Emerging Infections and Pertinent Infections Related to Travel for Patients with Primary Immunodeficiencies

Abstract

In today’s global economy and affordable vacation travel, it is increasingly important that visitors to another country and their physician be familiar with emerging infections, infections unique to a specific geographic region, and risks related to the process of travel. This is never more important than for patients with primary immunodeficiency disorders (PIDD). A recent review addressing common causes of fever in travelers provides important information for the general population Thwaites and Day (N Engl J Med 376:548-560, 2017 ). This review covers critical infectious and management concerns specifically related to travel for patients with PIDD. This review will discuss the context of the changing landscape of infections, highlight specific infections of concern, and profile distinct infection phenotypes in patients who are immune compromised. The organization of this review will address the environment driving emerging infections and several concerns unique to patients with PIDD. The first section addresses general considerations, the second section profiles specific infections organized according to mechanism of transmission, and the third section focuses on unique phenotypes and unique susceptibilities in patients with PIDDs. This review does not address most parasitic diseases. Reference tables provide easily accessible information on a broader range of infections than is described in the text.

Social determinants of health and primary immunodeficiency

“…Climate changes include increased temperatures, changes in precipitation, wind, and humidity, and location and rate of extreme weather events, such as floods, droughts, and hurricanes. 2 Changes in temperature, humidity, and precipitation primarily affect the rate of vector-borne diseases by affecting the reproduction, viability, and behavior of a vector and the incubation period of a pathogen. 2,3 The mosquito genus Anopheles transmits Plasmodium protozoan, responsible for malaria.…”

“…2 Changes in temperature, humidity, and precipitation primarily affect the rate of vector-borne diseases by affecting the reproduction, viability, and behavior of a vector and the incubation period of a pathogen. 2,3 The mosquito genus Anopheles transmits Plasmodium protozoan, responsible for malaria. Malaria transmission has been associated with increased humidity and temperature and standing water.…”

“…16 As most immunoglobulin products are produced in Europe and United States, the antibodies they contain reflect the epidemiology of these regions. 2 As a result, patients may have suboptimal protection against infectious organisms causing local epidemics, such as dengue fever. 16 Finally, recent advancements in the understanding of IEI have led to development of targeted therapies for several of these conditions, including CTLA4 and LRBA mutations treated with abatacept, activated phosphoinositide 3-kinase d syndrome treatment with PI3Kd inhibitors, adenosine deaminase deficiency treatment with gene therapy, and more.…”

Co-infections of MERS-CoV with other respiratory viruses in Saudi Arabia

“…Consumption of raw or undercooked meat and milk is a risk factor for zoonotic transmission, therefore, animal products should be processed appropriately through cooking or pasteurization and handled with care to avoid cross-contamination with uncooked food items. Although, camel products have proven to be nutritious, they should only be consumed after cooking or heat treatment or pasteurization (9). Persons who are immunocompromised or have renal failure, diabetes and chronic lung disease are considered to be at high-risk for severe MERS-CoV infection.…”

Nervous System Infections and the Global Traveler

“…1 As economic incentives often draw individuals from rural to urban settings, overcrowding in cities is a major driver of the spread of communicable diseases. 2,5 A lack of sanitary living conditions and deficits in the public health services make inner city populations particularly vulnerable to emerging pathogens. 1 Climate change has also had a significant impact on the emergence and reemergence of infectious diseases globally.…”