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Among ill returned travelers to Schistosoma-endemic areas reported to the GeoSentinel Surveillance Network over a decade 410 schistosomiasis diagnoses were identified: 102 Schistosoma mansoni, 88 S. haematobium, 7 S. japonicum, and 213 Schistosoma unknown human species. A total of 83% were acquired in Africa. Unlike previous large case series, individuals born in endemic areas were excluded. Controlling for age and sex, those traveling for missionary or volunteer work, or as expatriates were more likely to be diagnosed with schistosomiasis. Sixty-three percent of those with schistosomiasis presented within six months of travel. Those seen early more often presented with fever and respiratory symptoms compared with those who presented later. One-third of patients with schistosomiasis were asymptomatic at diagnosis. Half of those examined for schistosomiasis were diagnosed with infection. Screening for schistosomiasis should be encouraged for all potentially exposed travelers and especially for missionaries, volunteers, and expatriates.

The incidence of S. aureus infection was significantly elevated in nasally colonized MICU patients. Techniques to rapidly detect colonization in this population may make targeted topical prevention strategies feasible.

A comprehensive medical evaluation to identify persistent and untreated tropical infections among members of the Sudanese group "Lost Boys of Sudan" living in Atlanta, GA, was initiated. Medical examinations and laboratory testing including blood cell counts, liver function tests, stool studies for parasites, hepatitis B serologies, and serologic testing for Schistosoma spp., Strongyloides, and filariae were performed. Preliminary results showed a high prevalence of untreated active schistosomiasis and strongyloidiasis infections in this group, 5 years after their resettlement in the United States. In addition, we found that many of them were infected with onchocerciasis and hepatitis B. We suggest that based on these preliminary results, pre-departure presumptive treatment and/or testing algorithms need to address some of these persistent tropical infections.

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