Journal of travel medicine最新文献

{"title":"Severe imported Plasmodium falciparum malaria with hyperparasitaemia: evaluation of determinants of critical disease in adult returning travellers.","authors":"Tilman Lingscheid, Johannes Jochum, Pinkus Tober-Lau, Johanna Schöllgen, Regina Stegherr, Juliane Dörfler, Henrik Nielsen, Alessandro Bartoloni, Kristine Mørch, Emmanuel Bottieau, Frieder Pfäfflin, Leif Erik Sander, Thomas Zoller, Michael Ramharter, Florian Kurth","doi":"10.1093/jtm/taaf049","DOIUrl":"https://doi.org/10.1093/jtm/taaf049","url":null,"abstract":"<p><strong>Background: </strong>Severe Plasmodium falciparum (P.f.) malaria remains a major health threat for travellers. WHO defines criteria for severe malaria, including hyperparasitaemia ≥10% infected red blood cells (iRBC), as major risk factors for adverse outcome. Additionally, WHO recognizes 'uncomplicated hyperparasitaemia' with 4-10% iRBC, a parasite density usually defining severe malaria outside endemic areas. Overall, the role of hyperparasitaemia as an independent risk factor in imported severe malaria is unclear, with most data predating the artemisinin era.</p><p><strong>Methods: </strong>We retrospectively analysed adult in-patients with hyperparasitaemia (≥4% iRBC) and/or severe P.f. malaria according to WHO-criteria who received artemisinin-based treatment at two German university hospitals 2013-2023, to assess the risk for critical disease with need for organ replacement therapy or vasopressors. Based on multivariable nominal logistic regression, we developed a scoring system to identify patients with critical disease and validated it on an independent cohort.</p><p><strong>Results: </strong>Of 168 patients, 33 (20%) developed critical disease, all of whom presented with at least one WHO-criterion other than hyperparasitaemia. Of 72 patients with isolated hyperparasitaemia, none developed critical disease. Hyperparasitaemia was no independent risk factor for critical disease in logistic regression (aOR 0.85 95%CI 0.23-3.12), in contrast to creatinine > 3 mg/dL (aOR 6.74 95%CI 1.06-42.75), oligo-/anuria (aOR 5.94 95%CI 1.27-27.82), lactate ≥5 mmol/L (aOR 8.16 95%CI 8.16-35.03), confusion (aOR 4.07 95%CI 1.39-11.94), and circulatory shock and respiratory failure, which are inherently critical conditions. The risk score identified all 33 patients with and 131/135 (97.0%) without critical disease (AUC = 0.99; sensitivity: 100%; specificity: 97.0%). In the validation cohort, all 8 patients with critical disease and 39/44 (89%) without were correctly identified.</p><p><strong>Conclusion: </strong>Isolated hyperparasitaemia was no independent risk factor for critical disease in this patient cohort treated with artemisinins, suggesting that such patients can be managed outside intensive care units.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazil's First H5N1 Outbreak in Commercial Poultry: A Sentinel Event for Cross-Border Preparedness.","authors":"Paulo Ricardo Martins-Filho, Lucindo José Quintans-Júnior","doi":"10.1093/jtm/taaf050","DOIUrl":"https://doi.org/10.1093/jtm/taaf050","url":null,"abstract":"<p><p>Brazil's first confirmed H5N1 outbreak in commercial poultry marks a critical shift in South America's avian influenza landscape. The event calls for strengthened coordination between animal and human health sectors, improved border surveillance, and early-warning systems to reduce zoonotic risk in regions with growing poultry production and international connectivity.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zika virus infection in a traveller returning to France from Seychelles, 2024.","authors":"Laura Pezzi, Nazli Ayhan, Justine Brulé, Guillaume André Durand, Gilda Grard, Xavier Lamballerie, Raphaelle Klitting","doi":"10.1093/jtm/taaf048","DOIUrl":"https://doi.org/10.1093/jtm/taaf048","url":null,"abstract":"<p><p>In August 2024, a case of Zika virus infection was identified in metropolitan France in a traveller returning from Seychelles. Genomic analysis confirmed the strain belongs to the Asian lineage. Recent epidemiological findings provide the first evidence of ZIKV circulation in the western Indian Ocean region.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Bismuth Subsalicylate on the Prevention of Travellers' Diarrhoea, 2018-2023.","authors":"Kristina M Angelo, Zainab Salah, Marina Rogova, Ian D Plumb, Allison T Walker, Graeme Prentice-Mott, Charandeep Waraich, Sunkyung Kim, Edward Ryan, Regina C LaRocque, Elizabeth Oliver, Kristen Heitzinger, K Allison Perry-Dow, Bradley A Connor","doi":"10.1093/jtm/taaf047","DOIUrl":"https://doi.org/10.1093/jtm/taaf047","url":null,"abstract":"<p><strong>Background: </strong>Travellers' diarrhoea (TD) is the most common travel-related illness. Bismuth subsalicylate (BSS) is indicated for the treatment of TD. BSS is also used off-label for the prevention of TD, based on studies from the 1980s indicating TD protection, however, these studies have limitations. The objective of this study was to determine the efficacy of BSS in the prevention of TD.</p><p><strong>Methods: </strong>This study was a prospective, double-blinded, placebo-controlled, randomized clinical trial (NCT03535272) with two arms: BSS 4 tablets twice daily (2.1 grams of BSS total) vs placebo. Travellers were included if they were ≥ 18 and < 70 years of age at the time of enrollment, were leaving for an international trip ≥7 days after their pretravel consultation, travelling in country for ≥7 days but ≤ 21 days, and travelling to either Southeast Asia, South Central Asia, North Africa, or Sub-Saharan Africa. Self-completed web-based questionnaires were administered before, during, and after travel.</p><p><strong>Results: </strong>270 participants were included. The median age was 32 years (Interquartile range [IQR]: 27-44); 63% were female. Travellers were most frequently White (144; 61%) and non-Hispanic (239; 94%). The most frequent country of travel was Kenya (n = 87; 32%). The median total trip duration was 10 days ([IQR]: 8-13). The most frequent reason for travel was leisure/tourism (230; 85%). There was no significant difference among the groups for symptoms of loose stool and/or diarrhoea, although target sample size was not reached.</p><p><strong>Conclusions: </strong>This study provides the first new data since the 1980s about the potential use of BSS in the prevention of TD. These data should not be viewed as evidence in isolation because of sample size constraints; further studies are needed to determine if there is a benefit in certain traveller groups or under certain circumstances.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis of isolated hyperparasitemia in adults with imported severe malaria.","authors":"Sébastien Gaultier, Sandrine Houzé, Marc Thellier, Michael Thy, Nathan Peiffer-Smadja, Hermann Do Rego, Stéphane Jauréguiberry, Jean-François Timsit, Etienne Montmollin","doi":"10.1093/jtm/taaf042","DOIUrl":"https://doi.org/10.1093/jtm/taaf042","url":null,"abstract":"<p><strong>Background: </strong>Parasitemia > 4% (HP) is the most frequent severity criterion considered in adults with imported malaria, isolated hyperparasitemia (iHP) accounting for 10-40% cases. Its prognostic significance is controversial.</p><p><strong>Methods: </strong>Multicenter retrospective study including all adult patients with imported Plasmodium falciparummalaria and HP admitted to 16 hospitals in the Greater Paris area between 2018 and 2022 and reported to the National Reference Center. Among HP patients, iHP at hospital admission was identified by retrospective analysis of medical records to minimize classification bias. The primary endpoint was a composite outcome using the Desirability of Outcome Ranking (DOOR) method with three levels of decreasing desirability: hospital survival, absence of organ support requirement, shortest length of stay. Association between HP, iHP and outcomes was evaluated by negative binomial regression models.</p><p><strong>Results: </strong>Of 355 patients enrolled with HP, 135 (38%) had iHP. iHP patients were predominantly male (55.6%), aged 41 [32-52.3] years, and born in an endemic country (86.4%). Compared with patients with HP and additional severity criteria, iHP was independently associated with a lower risk of worse DOOR (RR 0.56, 95%CI[0.48-0.65]). No deaths were recorded in the iHP population, and 2/135 (1.5%) patients required organ support. In the iHP population, immunosuppression (RR 1.65, 95%CI[1.16-2,37]) and parasitemia>10% (RR 1.57, 95%CI[1.01-2.24]) were independently associated with worse DOOR. Only 47 (34.8%) iHP patients were admitted to an ICU at diagnosis, and 40 (29.6%) were treated with oral therapy alone.</p><p><strong>Conclusion: </strong>In imported malaria in France, iHP was associated with a low risk of serious adverse outcomes overall. In patients with iHP, immunosuppression and parasitemia > 10% were associated with an increased risk of adverse outcome, highlighting the importance of a close hospital monitoring.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measles Immunity Gaps: Distinct Serological Profiles from the United States and India.","authors":"Huy Quang Quach, Inna G Ovsyannikova, Gregory A Poland, Richard B Kennedy","doi":"10.1093/jtm/taaf043","DOIUrl":"https://doi.org/10.1093/jtm/taaf043","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prochlorperazine maleate versus placebo for the prophylaxis of Acute Mountain sickness: a double-blind randomized controlled trial.","authors":"Elan Small, Harrison Steins, Martin Musi, Julia Perry, Elizabeth Goldberg, Mary Ryan, Lake Crawford, Brian Strickland, Tiana Linkus, Caleb Phillips, Ryan Paterson, Nathaniel Zona, Max Smolkin, Mia Derstine, Jay Lemery, Jennifer L Hoffman, Steven R Hick, Adit A Ginde, Peter Hackett, Linda E Keyes","doi":"10.1093/jtm/taaf044","DOIUrl":"https://doi.org/10.1093/jtm/taaf044","url":null,"abstract":"<p><strong>Background: </strong>Acute mountain sickness (AMS) is a debilitating condition that may occur on ascent to high altitude, with limited options for chemoprophylaxis. The pathophysiology of AMS is poorly understood though may be similar to migraine. This study aimed to determine the efficacy of prochlorperazine, a first-line agent for acute migraine, for AMS prophylaxis.</p><p><strong>Methods: </strong>We performed a randomized, double-blind, placebo-controlled trial involving healthy, unacclimatized adult participants, primarily from the Denver area (1609 meters (m)) who received either oral prochlorperazine or placebo three times daily for 24 hours during rapid ascent to Mount Blue Sky, Colorado (4348 m). We evaluated individuals who received at least the first dose of placebo or intervention following a modified intent-to-treat approach. Participants travelled by vehicle to 3910 m, then hiked to the summit of Mount Blue Sky where they slept overnight. The primary outcome was AMS incidence as defined by the 2018 Lake Louise Questionnaire, which was assessed on the evening of ascent and the following morning.</p><p><strong>Results: </strong>We analysed fifty-six participants (25 women), with a mean age of 39 [IQR 28-49] with 28 participants in each study arm. Key baseline characteristics were equally distributed and well-matched between study arms. The incidence of AMS was 28 (50%), with 18 (64%) in the placebo arm and 10 (36%) in the prochlorperazine arm (p = 0.06). The absolute risk reduction was 28.6%, the number needed to treat was 4 and the odds ratio was 0.28 (95% C.I. 0.11-0.94). There were no serious adverse events, and there were no significant differences in the side effects between arms including for drowsiness (p = 0.47).</p><p><strong>Conclusions: </strong>Our results suggest that prochlorperazine is effective in preventing AMS. Larger studies are warranted to validate our findings.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognizing post malaria neurological syndrome in travellers: insights from three cases.","authors":"Elisa Riera, Alex Almuedo, Miriam J Álvarez-Martínez, Daniel Camprubí-Ferrer","doi":"10.1093/jtm/taaf041","DOIUrl":"https://doi.org/10.1093/jtm/taaf041","url":null,"abstract":"<p><p>Post malaria neurological syndrome (PMNS) is infrequent, but might be underdiagnosed in travellers. Following a previous publication on the Journal, we present three additional cases of PMNS to broaden the discussion and offer possible insights on when to suspect it and how to proceed.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waning immunity 1-2 years after fractional intradermal Japanese encephalitis vaccination.","authors":"Deborah J Mills, Narayan Gyawali, Nirupama A Nammunige, Christine Mills, Gregor J Devine, Colleen L Lau, Luis Furuya-Kanamori","doi":"10.1093/jtm/taaf040","DOIUrl":"https://doi.org/10.1093/jtm/taaf040","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new non-live chikungunya vaccine for travellers.","authors":"David O Freedman","doi":"10.1093/jtm/taaf039","DOIUrl":"https://doi.org/10.1093/jtm/taaf039","url":null,"abstract":"<p><p>CHIK-VLP, a single dose non-live vaccine provides > 95% overall short-term seroresponse rates in robust trials in potential travellers to endemic areas with onset of sero-protection that may be as short as 8 days. Vaccination is recommended for travel to outbreak areas and for extended travel (≥6 months) to areas with CDC designated risk.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}