Journal of travel medicine最新文献

{"title":"Hypoxic Pre-acclimatization Strategies Before Rapid Ascent for Preventing Acute Mountain Sickness: A Systematic Review and Network Meta-analysis.","authors":"Shubao Chen, Xu Yang, Chunlei Li, Limingfei Zhou","doi":"10.1093/jtm/taag087","DOIUrl":"https://doi.org/10.1093/jtm/taag087","url":null,"abstract":"<p><strong>Background: </strong>Acute mountain sickness (AMS) commonly affects unacclimatized lowlanders traveling above 2500 m. Hypoxic pre-acclimatization may reduce AMS risk, but its effectiveness before rapid ascent and the relative merits of different protocols remain uncertain. Therefore, this study compared hypoxic pre-acclimatization strategies for AMS incidence, AMS severity, and peripheral oxygen saturation after rapid ascent.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, SPORTDiscus, and Web of Science were searched from inception to December 2, 2025. The review followed PRISMA-NMA guidance. We included randomized controlled trials enrolling healthy adults without prior high-altitude acclimatization that evaluated hypoxic pre-acclimatization and reported AMS incidence or severity after rapid ascent. Two reviewers independently extracted data. Primary outcomes were AMS incidence and severity; peripheral oxygen saturation was the secondary outcome. Bayesian random-effects network meta-analyses estimated odds ratio (OR), standardized mean difference (SMD), and mean difference (MD) with 95% credible interval (CrI). Interventions were ranked using surface under the cumulative ranking curve (SUCRA) values.</p><p><strong>Results: </strong>Thirteen randomized controlled trials involving 576 participants were included. Point estimates for primary outcomes generally favored hypoxic pre-acclimatization over control. Among statistically significant findings, staging at 4300 m showed the most favorable estimate for AMS incidence (OR, 0.02; 95% CrI, 0.001 to 0.33), and staging at 3500 m showed the most favorable estimate for AMS severity (SMD, -1.22; 95% CrI, -2.40 to -0.04). Several interventions increased post-ascent peripheral oxygen saturation. No consistent significant differences were observed between staging and intermittent hypoxic exposure or among intermittent hypoxic exposure modalities. Certainty of evidence for primary outcomes ranged from very low to moderate.</p><p><strong>Conclusions: </strong>Hypoxic pre-acclimatization may prevent AMS and reduce its severity after rapid ascent. Staging effects may vary by implementation altitude, and intermittent hypoxic exposure modalities showed generally consistent protective directions. The choice between IHE and staging should be guided by preparation time, individual tolerance, and risk preferences.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075140","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":"Shared evidence, different recommendations: a comparative analysis of Qdenga (TAK-003) dengue vaccine guidance for travellers across countries.","authors":"Sarah L McGuinness, Dipti Patel, Helena H Askling, Camilla Rothe, Steven Schofield, Robert Steffen, Leo G Visser, Lin H Chen","doi":"10.1093/jtm/taag065","DOIUrl":"10.1093/jtm/taag065","url":null,"abstract":"<p><strong>Introduction: </strong>Dengue is an increasingly important cause of illness in travellers, and Qdenga (TAK-003) is the first dengue vaccine incorporated into guidance for travellers in multiple countries. However, clinicians and travellers may encounter differing recommendations across jurisdictions. This study compared guidance on the use of Qdenga in travellers across countries.</p><p><strong>Methods: </strong>We conducted a comparative analysis of national guidance on Qdenga use for travellers across countries, using survey data and structured review of publicly available recommendations. Guidance was synthesized according to dengue immune status and mapped across recurring decision domains.</p><p><strong>Results: </strong>Survey responses were obtained from 18 advisory bodies across 17 countries between March and April 2026, including 12 non-endemic countries where Qdenga was licensed and guidance published. Guidance was generally more restrictive than regulatory authorization. While there was broad agreement in recommending vaccination for travellers with laboratory-confirmed prior dengue infection, recommendations for those without documented infection varied widely. All advisory bodies considered destination-specific dengue risk but differed in whether and how they used travel duration, repeated or cumulative exposure, traveller characteristics and host susceptibility factors to determine vaccine eligibility. Some recommendations restricted vaccination to travellers with prior dengue infection, whereas others extended eligibility to selected travellers without documented prior infection or recommended vaccination based on exposure risk, irrespective of serostatus. Approaches also differed in assessment of prior dengue infection and whether completion of the two-dose series before travel was required.</p><p><strong>Conclusions: </strong>Variation in Qdenga guidance reflects differences in how advisory bodies interpret shared evidence and manage uncertainty arising from data gaps and differences between trial populations and travellers. Additional data on vaccine effectiveness and clinical outcomes among seronegative travellers and older adults may help reduce uncertainty and support greater alignment of future recommendations. Regardless, transparency and shared clinical decision-making remain essential when discussing dengue vaccination with travellers.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the introduction risk and sustained transmission of the Ebola Bundibugyo outbreak 2026 in the Democratic Republic of Congo.","authors":"Reagan Luvande Okingo, Berthe Amélie Iroungou, Eugenio Valdano","doi":"10.1093/jtm/taag057","DOIUrl":"10.1093/jtm/taag057","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295495","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":"Counting everyone onboard is not enough: modelling lessons from the MV Hondius Andes virus outbreak.","authors":"Gerardo Chowell, Kenji Mizumoto","doi":"10.1093/jtm/taag036","DOIUrl":"10.1093/jtm/taag036","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308348","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":"Arboviral risk at Brazilian tourist destinations.","authors":"Sebastian Vernal, Eloise Skinner, Beatris M Martin, Sheng-Hsun Lee, Expedito J A Luna, Ester C Sabino, Benn Sartorius, Luis Furuya-Kanamori","doi":"10.1093/jtm/taag064","DOIUrl":"10.1093/jtm/taag064","url":null,"abstract":"<p><strong>Introduction: </strong>Brazil is a popular travel destination that experiences recurrent outbreaks of dengue, chikungunya, and yellow fever (YF), posing a significant health risk to both residents and international travellers. We aimed to identify high-risk regions for arboviral infections and develop a user-friendly, map-based resource to support clinical decision-making in travel medicine.</p><p><strong>Methods: </strong>We analysed laboratory-confirmed cases and deaths from dengue, chikungunya, and YF reported to Brazil's national surveillance system from 2019 to 2024 (from 2015 for YF). Data were aggregated into 133 Intermediate Geographic Regions (IGRs). IGRs without a confirmed case during the studied period were excluded. A composite risk score was calculated for each IGR by combining (i) transmission duration (months with reported cases per year, score 0-12) and (ii) disease burden, based on national quartiles of monthly incidence and mortality (score 1-4). Annual scores were summed to produce risk maps for each arbovirus. High-risk IGRs (defined as the top quartile of composite score) were overlaid with popular tourist destinations to create an intuitive visual guide.</p><p><strong>Results: </strong>We analysed 4.35 million dengue, 294 921 chikungunya, and 2312 YF cases, resulting in 7846, 565, and 794 deaths, respectively. Dengue affected all IGRs, with high-risk IGRs in the Midwest, including the Pantanal. Chikungunya was also identified in all IGRs, with high-risk IGRs in the Northeast, overlapping with popular beaches such as Recife. YF was identified in 38.3% of IGRs, notably in the Southeast, including São Paulo state.</p><p><strong>Conclusions: </strong>Arboviruses pose a diverse risk across Brazil. Our spatially integrated map provides a novel tool for travel medicine, enabling healthcare practitioners to offer tailored advice and pre-travel vaccinations to travellers.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520541","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":"What leads to a Public Health Emergency of International Concern? A comparison of the 2026 Ebola and hantavirus outbreaks.","authors":"Adam T Craig, Meru Sheel, Eric J Nilles, Colleen L Lau","doi":"10.1093/jtm/taag053","DOIUrl":"10.1093/jtm/taag053","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heat-related health risks for spectators at the 2026 FIFA World Cup.","authors":"Salim Parker, Ozayr Mahomed, Keston Daniel, Najim Z Alshahrani, Ziad A Memish","doi":"10.1093/jtm/taag049","DOIUrl":"10.1093/jtm/taag049","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271938","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":"Estimating importation risk of Bundibugyo Ebola virus disease to Europe under different outbreak expansion scenarios.","authors":"Federico Fanelli, Francesco Parino, Chiara Poletto, Vittoria Colizza","doi":"10.1093/jtm/taag055","DOIUrl":"10.1093/jtm/taag055","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295499","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":"The 2026 Bundibugyo outbreak exposes critical gaps in Ebola vaccine preparedness beyond Zaire and Sudan.","authors":"Deepak Juyal, Shweta Thaledi, Shekhar Pal","doi":"10.1093/jtm/taag067","DOIUrl":"10.1093/jtm/taag067","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584661","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":"Probabilistic assessment of transmission risk in a cruise ship hantavirus outbreak.","authors":"Jonathan Bastard PhD, Raphaëlle Métras Dvm PhD, Pierre-Yves Boëlle Md PhD","doi":"10.1093/jtm/taag070","DOIUrl":"10.1093/jtm/taag070","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592369","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}