Travel Medicine and Infectious Disease最新文献

英文中文

Incidence and clinical significance of non-tuberculous mycobacteria among migrants in Denmark: A nationwide register-based cohort study from 1991 through 2021 丹麦移民中非结核分枝杆菌的发病率和临床意义：1991 年至 2021 年基于全国登记的队列研究。

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2024-07-10 DOI: 10.1016/j.tmaid.2024.102736

Background

There is limited knowledge about non-tuberculous mycobacteria (NTM) infections in migrants. We aimed to assess the incidence and clinical significance of NTM among migrants in Denmark.

Method

Nationwide register-based cohort study of migrants with a positive NTM culture in Denmark from 1991 through 2021, stratified by patient demographics, disease localisation, species, and clinical significance.

Results

433 migrants had a positive NTM culture, resulting in an overall incidence rate (IR) of 3.7 (95%CI 3.3–4.0) per 100,000 migrants. Overall NTM IRs for definite disease were 1.0 (95%CI 0.9–1.2), possible disease 1.0 (95%CI 0.8–1.2), and isolation 1.7 (95%CI 1.4–1.9) per 100,000 migrants. Migrants had considerably higher age- and sex-adjusted NTM IRs of positive cultures (incidence rate ratio [IRR] = 2.1, 95%CI 1.9–2.3, p < 0.001), possible disease (IRR = 2.4, 95%CI 2.0–3.0, p < 0.001), and isolation (IRR = 4.6, 95%CI 3.9–5.4, p < 0.001) compared to Danish-born, but not of definite disease (IRR = 1.1, 95%CI 0.9–1.3, p = 0.562). IRs of migrants with positive NTM cultures did not increase over time (−0.8 %/year, p = 0.133).

Conclusions

Migrants have a higher, but stable, burden of NTM compared with Danish-born. The higher rates likely reflect that more specimens are examined for Mycobacterium tuberculosis. Microbiologically classified definite NTM disease is not substantially more common among migrants.

背景：有关移民非结核分枝杆菌（NTM）感染的知识有限。我们旨在评估丹麦移民中 NTM 的发病率和临床意义：方法：对1991年至2021年期间在丹麦NTM培养呈阳性的移民进行全国范围的登记队列研究，按患者人口统计学、疾病定位、种类和临床意义进行分层：433名移民的非淋菌性肺结核培养呈阳性，总发病率（IR）为每10万移民3.7例（95%CI 3.3-4.0）。每 10 万名移民中，NTM 确诊病例的总发病率为 1.0（95%CI 0.9-1.2），可能病例为 1.0（95%CI 0.8-1.2），隔离病例为 1.7（95%CI 1.4-1.9）。经年龄和性别调整后，移民的培养阳性非淋菌性肺结核 IRs 要高得多（发病率比 [IRR]=2.1, 95%CI 1.9-2.3, p结论：与丹麦出生的人相比，移民的非淋菌性肺结核发病率较高，但比较稳定。较高的发病率可能反映了更多标本接受了结核杆菌检查。此外，微生物学分类明确的非结核性疾病在移民中并不常见。

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引用次数: 0

Mosquito-borne Murray Valley encephalitis: Re-emergence in Western Australia 蚊媒墨累山谷脑炎：重新出现在西澳大利亚州。

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2024-07-01 DOI: 10.1016/j.tmaid.2024.102734

引用次数: 0

Unexpected discovery of Trypanosoma brucei gambiense on CSF in a western country: About a case 在一个西方国家的脑脊液中意外发现布氏锥虫：关于一个病例。

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2024-07-01 DOI: 10.1016/j.tmaid.2024.102741

引用次数: 0

Zika and Chikungunya in Europe 2100 – A GIS based model for risk estimation 2100 年欧洲的寨卡病毒和基孔肯雅病毒--基于地理信息系统的风险评估模型。

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2024-07-01 DOI: 10.1016/j.tmaid.2024.102737

J. Kronen , M. Leuchner , T. Küpper

Background

The spread of vector-borne infectious diseases is determined, among other things, by temperature. Thus, climate change will have an influence on their global distribution. In the future, Europe will approach the temperature optimum for the transmission of ZIKV and CHIKV. Climate scenarios and climate models can be used to depict future climatic changes and to draw conclusions about future risk areas for vector-borne infectious diseases.

Methods

Based on the RCP 4.5 and RCP 8.5 climate scenarios, a geospatial analysis was carried out for the future temperature suitability of ZIKV and CHIKV in Europe. The results were presented in maps and the percentage of the affected areas calculated.

Results

Due to rising temperatures, the risk areas for transmission of ZIKV and CHIKV spread in both RCP scenarios. For CHIKV transmission, Spain, Portugal, the Mediterranean coast and areas near the Black Sea are mainly affected. Due to high temperatures, large areas throughout Europe are at risk for ZIKV and CHIKV transmission.

Conclusion

Temperature is only one of many factors influencing the spread of vector-borne infectious diseases. Nevertheless, the representation of risk areas on the basis of climate scenarios allows an assessment of future risk development. Monitoring and adaptation strategies are indispensable for coping with and containing possible future autochthonous transmissions and epidemics in Europe.

背景：病媒传染病的传播主要取决于温度。因此，气候变化将对这些疾病的全球分布产生影响。未来，欧洲将接近 ZIKV 和 CHIKV 传播的最佳温度。气候情景和气候模型可用于描绘未来的气候变化，并就未来病媒传染病的风险区域得出结论：方法：根据 RCP 4.5 和 RCP 8.5 气候情景，对欧洲 ZIKV 和 CHIKV 的未来温度适宜性进行了地理空间分析。分析结果以地图形式呈现，并计算了受影响地区的百分比：结果：由于气温升高，ZIKV 和 CHIKV 传播的风险区域在两种 RCP 情景中都有所扩大。就 CHIKV 传播而言，西班牙、葡萄牙、地中海沿岸和黑海附近地区主要受到影响。由于气温较高，欧洲大部分地区都面临 ZIKV 和 CHIKV 传播的风险：气温只是影响病媒传染病传播的众多因素之一。尽管如此，根据气候情景对风险地区进行描述，可以对未来的风险发展进行评估。要应对和遏制欧洲未来可能出现的自体传播和流行病，监测和适应战略必不可少。

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引用次数: 0

Not all severe malaria cases are severe: Is it time to redefine severity criteria for malaria in non-endemic regions? 并非所有重症疟疾病例都是重症：现在是重新定义非疟疾流行地区疟疾严重程度标准的时候了吗？

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2024-07-01 DOI: 10.1016/j.tmaid.2024.102740

Background

The current definition of severe malaria in non-endemic areas follows WHO criteria, which mainly target children in malaria-endemic areas, potentially misclassifying cases in non-endemic regions. We assessed the performance of a modified severe malaria classification criteria within our patient cohort.

Methods

A cohort study of patients managed for malaria in a non-endemic setting (2005–2023) was analyzed. We classified patients into severe malaria (SM) using WHO 2013 criteria except for hyperparasitemia, where 2 % threshold was applied. Patients with SM were distinguished as very severe malaria (VSM) when presenting at least one of the following conditions: parasitemia >10 %, pulmonary edema, impaired consciousness, seizures, renal failure, metabolic acidosis or hyperlactatemia, shock or hypoglycemia. In patients with SM and no criteria for VSM, less severe malaria (LSM) was defined by: 2–10 % parasitemia, hyperbilirubinemia, prostration, anemia or minor bleeding. The primary composite outcome was death or the need for a life-saving intervention, as analyzed in the three comparative groups. Secondary outcome was the prevalence of co-infections.

Results

Among 506 patients with malaria, 176 (34.8 %) presented with SM. A total of 37 (7.3 %) patients developed a life-threatening condition, namely death (n = 4) and/or the need for life-saving interventions (n = 34). All fatalities and 33 out of the 34 life-saving interventions occurred in the VSM group. Patients in LSM group did not develop any life-threatening conditions. As to co-infections, 28 (5.5 %) patients had a community-acquired co-infection, with no differences between groups (p = 0.763).

Conclusions

Severity criteria definitions would benefit from a review when assessing patients with malaria in non-endemic areas. Within the spectrum of SM, patients reclassified as LSM have a low risk of developing a life-threatening condition and present low co-infection incidence and could benefit from management out of intensive care units and a restrictive use of empirical antibiotics.

背景：目前，非疟疾流行地区重症疟疾的定义遵循世界卫生组织的标准，该标准主要针对疟疾流行地区的儿童，可能会误诊非疟疾流行地区的病例。我们在患者队列中评估了修改后的重症疟疾分类标准的性能：我们对在非疟疾流行地区接受疟疾治疗的患者进行了队列研究（2005-2023 年）。我们采用世界卫生组织 2013 年标准将患者分为重症疟疾 (SM)，但高寄生虫血症除外，因为高寄生虫血症的阈值为 2%。重症疟疾患者如果至少出现以下一种情况，即寄生虫血症>10%、肺水肿、意识障碍、癫痫发作、肾功能衰竭、代谢性酸中毒或高乳酸血症、休克或低血糖，则被区分为极重症疟疾（VSM）。对于不符合 VSM 标准的 SM 患者，较轻疟疾（LSM）的定义是：2-10%寄生虫血症、高胆红素血症、衰弱、贫血或轻微出血。三个比较组的主要综合结果是死亡或需要救生干预。次要结果是合并感染的发生率：在 506 名疟疾患者中，176 人（34.8%）患有 SM。共有 37 名（7.3%）患者出现危及生命的情况，即死亡（4 人）和/或需要采取救生措施（34 人）。所有死亡病例和 34 次抢救中的 33 次都发生在 VSM 组。LSM组患者没有出现任何危及生命的情况。在合并感染方面，28（5.5%）名患者合并社区获得性感染，组间无差异（P=0.763）：结论：在评估非疟疾流行地区的疟疾患者时，对严重程度标准定义进行审查将是有益的。在疟疾严重程度的范围内，被重新分类为低度严重程度的患者出现危及生命的情况的风险较低，合并感染的发生率也较低，可以从重症监护室外的管理和限制使用经验性抗生素中获益。

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引用次数: 0

Communicable diseases in Ukraine during the period of 2018–2023: Impact of the COVID-19 pandemic and war 2018-2023 年期间乌克兰的传染病：COVID-19 大流行和战争的影响。

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2024-07-01 DOI: 10.1016/j.tmaid.2024.102733

Pavlo Petakh , Viktoriia Tymchyk , Oleksandr Kamyshnyi

Background

By examining 2018–2023 data, this study explored the intricate impact of the Russian invasion, ongoing COVID-19 pandemic, and environmental disruptions on communicable diseases in Ukraine. This conflict exacerbates challenges in disease surveillance and healthcare, compounding stress among the population.

Methods

Leveraging the Centers for Disease Prevention Control's surveillance system, the study employs active and passive surveillance, utilizing medical records and laboratory reports. Notification rates gauge the incidence of communicable diseases, offering insights into trends during the study period.

Results

While salmonellosis, shigellosis, and rotavirus incidence are decreasing overall, there is a surge in viral hepatitis A, chronic hepatitis B, and C. This conflict hampers hepatitis C management, as evidenced by decreased numbers of treatment centers and patient enrollment. The prevalence of cough cases will increase in 2023, emphasizing the importance of sustained vaccination. The incidence of tuberculosis will increase in 2023 despite a general decrease.

Conclusion

This study underscores the urgent need for sustained efforts and adequate resources, infrastructure, and international support to mitigate public health challenges in conflict-ridden Ukraine. Prioritizing vaccination programmes and enhancing healthcare accessibility in affected regions are crucial.

背景：通过研究 2018-2023 年的数据，本研究探讨了俄罗斯入侵、COVID-19 大流行和环境干扰对乌克兰传染病的复杂影响。这场冲突加剧了疾病监测和医疗保健方面的挑战，加重了民众的压力：这项研究利用疾病预防控制中心的监测系统，通过医疗记录和实验室报告进行主动和被动监测。结果：虽然沙门氏菌病、志贺氏菌病和痢疾的发病率有所下降，但沙门氏菌病、志贺氏菌病和痢疾的发病率却有所上升：虽然沙门氏菌病、志贺氏菌病和轮状病毒的发病率总体上在下降，但甲型病毒性肝炎、慢性乙型肝炎和丙型肝炎的发病率却在激增。2023 年，咳嗽病例的发病率将上升，这强调了持续接种疫苗的重要性。尽管结核病发病率普遍下降，但 2023 年仍将上升：本研究强调，在冲突频发的乌克兰，迫切需要持续的努力、充足的资源、基础设施和国际支持，以缓解公共卫生挑战。在受影响地区优先实施疫苗接种计划和提高医疗服务的可及性至关重要。

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引用次数: 0

Rabies knowledge gaps and risk behaviour in Dutch travellers: An observational cohort study 荷兰旅行者的狂犬病知识差距和风险行为：一项观察性队列研究。

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2024-07-01 DOI: 10.1016/j.tmaid.2024.102739

Background

Travellers visiting rabies-endemic countries are at risk of rabies infection. Assessing travellers’ knowledge and risk perception of rabies and risk behaviour during travel can help identify knowledge gaps and improve pre-travel risk education.

Methods

Cohort study in Dutch adult travellers, using two surveys: one before travel to assess knowledge and perception of rabies, and one after return to identify risk behaviour during travel.

Results

The pre-travel and post-travel survey were completed by 301 and 276 participants, respectively. 222 participants had travelled to a high-risk rabies-endemic country. 21.6 % of the participants scored their rabies knowledge as poor. Some participants were unaware cats or bats can transmit rabies (26.6 % and 13.6 %, respectively), or that post-exposure prophylaxis (PEP) is required for certain exposures such as skin abrasions without bleeding or licks on damaged skin (35.5 % and 18.9 %, respectively), while 27.9 % of participants did not know PEP needs to be administered within one day. 115 participants (51.8 %) reported any form of contact with any animal during travel. Two participants reported animal exposure, of which one took adequate PEP measures. Risk factors for animal contact abroad were regularly touching cats or dogs at home or abroad, longer travel duration, having pets during childhood and being an animal lover.

Conclusions

Pre-travel rabies risk education currently does not meet travellers’ needs, which is reflected in knowledge gaps and engagement in risk behaviour during travel. During pre-travel health advice, avoiding animal contact abroad should be emphasized, and additional education is required about indications for PEP.

背景：前往狂犬病流行国家的旅行者有感染狂犬病的风险。评估旅行者对狂犬病的知识和风险认知以及旅行期间的风险行为有助于找出知识差距并改进旅行前的风险教育：方法：对荷兰成年旅行者进行队列研究，使用两次调查：一次在旅行前，评估对狂犬病的知识和看法；一次在回国后，确定旅行期间的风险行为：结果：分别有 301 名和 276 名参与者完成了旅行前和旅行后调查。222名参与者曾前往狂犬病高风险流行国家旅行。21.6%的参与者对狂犬病知识知之甚少。一些参与者不知道猫或蝙蝠会传播狂犬病（分别为 26.6% 和 13.6%），也不知道某些接触需要进行接触后预防（PEP），例如没有出血的皮肤擦伤或舔舐受损皮肤（分别为 35.5% 和 18.9%），还有 27.9% 的参与者不知道需要在一天内进行接触后预防。115 名参与者（51.8%）报告在旅行期间与任何动物有过任何形式的接触。两名参与者报告了接触动物的情况，其中一人采取了适当的预防措施。在国外接触动物的风险因素包括：经常在国内或国外接触猫或狗、旅行时间较长、童年时养过宠物以及是动物爱好者：目前，旅行前狂犬病风险教育并不能满足旅行者的需求，这反映在知识缺口和旅行期间的风险行为上。在旅行前的健康建议中，应强调避免在国外接触动物，并需要增加有关预防性治疗适应症的教育。

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引用次数: 0

Imported schistosomiasis in travelers: Experience from a referral tropical medicine unit in Barcelona, Spain 旅行者中的输入性血吸虫病：西班牙巴塞罗那热带医学转诊单位的经验。

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2024-07-01 DOI: 10.1016/j.tmaid.2024.102742

Background

Acute schistosomiasis occurs most often in travelers to endemic regions. The aim of the study is to describe the epidemiological, clinical and parasitological characteristics of patients with schistosomiasis acquired during an international travel.

Methods

Observational retrospective study including all travel-related schistosomiasis cases seen at the International Health Unit Vall d’Hebron-Drassanes (Barcelona, Spain) from 2009 to 2022. Diagnosis of schistosomiasis was defined by the presence of Schistosoma eggs in stools or urine or the positivity of a serological test. We collected demographic, epidemiological, clinical, parasitological, and therapeutic information.

Results

917 cases of schistosomiasis were diagnosed, from whom 96 (10.5 %) were travel-related. Mean age of the patients was 34.9 years, and 53.1 % were women. Median duration of the travel was 72 days, and geographical areas where travelers had contact with fresh water were Africa (82.3 %), Asia (12.5 %), and South America (5.2 %). Twenty (20.8 %) patients reported having had some clinical symptom, being gastrointestinal symptoms the most frequent. Two patients developed the classical Katayama syndrome. In eleven (11.5 %) cases eggs were observed in urine or feces samples, and 85 (88.5 %) cases were diagnosed by a positive serology. Ninety-one (94.8 %) patients received treatment with praziquantel with different therapeutic schemes. The two patients with Katayama syndrome received concomitant treatment with corticosteroids.

Conclusions

Schistosomiasis in travelers represented 10 % of the overall schistosomiasis cases in our center. Increasing the awareness in the pre-travel advice and implementing specific screening in those travelers at risk (long travelers, contact with fresh water) could reduce the incidence and associated morbidity in this group.

背景：急性血吸虫病多发于前往血吸虫病流行地区的旅行者。本研究旨在描述在国际旅行期间感染血吸虫病的患者的流行病学、临床和寄生虫学特征：观察性回顾研究包括 2009 年至 2022 年期间在 Vall d'Hebron-Drassanes 国际医疗中心（西班牙巴塞罗那）就诊的所有与旅行有关的血吸虫病病例。血吸虫病的诊断标准是粪便或尿液中出现血吸虫卵或血清学检测呈阳性。我们收集了人口统计学、流行病学、临床、寄生虫学和治疗信息：结果：共确诊 917 例血吸虫病患者，其中 96 例（10.5%）与旅行有关。患者平均年龄为 34.9 岁，53.1% 为女性。旅行时间中位数为 72 天，旅行者接触过淡水的地区包括非洲（82.3%）、亚洲（12.5%）和南美洲（5.2%）。有 20 名（20.8%）患者表示出现过一些临床症状，其中以胃肠道症状最为常见。两名患者出现了典型的片山综合征。在 11 个病例（11.5%）的尿液或粪便样本中观察到虫卵，85 个病例（88.5%）通过阳性血清学确诊。91例（94.8%）患者接受了不同治疗方案的吡喹酮治疗。两名片山综合征患者同时接受了皮质类固醇治疗：结论：旅行者血吸虫病占本中心血吸虫病病例总数的 10%。提高旅行前咨询的意识，并对高危旅行者（长期旅行者、接触淡水者）实施特定筛查，可降低该群体的发病率和相关发病率。

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引用次数: 0

A case report of travel-associated infection with melioidosis pneumonia and septicemia 与旅行相关的美拉德氏病肺炎和败血症感染病例报告。

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2024-07-01 DOI: 10.1016/j.tmaid.2024.102743

引用次数: 0

Now is the time to set up formal forums for clinical advice with emerging and zoonotic infections: A shared experience 现在是时候设立正式论坛，为新发感染和人畜共患感染提供临床建议了：经验分享。

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2024-07-01 DOI: 10.1016/j.tmaid.2024.102738

Stephen D. Woolley, Jeremy Nel, Jacqueline Weyer, Anne Neary, Lucille Blumberg, Michael BJ. Beadsworth, NHS England Airborne High Consequence Infectious Diseases Network

引用次数: 0

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