Journal of travel medicine最新文献

{"title":"Transmission characteristics of Sudan virus disease outbreak in Uganda in early 2025.","authors":"Zihan Yuan, Yang Ge, Zihao Guo, Hao Lei, Jun Cai, Salihu S Musa, Sheikh T Ali, Jiashu Xue, Kai Wang, Sukhyun Ryu, Ka Chun Chong, Daihai He, Shi Zhao, Abdulrazaq G Habib, Yuantao Hao","doi":"10.1093/jtm/taaf036","DOIUrl":"10.1093/jtm/taaf036","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988994","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":"Performance of ChatGPT-4o in the diagnostic workup of fever among returning travellers requiring hospitalization: a validation study.","authors":"Dana Yelin, Neta Shirin, Itai Harris, Yovel Peretz, Dafna Yahav, Eli Schwartz, Eyal Leshem, Ili Margalit","doi":"10.1093/jtm/taaf005","DOIUrl":"10.1093/jtm/taaf005","url":null,"abstract":"<p><strong>Background: </strong>Febrile illness in returned travellers presents a diagnostic challenge in non-endemic settings. Chat generative pretrained transformer (ChatGPT) has the potential to assist in medical tasks, yet its diagnostic performance in clinical settings has rarely been evaluated. We conducted a validation assessment of ChatGPT-4o's performance in the workup of fever in returning travellers.</p><p><strong>Methods: </strong>We retrieved the medical records of returning travellers hospitalized with fever during 2009-2024. Their clinical scenarios at time of presentation to the emergency department were prompted to ChatGPT-4o, using a detailed uniform format. The model was further prompted with four consistent questions concerning the differential diagnosis and recommended workup. To avoid training, we kept the model blinded to the final diagnosis. Our primary outcome was ChatGPT-4o's success rates in predicting the final diagnosis when requested to specify the top three differential diagnoses. Secondary outcomes were success rates when prompted to specify the single most likely diagnosis, and all necessary diagnostics. We also assessed ChatGPT-4o as a predicting tool for malaria and qualitatively evaluated its failures.</p><p><strong>Results: </strong>ChatGPT-4o predicted the final diagnosis in 68% [95% confidence interval (CI) 59-77%], 78% (95% CI 69-85%) and 83% (95% CI 74-89%) of the 114 cases, when prompted to specify the most likely diagnosis, top three diagnoses and all possible diagnoses, respectively. ChatGPT-4o showed a sensitivity of 100% (95% CI 93-100%) and a specificity of 94% (95% CI 85-98%) for predicting malaria. The model failed to provide the final diagnosis in 18% (20/114) of cases, primarily by failing to predict globally endemic infections (16/21, 76%).</p><p><strong>Conclusions: </strong>ChatGPT-4o demonstrated high diagnostic accuracy when prompted with real-life scenarios of febrile returning travellers presenting to the emergency department, especially for malaria. Model training is expected to yield an improved performance and facilitate diagnostic decision-making in the field.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007589","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":"Evidence for the long-distance transport of ticks and tick-borne pathogens by human travellers to Texas, USA.","authors":"Michael S Allen, Rebecca J Kilgore, Yan Zhang, Megan T Williams, Sabrina N White, Pete D Teel","doi":"10.1093/jtm/taaf032","DOIUrl":"10.1093/jtm/taaf032","url":null,"abstract":"<p><strong>Background: </strong>The incidence of tick-borne diseases in the USA has surged in recent years, with >50 000 cases reported from an estimated half-million cases annually. While domestic vectors are well characterized, the role of human travel in transporting exotic ticks and pathogens remains poorly understood.</p><p><strong>Methods: </strong>We analysed 4808 submissions of ticks removed from individuals to the Tick-Borne Disease Research Laboratory in Texas, USA, from 2004 to 2024. Tick species were identified phenotypically or through DNA-based sequencing, and pathogens (Borrelia spp., Rickettsia spp., Ehrlichia spp., Anaplasma phagocytophilum and Babesia microti) were detected using molecular assays. Submitter travel histories were cross-referenced with known tick geographic ranges to identify long-distance transport.</p><p><strong>Results: </strong>We documented cases of intercontinental, international and domestic interstate transport of ticks by human travellers. Four Ixodes ricinus ticks-originating from Europe-were transported to Texas; one tick carried Borrelia afzelii, a Lyme disease pathogen not endemic to North America. Central and South American Amblyomma species were repeatedly imported, raising concerns for pathogen transmission and tick establishment. Domestic travellers also carried Ixodes scapularis ticks infected with Borrelia burgdorferi sensu stricto, Babesia microti and A. phagocytophilum from Lyme-endemic regions of the USA to Texas, along with non-native species Ixodes pacificus, Dermacentor andersoni and Dermacentor occidentalis from endemic areas in the western United States.</p><p><strong>Conclusions: </strong>Long-distance transport of ticks by travellers represents an underrecognized pathway for the global spread of ticks and tick-borne pathogens. Clinicians should consider travel history in tick-borne illness diagnostics. Enhanced surveillance, public education and travel screening are critical to mitigating these risks.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028602","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":"Histoplasma capsulatum mimicking lung cancer in a returning traveller.","authors":"Milou J V Serbée, Mirthe de Boer, Iris Storms-Frentz, Robert-Jan Hassing, Maurits P A van Meer","doi":"10.1093/jtm/taaf034","DOIUrl":"10.1093/jtm/taaf034","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999607","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":"Paracoccidioidomycosis in a Venezuelan migrant.","authors":"Leidy J Medina-Lozano, Adalberto E Lobato Ureche, José Jaramillo Osorio, Abraham Katime Zuñiga, Bertha Lacouture Ortiz, Álvaro A Faccini-Martínez","doi":"10.1093/jtm/taaf024","DOIUrl":"10.1093/jtm/taaf024","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625057","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":"Toxic travels: the rising threat of methanol poisoning in international travellers.","authors":"Sawettachai Jaita, Gerard Flaherty","doi":"10.1093/jtm/taaf003","DOIUrl":"10.1093/jtm/taaf003","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971577","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":"Travel to low- and middle-income countries and travellers' diarrhoea increase risk of mismatching antimicrobial therapy for urinary tract infection.","authors":"Anu Patjas, Anu Kantele","doi":"10.1093/jtm/taaf025","DOIUrl":"10.1093/jtm/taaf025","url":null,"abstract":"<p><strong>Background: </strong>Travel to low- and middle-income countries (LMICs) increases the risk of urinary tract infections (UTIs), including those caused by extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE). Focusing on international travel, we explored resistance profiles of urinary ESBL-PE and non-ESBL-PE isolates in a low antimicrobial resistance prevalence country and factors associated with UTI treatment failure.</p><p><strong>Methods: </strong>During 2015-19, we recruited 18-65-year-old individuals with recent ESBL-PE UTI and a respective cohort of those with non-ESBL-PE UTI to complete questionnaires on symptoms, antibiotic therapies and treatment failure risk factors. We compared uropathogens' resistance profiles amongst patients with or without LMIC travel history and conducted multivariable analyses to identify factors contributing to mismatching antimicrobial treatment (uropathogen resistant to the initial antimicrobial used) and clinical failure.</p><p><strong>Results: </strong>Amongst non-ESBL-PE UTI patients (n = 187), trimethoprim resistance was more common in isolates from individuals with recent LMIC travel (8/19, 42.1%) compared to those without (30/167, 18.0%) [odds ratio (OR) 3.3, compatibility interval (CI) 95% 1.2-9.0]. ESBL-PE isolates (n = 130) showed no differences in resistance profiles with respect to LMIC travel history.In the group non-ESBL-PE UTI, risk factors included microbiological mismatching recent LMIC travel [adjusted odds ratio (AOR) 3.6, CI 95% 1.0-12.7] and travellers' diarrhoea (AOR 7.1, CI 95% 1.1-45.6); no factors were significantly associated with mismatching in the group ESBL-PE UTI. As risk factors for clinical failure, in the group non-ESBL-PE UTI, we identified microbiological mismatching (AOR 15.2, CI 95% 4.0-57.9), and renal/bladder disease (AOR 5.2, CI 95% 1.1-23.2), and in the group ESBL-PE UTI, microbiological mismatching (AOR 8.1, CI 95% 2.6-24.7).</p><p><strong>Conclusions: </strong>LMIC travel increases the risk of nonmatching empiric antimicrobials, concurring with increased trimethoprim resistance rates amongst the non-ESBL-PE isolates. Our data suggest that UTI patients with recent LMIC travel should not be empirically treated with trimethoprim and, when possible, urinary culturing is warranted.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743253","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":"Re-imagining combination vaccines for travel medicine.","authors":"Sarah L McGuinness, Sue Ann Costa Clemens, Ralf Clemens, Lin H Chen, Pierre Damme, Robert Steffen","doi":"10.1093/jtm/taaf033","DOIUrl":"https://doi.org/10.1093/jtm/taaf033","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971300","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":"Predicting influenza trends in the context of post COVID immunity gaps in Macao, China.","authors":"Ying Liu, Kefeng Li, Hoiman Ng, Qianhong Ye, Henry H Y Tong","doi":"10.1093/jtm/taaf035","DOIUrl":"https://doi.org/10.1093/jtm/taaf035","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041684","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":"Forced Migration and Mortality: Health Disparities Among Venezuelan Migrants in Peru and Colombia.","authors":"Liuyi Chen-Cao, Angela Cadavid Restrepo, Miguel M Cabada, Kasim Allel, Wondimeneh Shiferaw, Deborah J Mills, Colleen L Lau, Luis Furuya-Kanamori","doi":"10.1093/jtm/taaf028","DOIUrl":"https://doi.org/10.1093/jtm/taaf028","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803711","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}