Hybrid journal (It can contain Open Access articles) ISSN (Print) 1195-1982 - ISSN (Online) 1708-8305 Published by Oxford University Press[419 journals]
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Authors:Steffen R; Schmitt H, Zavadska D. Abstract: Tick-borne encephalitis vaccine efficacy approximates 90% after the initial two doses, but the duration of protection is unknown. Emerging evidence indicates that vaccine effectiveness does not depend on the seropersistence of antibodies but on the boostability. Thus, conventional recommendations with booster doses every 3 or 5 years need to be reconsidered. PubDate: Wed, 02 Mar 2022 00:00:00 GMT DOI: 10.1093/jtm/taac030 Issue No:Vol. 29, No. 2 (2022)
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Authors:Balogun O; Brown A, Angelo K, et al. Abstract: AbstractBackgroundNon-immune international travellers are at risk of acquiring hepatitis A. Although hepatitis A vaccination is recommended for unvaccinated travellers to high or intermediate hepatitis A virus endemicity, compliance with this recommendation is not universal.The main objective was to describe the demographic and travel characteristics of international travellers infected with hepatitis A during travel.MethodsAvailable data on travellers with confirmed (positive molecular test) or probable (symptomatic individuals with a single positive IgM test) hepatitis A diagnosed during and after travel from January 2008 to December 2020 were obtained from the GeoSentinel Surveillance Network database. We analysed demographic and travel characteristics of infected travellers.ResultsAmong 254 travellers with hepatitis A (185 confirmed and 69 probable), the median age was 28 years (interquartile range: 19–40), 150 (59%) were male, and among 54 travellers with information available, 53 (98%) were unvaccinated. The most common reasons for travel included tourism (n = 120; 47%) and visiting friends or relatives (VFR; n = 72; 28%). About two-thirds of VFR travellers with hepatitis A (n = 50; 69%) were younger than 20 years old. Hepatitis A was acquired most frequently in South-Central Asia (n = 63; 25%) and sub-Saharan Africa (n = 61; 24%), but 16 travellers (6%) acquired hepatitis A in regions with low endemicity including Western Europe (n = 7; 3%), the Caribbean (n = 6; 2%) and North America (n = 3; 1%). Median duration from illness onset to GeoSentinel site presentation was ~7 days (interquartile range : 4–14 days). Among 88 travellers with information available, 59% were hospitalized.ConclusionsDespite availability of highly effective vaccines, travellers still acquire hepatitis A, even when traveling to low-endemicity destinations. Providing pre-departure hepatitis A vaccine to susceptible travellers is crucial to reducing travel-associated hepatitis A and should be offered to all travellers as part of the pre-travel consultation, regardless of destination. PubDate: Thu, 03 Feb 2022 00:00:00 GMT DOI: 10.1093/jtm/taac013 Issue No:Vol. 29, No. 2 (2022)
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Authors:Bravo C; Castells V, Zietek-Gutsch S, et al. Abstract: AbstractBackgroundTravellers can access online information to research and plan their expeditions/excursions, and seek travel-related health information. We explored German travellers’ attitude and behaviour toward vaccination, and their travel-related health information seeking activities.MethodsWe used two approaches: web ‘scraping’ of comments on German travel-related sites and an online survey. ‘Scraping’ of travel-related sites was undertaken using keywords/synonyms to identify vaccine- and disease-related posts. The raw unstructured text extracted from online comments was converted to a structured dataset using Natural Language Processing Techniques. Traveller personas were defined using K-means based on the online survey results, with cluster (i.e. persona) descriptions made from the most discriminant features in a distinguished set of observations. The web-scraped profiles were mapped to the personas identified. Travel and vaccine-related behaviours were described for each persona.ResultsWe identified ~2.6 million comments; ~880 k were unique and mentioned ~280 k unique trips by ~65 k unique profiles. Most comments were on destinations in Europe (37%), Africa (21%), Southeast Asia (12%) and the Middle East (11%). Eight personas were identified: ‘middle-class family woman’, ‘young woman travelling with partner’, ‘female globe-trotter’, ‘upper-class active man’, ‘single male traveller’, ‘retired traveller’, ‘young backpacker’, and ‘visiting friends and relatives’. Purpose of travel was leisure in 82–94% of profiles, except the ‘visiting friends and relatives’ persona. Malaria and rabies were the most commented diseases with 12.7 k and 6.6 k comments, respectively. The ‘middle-class family woman’ and the ‘upper-class active man’ personas were the most active in online conversations regarding endemic disease and vaccine-related topics, representing 40% and 19% of comments, respectively. Vaccination rates were 54%–71% across the traveller personas in the online survey. Reasons for vaccination reluctance included perception of low risk to disease exposure (21%), price (14%), fear of side effects (12%) and number of vaccines (11%).ConclusionsThe information collated on German traveller personas and behaviours toward vaccinations should help guide counselling by healthcare professionals. PubDate: Thu, 27 Jan 2022 00:00:00 GMT DOI: 10.1093/jtm/taac009 Issue No:Vol. 29, No. 2 (2022)
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Authors:Camprubí-Ferrer D; Cobuccio L, Van Den Broucke S, et al. Abstract: AbstractBackgroundEtiological diagnosis of febrile illnesses in returning travelers is a great challenge, particularly when presenting with no focal symptoms [acute undifferentiated febrile illnesses (AUFI)], but is crucial to guide clinical decisions and public health policies. In this study, we describe the frequencies and predictors of the main causes of fever in travelers.MethodsProspective European multicenter cohort study of febrile international travelers (November 2017–November 2019). A predefined diagnostic algorithm was used ensuring a systematic evaluation of all participants. After ruling out malaria, PCRs and serologies for dengue, chikungunya and Zika viruses were performed in all patients presenting with AUFI ≤ 14 days after return. Clinical suspicion guided further microbiological investigations.ResultsAmong 765 enrolled participants, 310/765 (40.5%) had a clear source of infection (mainly traveler’s diarrhea or respiratory infections), and 455/765 (59.5%) were categorized as AUFI. AUFI presented longer duration of fever (p < 0.001), higher hospitalization (p < 0.001) and ICU admission rates (p < 0.001). Among travelers with AUFI, 132/455 (29.0%) had viral infections, including 108 arboviruses, 96/455 (21.1%) malaria and 82/455 (18.0%) bacterial infections. The majority of arboviral cases (80/108, 74.1%) was diagnosed between May and November. Dengue was the most frequent arbovirosis (92/108, 85.2%). After 1 month of follow-up, 136/455 (29.9%) patients with AUFI remained undiagnosed using standard diagnostic methods. No relevant differences in laboratory presentation were observed between undiagnosed and bacterial AUFI.ConclusionsOver 40% of returning travelers with AUFI were diagnosed with malaria or dengue, infections that can be easily diagnosed by rapid diagnostic tests. Arboviruses were the most common cause of AUFI (above malaria) and most cases were diagnosed during Aedes spp. high season. This is particularly relevant for those areas at risk of introduction of these pathogens. Empirical antibiotic regimens including doxycycline or azithromycin should be considered in patients with AUFI, after ruling out malaria and arboviruses. PubDate: Tue, 18 Jan 2022 00:00:00 GMT DOI: 10.1093/jtm/taac002 Issue No:Vol. 29, No. 2 (2022)
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Authors:Pugh S; Moïsi J, Kundi M, et al. Abstract: Vaccine effectiveness (VE) was consistently high following two doses (94.6–97.4%) and three doses (96.1%) of the tick-borne encephalitis (TBE) vaccine. These data support the public health value of providing two doses of the TBE vaccine to a traveller to an endemic area presenting with insufficient time to complete the full three-dose primary series. PubDate: Thu, 06 Jan 2022 00:00:00 GMT DOI: 10.1093/jtm/taab193 Issue No:Vol. 29, No. 2 (2022)
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Authors:Faucon C; Godefroy N, Itani O, et al. Abstract: We report the spectrum of skin diseases in returning international travellers seen in our department, with the participation of a dermatologist for each consultation. Of 135 dermatoses (60% appearing abroad), 33.3% were considered as tropical, and 44–52% were related to arthropod exposure, highlighting the need and importance of anti-mosquito measures. PubDate: Thu, 16 Dec 2021 00:00:00 GMT DOI: 10.1093/jtm/taab189 Issue No:Vol. 29, No. 2 (2021)
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Authors:Mills D; Lau C, Mills C, et al. Abstract: AbstractBackgroundCurrently, there is limited data on long-term persistence of antibodies and boostability of intradermal (ID) rabies pre-exposure prophylaxis (PrEP) schedules. This study investigated travellers who received a primary ID PrEP schedule at least 5 years previously to determine the persistence of antibodies and subsequent antibody response after one 0.1-ml ID booster dose.MethodsAdults (age ≥ 18 years) who had previously received ID PrEP at a specialist travel medicine clinic in Brisbane, Australia were included. At Day 0, blood was collected for serology and one dose of 0.1-ml ID rabies vaccine (Verorab®) was administered. At Day 7, serology was repeated. At Day 14, participants were given results and enquired if they experienced adverse events following immunization (AEFIs). Antibodies were measured using Platelia Rabies II ELISA; levels ≥0.5 EU/mL were considered antibody-positive.Results158 participants were included [64.6% female, median age at enrolment 56.4 years, interquartile range (IQR) 42.4–65.2 years], and median time since the primary ID PrEP was 8.5 years (IQR 6.9–11.7 years). The majority of participants (82.3%) were antibody-positive at Day 0. The proportion of participants who were antibody-positive at Day 0 was higher among those who were younger at primary vaccination (87.0% if aged<50 years, 75.8% of aged ≥50 years). The proportion of participants who were antibody-positive declined as median time since primary vaccination increased, though the trend was not statistically significant (p-trend = 0.187). All except one participant (99.4%) were antibody-positive after one ID booster dose. AEFIs were reported by 42.4% of participants and were mainly mild.ConclusionsRabies antibodies persist for many years after ID PrEP and can be rapidly boosted with a single ID dose. Future studies are needed to confirm that ID PrEP primes the immune system sufficiently so that boosters are not routinely needed, and only given in the event of a rabies-prone exposure. PubDate: Tue, 07 Dec 2021 00:00:00 GMT DOI: 10.1093/jtm/taab188 Issue No:Vol. 29, No. 2 (2021)
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Authors:Chamorro-Tojeiro S; Navas E, Liébana M, et al. Abstract: Vaccine-preventable diseases should be considered in returning travellers presenting with a rash. A patient with measles, probably acquired during an evacuation flight from Afghanistan to the USA, was diagnosed on return from Brazil. Misdiagnosis of highly contagious viral infections such as measles may have significant public health repercussions. PubDate: Fri, 26 Nov 2021 00:00:00 GMT DOI: 10.1093/jtm/taab182 Issue No:Vol. 29, No. 2 (2021)
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Authors:Assoumani L; De Maria L, La Scola B, et al. Abstract: Three children <4 years were diagnosed with influenza A/H3N2 on returning from Comoros to Marseille, France in summer 2021. An outbreak of influenza-like illness is currently affecting children in Comoros. Sentinel travellers returning to developed countries allow identifying pathogens circulating in tropical areas where diagnostic tools are lacking. PubDate: Sat, 20 Nov 2021 00:00:00 GMT DOI: 10.1093/jtm/taab181 Issue No:Vol. 29, No. 2 (2021)
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Authors:Renshaw A; Lai I. Abstract: The negative impact of medical misinformation on travellers in a multinational organizational context is substantial. A clear framework for assessing and reducing the risk of inaccurate health information is required in the current rapidly changing travel context, especially to locations where the healthcare system is unfamiliar. PubDate: Tue, 16 Nov 2021 00:00:00 GMT DOI: 10.1093/jtm/taab179 Issue No:Vol. 29, No. 2 (2021)
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Authors:Hills S; Broussard K, Broyhill J, et al. Abstract: AbstractBackgroundTick-borne encephalitis (TBE) is an arboviral disease that is focally endemic in parts of Europe and Asia. TBE cases among US travellers are rare, with previous reports of only six cases among civilian travellers through 2009 and nine military-related cases through 2020. A TBE vaccine was licenced in the USA in August 2021. Understanding TBE epidemiology and risks among US travellers can help with the counselling of travellers going to TBE-endemic areas.MethodsDiagnostic testing for TBE in the USA is typically performed at the Centers for Disease Control and Prevention (CDC) because no commercial testing is available. Diagnostic testing for TBE at CDC since 2010 was reviewed. For individuals with evidence of TBE virus infection, information was gathered on demographics, clinical presentations and risk factors for infection.ResultsFrom 2010–20, six patients with TBE were identified. Cases occurred among both paediatric and adult travellers and all were male. Patients were diagnosed with meningitis (n = 2) or encephalitis (n = 4); none died. Cases had travelled to various countries in Europe or Russia. Three cases reported visiting friends or relatives. Activities reported included hiking, camping, trail running, or working outdoors, and two cases had a recognized tick bite.ConclusionsTBE cases among US travellers are uncommon, with these six cases being the only known TBE cases among civilian travellers during this 11-year period. Nonetheless, given potential disease severity, pre-travel counselling for travellers to TBE-endemic areas should include information on measures to reduce the risk for TBE and other tick-borne diseases, including possible TBE vaccine use if a traveller’s itinerary puts them at higher risk for infection. Clinicians should consider the diagnosis of TBE in a patient with a neurologic or febrile illness recently returned from a TBE-endemic country, particularly if a tick bite or possible tick exposure is reported. PubDate: Sat, 06 Nov 2021 00:00:00 GMT DOI: 10.1093/jtm/taab167 Issue No:Vol. 29, No. 2 (2021)
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Authors:Schmidt A; Altpeter E, Graf S, et al. Abstract: AbstractBackgroundIn 2006, the Swiss Federal Office of Public Health (FOPH) decided recommending a prolongation of vaccine booster intervals after the third dose for the prevention of tick-borne encephalitis (TBE) from 3 to 10 years.MethodsTo ascertain whether this amendment resulted in an increased rate of vaccine breakthroughs, we conducted a retrospective analysis of surveillance data collected 2000–19 by mandatory reporting to the Swiss FOPH. Fractions of breakthroughs [with 95% confidence intervals (CIs)]—0–3 years vs >3–10 years after the third vaccination dose—were compared across time periods and age groups.ResultsAmong 3205 notified TBE cases, known vaccination status was reported in 2562 (79.9%), including 103 patients with ≥3 vaccine doses (4.0%). Among those, there were 39 patients who had received the last dose within 3 years and 48 patients in the >3–10 years group. During the 2010–19 period in which the new booster strategy was implemented there were 23 and 38 breakthroughs, respectively, and the annual breakthrough rate was 7.7 (95% CI 5.0–11.7) cases during the first 3 years after the last dose, and 5.4 (95% CI 3.9–7.5) cases in following 7 years. We observed no significant trend of TBE breakthroughs with increasing age. Increasing numbers of TBE and of vaccine breakthroughs over time have been associated with spreading endemicity and higher vaccination coverage in Switzerland.ConclusionsThere is no indication that extended booster intervals resulted in an increased rate of breakthroughs, but there was a marked public health benefit with respect to increased acceptability of TBE immunization in the general population. PubDate: Tue, 28 Sep 2021 00:00:00 GMT DOI: 10.1093/jtm/taab158 Issue No:Vol. 29, No. 2 (2021)
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Authors:Norman F; Chamorro S, Tenorio M, et al. Abstract: screeninghepatitis B virushemoglobin Sschistosomiasisstrongyloidiasismigrant PubDate: Tue, 28 Sep 2021 00:00:00 GMT DOI: 10.1093/jtm/taab152 Issue No:Vol. 29, No. 2 (2021)
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Authors:Billiet A; Vanderschueren S, Lagrou K, et al. Abstract: A 23-year-old man presented to the emergency department with recurrent fever after returning from a camping trip on the Greek island of Tilos in the Aegean sea. In the last 2 months, four distinct episodes of fever, chills and myalgia occurred. A peripheral-blood smear revealed an unexpected guest. PubDate: Wed, 12 May 2021 00:00:00 GMT DOI: 10.1093/jtm/taab073 Issue No:Vol. 29, No. 2 (2021)
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Authors:Weitzel T; Perez I, Porte L. Abstract: Since Lyme borreliosis is endemic in the Northern Hemisphere, it is usually not in the spotlight of travel medicine. However, borreliosis is a relevant problem and diagnostic challenge in travelers from the Southern Hemisphere returning from trips to Europe and North America. PubDate: Fri, 05 Mar 2021 00:00:00 GMT DOI: 10.1093/jtm/taab030 Issue No:Vol. 29, No. 2 (2021)
Hybrid journal (It can contain Open Access articles)
[419 journals]
