Travel Medicine and Infectious Disease RSS feed: Current Issue. The journal will publish original papers and invited reviews covering all aspects of travel medicine and infectious disease. These will include the epidemiology and surveillance of travel-related infectious disease, vaccine-preventable disease, illness in returning travellers, aviation medicine including psychological aspects, environmental hazards of travel, practical clinical issues for travellers, tropical medicine and tropical skin disease and general aspects of travel medicine and infectious disease. The journal will also bring together knowledge from different specialties involved in the research and clinical practice of travel medicine and infectious disease. The journal will publish topical leading academic reviews and opinion papers, original articles and case reports as well as a correspondence section.http://www.travelmedicinejournal.com/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Travel Medicine and Infectious Disease1477-893983May 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.travelmedicinejournal.com/article/PIIS1477893910000761/abstract?rss=yesEditorial board10.1016/S1477-8939(10)00076-1Travel Medicine and Infectious Disease 8, 3 (2010)2010-05-01Travel Medicine and Infectious Disease2010-05-0183S1477-8939(10)X0004-7iihttp://www.travelmedicinejournal.com/article/PIIS1477893910000451/abstract?rss=yesSummary: The 19th Commonwealth Games, conducted once in every four years since 1930, will be held in New Delhi from the 3rd through until the 14th of October, 2010. There will be approximately 17 sports on display and there will also be 15 para-sporting events. This paper focuses on health and safety issues for travellers to India in general, although it provides specific references to advice for visiting Commonwealth Games athletes and team staff, who will be travelling to the games. Whilst it needs be remembered that travel health advice can change, travellers are advised to seek up-to-date travel health advice for India, from their professional providers, closer to their departure.Travelling to India for the Delhi XIX Commonwealth Games 2010Marc T.M. Shaw, Peter A. Leggat, Santanu Chatterjee10.1016/j.tmaid.2010.04.007Travel Medicine and Infectious Disease 8, 3 (2010)2010-06-02Travel Medicine and Infectious Disease2010-06-0283S1477-8939(10)X0004-7Reviews129138http://www.travelmedicinejournal.com/article/PIIS1477893910000608/abstract?rss=yesSummary: During recent years, new foci of Crimean–Congo hemorrhagic fever (CCHF) have emerged in several Balkan countries, southwest Russia, and Turkey. Starting in 2002, Turkey experiences the largest ever recorded outbreak with more than 2500 cases. Potential reasons for the emergence or re-emergence of CCHF include climate changes which may have a significant impact on the reproduction rate of the vector Hyalomma ticks, as well as anthropogenic factors (e.g. changes in agricultural and hunting activities). Given the abundance of its vector, the numerous animals that can serve as hosts, and the favorable climate and ecologic parameters in other southern Europe Mediterranean countries, CCHF is an example of a vector-borne disease which may be knocking the door in this area. There are models which show probability of CCHF extending to other countries around the Mediterranean basin suggesting that the vector, veterinarian, and human surveillance should be enhanced.Crimean–Congo hemorrhagic fever: Risk for emergence of new endemic foci in Europe?Helena C. Maltezou, Anna Papa10.1016/j.tmaid.2010.04.008Travel Medicine and Infectious Disease 8, 3 (2010)2010-05-31Travel Medicine and Infectious Disease2010-05-3183S1477-8939(10)X0004-7Reviews139143http://www.travelmedicinejournal.com/article/PIIS147789391000027X/abstract?rss=yesSummary: Background: Imported malaria has been an increasing problem in Italy in the last three decades of the 1900s, representing the main risk for travelers visiting tropical and sub-tropical countries where malaria is endemic. Even though the total number of imported cases has been declining since 2000, malaria still represents the most frequent notifiable imported disease in Italy. The present study analyzes all the malaria cases reported in Italy in 2000–2006 in order to assess the trend of incidence over the time and reviewing the risk factors for travelers visiting malaria endemic countries.Methods: All 2000–2006 case report forms were analyzed. The incidence of malaria in Italian travelers was calculated by continent and by countries most visited, using data provided by the Ministry of Transportation.Results: Out of the 5219 malaria cases reported and confirmed in the study period five were autochthonous and 5214 imported, 1518 of which occurred in Italian citizen and 3696 in foreigners. Between 2000 and 2006 imported malaria cases fell from 977 to 630 respectively, with a total reduction of about 36%. Most of the cases were contracted in Africa (93%) and Plasmodium falciparum was the etiological agent in 83% of the cases, with an annual average fatality rate of about 0.5%. The average of the crude incidence rate (CIR) among Italians was calculated by continent for both global cases (gCIR) and for P. falciparum cases (pfCIR) resulting of 1.2/1000 and 0.9 for Africa, 0.08/1000 and 0.02 for Asia, 0.03/1000 and 0.003 for Central and South America, respectively. The gCIR by continent slightly but decreased constantly over the study period.Discussion: The different factors which may influence the risk of contracting malaria for travelers visiting endemic countries and the strategy to reduce completely the number of fatal cases were considered and discussed.Incidence of malaria and risk factors in Italian travelers to malaria endemic countriesRoberto Romi, Daniela Boccolini, Stefania D'Amato, Corrado Cenci, Mario Peragallo, Fortunato D'Ancona, Maria Grazia Pompa, Giancarlo Majori10.1016/j.tmaid.2010.02.001Travel Medicine and Infectious Disease 8, 3 (2010)2010-03-08Travel Medicine and Infectious Disease2010-03-0883S1477-8939(10)X0004-7Original Articles144154http://www.travelmedicinejournal.com/article/PIIS1477893910000335/abstract?rss=yesSummary: This paper reviews the risk and vaccine recommendations for tetanus, diphtheria, pertussis and poliomyelitis for adult travellers. The travel clinic presents a unique opportunity to evaluate whether routine vaccinations are up-to-date. Tetanus, diphtheria and pertussis occur worldwide but are more common in low resource countries due to incomplete childhood vaccination coverage, environmental and socio-economic factors. Diphtheria has been reported in travellers without adequate protection. A booster against tetanus and diphtheria is recommended for all adult travellers, regardless of travel destination and duration. The incidence of pertussis in general adult travellers has been poorly studied. Extrapolating from the reported high incidence in travellers to the Hajj, the risk may be more substantial than thought. There are no universal recommendations for pertussis vaccination for adult travellers, and studies are needed to develop evidence based guidelines. Poliomyelitis is well controlled and now only occurs in a small number of countries. Travellers to and from endemic and re-infected countries should be fully vaccinated against poliomyelitis.Vaccination against tetanus, diphtheria, pertussis and poliomyelitis in adult travellersPhilippe Gautret, Annelies Wilder-Smith10.1016/j.tmaid.2010.02.007Travel Medicine and Infectious Disease 8, 3 (2010)2010-03-22Travel Medicine and Infectious Disease2010-03-2283S1477-8939(10)X0004-7Original Articles155160http://www.travelmedicinejournal.com/article/PIIS1477893910000049/abstract?rss=yesSummary: Among all travel-acquired illnesses, malaria carries the greatest burden not only considering the number of imported cases but also the potential of a fatal outcome. The increased number of imported malaria cases in developed countries in the last decades has been attributed to the increasing number of travel to tropical destinations in combination with the enormous influx of immigrants. At present, immigrants visiting friends and relatives (VFRs) constitute the most significant group of travellers for malaria importation in developed countries, with sub-Saharan Africa destinations carrying the highest risk. VFRs typically demonstrate travel and behavioural patterns which render them at high risk for acquisition of this largely preventable infection. Pre-travel services are rarely sought by VFRs, whereas misconceptions that they possess life-long immunity against malaria make them less likely to receive or adhere to antimalarial chemoprophylaxis recommendations. There is an urgent need to increase awareness about malaria of this group of travellers.Malaria and travellers visiting friends and relativesAndroula Pavli, Helena C. Maltezou10.1016/j.tmaid.2010.01.003Travel Medicine and Infectious Disease 8, 3 (2010)2010-02-22Travel Medicine and Infectious Disease2010-02-2283S1477-8939(10)X0004-7Original Articles161168http://www.travelmedicinejournal.com/article/PIIS1477893910000372/abstract?rss=yesSummary: Background: Ecotourism can function as a powerful tool for species conservation. However, a significant proportion of travelers at wildlife sanctuaries may be ill and potentially infectious, creating unnecessary risk of pathogen transmission to wildlife.Methods: A questionnaire was distributed to adult visitors at the Sepilok Orangutan Rehabilitation Centre, Sabah, Malaysia. The questionnaire recorded age, occupation, region of origin, history of recent travel, recent contact with livestock, domestic and wild animals, and diagnoses/symptoms of various infections.Results: 15% of the 633 tourists self-reported at least one of the following current symptoms: cough, sore throat, congestion, fever, diarrhea and vomiting. Participants who reported recent animal contact were significantly more likely to report current respiratory symptoms compared to other participants. Likewise, participants with a medical-related occupation were more likely to report current respiratory symptoms while at Sepilok compared to other participants.Conclusions: Despite being ill and potentially infectious, these tourists were visiting a wildlife sanctuary to view endangered species. Many of these visitors had animal contact immediately prior to arriving, and many had at least some basic knowledge about infection transmission. While participants in nature-based tourism are generally concerned about environmental protection, present analyses suggest that a significant proportion of ecotourists are uninformed of the risks they may pose to non-human animal health.Unhealthy travelers present challenges to sustainable primate ecotourismMichael P. Muehlenbein, Leigh Ann Martinez, Andrea A. Lemke, Laurentius Ambu, Senthilvel Nathan, Sylvia Alsisto, Rosman Sakong10.1016/j.tmaid.2010.03.004Travel Medicine and Infectious Disease 8, 3 (2010)2010-04-20Travel Medicine and Infectious Disease2010-04-2083S1477-8939(10)X0004-7Original Articles169175http://www.travelmedicinejournal.com/article/PIIS147789391000030X/abstract?rss=yesSummary: Background: Hepatitis A is one of the most frequently reported vaccine-preventable diseases throughout the world and remains endemic in many areas. Studies in various communities have shown that Hepatitis A virus (HAV) prevalence rises with age. The current data regarding hepatitis A epidemiology in Iran is limited. The aim of this study was to determine the seroepidemiology of hepatitis A in children of different age groups in Tehran, Iran.Methods: Plasma samples of 1065 children between ages of 6 months and 20 years were tested for the presence of total anti-HAV. The study population was stratified according to age.Results: The prevalence of total anti-HAV was 61.6%. HAV prevalence rates according to age groups were as follows: 61.5% between 6 months and 1.9 years, 51.7% between 2 and 5.9 years, 52.9% between 6 and 10.9 years, 65.2% between 11 and 15.9 years, 85% between 16 and 20 years. Total anti-HAV seroprevalence was significantly different between age groups.Conclusion: The study findings indicate that hepatitis A is prevalent in children in Tehran, Iran and HAV infection is an important public health problem in this region.Seroepidemiology of hepatitis A virus in children of different age groups in Tehran, Iran: Implications for health policyMasoomeh Sofian, Arezoo Aghakhani, Ali-Asghar Farazi, Mohammad Banifazl, Gelavizh Etemadi, Saeed Azad-Armaki, Abolhassan Ziazarifi, Zohreh Abhari, Ali Eslamifar, Akbar Khadem-Sadegh, Nabiallah Izadi, Amitis Ramezani10.1016/j.tmaid.2010.02.004Travel Medicine and Infectious Disease 8, 3 (2010)2010-03-12Travel Medicine and Infectious Disease2010-03-1283S1477-8939(10)X0004-7Original Articles176179http://www.travelmedicinejournal.com/article/PIIS1477893910000311/abstract?rss=yesSummary: Global health and international health are prominent concepts within development issues today. Health is at the heart of many of the Millennium Development Goals, and the idea of a human right to health and health care has taken more hold in the forefronts of our minds.In acknowledgement of the globalised and interdependent society in which we live, this reflective piece uses personal experiences of anthropology and travel throughout the author's medical education to illustrate the pressing need for a better understanding between health workers and local populations. Experiences in Ecuador, Peru, India and Nepal, highlight the plurality of medicine. They show how medical education in the UK forms only one part of medical knowledge, and in particular how clinical practice requires the appreciation of a wider context.Within a multi-cultural society, it is essential that medical students learn new skills for the future. Teaching Anthropology and Sociology within the curriculum in the UK can educate students about how knowledge is created within a culture and to appreciate the diversity between cultures. Consideration of patients' backgrounds and beliefs allows health workers to develop relationships with the local population, which can be of invaluable use in making global health equality a reality.Developing an understanding between people: The key to global healthAlina Serafin10.1016/j.tmaid.2010.02.005Travel Medicine and Infectious Disease 8, 3 (2010)2010-03-24Travel Medicine and Infectious Disease2010-03-2483S1477-8939(10)X0004-7First Look - Student Research180183http://www.travelmedicinejournal.com/article/PIIS1477893910000414/abstract?rss=yesSummary: A case is presented of intestinal schistosomiasis due to both Schistosoma intercalatum and Schistosoma mansoni in a 30-year-old man from Senegal with discussion of diagnostic approach, species identification and determination of the effect of treatment. The patient was admitted to hospital for investigation of renal failure, arterial hypertension and hypereosinophilia. Repeated stool examinations for ova and parasites were negative. Ultrasonography (US) and computed tomography (CT) of the abdomen showed no abnormalities. US of the urinary tract showed kidneys of borderline size with increased echogenicity. Cystoscopy and histopathological examination of bladder biopsy specimens were normal. Flexible colonoscopy revealed numerous nodular lesions in the rectosigmoid region and a few similar lesions in the transverse colon, the histopathological examination of which showed deposition of Schistosoma ova with granuloma formation. Examination of multiple crush biopsy specimens from the rectosigmoid region revealed numerous granulomas formed around Schistosoma eggs which had a terminal spine and were identified as S. intercalatum (longer than Schistosoma haematobium and with a slightly curved terminal spine) and a very few S. mansoni eggs. Crush biopsies from the lesions in the transverse colon showed only S. mansoni eggs. In conclusion, the examination of multiple crush biopsy specimens is a very sensitive and specific technique for species identification of Schistosoma, especially in mixed infections, and for defining the location and extent of the granulomas evoked by each species.Intestinal schistosomiasis caused by both Schistosoma intercalatum and Schistosoma mansoniKonstantina Tzanetou, Myrto Astriti, Vassilios Delis, George Moustakas, Theodosia Choreftaki, Eugenia Papaliodi, Katerina Sarri, George Adamis10.1016/j.tmaid.2010.04.003Travel Medicine and Infectious Disease 8, 3 (2010)2010-05-06Travel Medicine and Infectious Disease2010-05-0683S1477-8939(10)X0004-7Commentaries184189http://www.travelmedicinejournal.com/article/PIIS1477893910000037/abstract?rss=yesSummary: A review of the recent foundation by The Australasian College of Tropical Medicine of the Sub-Faculty of Expedition Medicine is presented. Information is given on aims, professional grades of membership, and the various activities of the Sub-Faculty, including publications and scientific meetings.Professional organisation profile: A Sub-Faculty of expedition medicine for AustralasiaPeter A. Leggat, Marc T.M. Shaw10.1016/j.tmaid.2010.01.002Travel Medicine and Infectious Disease 8, 3 (2010)2010-03-08Travel Medicine and Infectious Disease2010-03-0883S1477-8939(10)X0004-7Commentaries190193http://www.travelmedicinejournal.com/article/PIIS1477893910000360/abstract?rss=yesWe note the paper by Zuckerman et al indicating that, in preventing malaria in UK travellers, the estimated effectiveness of atovaquone/proguanil (A/P) substantially exceeded that of doxycyline (DOX) and of mefloquine (MEF). While the conclusion might (or might not) be valid, we are vexed by several issues, some of which are mentioned in the limitations section of the article; these concerns lead us to seriously question the conclusion. The data used in the article may not be representative of the “real world”: data about prophylaxis are only available for 55% of all the cases of malaria; data about prescriptions are only from 121 general practitioners, which is an unstated fraction of all the GPs in the CSD UK database; as mentioned in the article, prescribing data are only from the GP sample and don't include other prescribing sources (e.g. travel health clinics); and, as mentioned in the article, there is no accounting for whether a prescription was actually dispensed or not (and there may be differential filling of prescriptions, e.g. based on cost with A/P particularly more expensive than MEF or DOX). There are important elements related to which prophylaxis is prescribed that are not included in the data: as mentioned in the article, without data on the duration of travel in the malarious area, one cannot tell if A/P is given more often for shorter travel itineraries and MEF for longer travel itineraries (all else being equal, the longer the duration of travel the more the risk of being infected); there is no accounting for the specific locale of travel (perhaps, MEF is given for higher risk locales and A/P for lower risk locales); and there is no accounting for the nature of travel (perhaps, businessmen are more likely to be prescribed A/P since they can afford to fill the prescription). Lastly, it is noted that all the authors have an affiliation, even a substantial affiliation for one, with GlaxoSmithKline, the manufacturer of A/P. Given the above concerns, we believe that this study should not be used to inform decision-making regarding malaria chemoprophylaxis for travellers.Letter to the editor of Travel Medicine and Infectious DiseaseMartin Tepper, Steven Schofield10.1016/j.tmaid.2010.03.003Travel Medicine and Infectious Disease 8, 3 (2010)2010-04-05Travel Medicine and Infectious Disease2010-04-0583S1477-8939(10)X0004-7Correspondence194194http://www.travelmedicinejournal.com/article/PIIS1477893910000359/abstract?rss=yesEDITOR – The approach used in our retrospective observational study provides an estimate on the use effectiveness of malaria chemoprophylaxis against infection with Plasmodium falciparum outside of a controlled clinical trial setting. Tepper and Schofield rightly point out – as we have done in our article – certain limitations regarding some of the inputs into this analysis. However, we believe that this study does in many ways mimic the nature of travel, with varying levels of risk, real world variance and substantial heterogeneity in the population.Response to “letter to the editor” submitted by Dr Martin Tepper and Dr Steven Schofield – Effectiveness of malaria chemoprophylaxis against Plasmodium falciparum infection in UK travellers: Retrospective observational data. Travel Medicine and Infectious Disease 2009;7:329–336Jane N. Zuckerman, Anthony J. Batty, Michael E. Jones10.1016/j.tmaid.2010.03.002Travel Medicine and Infectious Disease 8, 3 (2010)2010-04-23Travel Medicine and Infectious Disease2010-04-2383S1477-8939(10)X0004-7Correspondence195196http://www.travelmedicinejournal.com/article/PIIS1477893910000347/abstract?rss=yesThe second edition of Notes on Medical Microbiology is a concise comprehensive account of disease of human caused by bacteria, viruses, prions, fungi and parasites, including description of the causal organism, epidemiology, pathology, diagnosis, clinical features and prevention and treatment. This updated volume, which has been revised extensively and meticulously, is the successor of the highly successful Notes on Medical Virology (first published in 1967 and which I still possess) written by Professor Morag Timbury, and Notes on Medical Microbiology (first published in 1981) written by Morag Timbury together with Professor J D Sleigh.Notes on medical microbiologyArie J. Zuckerman10.1016/j.tmaid.2010.03.001Travel Medicine and Infectious Disease 8, 3 (2010)2010-04-02Travel Medicine and Infectious Disease2010-04-0283S1477-8939(10)X0004-7Book Review197197