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First evidence of significant autochthonous transmission of strongyloidiasis in northern Spain: A retrospective study from Asturias, Spain 西班牙北部圆线虫病重要本土传播的第一个证据:来自西班牙阿斯图里亚斯的回顾性研究。
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-09-01 DOI: 10.1016/j.tmaid.2025.102900
Mercedes Rodríguez-Pérez , Belén Rivaya , Fernando Vazquez , José Antonio Boga , Enrique de Andrés-Galiana , Rebeca Cabo , Juan Luis Fernández-Martínez , Azucena Rodríguez- Guardado

Background

Autochthonous strongyloidiasis in Spain has traditionally been considered a recognized but underdiagnosed condition, primarily affecting individuals in agricultural environments along the Mediterranean coast. We describe the first series of autochthonous strongyloidiasis cases diagnosed in Asturias, a region in northern Spain with no previously documented endemic transmission.

Methods

This is a retrospective review of all diagnosed cases of autochthonous strongyloidiasis at the Central University Hospital of Asturias, from 2016 to 2024. Inclusion required no travel history to endemic areas. Clinical records were reviewed for demographic data, symptoms, risk factors, laboratory findings, and treatment outcomes.
Diagnosis was based on stool microscopy, S. stercoralis IgG serology, and polymerase chain reaction.

Results

We identified 33 patients (54.5 % female, mean age 52 ± 20 years). The primary risk factor was residence in a rural area (63.6 %), frequently associated with gardening that was the most common risk factor (57.5 %). Symptoms were reported in 78.7 % of cases, most commonly abdominal pain (46 %) and pruritus (38.4 %). Eosinophilia was present in 33.3 % of cases. Diagnosis relied primarily on serology (71.4 %) and PCR (56.2 %). Stool microscopy detected larvae in only two patients (6 %). Three patients (9.3 %) developed severe forms, including one fatal case.

Conclusions

This study provides strong evidence of ongoing autochthonous transmission of Strongyloides stercoralis in northern Spain, affecting a younger and more gender-balanced population than previously described. Recreational rather than occupational exposure was the predominant risk factor. Routine screening should be considered in autochthonous individuals with eosinophilia or prior to immunosuppressive therapy to prevent severe outcomes.
背景:西班牙的本土圆线虫病传统上被认为是一种公认但未得到诊断的疾病,主要影响地中海沿岸农业环境中的个体。我们描述了在西班牙北部阿斯图里亚斯地区诊断的第一批本地圆线虫病病例,该地区以前没有记录的地方性传播。方法:回顾性分析2016年至2024年阿斯图里亚斯中央大学医院所有确诊的先天性圆线虫病病例。纳入研究不需要有去过流行地区的旅行史。临床记录回顾了人口统计数据、症状、危险因素、实验室结果和治疗结果。诊断基于粪便显微镜,粪球菌IgG血清学和聚合酶链反应。结果:33例患者(女性54.5%,平均年龄52±20岁)。主要危险因素是居住在农村地区(63.6%),通常与园艺有关,这是最常见的危险因素(57.5%)。78.7%的病例报告有症状,最常见的是腹痛(46%)和瘙痒(38.4%)。33.3%的病例存在嗜酸性粒细胞增多。诊断主要依靠血清学(71.4%)和PCR(56.2%)。粪便显微镜仅在两名患者(6%)中检测到幼虫。3名患者(9.3%)发展为严重形式,包括1例死亡病例。结论:这项研究提供了强有力的证据,表明西班牙北部存在粪类圆线虫的持续本地传播,影响的人群比先前描述的更年轻,性别更平衡。主要的危险因素是娱乐性而非职业性暴露。在原生嗜酸性粒细胞增多症患者或免疫抑制治疗前应考虑常规筛查,以防止严重后果。
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引用次数: 0
Leishmaniasis in the United Kingdom: Experience of a national multidisciplinary team meeting in a non-endemic setting 英国的利什曼病:在非地方性环境中召开的国家多学科小组会议的经验。
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-09-01 DOI: 10.1016/j.tmaid.2025.102903
Owain Donnelly , Rachel Southern-Thomas , Simran Goyal , Ciara Mahon , Adam T. Gray , Peter L. Chiodini , June Minton , Jonathan Joseph , Sarah Eisen , Elinor Moore , Naomi F. Walker , Mark S. Bailey , Laura Nabarro , Stephen L. Walker , Anna M. Checkley

Introduction

Leishmaniasis is a parasitic disease caused by protozoa of the genus Leishmania. Disease phenotypes are heterogenous, and diagnosis is frequently delayed. Treatment is often challenging, and international guidelines recommend consultation with experts. The UK Leishmaniasis Multidisciplinary Team (UKLMDT) meeting provides an accessible online forum for clinicians to discuss cases of leishmaniasis, facilitating access to expertise and enabling local care for patients where possible.

Methods

Three years of UKLMDT discussions, from its inception in November 2021 to October 2024, were reviewed using electronic patient records. An anonymous feedback questionnaire was sent to referrers. Data regarding treatment outcomes for patients discussed up to June 2024 were gathered using a separate questionnaire completed by their responsible clinician.

Results

The UKLMDT contributed to 139 patient discussions involving 80 patients over in total over the study period. Just over half of individuals (45/80; 56.2 %) had cutaneous leishmaniasis, a quarter had visceral leishmaniasis (20/80; 25 %) and a tenth had mucosal leishmaniasis (8/80; 10 %). Seven patients (8.8 %) were found not to have leishmaniasis. In total, 24/80 (30 %) of patients were immunocompromised, but only in four cases (5 %) was HIV the cause of immunosuppression. All visceral leishmaniasis cases were acquired in Europe, and the majority acquired their disease in Spain. Leishmania donovani complex was the commonest causative agent overall, including in visceral and mucosal disease, whereas Leishmania Viannia subgenus was commonest in cutaneous leishmaniasis. Patients with mucosal or visceral leishmaniasis were more frequently immunosuppressed than those with cutaneous leishmaniasis. Outcomes and feedback on the UKLMDT were generally positive.

Discussion

The experience of the UKLMDT specialist forum provides insight into leishmaniasis in the UK, a non-endemic setting. Key findings include that southern Europe is the primary destination where UK-based leishmaniasis is acquired, and that Leishmania donovani complex (most likely Leishmania infantum) in immunosuppressed hosts is an important cause of mucosal leishmaniasis in Europe. The UKLMDT offers equitable access to expertise for a rare disease in the UK, as well as serving as a model for national provision of multidisciplinary advice for other rare diseases.
简介:利什曼病是一种由利什曼原虫属原虫引起的寄生虫病。疾病表型是异质性的,诊断经常被延迟。治疗通常具有挑战性,国际指南建议咨询专家。联合王国利什曼病多学科小组(UKLMDT)会议为临床医生提供了一个可访问的在线论坛,以讨论利什曼病病例,促进获得专业知识并在可能的情况下为患者提供当地护理。方法:使用电子病历对UKLMDT从2021年11月成立到2024年10月的三年讨论进行回顾。向推荐人发送了一份匿名反馈问卷。截至2024年6月,通过由其负责的临床医生完成的单独问卷收集有关所讨论患者治疗结果的数据。结果:在研究期间,UKLMDT共参与了139次患者讨论,涉及80多名患者。略多于一半的个体(45/80;56.2%)患有皮肤利什曼病,四分之一的个体患有内脏利什曼病(20/80;25%),十分之一的个体患有粘膜利什曼病(8/80;10%)。未检出利什曼病7例(8.8%)。总共有24/80(30%)的患者免疫功能低下,但只有4例(5%)是HIV引起的免疫抑制。所有内脏利什曼病病例都是在欧洲获得的,其中大多数是在西班牙获得的。多诺瓦利什曼原虫复合体是最常见的病原体,包括内脏和粘膜疾病,而维亚利什曼原虫亚属在皮肤利什曼病中最常见。粘膜或内脏利什曼病患者比皮肤利什曼病患者更容易出现免疫抑制。患者结果和转诊者对UKLMDT会议的反馈总体上是积极的。讨论:UKLMDT专家论坛的经验提供了对英国非地方性环境中的利什曼病的深入了解。主要发现包括南欧是获得英国利什曼病的主要目的地,免疫抑制宿主中的多诺瓦利什曼原虫复合体(很可能是幼年利什曼原虫)是欧洲粘膜利什曼病的重要原因。uklmd在英国提供公平获取罕见疾病专业知识的机会,并作为国家为其他罕见疾病提供多学科咨询的典范。
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引用次数: 0
Plasmodium falciparum malaria in Suriname: how targeted interventions in marginalized populations led to elimination 苏里南的恶性疟原虫疟疾:边缘化人群的针对性干预如何导致消灭
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-09-01 DOI: 10.1016/j.tmaid.2025.102910
Hélène Hiwat-Van Laar , Hedley Cairo , Loretta Hardjopawiro , Marthelise Eersel , Stephen Vreden , Malti Adhin , Dayanand Panchoe , Edward van Eer , Herman Jintie , Maureen van Dijk , Oscar Mesones Lapouble

Background

Plasmodium falciparum (Pf) was the primary malaria species in Suriname for many decades. Following the introduction of targeted and inclusive interventions malaria incidence in the country decreased. Pf ceased to be the primary prevalent species in 2007. The aim of this study is to describe the interventions and discuss the strategies that contributed to Pf elimination in Suriname.

Methods

National malaria surveillance data from 2000 to 2024 were analyzed, with a focus on Pf. Data were disaggregated to age and sex and country of origin. Interventions aimed at progressing from control to pre-elimination, elimination, and prevention of re-introduction of malaria were assessed and described.

Results

Progressing towards elimination, Pf malaria moved from being a disease of the indigenous and tribal communities in the Interior of Suriname to an occupational disease primarily affecting mobile migrants in the remote gold mining sites. The last indigenous Pf case in Suriname was reported in 2018. The national elimination strategy focused on parasite elimination by providing low barrier access to care for all populations at risk.

Conclusions

Suriname eliminated Pf using a targeted and inclusive elimination strategy. Continued importation of Pf into Suriname from neighboring countries in conjunction with a costly elimination strategy in a context of a national economic downfall and a potential decrease in external funding, generate a risk of re-introduction. Elevating the elimination goal to the regional Guiana Shield level, combined with a continuous alertness for and immediate response to imported Pf cases is needed to sustain Pf elimination in Suriname.
背景恶性疟原虫(Pf)是苏里南几十年来的主要疟疾种类。在采取有针对性和包容性的干预措施后,该国的疟疾发病率有所下降。2007年Pf不再是主要流行物种。本研究的目的是描述干预措施并讨论有助于在苏里南消除疟疾的战略。方法对2000 - 2024年全国疟疾监测数据进行分析,以Pf为重点,按年龄、性别和原籍国进行分类。评估和描述了旨在从控制到预消除、消除和预防疟疾再次传入的干预措施。结果:在逐步消除疟疾的过程中,疟疾从苏里南内陆土著和部落社区的一种疾病转变为一种主要影响偏远金矿矿区流动移民的职业病。苏里南最后一例土著Pf病例报告于2018年。国家消除战略的重点是消除寄生虫,为所有有风险的人群提供低障碍获得保健的机会。结论苏里南采用有针对性和包容性的消除策略消除了Pf。在国家经济衰退和外部资金可能减少的情况下,从邻国继续向苏里南输入Pf,再加上代价高昂的消灭战略,产生了重新引进Pf的危险。要使苏里南的消灭脊灰工作持续下去,就需要将消灭目标提升到圭亚那区域之盾级别,同时对输入性脊灰病例保持持续警惕并立即作出反应。
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引用次数: 0
Protective efficacy of skin-applied arthropod repellents against Chrysops bites in a Loa loa hyperendemic region in Gabon: A placebo-controlled randomized clinical trial of DEET, icaridin, citriodiol, and IR3535 加蓬Loa Loa高流行区皮肤应用节肢动物驱蚊剂对金蛉叮咬的保护效果:避蚊胺、心红素、柠檬醇和IR3535的安慰剂对照随机临床试验
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-09-01 DOI: 10.1016/j.tmaid.2025.102899
Ange G. Doumba Ndalembouly , Stravensky T. Boussougou-Sambe , Barclaye Ngossanga , Ynous Djida , Jacob Werner , Rella Zoleko Manego , Roland C. Zinga Koumba , Rodrigue Mintsa , Ayôla A. Adegnika , Albert Eisenbarth , Michael Ramharter

Background

Loa loa – a filarial pathogen causing loiasis –is transmitted by deer fly species Chrysops dimidiata and C. silacea. There are no established control tools available to reduce loiasis transmission in endemic regions. Although the use of repellents has been explored against other arthropods, their protective efficacy against Chrysops bites in humans has not yet been systematically evaluated. The aim of this randomized controlled clinical trial was to assess the efficacy of four commercial skin-applied arthropod repellents against Chrysops bites in a hyperendemic region in Gabon.

Methods

Volunteers were randomly assigned to apply the skin repellents DEET, icaridin, citriodiol, IR3535 or an inactive control. The primary endpoint was the number of blood meal attempts by Chrysops flies. Secondary outcomes were the frequency and duration of Chrysops landings on clothing and skin. This study is registered with the Pan African Clinical Trials Registry (PACTR202406779622099).

Results

Blood meal attempts were significantly reduced by citriodiol (−50 %, p = 0.04) and DEET (−50 %, p < 0.001), but not by icaridin (0 %, p = 0.48) and IR3535 (0 %, p = 0.69). Concordantly, the time spent by the fly on the skin was significantly shortened by citriodiol (−66 %, p = 0.02) and DEET (−46 %, p < 0.001), but not with icaridin (+2 %, p = 0.35) and IR3535 (0 %, p = 0.93). Conversely, the number of Chrysops landings on untreated clothing was not reduced by DEET and icaridin, while citriodiol and IR3535 treated individuals experienced a higher number of landings (p = 0.005 and p = 0.01, respectively).

Conclusions

Citriodiol and DEET showed substantial but not complete protective efficacy against the bite of loiasis vectors. Icaridin and IR3535 were ineffective.
loa loa是一种引起loasis的丝状病原体,由鹿蝇种Chrysops dimidiata和C. silacea传播。没有既定的控制工具可用于减少地方病传播。虽然对其他节肢动物使用驱蚊剂进行了探索,但对人类对金蛹叮咬的保护效果尚未进行系统评估。这项随机对照临床试验的目的是评估加蓬高流行地区四种商业皮肤应用节肢动物驱避剂对金蛉叮咬的效果。方法志愿者被随机分配使用避蚊胺、心红素、柠檬醇、IR3535或无活性对照。研究的主要终点是金蝇尝试吸血的次数。次要结局是白蛉落在衣服和皮肤上的频率和持续时间。本研究已在泛非临床试验注册中心注册(PACTR202406779622099)。结果柠檬酸二醇(- 50%,p = 0.04)和避蚊胺(- 50%,p < 0.001)显著降低了血餐次数,但伊卡苷(0%,p = 0.48)和IR3535 (0%, p = 0.69)没有显著降低血餐次数。同样,柠檬酸二醇(- 66%,p = 0.02)和避蚊胺(- 46%,p < 0.001)显著缩短了苍蝇在皮肤上停留的时间,但鸢尾素(+ 2%,p = 0.35)和IR3535 (0%, p = 0.93)没有显著缩短。相反,避蚊胺和鸢尾素对未处理衣物上的瓢虫数量没有减少,而柠檬醇和IR3535处理的个体则有更多的瓢虫降落(p = 0.005和p = 0.01)。结论氯吡二醇和避蚊胺对蜱病媒介的叮咬有一定的保护作用,但保护作用不完全。Icaridin和IR3535无效。
{"title":"Protective efficacy of skin-applied arthropod repellents against Chrysops bites in a Loa loa hyperendemic region in Gabon: A placebo-controlled randomized clinical trial of DEET, icaridin, citriodiol, and IR3535","authors":"Ange G. Doumba Ndalembouly ,&nbsp;Stravensky T. Boussougou-Sambe ,&nbsp;Barclaye Ngossanga ,&nbsp;Ynous Djida ,&nbsp;Jacob Werner ,&nbsp;Rella Zoleko Manego ,&nbsp;Roland C. Zinga Koumba ,&nbsp;Rodrigue Mintsa ,&nbsp;Ayôla A. Adegnika ,&nbsp;Albert Eisenbarth ,&nbsp;Michael Ramharter","doi":"10.1016/j.tmaid.2025.102899","DOIUrl":"10.1016/j.tmaid.2025.102899","url":null,"abstract":"<div><h3>Background</h3><div><em>Loa loa – a filarial pathogen causing loiasis –</em>is transmitted by deer fly species <em>Chrysops dimidiata</em> and <em>C. silacea</em>. There are no established control tools available to reduce loiasis transmission in endemic regions. Although the use of repellents has been explored against other arthropods, their protective efficacy against <em>Chrysops</em> bites in humans has not yet been systematically evaluated. The aim of this randomized controlled clinical trial was to assess the efficacy of four commercial skin-applied arthropod repellents against <em>Chrysops</em> bites in a hyperendemic region in Gabon.</div></div><div><h3>Methods</h3><div>Volunteers were randomly assigned to apply the skin repellents DEET, icaridin, citriodiol, IR3535 or an inactive control. The primary endpoint was the number of blood meal attempts by <em>Chrysops</em> flies. Secondary outcomes were the frequency and duration of <em>Chrysops</em> landings on clothing and skin. This study is registered with the Pan African Clinical Trials Registry (PACTR202406779622099).</div></div><div><h3>Results</h3><div>Blood meal attempts were significantly reduced by citriodiol (−50 %, p = 0.04) and DEET (−50 %, p &lt; 0.001), but not by icaridin (0 %, p = 0.48) and IR3535 (0 %, p = 0.69). Concordantly, the time spent by the fly on the skin was significantly shortened by citriodiol (−66 %, p = 0.02) and DEET (−46 %, p &lt; 0.001), but not with icaridin (+2 %, p = 0.35) and IR3535 (0 %, p = 0.93). Conversely, the number of <em>Chrysops</em> landings on untreated clothing was not reduced by DEET and icaridin, while citriodiol and IR3535 treated individuals experienced a higher number of landings (p = 0.005 and p = 0.01, respectively).</div></div><div><h3>Conclusions</h3><div>Citriodiol and DEET showed substantial but not complete protective efficacy against the bite of loiasis vectors. Icaridin and IR3535 were ineffective.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"67 ","pages":"Article 102899"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An outbreak of acute pulmonary histoplasmosis after exposure to guano in a hollow tree in Ecuador 厄瓜多尔一棵空心树暴露于鸟粪后爆发急性肺组织胞浆菌病
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-09-01 DOI: 10.1016/j.tmaid.2025.102902
Andrea Giacomelli , Cristina Gervasoni , Giacomo Casalini , Alessandro Torre , Marco Schiuma , Sara Lo Menzo , Monica Brundu , Maria Mazzitelli , Samuele Gardin , Anna Grancini , L. Joseph Wheat , Spinello Antinori , Annamaria Cattelan

Background

Outside of classic endemic areas, histoplasmosis has gained attention due to an increased incidence in immunocompetent travellers, attributable to changes in behaviours during travel.

Methods

A cluster of five patients who presented with acute pulmonary histoplasmosis after travelling to the Ecuadorian Amazon Region is described in this article.

Results

Five patients (four females and one male), all in their 20s, presented with acute pulmonary histoplasmosis between sixteen and twenty-three days after the potential airborne exposure after travelling to the Ecuadorian Amazon Region. The initial common exposure is presumed to have occurred during activities inside a hollow tree trunk with guano exposure. Initial symptoms included fever and arthro-myalgias in three cases, and gastrointestinal symptoms with asthenia and lymphadenopathy in the other two cases. Symptoms progressed variably within one week to include chest pain, dyspnoea, and night sweats. Serology was negative in 2 patients during the acute phase but subsequently turned positive in all five cases. Chest CT scans performed within one week from symptom onset in all cases revealed multiple bilateral nodules. In three cases, follow-up chest CT scans performed four-six weeks after symptom onset showed the evolution of nodules into cavitations despite treatment with itraconazole.

Conclusions

This cluster of histoplasmosis cases highlights the clinical variability associated with this fungal infection. The development of pulmonary cavitation during the acute phase of the disease is an infrequent finding that poses additional clinical challenges and suggests the requirement of rigorous follow-up in individuals with acute histoplasmosis returning from the Amazon region.
背景:在经典流行地区之外,由于旅行过程中行为的改变,免疫能力强的旅行者的发病率增加,组织浆菌病引起了人们的关注。方法对5例前往厄瓜多尔亚马逊地区旅行后出现急性肺组织胞浆菌病的患者进行分析。结果5例患者(4女1男)均为20多岁,在前往厄瓜多尔亚马逊地区旅行后可能经空气接触后16至23天内出现急性肺组织胞浆菌病。据推测,最初的常见接触是在中空树干内活动时发生的鸟粪接触。最初症状包括3例发热和关节肌痛,另外2例胃肠症状伴虚弱和淋巴结肿大。症状在一周内有不同程度的进展,包括胸痛、呼吸困难和盗汗。2例患者急性期血清学阴性,但随后全部转为阳性。所有病例均在症状出现后一周内进行胸部CT扫描,发现双侧多发结节。在3例患者中,症状出现4 - 6周后随访胸部CT扫描显示,尽管给予伊曲康唑治疗,结节仍演变为空洞。结论这组组织胞浆菌病病例突出了与真菌感染相关的临床变异性。在疾病急性期肺空化的发展是一种罕见的发现,这带来了额外的临床挑战,并建议对从亚马逊地区返回的急性组织浆菌病患者进行严格的随访。
{"title":"An outbreak of acute pulmonary histoplasmosis after exposure to guano in a hollow tree in Ecuador","authors":"Andrea Giacomelli ,&nbsp;Cristina Gervasoni ,&nbsp;Giacomo Casalini ,&nbsp;Alessandro Torre ,&nbsp;Marco Schiuma ,&nbsp;Sara Lo Menzo ,&nbsp;Monica Brundu ,&nbsp;Maria Mazzitelli ,&nbsp;Samuele Gardin ,&nbsp;Anna Grancini ,&nbsp;L. Joseph Wheat ,&nbsp;Spinello Antinori ,&nbsp;Annamaria Cattelan","doi":"10.1016/j.tmaid.2025.102902","DOIUrl":"10.1016/j.tmaid.2025.102902","url":null,"abstract":"<div><h3>Background</h3><div>Outside of classic endemic areas, histoplasmosis has gained attention due to an increased incidence in immunocompetent travellers, attributable to changes in behaviours during travel.</div></div><div><h3>Methods</h3><div>A cluster of five patients who presented with acute pulmonary histoplasmosis after travelling to the Ecuadorian Amazon Region is described in this article.</div></div><div><h3>Results</h3><div>Five patients (four females and one male), all in their 20s, presented with acute pulmonary histoplasmosis between sixteen and twenty-three days after the potential airborne exposure after travelling to the Ecuadorian Amazon Region. The initial common exposure is presumed to have occurred during activities inside a hollow tree trunk with guano exposure. Initial symptoms included fever and arthro-myalgias in three cases, and gastrointestinal symptoms with asthenia and lymphadenopathy in the other two cases. Symptoms progressed variably within one week to include chest pain, dyspnoea, and night sweats. Serology was negative in 2 patients during the acute phase but subsequently turned positive in all five cases. Chest CT scans performed within one week from symptom onset in all cases revealed multiple bilateral nodules. In three cases, follow-up chest CT scans performed four-six weeks after symptom onset showed the evolution of nodules into cavitations despite treatment with itraconazole.</div></div><div><h3>Conclusions</h3><div>This cluster of histoplasmosis cases highlights the clinical variability associated with this fungal infection. The development of pulmonary cavitation during the acute phase of the disease is an infrequent finding that poses additional clinical challenges and suggests the requirement of rigorous follow-up in individuals with acute histoplasmosis returning from the Amazon region.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"67 ","pages":"Article 102902"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infectious diseases on passenger ships: Port preparedness and response - A narrative systematic review. 客船传染病:港口准备和应对——叙述系统综述。
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-09-01 Epub Date: 2025-08-06 DOI: 10.1016/j.tmaid.2025.102886
Johannes A Neumann, Jette Zimmermann, Marie Frese, Martin Dirksen-Fischer, Scarlett Kleine-Kampmann, Volker Harth, Jan Heidrich

Background: Ships are environments conducive to the spread of infectious diseases among passengers and crew members. In this context, it is essential to establish effective prevention and control measures to protect the health of passengers and crew members while ensuring that shipping minimizes its contribution to the global spread of disease via ship-to-shore interactions. The aim of this review is to provide knowledge on the impact of infectious diseases on board large passenger ships on the port, the port community and other land-based operations.

Methods: A systematic literature review was conducted, searching the PubMed, Scopus and Cochrane Library databases and including additional articles from hand searches up to July 2024. Peer-reviewed studies of infectious disease outbreaks related to large passenger ship travel that described ship-shore interaction, port preparedness and impact on the port community were included. Article selection and data extraction were conducted by two independent reviewers.

Results: A total of 593 publications were initially identified, with 23 articles included in the analysis. Most studies reported COVID-19 outbreaks on cruise ships; other communicable diseases reported were influenza, gastroenteritis, and varicella. The articles highlighted the importance of comprehensive management plans and proactive risk assessment during infectious disease outbreaks that impact ship-to-shore interactions.

Conclusions: Effective stakeholder collaboration, ship-to-shore communication, coordination of diagnostic testing and medical transport, isolation, and quarantine measures are essential components of infectious disease prevention, mitigation, and management in passenger shipping within the port environment.

背景:船舶是有利于传染病在乘客和船员之间传播的环境。在这种情况下,必须制定有效的预防和控制措施,以保护乘客和船员的健康,同时确保航运通过船岸互动最大限度地减少其对疾病全球传播的贡献。本次审查的目的是提供关于大型客船上的传染病对港口、港口社区和其他陆上作业的影响的知识。方法:系统文献综述,检索PubMed、Scopus和Cochrane图书馆数据库,并纳入截至2024年7月的人工检索文章。包括了与大型客船旅行有关的传染病暴发的同行评审研究,这些研究描述了船岸相互作用、港口准备和对港口社区的影响。文章选择和数据提取由两名独立审稿人进行。结果:初步确定了593篇出版物,其中23篇纳入分析。大多数研究报告了游轮上的COVID-19疫情;报告的其他传染病有流感、肠胃炎和水痘。这些文章强调了在影响船岸相互作用的传染病爆发期间全面管理计划和主动风险评估的重要性。结论:有效的利益相关方协作、船岸沟通、诊断检测和医疗运输协调、隔离和检疫措施是港口环境下客船传染病预防、缓解和管理的重要组成部分。
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引用次数: 0
Plasmodium vivax microgametes in a Colombian malaria case: A diagnostic challenge 哥伦比亚疟疾病例中的间日疟原虫小配子:诊断挑战
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-08-25 DOI: 10.1016/j.tmaid.2025.102895
Diego Andrés Rodríguez Lugo , Jorge A. Morcillo Muñoz , Leidy J. Medina-Lozano , Álvaro A. Faccini-Martínez
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引用次数: 0
Preliminary screening of ESBL-producing Escherichia coli and Klebsiella pneumoniae carriage among migrant communities in Klang Valley, Malaysia 马来西亚巴生谷移民社区产esbl大肠杆菌和肺炎克雷伯菌携带的初步筛选
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-08-25 DOI: 10.1016/j.tmaid.2025.102894
Muhammad Azreen Mat Husin , Adrian Anthony Peirera , Thana Seelan , Ramliza Ramli , Ilana Lopes Baratella da Cunha Camargo , Sheila Nathan , Hui-min Neoh
Economic migrant workers are crucial for a country's development but may also contribute to transboundary transmission of antimicrobial resistance (AMR). This study aimed to investigate the silent carriage of ESBL-producing Escherichia coli (ESBLEC) and Klebsiella pneumoniae (ESBLKP) among economic migrants from Indonesia, Bangladesh and Nepal residing in Klang Valley, Malaysia. Between December 2023 and May 2024, 263 study participants of Indonesian, Bangladeshi, and Nepalese migrant communities were recruited and rectal swabs collected. Swabs were then cultured on CHROMagar™ ESBL; presumptive ESBL-positive strains were confirmed and antimicrobial susceptibility-tested using a VITEK 2 system. ESBL genotyping was also performed on confirmed isolates. A total of 67 and five strains were confirmed as ESBLEC and ESBLKP, respectively. Both ESBLEC and ESBLKP strains showed similar resistance to penicillin and 3rd generation cephalosporins, though more ESBLKP strains were resistant to 4th generation cephalosporins. More ESBLEC strains were resistant to ciprofloxacin. No carbapenem-resistant strains were detected. The blaCTX-M-1 gene family was predominantly found in ESBLEC strains from all three nationalities, while ESBLKP strains frequently harboured blaTEM, blaCTX-M, and blaSHV genes. The prevalence of ESBL-producing strains was highest among Bangladeshi participants (n = 16, 31.4 %), followed by Indonesians (n = 47, 29.7 %) and Nepalis (n = 9, 19.1 %) working in domestic or manufacturing sectors. These findings highlight the public health risks of high ESBLEC and ESBLKP carriage in healthy migrant workers, which may impact recruitment and retention, leading to labour shortages and higher costs. Screening and increased awareness are crucial to limit the spread of these pathogens.
经济移徙工人对一个国家的发展至关重要,但也可能促进抗微生物药物耐药性的跨界传播。本研究旨在调查居住在马来西亚巴生谷的来自印度尼西亚、孟加拉国和尼泊尔的经济移民中产esblc大肠杆菌(ESBLEC)和肺炎克雷伯菌(ESBLKP)的无声携带情况。在2023年12月至2024年5月期间,研究人员招募了263名来自印度尼西亚、孟加拉国和尼泊尔移民社区的研究参与者,并收集了直肠拭子。然后在CHROMagar™ESBL上培养拭子;用VITEK 2系统对推定的eslb阳性菌株进行确认和抗菌药物敏感性测试。对确认的分离株也进行了ESBL基因分型。ESBLEC和ESBLKP分别鉴定为67株和5株。ESBLEC和ESBLKP菌株对青霉素和第3代头孢菌素耐药相似,但ESBLKP菌株对第4代头孢菌素耐药较多。更多的ESBLEC菌株对环丙沙星耐药。未检出碳青霉烯耐药菌株。blaCTX-M-1基因家族主要存在于三个民族的ESBLEC菌株中,而ESBLKP菌株经常含有blactem、blaCTX-M和blaSHV基因。产esbl菌株的流行率在孟加拉国参与者中最高(n = 16, 31.4%),其次是印度尼西亚人(n = 47, 29.7%)和在国内或制造业工作的尼泊尔人(n = 9, 19.1%)。这些研究结果突出了健康移徙工人中ESBLEC和ESBLKP高携带的公共卫生风险,这可能影响招聘和保留,导致劳动力短缺和更高的成本。筛查和提高认识对于限制这些病原体的传播至关重要。
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引用次数: 0
A decade of dengue disease burden in Africa (2013–2023): a systematic review 非洲登革热疾病负担十年(2013-2023年):系统回顾
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-08-25 DOI: 10.1016/j.tmaid.2025.102897
Gaspary O. Mwanyika , Monika Moir , Abdualmoniem O. Musa , Jenicca Poongavanan , Graeme Dor , Eduan Wilkinson , Cheryl Baxter , Tulio de Oliveira , Houriiyah Tegally

Background

Dengue is a major mosquito-borne disease worldwide. The epidemiological trends of the disease in Africa over the past decade remain unclear. This review aims to provide insight into the epidemiological trends of dengue in Africa from 2013 to 2023.

Methods

We systematically searched PubMed/MEDLINE and Scopus for studies published between January 2013 and December 2023. Additionally, we collected official records from the World Health Organization for Africa and African Centre for Disease Control. We included studies that reported dengue cases in humans in Africa and excluded publications prior to 2013, review articles and non-human studies. For specific countries, the suspected cases per 100,000 population and fatality rates were estimated and the trend predicted using a negative binomial model. The statistical analyses and visualisations were performed using R programming.

Results

Of the 453 reports screened, 87 from 25 African countries were selected for systematic review. Of which 55.2 % (48/87) were indicator-based, 40.2 % (35/87) research and 4.6 % (4/87) event-based reports. Between 2013 and 2023, approximately 200,000 suspected dengue cases, 90,000 confirmed cases and 900 deaths were reported in Africa. Over 80 % of confirmed cases originated from West Africa, with Burkina Faso reporting over 500 cases per 100,000 population. DENV1 and DENV2 predominated at different times with transmission closely linked to rainy seasons.

Conclusions

The rising dengue cases across Africa, highlight the need to strengthen surveillance and implement effective regional-specific interventions against future dengue outbreaks. Further research is necessary to improve our understanding on dengue transmission dynamics and suitability of regions in Africa.
登革热是世界范围内一种主要的蚊媒疾病。过去十年来该疾病在非洲的流行病学趋势仍然不清楚。本综述旨在深入了解2013年至2023年非洲登革热的流行病学趋势。方法系统检索2013年1月至2023年12月间发表的PubMed/MEDLINE和Scopus研究。此外,我们还收集了世界卫生组织非洲和非洲疾病控制中心的官方记录。我们纳入了报道非洲人类登革热病例的研究,排除了2013年之前的出版物、综述文章和非人类研究。对于特定国家,估计了每10万人中的疑似病例和死亡率,并使用负二项模型预测了趋势。使用R编程进行统计分析和可视化。结果在筛选的453份报告中,选择了来自25个非洲国家的87份报告进行系统审查。其中55.2%(48/87)为基于指标的报告,40.2%(35/87)为研究报告,4.6%(4/87)为基于事件的报告。2013年至2023年期间,非洲报告了约20万登革热疑似病例、9万确诊病例和900例死亡。80%以上的确诊病例来自西非,布基纳法索报告每10万人中有500多例病例。登革热1型和登革热2型在不同时期占优势,传播与雨季密切相关。结论:非洲各地登革热病例的不断上升,突出了加强监测和实施有效的区域特定干预措施的必要性,以防止未来的登革热疫情。需要进一步的研究来提高我们对非洲地区登革热传播动态和适宜性的认识。
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引用次数: 0
Climate change and dengue Fever: A 14-year study of mortality trends during 2010–2023 in Indonesia 气候变化与登革热:印度尼西亚2010-2023年死亡率趋势的14年研究
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-08-23 DOI: 10.1016/j.tmaid.2025.102893
Kurnia Ardiansyah Akbar , Rosa Kumala Fatma , Fauzi Elamouri , Jürgen Kurt Rockstroh

Background

Dengue fever remains a critical public health issue in Indonesia, with a significant increase in mortality cases in recent years. As a vector-borne disease, dengue fever is highly influenced by environmental conditions, making it particularly sensitive to the impacts of climate change. Indonesia, being heavily affected by global climate change, faces increasing challenges in managing dengue fever. This study aims to investigate the association between dengue fever mortality and climate variables, specifically annual rainfall, and temperature, in Indonesia from 2010 to 2023.

Methods

Secondary data on dengue fever cases from 2010 to 2023 were collected from the Ministry of Health of Indonesia. Data on annual rainfall and annual temperature were obtained from the Indonesia Meteorology, Climatology, and Geophysics Council, with information gathered from 116 stations across Indonesia. Linear regression analysis was used to determine the association between these variables and dengue fever mortality.

Results

The analysis revealed a significant association between annual temperature (p = 0.049; R2 = 0.212; 95 % CI: 710.85–2.233) and dengue fever mortality. Additionally, annual dengue fever cases were significantly associated with mortality (p < 0.001; R2 = 1.075; 95 % CI: 0.007–0.010). However, annual rainfall was not found to be significant in this study.

Conclusion

These findings underscore the importance of monitoring climatic changes and their impact on public health, particularly concerning vector-borne diseases. Enhanced surveillance and targeted interventions could mitigate the adverse effects of these climatic variables on dengue fever mortality in Indonesia.
背景登革热在印度尼西亚仍然是一个严重的公共卫生问题,近年来死亡病例显著增加。作为一种病媒传播疾病,登革热受环境条件的影响很大,使其对气候变化的影响特别敏感。印度尼西亚受到全球气候变化的严重影响,在管理登革热方面面临越来越大的挑战。本研究旨在调查2010年至2023年印度尼西亚登革热死亡率与气候变量(特别是年降雨量和温度)之间的关系。方法收集印度尼西亚卫生部2010 - 2023年登革热病例二级资料。年降雨量和年气温数据来自印度尼西亚气象、气候学和地球物理委员会,信息来自印度尼西亚116个气象站。采用线性回归分析确定这些变量与登革热死亡率之间的关系。结果年气温与登革热病死率有显著相关性(p = 0.049; R2 = 0.212; 95% CI: 710.85 ~ 2.233)。此外,每年登革热病例与死亡率显著相关(p < 0.001; R2 = 1.075; 95% CI: 0.007-0.010)。然而,年降雨量在本研究中没有发现显著性。结论这些发现强调了监测气候变化及其对公共卫生的影响的重要性,特别是对媒介传播疾病的影响。加强监测和有针对性的干预措施可以减轻这些气候变量对印度尼西亚登革热死亡率的不利影响。
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引用次数: 0
期刊
Travel Medicine and Infectious Disease
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