Davide Mileto, Marta Stracuzzi, Alessandro Mancon, Erika Naddeo, Alberto Rizzo, Roberta Caiazzo, Federica Salari, Margherita Longo, Alessandra Lombardi, Alberto Dolci, Vania Giacomet
{"title":"Hemorrhagic manifestations in primary DENV-3 infection: A case of dengue with warning signs in an adolescent","authors":"Davide Mileto, Marta Stracuzzi, Alessandro Mancon, Erika Naddeo, Alberto Rizzo, Roberta Caiazzo, Federica Salari, Margherita Longo, Alessandra Lombardi, Alberto Dolci, Vania Giacomet","doi":"10.1016/j.tmaid.2026.103005","DOIUrl":"10.1016/j.tmaid.2026.103005","url":null,"abstract":"<div><div>Severe dengue is typically linked to secondary infection. We report dengue with warning signs due to primary DENV-3 infection in a healthy Italian adolescent returning from the Philippines. Severe thrombocytopenia and mucosal bleeding, with clinical and laboratory features suggestive of possible plasma leakage, were managed without shock, highlighting the need for multidisciplinary monitoring and care even in primary dengue.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"72 ","pages":"Article 103005"},"PeriodicalIF":5.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Duojiao Li, Feng Tian, Yu Niu, Huipeng Li, Xuezheng Ma
{"title":"Surveillance of airborne microorganisms and associated influencing factors at an international airport in China, 2019-2020","authors":"Duojiao Li, Feng Tian, Yu Niu, Huipeng Li, Xuezheng Ma","doi":"10.1016/j.tmaid.2026.102992","DOIUrl":"10.1016/j.tmaid.2026.102992","url":null,"abstract":"<div><h3>Background</h3><div>As a major international transportation hub, airports are critical nodes for cross-border and regional spread of respiratory diseases. Real-time airborne microbial monitoring facilitates surveillance and control of travel-related infections, strengthens early warning, and supports public health interventions.</div></div><div><h3>Methods</h3><div>Air samples were collected weekly from November 2019 to August 2020 at two security checkpoints of an international airport in China (288 samples total) using two air samplers (FJ and SKC). qPCR detected bacteria (<em>Streptococcus</em>, <em>Staphylococcus</em>, <em>Micrococcus</em>), fungi, and six respiratory viruses; SARS-CoV-2 was added following the COVID-19 outbreak. Spearman correlation analysis was performed to evaluate relationships between microbial detection rates and environmental parameters. Binary logistic regression was employed to evaluate the impact of sampling and environmental factors on detection rates.</div></div><div><h3>Results</h3><div>Passenger throughput demonstrated significant positive correlations with temperature, particulate matter concentration, and detection rates of <em>Streptococcus</em>/<em>Staphylococcus</em>. <em>Staphylococcus</em> showed the highest detection rate (37.50%). The SKC biosampler outperformed FJ for bacterial detection, while FJ was superior for fungal detection. Fungal detection rates exceeded 60% and correlated positively with humidity. All samples collected after the COVID-19 outbreak tested negative for SARS-CoV-2. Other six respiratory viruses were detected in 12 samples, which exhibited higher detection rates in the post-pandemic period. Particulate matter concentration negatively correlated with viral detection.</div></div><div><h3>Conclusion</h3><div>Airport airborne microbial monitoring can serve as an early-warning signal for emerging respiratory infectious diseases. Interventions including mask-wearing, environmental disinfection, and passenger flow control significantly reduced airborne pathogen detection rates, providing a scientific basis for optimizing ventilation systems, formulating cleaning and disinfection protocols, and establishing comprehensive infectious disease prevention and control systems.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"72 ","pages":"Article 102992"},"PeriodicalIF":5.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jaime Vega-Costa , Pau Bosch-Nicolau , Maria Luisa Aznar , Fernando Salvador , Adrián Sánchez-Montalvá , Núria Serre-Delcor , Inés Oliveira , Diana Pou , Aroa Silgado , Juan Espinosa-Pereiro , Joan Martínez-Campreciós , Joan Roig-Sanchis , Elena Sulleiro , Israel Molina
{"title":"Safety and tolerability of benznidazole in older patients with chronic Chagas disease","authors":"Jaime Vega-Costa , Pau Bosch-Nicolau , Maria Luisa Aznar , Fernando Salvador , Adrián Sánchez-Montalvá , Núria Serre-Delcor , Inés Oliveira , Diana Pou , Aroa Silgado , Juan Espinosa-Pereiro , Joan Martínez-Campreciós , Joan Roig-Sanchis , Elena Sulleiro , Israel Molina","doi":"10.1016/j.tmaid.2026.102981","DOIUrl":"10.1016/j.tmaid.2026.102981","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines recommend treating chronic Chagas disease (CD) with benznidazole up to 50 years of age, with individualized decisions in older individuals due to limited safety data. We aimed to compare the safety, tolerability and long-term outcomes of benznidazole in individuals above and below 50 years.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study at Vall d’Hebron-Drassanes (Barcelona), including individuals aged 35-69 years treated with benznidazole between 2008 and 2017. Participants were divided into two age groups: (35-49 and 50-69 years), with biannual follow-up. The primary outcome was treatment discontinuation due to toxicity. Secondary outcomes included adverse events (AEs), cardiac progression, and other clinical events over 5 years.</div></div><div><h3>Results</h3><div>A total of 339 patients were included, of whom 59 (17.4%) were ≥50 years. AEs occurred in 82% of individuals, with no significant differences between groups (p = 0.50). Cutaneous reactions were the most frequent AEs (54%), and did not differ significantly by age (57% vs. 46%, p = 0.11). Treatment discontinuation due to toxicity was similar in older and younger individuals (20.3% vs. 13.7%; p = 0.19). Cardiac progression was more frequent in older individuals (1.73 vs. 0.68 events/100 person-years; p = 0.03), though this was not significant after adjustment (p = 0.52). New cardiovascular risk factors and malignancies were more frequent in older individuals.</div></div><div><h3>Conclusions</h3><div>Benznidazole was associated with a high frequency of adverse events and a clinically relevant rate of treatment discontinuation, with no statistically significant differences between age groups. These findings support considering benznidazole in selected individuals over 50, suggesting that age alone should not prevent treatment.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"71 ","pages":"Article 102981"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charles Declerck , Simon Kravetz , Olivier Bouchaud , Justine Dorchies , Damien Dupont , Maeva Lefebvre , Christelle Pomares , Alexandre Duvignaud , Charlotte Boullé , Antoine Specklin , Jordan Leroy , Julie Bonhomme , Laura Courtellemont , Victor Gerber , Jean-Pierre Gangneux , Assia Benelhadj Djelloul , Charles Maurille , Claire Hoffmann , Marie Gladys Robert , Hélène Yera , Vincent Dubée
{"title":"Clinical characteristics and treatments of imported loiasis patients with microfilaraemia diagnosed in France, 2000-2022","authors":"Charles Declerck , Simon Kravetz , Olivier Bouchaud , Justine Dorchies , Damien Dupont , Maeva Lefebvre , Christelle Pomares , Alexandre Duvignaud , Charlotte Boullé , Antoine Specklin , Jordan Leroy , Julie Bonhomme , Laura Courtellemont , Victor Gerber , Jean-Pierre Gangneux , Assia Benelhadj Djelloul , Charles Maurille , Claire Hoffmann , Marie Gladys Robert , Hélène Yera , Vincent Dubée","doi":"10.1016/j.tmaid.2026.102982","DOIUrl":"10.1016/j.tmaid.2026.102982","url":null,"abstract":"<div><h3>Introduction</h3><div>Loiasis has been associated with increased morbidity and mortality, particularly in cases of high microfilarial density. Treatment depends on initial microfilaraemia (Mf) and relies on ivermectin (IVM), diethylcarbamazine (DEC) or albendazole (ALB), all associated with serious adverse events. Our objective was to describe the clinical characteristics, management and outcomes of patients diagnosed with loiasis and Mf in France.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective study including patients with loiasis and Mf diagnosed and treated in France between 2000 and 2022, with at least one follow-up evaluation. We collected clinical and biological data, including Mf kinetics, for each treatment episode.</div></div><div><h3>Results</h3><div>A total of 150 patients (181 treatment episodes) were included across 27 centers. Median age was 35 years, and most patients presented symptoms (75.3%). Median Mf was 500 mf/ml; for 74% of episodes, baseline Mf below 2000 mf/ml, while 8% had baseline Mf above 8000 mf/ml. Twelve different treatment schemes were identified, the most common being a single dose of IVM (39%). Adverse events occurred in 12% of episodes, including one fatal event. On last follow-up visit, 9.3% of patients still experienced symptoms, 24.7% exhibited persistent Mf, and 19.3% had persistent blood eosinophilia, patients treated with stand-alone IVM experienced worse outcomes (18%, 72% and 39%, respectively).</div></div><div><h3>Conclusion</h3><div>In France, loiasis treatment is inconsistent and frequently relies on inadequate options, including IVM monotherapy, which lacks therapeutic efficacy, and carries safety concerns. Our findings highlight real-world practices and indicates that better training is needed for practitioners treating patients with loiasis.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"71 ","pages":"Article 102982"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mehdi Borhani , Sayed Hussain Mosawi , Mohammad Shafi Fazli , Saeid Fathi , Paul Calame , Hao Wen
{"title":"Cerebral cystic echinococcosis: A retrospective series of 7 cases","authors":"Mehdi Borhani , Sayed Hussain Mosawi , Mohammad Shafi Fazli , Saeid Fathi , Paul Calame , Hao Wen","doi":"10.1016/j.tmaid.2026.102984","DOIUrl":"10.1016/j.tmaid.2026.102984","url":null,"abstract":"<div><div>Cystic echinococcosis (CE), caused by <em>Echinococcus granulosus sensu lato</em> and other <em>Echinococcus</em> species, is a neglected tropical disease that predominantly affects the liver and lungs, with central nervous system involvement being rare but potentially severe. Data on cerebral CE in Afghanistan remain limited, resulting in insufficient characterization of its clinical and management patterns. This study describes seven patients (aged 7–45 years) with isolated cerebral CE and a history of livestock exposure or CE in family members. Lesions were located in the frontal, parietal, or temporal lobes. Headache was present in all patients (100%), followed by seizures (85.7%) and focal neurological deficits (28.6%). All patients underwent complete surgical cystectomy, followed by a three-month course of albendazole. Short-term outcomes were favorable, with resolution of headache in all cases and seizure control achieved in the majority (83.3%). These findings highlight the occurrence of cerebral CE in different regions of Afghanistan, and demonstrate a favorable early clinical response to the combined surgical and medical treatment approach.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"71 ","pages":"Article 102984"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patricia Sánchez-Mora , Francisca Molero , Ana Navascués , Nelly Daniela Zurita , Pilar Zamarrón , Eduardo Lagarejos , Sara Gómez , Pere Joan Cardona , Blanca Carrasco , Marta López-Lomba , Isabel Escribano , Óscar Martínez-Expósito , Teresa del Peso , Laura Herrero , Anabel Negredo , Laura Guillén-Calvo , Ana Peña , Rafael Gutiérrez-López , Nuria Labiod , Ana Vázquez , María Paz Sánchez-Seco
{"title":"Molecular epidemiology and surveillance of imported dengue in travellers returning to Spain, 2022-2024","authors":"Patricia Sánchez-Mora , Francisca Molero , Ana Navascués , Nelly Daniela Zurita , Pilar Zamarrón , Eduardo Lagarejos , Sara Gómez , Pere Joan Cardona , Blanca Carrasco , Marta López-Lomba , Isabel Escribano , Óscar Martínez-Expósito , Teresa del Peso , Laura Herrero , Anabel Negredo , Laura Guillén-Calvo , Ana Peña , Rafael Gutiérrez-López , Nuria Labiod , Ana Vázquez , María Paz Sánchez-Seco","doi":"10.1016/j.tmaid.2026.102986","DOIUrl":"10.1016/j.tmaid.2026.102986","url":null,"abstract":"<div><h3>Introduction</h3><div>Dengue is the most significant vector-borne viral disease in global morbidity and mortality, and it is considered a re-emerging disease spreading into new regions. The risk of autochthonous dengue virus transmission in Spain remains high due to the increasing number of travellers returning from endemic areas and the presence of <em>Aedes albopictus</em> within our territory. Conducting epidemiological and molecular studies on returning travellers from endemic areas may be crucial to discern transmission patterns and track the global spread of the virus. This study focuses on the molecular characterization of suspected imported dengue cases from 2022 to 2024.</div></div><div><h3>Methods</h3><div>We analysed 600 samples from 539 suspected dengue-infected travellers between 2022 and 2024. All samples were tested by a quantitative RT-PCR, and PCR-positive cases were confirmed by performing a non-overlapping nested RT-PCR, going under subsequent sequencing to identify viral diversity.</div></div><div><h3>Results</h3><div>Of the 539 suspected cases, 183 were confirmed as DENV-positive, with Cuba as the most common travel origin associated with infections. Molecular analysis of positive samples identified all four DENV serotypes and ten genotype groups, with DENV-3 genotype III as the most predominant. Additionally, among confirmed cases reported from regions with <em>Aedes albopictus</em> presence, 73% (94/129) occurred during the vector's active season (May–November), increasing the risk of local transmission.</div></div><div><h3>Conclusion</h3><div>Our results highlight the importance of returning travellers as sentinels for ongoing dengue outbreaks and epidemiology in endemic regions. Additionally, these emphasize the importance of early case identification through sentinel surveillance to prevent potential autochthonous transmission.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"71 ","pages":"Article 102986"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miquel Alberca-Ballell , Mireia López-Siles , Christen R. Stensvold , Noelia Arenal-Andrés , Nerea San Miguel-Sebastián , Pamela C. Köster , Sergio Sánchez , Antonio J. Martín-Galiano , Marc Llirós-Dupré , David Carmena
{"title":"Refractory giardiasis: Exploring the contribution of bacterial community shifts","authors":"Miquel Alberca-Ballell , Mireia López-Siles , Christen R. Stensvold , Noelia Arenal-Andrés , Nerea San Miguel-Sebastián , Pamela C. Köster , Sergio Sánchez , Antonio J. Martín-Galiano , Marc Llirós-Dupré , David Carmena","doi":"10.1016/j.tmaid.2026.102983","DOIUrl":"10.1016/j.tmaid.2026.102983","url":null,"abstract":"<div><div><em>Giardia duodenalis</em> infection is a common cause of diarrhoea in returning travellers from low-income regions. The increasing prevalence of resistance to nitroimidazoles, as first-line therapy, are of global concern. The interaction between <em>Giardia</em> and the host's gut microbiota plays a crucial role in the pathophysiology of giardiasis. Yet, longitudinal data assessing the course of the infection are scarce, and non-existent in patients refractory to treatment. Here, we provide the first longitudinal bacterial community study, carried out in two <em>Giardia</em>-infected Spanish adult patients refractory to treatment after travelling to India, a <em>Giardia</em>-hyperendemic country, which offers insights into the gut microbiota's response to infection and therapy over time. A significant reduction in alpha diversity was evidenced during and post-infection, accompanied by changes in bacterial taxa contribution, with an important individual effect. We evidenced microbial shifts that may be associated with infection, treatment effectiveness or microbial restoration after infection, which can potentially be used to monitor disease evolution and adjust the therapeutic strategy.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"71 ","pages":"Article 102983"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yu Yan , Yan Li , Meng Zhang , Xiaohua Tan , Yunxia Mao , Ximing Huang , Jianqian Chen , Guopeng He , Wei Ma
{"title":"Socioeconomic status and post-cyclone dengue Vulnerability: The mediating roles of knowledge and risk perception in Southern China","authors":"Yu Yan , Yan Li , Meng Zhang , Xiaohua Tan , Yunxia Mao , Ximing Huang , Jianqian Chen , Guopeng He , Wei Ma","doi":"10.1016/j.tmaid.2026.102955","DOIUrl":"10.1016/j.tmaid.2026.102955","url":null,"abstract":"<div><h3>Background</h3><div>Although numerous studies have investigated the link between tropical cyclones and dengue transmission, this body of research is predominantly ecological. How individual-level factors modify vulnerability to this risk remains understudied. We investigated how socioeconomic status, knowledge, attitudes, practices (KAP), and risk perception modulate post-cyclone vulnerability to inform targeted interventions.</div></div><div><h3>Methods</h3><div>We conducted a 1:1 matched case-control study in Guangzhou, Zhongshan, and Foshan cities between September 14 and October 1, 2024, following the Super Typhoon Yagi on September 7, 2024. Cases were confirmed using the local surveillance system and matched to controls recruited via community sampling by age and sex. Structural equation modeling (SEM) was used to identify the mediating pathways between SES and vulnerability, while multivariable conditional logistic regression was used to identify independent direct predictors of dengue infection.</div></div><div><h3>Results</h3><div>Structural equation modeling identified a significant pathway in which a higher socioeconomic status predicted greater knowledge (<em>β</em> = 0.34, <em>p</em> < 0.01), which in turn was associated with stronger preventive practices. In the final multivariable logistic regression, higher scores for practice (aOR = 0.62, 95 % CI: 0.43, 0.88), environment risk perception (aOR = 0.73, 95 % CI: 0.59, 0.91), and knowledge (aOR = 0.57, 95 % CI: 0.42, 0.77) were significant protective factors against dengue. Conversely, frequent mosquito exposure emerged as the strongest risk factor. Compared to individuals bitten weekly or less often, those experiencing daily bites had more than double the odds of infection (aOR = 2.38, 95 % CI: 1.43, 3.97).</div></div><div><h3>Conclusion</h3><div>Individual-level determinants, particularly adaptive practices and environmental risk perception, are critical mediators of post-cyclone dengue risk. Public health interventions should be tailored to bolster these protective behaviors, mitigating outbreak threats in vulnerable populations.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"70 ","pages":"Article 102955"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}