13 research outputs found
Spectrum of Illness in International Migrants Seen at GeoSentinel Clinics in 1997-2009, Part 2: Migrants Resettled Internationally and Evaluated for Specific Health Concerns
Of 7629 migrants, one third were infected with tuberculosis (22% active, 10% latent), one quarter with a variety of parasites (malaria 7%, schistosomes 6%, Strongyloides 5%, miscellaneous 5%), and 17% with chronic viral hepatitis (12% hepatitis B, 5% hepatitis C
Imported Human Rabies Cases Worldwide, 1990–2012
<div><p>Sixty cases of human rabies in international travelers were reviewed from 1990–2012. A significant proportion of the cases were observed in migrants or their descendants when emigrating from their country of origin or after a trip to visit friends and relatives or for other reasons (43.3%). The cases were not necessarily associated with long-term travel or expatriation to endemic countries; moreover, cases were observed in travelers after short trips of two weeks or less. A predominance of male patients was observed (75.0%). The proportion of children was low (11.7%). Cases from India and Philippines were frequent (16 cases/60). In a significant proportion of cases (51.1%), diagnosis was challenging, with multiple missed diagnoses and transfers from ward to ward before the final diagnosis of rabies. Among the 28 patients whose confirmed diagnosis was obtained ante-mortem, the mean time between hospitalization and diagnosis was 7.7 days (median time: 6.0 days, range 2–30) including four cases with a diagnosis delayed by 15 or more days. In five cases, a patient traveled through one or more countries before ultimately being hospitalized. Three factors played a role in delaying the diagnosis of rabies in a number of cases: (i) a low index of suspicion for rabies in countries where the disease has been eradicated for a long time or is now rare, (ii) a negative history of animal bites or exposure to rabies, and (iii) atypical clinical presentation of the disease. Clinical symptomatology of rabies is complex and commonly confuses physicians. Furthermore, failure in diagnosing imported cases in more developed countries is most likely related to the lack of medical familiarity with even the typical clinical features of the disease.</p> </div
Demographics, travel characteristics and source of exposure for 60 travel-associated human rabies cases (1990–2012).
1<p>France: 7, Russia and other former USSR countries: 7, United Kingdom and Ireland: 5, Germany: 4, The Netherlands: 2, Italy; 2, Austria: 1, Portugal: 1, Sweden: 1.</p>2<p>US: 12, Canada: 1.</p>3<p>China: 3, Japan: 2, Philippines: 1, Myanmar: 1.</p>4<p>Mexico: 3, Haiti: 1.</p>5<p>Israel: 1, United Arabian Emirates: 1, Iraq: 1.</p>6<p>Algeria: 1, Nigeria: 1.</p>7<p>non-recent migrants or their descendants visiting friends and relatives in their origin countries.</p
Country of exposure and place where the case was imported for 60 human rabies cases in travelers (1990–2012).
<p>Country of exposure: circle placed in, place where the cases was imported: according to color of circle.</p
Incubation time (47 human rabies cases in travelers (1990–2012).
<p>Logarithmic scale. Each circle represents one patient.</p
Number of human rabies cases in travelers per year (60 cases, 1990–2012).
<p>Number of human rabies cases in travelers per year (60 cases, 1990–2012).</p
Treatment in 60 travel-associated human rabies cases (1990–2012).
1<p>Incomplete course in 2 cases.</p>2<p>Treatment was initiated after the onset of symptoms in all cases.</p>3<p>induction of coma with pentobarbital, midazolam and ketamine and use of antivirals amantadine and ribavirin.</p
Clinical and microbiological features of 60 travel-associated human rabies cases (1990–2012).
1<p>Furious form : classic febrile encephalitic form where signs of irritation of the central nervous system predominate, including agitation, confusion, hydrophobia and aerophobia; paralytic form : paralysis involving the peripheral nerves, usually accompanied by fever.</p>2<p>The sum of percentages is over 100% because rabies was confirmed by more than one method in a number of patients.; RTPCR = reverse transcriptase polymerase chain reaction; FAT = fluorescent antibody test.</p
Mycobacterium bovis Pulmonary Tuberculosis after Ritual Sheep Sacrifice in Tunisia
International audienc
Hajj-associated viral respiratory infections: A systematic review
International audienceRespiratory tract infections (RTI) are the most common infections transmitted between Hajj pilgrims. The aim of this systematic review was to determine the prevalence of virus carriage potentially responsible for RTI among pilgrims before and after participating in the Hajj. A systematic search for relevant literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. 31 studies were identified. Severe Acute Respiratory Syndrome coronavirus and Middle East Respiratory Syndrome coronavirus (MERS) were never isolated in Hajj pilgrims. The viruses most commonly isolated from symptomatic patients during the Hajj by PCR were rhinovirus (5.9-48.8% prevalence), followed by influenza virus (4.5-13.9%) and non-MERS coronaviruses (2.7-13.2%) with most infections due to coronavirus 229E; other viruses were less frequently isolated. Several viruses including influenza A, rhinovirus, and non-MERS coronaviruses had low carriage rates among arriving pilgrims and a statistically significant increase in their carriage rate was observed, following participation in the Hajj. Further research is needed to assess the role of viruses in the pathogenesis of respiratory symptoms and their potential role in the severity of the symptoms. (C) 2016 Elsevier Ltd. All rights reserved