: PMC8415653 DOI: 10.4103/jfmpc.jfmpc_2354_20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/24/2020] [Accepted: 03/17/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction Travel medicine deals with prevention and management of health problems of travelers to avoid or reduce the risk of avoidable illnesses. Primary healthcare physicians are the key individuals to provide the same. The objective of current study was to explore the level of knowledge, attitude, and current practical application of travel medicine among primary health care physicians serving in the Riyadh Health Cluster, Saudi Arabia. Methodology A descriptive cross-sectional study among 210 primary healthcare physicians serving in Riyadh Health Cluster was conducted using a paper-based self-administered questionnaire collecting information on socio-demographic characteristics and knowledge, attitude as well as practice of travel medicine. Results The majority of study participants were females (117, 55.7%) and 63% (n = 133) were non-Saudi physicians. More than 30% that is 66 participants had clinical experience of less than 5 years and around 67% (i.e., 141) participants were serving at the designation of registrar/senior registrar. One hundred sixty-seven participants (79.5%) had ever provided health advice to the travelers. Majority of the study participants had gained information on the travel medicine through Ministry of Health guidelines (66%). Nearly 11.4% participants were not sure about the cause of occurrence of typhoid infection. As reported by 30.5%, travelers never really sought advice on the travel insurance. Nearly 79.5% participants reported to have provided post-travel consultation for diarrhea, followed by respiratory infection (45.2%), fever (42%), and skin problems (21%). Conclusion The knowledge, attitude, and practice of travel medicine among primary healthcare physicians was found to be sub-optimal in Riyadh.
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Affiliation(s)
- Abeer Ahmed Sharahili
- Family Medicine Resident, Family Medicine Academy at King Saud Medical City, Riyadh, Saudi Arabia
| | - Fayiz Al-Eanzi
- Consultant Family Medicine and Medical Education, Academic Affairs King Salman Hospital, Riyadh, Saudi Arabia
| | - Amal Ahmed Ghzwany
- Family Medicine Resident, Family Medicine Academy at King Saud Medical City, Riyadh, Saudi Arabia
| | - Alhanouf Mamluh Alazmi
- Family Medicine Resident, Family Medicine Academy at King Saud Medical City, Riyadh, Saudi Arabia
| | - Esra Ali Alhwsawi
- Family Medicine Resident, Family Medicine Academy at King Saud Medical City, Riyadh, Saudi Arabia
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Serrano D, Santos-Reis A, Silva C, Dias A, Dias B, Toscano C, Conceição C, Baptista-Fernandes T, Nogueira F. Imported Malaria in Portugal: Prevalence of Polymorphisms in the Anti-Malarial Drug Resistance Genes pfmdr1 and pfk13. Microorganisms 2021; 9:microorganisms9102045. [PMID: 34683365 PMCID: PMC8538333 DOI: 10.3390/microorganisms9102045] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 02/04/2023] Open
Abstract
Malaria is one of the ‘big three’ killer infectious diseases, alongside tuberculosis and HIV. In non-endemic areas, malaria may occur in travelers who have recently been to or visited endemic regions. The number of imported malaria cases in Portugal has increased in recent years, mostly due to the close relationship with the community of Portuguese language countries. Samples were collected from malaria-infected patients attending Centro Hospitalar Lisboa Ocidental (CHLO) or the outpatient clinic of Instituto de Higiene e Medicina Tropical (IHMT-NOVA) between March 2014 and May 2021. Molecular characterization of Plasmodium falciparum pfk13 and pfmdr1 genes was performed. We analyzed 232 imported malaria cases. The majority (68.53%) of the patients came from Angola and only three patients travelled to a non-African country; one to Brazil and two to Indonesia. P. falciparum was diagnosed in 81.47% of the cases, P. malariae in 7.33%, P. ovale 6.47% and 1.72% carried P. vivax. No mutations were detected in pfk13. Regarding pfmdr1, the wild-type haplotype (N86/Y184/D1246) was also the most prevalent (64.71%) and N86/184F/D1246 was detected in 26.47% of the cases. The typical imported malaria case was middle-aged male, traveling from Angola, infected with P. falciparum carrying wild type pfmdr1 and pfk13. Our study highlights the need for constant surveillance of malaria parasites imported into Portugal as an important pillar of public health.
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Affiliation(s)
- Debora Serrano
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa (IHMT-NOVA), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (D.S.); (A.S.-R.); (C.S.); (B.D.); (C.C.)
| | - Ana Santos-Reis
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa (IHMT-NOVA), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (D.S.); (A.S.-R.); (C.S.); (B.D.); (C.C.)
| | - Clemente Silva
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa (IHMT-NOVA), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (D.S.); (A.S.-R.); (C.S.); (B.D.); (C.C.)
| | - Ana Dias
- Laboratório de Microbiologia Clínica e Biologia Molecular, Serviço de Patologia Clínica, Centro Hospitalar Lisboa Ocidental (CHLO), Rua da Junqueira 126, 1349-019 Lisboa, Portugal; (A.D.); (C.T.); (T.B.-F.)
| | - Brigite Dias
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa (IHMT-NOVA), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (D.S.); (A.S.-R.); (C.S.); (B.D.); (C.C.)
| | - Cristina Toscano
- Laboratório de Microbiologia Clínica e Biologia Molecular, Serviço de Patologia Clínica, Centro Hospitalar Lisboa Ocidental (CHLO), Rua da Junqueira 126, 1349-019 Lisboa, Portugal; (A.D.); (C.T.); (T.B.-F.)
| | - Cláudia Conceição
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa (IHMT-NOVA), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (D.S.); (A.S.-R.); (C.S.); (B.D.); (C.C.)
| | - Teresa Baptista-Fernandes
- Laboratório de Microbiologia Clínica e Biologia Molecular, Serviço de Patologia Clínica, Centro Hospitalar Lisboa Ocidental (CHLO), Rua da Junqueira 126, 1349-019 Lisboa, Portugal; (A.D.); (C.T.); (T.B.-F.)
| | - Fatima Nogueira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa (IHMT-NOVA), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (D.S.); (A.S.-R.); (C.S.); (B.D.); (C.C.)
- Correspondence: ; Tel.: +351-213652600
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40
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Camprubí-Ferrer D, Rodriguez-Valero N, Muelas M, Almuedo-Riera A, Romero L, Muñoz J. Blister beetle dermatitis with mirror lesions in a cluster of travellers from Kenya. J Travel Med 2021; 28:6193610. [PMID: 33772574 DOI: 10.1093/jtm/taab052] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/12/2022]
Abstract
After returning from Kenya, a 20-year-old Caucasian girl presented with multiple itching and burning erythematous skin lesions in her limbs, which progressively evolved to pustulous linear lesions, some of them with mirror distribution. Toxic ‘dermatitis linearis’ due to Paederus spp. was confirmed by the identification of rove beetles.
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Affiliation(s)
- Daniel Camprubí-Ferrer
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic - Universitat de Barcelona, 08036 Barcelona, Spain
| | - Natalia Rodriguez-Valero
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic - Universitat de Barcelona, 08036 Barcelona, Spain
| | - Magdalena Muelas
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic - Universitat de Barcelona, 08036 Barcelona, Spain
| | - Alex Almuedo-Riera
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic - Universitat de Barcelona, 08036 Barcelona, Spain
| | - Lucía Romero
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic - Universitat de Barcelona, 08036 Barcelona, Spain
| | - Jose Muñoz
- Barcelona Institute for Global Health (ISGlobal) - Hospital Clínic - Universitat de Barcelona, 08036 Barcelona, Spain
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41
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Camprubí-Ferrer D, Romero L, Van Esbroeck M, Wammes LJ, Almuedo-Riera A, Rodriguez-Valero N, Balerdi-Sarasola L, Hoekstra PT, Subirà C, Valls ME, Micalessi I, Corstjens P, Cortes-Serra N, Huyse T, Benegas M, Álvarez-Martínez MJ, Muñoz J, van Lieshout L. Improving the diagnosis and management of acute schistosomiasis with antibody, antigen and molecular techniques: lessons from a cluster of six travellers. J Travel Med 2021; 28:6316243. [PMID: 34230958 DOI: 10.1093/jtm/taab101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/18/2021] [Accepted: 06/29/2021] [Indexed: 11/12/2022]
Abstract
Different diagnostic tests were evaluated in a cluster of six European travellers with acute schistosomiasis (AS) acquired in Mozambique. Adult worm and soluble egg antibodies, circulating anodic antigen (CAA) and DNA detection allowed early confirmation of AS. CAA permitted monitoring treatment response and Sm1-7 polymerase chain reaction allowed identification of Schistosoma mansoni complex.
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Affiliation(s)
| | - Lucía Romero
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona 08036, Spain
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp 2000, Belgium
| | - Linda J Wammes
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Alex Almuedo-Riera
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona 08036, Spain
| | | | | | - Pytsje T Hoekstra
- Department of Parasitology, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Carme Subirà
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona 08036, Spain
| | | | - Isabel Micalessi
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp 2000, Belgium
| | - Paul Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Nuria Cortes-Serra
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona 08036, Spain
| | - Tine Huyse
- Department of Biology, Royal Museum for Central Africa, Tervuren 3080, Belgium
| | - Mariana Benegas
- Radiology Department, Hospital Clínic Barcelona, Barcelona 08036, Spain
| | | | - Jose Muñoz
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona 08036, Spain
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
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42
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Gerber V, Le Govic Y, Ramade C, Chemla C, Hamane S, Desoubeaux G, Durieux MF, Degeilh B, Abou-Bacar A, Pfaff AW, Candolfi E, Greigert V, Brunet J. Ancylostoma ceylanicum as the second most frequent hookworm species isolated in France in travellers returning from tropical areas. J Travel Med 2021; 28:6121697. [PMID: 33506263 DOI: 10.1093/jtm/taab014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/09/2021] [Accepted: 01/19/2021] [Indexed: 12/12/2022]
Abstract
Ancylostoma ceylanicum is the second most common hookworm species infecting humans in Southeast Asia and Oceania. We performed a 3 years multicenter study to assess its frequency in hookworm infecting patients returning from tropical areas to France and found that A. ceylanicum was the second most frequent hookworm species isolated.
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Affiliation(s)
- Victor Gerber
- Institut de Parasitologie et Pathologie Tropicale, Université de Strasbourg, 67000 Strasbourg, France
| | - Yohann Le Govic
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Université d'Angers, 49035 Angers, France
| | - Cécile Ramade
- Hospices Civils de Lyon, Institut des Agents Infectieux, Parasitologie Mycologie, Hôpital de la Croix-Rousse, 69004 Lyon, France
| | - Cathy Chemla
- EA7510 ESCAPE, Université de Reims Champagne Ardenne et Laboratoire de Parasitologie-Mycologie CHU Reims, 51092 Reims, France
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, 75010 Paris, France
| | | | | | - Brigitte Degeilh
- Laboratoire de Parasitologie-Mycologie, CHU Rennes, Rue Henri le Guillou, 35033 Rennes, France
| | - Ahmed Abou-Bacar
- Institut de Parasitologie et Pathologie Tropicale, Université de Strasbourg, 67000 Strasbourg, France.,Laboratoire de Parasitologie et de Mycologie Médicales, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, F-67091 Strasbourg, France
| | - Alexander W Pfaff
- Institut de Parasitologie et Pathologie Tropicale, Université de Strasbourg, 67000 Strasbourg, France.,Laboratoire de Parasitologie et de Mycologie Médicales, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, F-67091 Strasbourg, France
| | - Ermanno Candolfi
- Institut de Parasitologie et Pathologie Tropicale, Université de Strasbourg, 67000 Strasbourg, France.,Laboratoire de Parasitologie et de Mycologie Médicales, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, F-67091 Strasbourg, France
| | - Valentin Greigert
- Institut de Parasitologie et Pathologie Tropicale, Université de Strasbourg, 67000 Strasbourg, France
| | - Julie Brunet
- Institut de Parasitologie et Pathologie Tropicale, Université de Strasbourg, 67000 Strasbourg, France.,Laboratoire de Parasitologie et de Mycologie Médicales, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, F-67091 Strasbourg, France
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43
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Duong CM, Le PVD, Pham OKN, Huynh HQ. Atypical gnathostomiasis-confirmed cutaneous larva migrans, Vietnam. BMJ Case Rep 2021; 14:14/7/e243276. [PMID: 34266828 DOI: 10.1136/bcr-2021-243276] [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: 11/03/2022] Open
Abstract
We reported a case of gnathostomiasis in a 42-year-old woman with an unclear history of eating high-risk foods and had a non-migratory skin lesion, negative serological testing and normal blood eosinophil counts. A diagnosis of gnathostomiasis was based on a live, third-stage Gnathostoma spinigerum larva that was randomly taken from the patient's skin lesion by herself. The presenting case report demonstrates challenges in correctly diagnose cutaneous gnathostomiasis even in endemic countries due to atypical skin lesions, negative serology testing and the absence of eosinophilia and thus, the widely used classic triad of suggestive evidence of gnathostomiasis is not fulfilled.
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Affiliation(s)
- Cuong Minh Duong
- School of Population Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Phuc Vinh Dinh Le
- Department of Infectious Diseases, MEDIC Medical Center, Ho Chi Minh City, Viet Nam
| | | | - Hong Quang Huynh
- Therapeutic and Research Department, Institute of Malariology, Parasitology, and Entomology Quy Nhon, Quy Nhon, Viet Nam
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44
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Akhmetzhanov AR, Mizumoto K, Jung SM, Linton NM, Omori R, Nishiura H. Estimation of the Actual Incidence of Coronavirus Disease (COVID-19) in Emergent Hotspots: The Example of Hokkaido, Japan during February-March 2020. J Clin Med 2021; 10:2392. [PMID: 34071502 PMCID: PMC8198150 DOI: 10.3390/jcm10112392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 01/12/2023] Open
Abstract
Following the first report of the coronavirus disease 2019 (COVID-19) in Sapporo city, Hokkaido Prefecture, Japan, on 14 February 2020, a surge of cases was observed in Hokkaido during February and March. As of 6 March, 90 cases were diagnosed in Hokkaido. Unfortunately, many infected persons may not have been recognized due to having mild or no symptoms during the initial months of the outbreak. We therefore aimed to predict the actual number of COVID-19 cases in (i) Hokkaido Prefecture and (ii) Sapporo city using data on cases diagnosed outside these areas. Two statistical frameworks involving a balance equation and an extrapolated linear regression model with a negative binomial link were used for deriving both estimates, respectively. The estimated cumulative incidence in Hokkaido as of 27 February was 2,297 cases (95% confidence interval (CI): 382-7091) based on data on travelers outbound from Hokkaido. The cumulative incidence in Sapporo city as of 28 February was estimated at 2233 cases (95% CI: 0-4893) based on the count of confirmed cases within Hokkaido. Both approaches resulted in similar estimates, indicating a higher incidence of infections in Hokkaido than were detected by the surveillance system. This quantification of the gap between detected and estimated cases helped to inform the public health response at the beginning of the pandemic and provided insight into the possible scope of undetected transmission for future assessments.
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Affiliation(s)
- Andrei R. Akhmetzhanov
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan; (A.R.A.); (S.-M.J.); (N.M.L.)
- Global Health Program, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei 10055, Taiwan
| | - Kenji Mizumoto
- Graduate School of Advanced Integrated Studies in Human Survivability, Kyoto University, Yoshida-Nakaadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan;
- Hakubi Center for Advanced Research, Kyoto University, Yoshidahonmachi, Sakyo-ku, Kyoto 606-8306, Japan
| | - Sung-Mok Jung
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan; (A.R.A.); (S.-M.J.); (N.M.L.)
- School of Public Health, Kyoto University, Yoshidakonoe cho, Sakyo ku, Kyoto 606-8501, Japan
| | - Natalie M. Linton
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan; (A.R.A.); (S.-M.J.); (N.M.L.)
- School of Public Health, Kyoto University, Yoshidakonoe cho, Sakyo ku, Kyoto 606-8501, Japan
| | - Ryosuke Omori
- Research Center for Zoonosis Control, Hokkaido University, Kita 19 Jo Nishi 10 Chome, Kita-ku, Sapporo-shi, Hokkaido 001-0019, Japan;
| | - Hiroshi Nishiura
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan; (A.R.A.); (S.-M.J.); (N.M.L.)
- School of Public Health, Kyoto University, Yoshidakonoe cho, Sakyo ku, Kyoto 606-8501, Japan
- Core Research for Evolutional Science and Technology (CREST), Japan Science and Technology Agency, Honcho 4-1-8, Kawaguchi, Saitama 332-0012, Japan
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45
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Mack N, Reyes AJ, Ramcharan K, Giddings SL. Acute myasthenic syndrome following coral snake envenomation in the Caribbean: a harbinger for admission to the intensive care unit. BMJ Case Rep 2021; 14:e241991. [PMID: 33766976 PMCID: PMC8006831 DOI: 10.1136/bcr-2021-241991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Narine Mack
- Medicine, San Fernando General Hospital, San Fernando, Trinidad and Tobago
| | - Antonio Jose Reyes
- Medicine, Neurology Unit, San Fernando Teaching Hospital, San Fernando, Trinidad and Tobago
| | | | - Stanley Lawrence Giddings
- Medicine, University of the West Indies at Saint Augustine, Saint Augustine, Tunapuna-Piarco, Trinidad and Tobago
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46
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Speidel V, Purrucker JC, Klobučníková K. Manifestation of Intracranial Lesions at High Altitude: Case Report and Review of the Literature. High Alt Med Biol 2021; 22:87-89. [PMID: 33709803 DOI: 10.1089/ham.2020.0223] [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: 11/13/2022] Open
Abstract
Speidel, Victor, Jan Christoph Purrucker, and Katarína Klobučníková. Manifestation of intracranial lesions at high altitude: case report and review of the literature. High Alt Med Biol. 22:87-89, 2021.-A 32-year-old man trekked to the South Everest Base Camp (5,364 m) in Nepal. On the last day of the ascent, he noticed some dysesthesia in his right leg and descended by helicopter. He suffered a generalized seizure shortly after his descent, followed by right-sided hemiparesis and speech arrest. Without the possibility of cerebral imaging, the patient was given dexamethasone intravenously who showed a marked improvement and regained the ability to speak. Magnetic resonance imaging later revealed a lesion in the left frontotemporal region with compression of brain parenchyma and minimal paralesional edema. A meningioma was later surgically resected. Although seizures are a common first manifestation of meningioma, we argue that the exposure to high altitude may have contributed to his symptoms, either by increasing the peritumoral edema by pathophysiology similar to high-altitude cerebral edema (HACE) or lowering the seizure threshold otherwise. This case shows a before unknown pre-existing condition becoming symptomatic at high altitude and illustrates the necessity for careful and immediate evaluation of every patient with new onset of unexplained focal neurological deficits or seizures at high altitude in addition to unspecific neurological symptoms commonly associated with HACE such as headaches, dizziness, lightheadedness, or ataxia.
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Affiliation(s)
- Victor Speidel
- Department of Emergency Medicine, Oberaargau Regional Hospital, Langenthal, Switzerland.,Department of Emergency Medicine, Inselspital, University of Bern, Bern University Hospital, Bern, Switzerland.,Pasang Lhamu Nicole Niquille Hospital, Lukla, Nepal
| | | | - Katarína Klobučníková
- 1st Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
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47
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Shlim DR, Connor BA, Taylor DN. What will travel medicine look like in the COVID-19 pandemic era? J Travel Med 2021; 28:5898235. [PMID: 32856040 PMCID: PMC7499722 DOI: 10.1093/jtm/taaa148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 11/13/2022]
Abstract
Travel medicine has virtually stopped in light of the coronavirus pandemic. It is worth contemplating how travel medicine will be affected by the ongoing pandemic when international travel starts to become more possible. How will we advise patients, and utilize the coming vaccines that may be available? Travel medicine practices are well-suited to play a major role in advising travelers in the pandemic era.
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Affiliation(s)
- David R Shlim
- Jackson Hole Travel and Tropical Medicine, PO Box 40, Kelly, WY 83011 USA
| | - Bradley A Connor
- Weill Cornell Medical College, New York, NY 10065 USA.,The New York Center for Travel and Tropical Medicine, 110 East 55th Street, 16th Floor, New York, NY 10022 USA
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48
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Abstract
A woman travelling to Australia in her early 70s presents to a regional emergency department with chest pain and associated shortness of breath. Her medical history was that of seasonal affective disorder treated with citalopram, and an allergy to ibuprofen. Subsequent CT imaging revealed aortic wall thickening and associated periaortic fluid, and a moderate pleural effusion. This was successfully treated with oral prednisolone, responding within 1 day. Further blood tests revealed a high CD4/CD8 T-cell ratio, which can be seen in autoimmune disease, sarcoidosis and haematological malignancies. Without evidence for other autoimmune processes, the patient was given a provisional diagnosis of descending thoracic aortitis secondary to sarcoidosis, prescribed a weaning regimen of prednisolone, and asked to seek further investigation and management in her home country. This is a case with several learning points; rare disease can cause common presentations/reports, and sometimes empirical therapy is the only therapy.
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Affiliation(s)
- Max Amos Hoffman
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Adel Ekladious
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
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49
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Seers T, Myneni J, Chaudhry NL, Ugarte M. Bilateral ocular toxoplasmosis in a returning traveller: age and route of infection as potential risk factors. BMJ Case Rep 2021; 14:14/1/e237068. [PMID: 33509864 PMCID: PMC7845719 DOI: 10.1136/bcr-2020-237068] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We report the case of a 69-year-old man, who presented in the UK with a short history of deteriorating vision and clinical features of bilateral atypical retinochoroiditis, after travelling to South America. Vitreous samples demonstrated Toxoplasma gondii DNA by PCR. Serology tests demonstrated recent acquired Toxoplasma gondii infection with IgM antibodies. He responded well to treatment with trimethoprim-sulfamethoxazole, azithromycin and oral steroids. This case is a reminder of the global importance of Toxoplasma related eye disease, and its uncommon bilateral severe presentation in a returning traveller, where the risk factors were age and the route of infection likely to be a virulent parasite oocyst from vegetables or water rather than undercooked meat or direct contact with cats.
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Affiliation(s)
- Tim Seers
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK.,Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jayavani Myneni
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Nadia L Chaudhry
- Stepping Hill Hospital, Stockport NHS Foundation Trust, Stockport, UK
| | - Marta Ugarte
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK .,Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
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50
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Hasegawa K, Ohji G, Iwata K. Anaphylaxis to simultaneous administration of inactivated tissue culture hepatitis A vaccine and purified chick embryo cell rabies vaccine after multiple doses. BMJ Case Rep 2021; 14:14/1/e237894. [PMID: 33504524 PMCID: PMC7843327 DOI: 10.1136/bcr-2020-237894] [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] [Indexed: 01/29/2023] Open
Abstract
Both the inactivated hepatitis A vaccine (Aimmugen) and purified chick embryo cell rabies vaccine (PCECV, Rabipur) are well tolerated. Anaphylaxis has rarely been reported as an adverse reaction of these vaccines. There have been no reports or published case reports of anaphylaxis due to Aimmugen. According to the Japanese Ministry of Health, Labour and Welfare Aimmugen adverse reaction report, no cases of anaphylaxis have been reported from April 2013 to August 2016. Twenty cases of anaphylaxis due to PCECV (RabAvert) have been reported from 1997 to 2005 in USA, whereas 2 cases have been reported from 2006 to 2016. We report a case of anaphylaxis after multiple vaccinations in a 24-year-old man with ulcerative colitis, previous medical history of tonsillectomy for IgA nephropathy and no history of allergies.
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Affiliation(s)
- Kohei Hasegawa
- Division of Infectious Disease Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Goh Ohji
- Division of Infectious Disease Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Kentaro Iwata
- Division of Infectious Disease Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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