Human African trypanosomiasis in travellers to Kenya

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Malaria prophylaxis policy for travellers from Europe to the Indian Sub Continent

Analysis of malaria imported into eight European countries from the Indian sub-continent (ISC) (India, Pakistan, Bangladesh and Sri Lanka) led to a consensus statement on the use of chemoprophylaxis within TropNetEurop. The proportion of cases from the ISC in 2004 ranged from 1.4%–4.6% of total imported cases. Plasmodium falciparum cases reported from the eight countries was only 23 (13% of all cases from the region). Total malaria reports between 1999–2004 fell from 317 to 180. The risk of malaria in UK residents visiting the region was > 1 case per 1,000 years exposed. The group recommended non-selective prescribing of chemoprophylaxis for visitors to India, Pakistan, Bangladesh and Sri Lanka should be dropped

Global results on reset-induced periodic trajectories of planar systems

We study the existence of asymptotically stable periodic trajectories induced by reset feedback. The analysis is developed for a planar system. Casting the problem into the hybrid setting, we show that a periodic orbit arises from the balance between the energy dissipated during flows and the energy restored by resets, at jumps. The stability of the periodic orbit is studied with hybrid Lyapunov tools. The satisfaction of the so-called hybrid basic conditions ensures the robustness of the asymptotic stability. Extensions of the approach to more general mechanical systems are discussed.Work supported in part by ANR under project LimICoS, contract number 12 BS03 005 01, by the iCODE institute, research project of the Idex ParisSaclay, and by the University of Trento, grant OptHySYS.This is the author accepted manuscript. It is currently under an indefinite embargo pending publication by IEEE

Reemergence of Strongyloidiasis, Northern Italy

Strongyloidiasis is a helminth infection caused by Strongyloides stercoralis, a nematode ubiquitous in tropical and subtropical countries and occasionally reported in temperate countries, including Italy (1). Sources of infection are filariform strongyloid larvae present in soil contaminated by infected feces; the larvae penetrate through the skin of a human host. After the first life cycle, a process of autoinfection begins, which persists indefinitely in the host if the infection is not effectively treated. The infection can remain totally asymptomatic for many years or forever or cause cutaneous (itching and rash), abdominal (epigastric pain, pseudoappendicitis, diarrhea), respiratory (cough, recurrent asthma), and systemic (weight loss, cachexia) symptoms that can be enervating. More importantly, when host immunity is impaired because of a concurrent disease or immunosuppressive therapy (including corticosteroids, sometimes used to treat symptoms of the unrecognized infection or the concurrent eosinophilia), disseminated strongyloidiasis may occur (2\u20134), causing a massive and almost invariably fatal invasion of virtually all organs and tissues by filariform larvae and even adult worms (Figure), often combined with bacterial superinfection. This complication is believed to be rare but is probably underestimated because of the extreme variability of the clinical presentation. Although strongyloidiasis can be suspected in the presence of symptoms or eosinophilia (which is frequent but not mandatory), the low sensitivity of direct diagnostic methods often lets the disease go unrecognized (5\u20137). By far the most sensitive diagnostic tools are serologic tests: sensitivity and specificity of indirect fluorescent antibody test (IFAT) (in-house produced IFAT) are 97.4% and 97.9%, respectively, at a dilution >1/20, and 70.5% and 99.8% at a dilution >1/80 (6). A suspected case is defined by a positive antibody titer >20 (IFAT); a case is confirmed by a positive direct test result (culture in agar being the most sensitive direct technique) or by a positive antibody titer >80 (6). Despite some anecdotal reports on the presence of strongyloidiasis in Italy (1,6), reliable information about the real prevalence of the infection is lacking. After seeing several patients affected by the disease, 1 of whom died because of dissemination (Z. Bisoffi, unpub. data), we decided to carry out a preliminary rapid assessment of the extent of the problem in elderly patients with eosinophilia. During a 4-month period, from February through May 2008, every patient born in 1940 or earlier who came to the clinical laboratories of 2 contiguous health districts in northern Italy (Mantova, Lombardy Region, and Legnago, Veneto Region) for a diagnostic blood test (hematocrit and leukocyte count/formula) for whatever reason and having a eosinophil count >500 cells/\u3bcL was asked to join the study. This study was the pilot phase of a larger, multicentered study, which obtained formal approval from the Ethical Committee of Sacro Cuore Hospital of Negrar, Verona. Informed consent was required of each patient. Of the 132 patients eligible for inclusion (mean age 76.4 years, range 68\u201390 years, male:female ratio 1.6), none refused to give informed consent. Serum specimens were subjected to the IFAT for S. stercoralis at the Sacro Cuore Hospital Centre for Tropical Diseases. Unexpectedly, we found that 37 (28%) of 132 patients were positive, with titers ranging between 20 and >320 (and >80 in most cases). However, caution should be exercised in interpreting the results because the patients may not be representative of the general population. Moreover, our results are based on an indirect (although highly sensitive and specific) test. Because the reported cases involve only a few patients every year (of whom some are anecdotally reported as dying from the infection, usually unpublished), we suspect that most strongyloidiasis cases remain undetected. If relevant transmission still exists in the area, it is unknown but is unlikely because of the improvement of hygienic conditions in the past 5 decades. Reports of the infection in children or young adults with no travel history outside Italy are lacking. Strongyloidiasis in the elderly is therefore most likely to result from an infection that occurred much earlier in life, either in infancy or at a young age, while walking or working barefoot in agricultural fields. The long persistence is the consequence of the autoinfection cycle typical of this parasite as described above. The result is an important and unrecognized public health problem affecting the geriatric population of northern Italy. These preliminary results confirm the need for the already planned, multicentered study involving a larger sample and a wider geographic area

Epidemiology of Strongyloides stercoralis in northern Italy: Results of a multicentre case-control study, February 2013 to July 2014

Strongyloides stercoralis is a soil-transmitted helminth widely diffused in tropical and subtropical regions of the world. Autochthonous cases have been also diagnosed sporadically in areas of temperate climate. We aimed at defining the epidemiology of strongyloidiasis in immigrants and Italians living in three northern Italian Regions. Screening for S. stercoralis infection was done with serology, confirmation tests were a second serological method or stool agar culture. A case-control approach was adopted and patients with a peripheral eosinophil count 65 500/mcL were classified as cases. Of 2,701 individuals enrolled here 1,351 were cases and 1,350 controls; 86% were Italians, 48% women. Italians testing positive were in 8% (97/1,137) cases and 1% (13/1,178) controls (adjusted odds ratio (aOR) 8.2; 95% confidence interval (CI): 4.5-14.8), while positive immigrants were in 17% (36/214) cases and in 2% (3/172) controls (aOR 9.6; 95% CI: 2.9-32.4). Factors associated with a higher risk of infection for all study participants were eosinophilia (p < 0.001) and immigration (p = 0.001). Overall, strongyloidiasis was nine-times more frequent in individuals with eosinophilia than in those with normal eosinophil count

Profile of Trypanosoma cruzi Infection in a Tropical Medicine Reference Center, Northern Italy

Chagas disease (CD) is endemic in Central and South America, Mexico and even in some areas of the United States. However, cases have been increasingly recorded also in non-endemic countries. The estimated number of infected people in Europe is in a wide range of 14000 to 181000 subjects, mostly resident in Spain, Italy and the United Kingdom

Interpreting genotype-by-environment interaction for biomass production in hybrid poplars under short-rotation coppice in Mediterranean environments

Understanding genotype × environment interaction (GEI) is crucial to optimize the deployment of clonal material to field conditions in short‐rotation coppice poplar plantations. Hybrid poplars are grown for biomass production under a wide range of climatic and edaphic conditions, but their adaptive performance in Mediterranean areas remains poorly characterized. In this work, site regression (SREG) and factorial regression mixed models are combined to gain insight into the nature and causes underlying GEI for biomass production of hybrid poplar clones. SREG addresses the issue of clonal recommendation in multi‐environment trials through a biplot representation that visually identifies superior genotypes. Factorial regression, alternatively, involves a description of clonal reaction to the environment in terms of physical variables that directly affect productivity. Initially, SREG aided in identifying cross‐over interactions that often involved hybrids of different taxonomic background. Factorial regression then selected latitude, mean temperature of the vegetative period (MTVP) and soil sand content as main site factors responsible for differential clonal adaptation. Genotypic responses depended strongly on taxonomic background: P. deltoides Bartr. ex Marsh. × P. nigra L. clones showed an overall positive sensitivity to increased MTVP and negative sensitivity to increased sand content, whereas the opposite occurred for P. trichocarpa Torr. & Gray × P. deltoides clones; the three‐cross hybrid [(P. deltoides × P. trichocarpa) × P. nigra] often displayed an intermediate performance. This information can contribute toward the identification and biological understanding of adaptive characteristics relevant for poplar breeding in Mediterranean conditions and facilitate clonal recommendation at eco‐regional level.This research was funded by MINECO (Spain) throughout the project RTA2008-00025-C02-01 and RTA2011-00006-00-00. We also acknowledge the collaboration of project AGL2009-11006. We would like to thank the public company SOMACYL for hosting one of the experimental plots. We are also grateful to Juan Pablo de la Iglesia and Ana Parras for their technical support throughout the experiment

Malaria in illegal Chinese immigrants, Italy.

A cluster of 22 imported malaria cases, 21 caused by Plasmodium falciparum, was observed among illegal Chinese immigrants in northern Italy in the summer of 2000. The rate of severe disease was high because the patients were not immune and they sought health-care services late in their illness because of their clandestine status. Recognition of the outbreak was delayed because no regional alert system among infectious diseases hospitals was in place

Superconducting RFQs

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