Enteric pathogens in German police officers after predominantly tropical deployments – A retrospective assessment over 5 years

Abstract

IntroductionThe study was performed to assess the infection risk of German police officers on predominantly tropical deployments, mostly United Nations missions, with gastrointestinal pathogens.MethodsPolice officers were offered PCR-based screening for gastrointestinal pathogens before and after deployment. The screening panel comprised enteroinvasive bacteria (Salmonella spp., Shigella spp./enteroinvasive Escherichia coli, Campylobacter jejuni, and Yersinia spp.), enteropathogenic protozoa (Entamoeba histolytica, Giardia duodenalis, Cryptosporidium spp., and Cyclospora cayetanensis), as well as enteric helminths (Ancyclostoma spp., Ascaris lumbricoides, Enterobius vermicularis, Hymenolepis nana, Necator americanus, African Schistosoma spp., Strongyloides stercoralis, Taenia saginata, Taenia solium, and Trichuris trichiura).ResultsG. duodenalis (n = 3), C. jejuni (n = 2), Salmonella spp. (n = 1), Shigella spp./enteroinvasive E. coli (n = 3), and S. stercoralis (n = 3) were detect in 12 out of 133 (9.0%) police officers. The majority had shown gastrointestinal symptoms on deployment and all were asymptomatic at the time of medical assessment. The major infection sites were Sub-Saharan Africa followed by Northern Africa and the Middle East.ConclusionsDeployment of police officers to tropical deployment sites on United Nations missions is associated with a considerable acquisition risk of gastrointestinal pathogens in a quantitatively relevant minority. Post-deployment screening is advisable to facilitate therapeutic and hygiene-related consequences.

New Developments in PCR-Based Diagnostics for Bacterial Pathogens Causing Gastrointestinal Infections—A Narrative Mini-Review on Challenges in the Tropics

“…As known from the data within the Geosentinel database on diseases acquired from international travel [9,10] as well as from experience with travelers in the tropics by our own group and others [5,11,12], infectious causes of gastroenteritis are bacteria, eukaryotic parasites and viruses in declining order in resource-poor tropical countries while viruses are most frequently etiologically relevant in Western industrialized countries followed by bacteria and parasites. In particular, diarrheagenic E. coli and Shigella spp., Campylobacter spp., and Salmonella enterica dominate in the tropics as shown in previous studies [5,7,11,[13][14][15][16][17][18][19]. Cold-affine Yersinia spp.…”

Comparative Assessment of In-House Real-Time PCRs Targeting Enteric Disease-Associated Microsporidia in Human Stool Samples

“…A total of 1339 residual nucleic acid extractions from stool samples were included in the assessment. Those materials comprised 20 residual samples from patients that had tested positive for intestinal microsporidiosis in the routine diagnostics department of the Bernhard Nocht Institute for Tropical Medicine in Hamburg (which is the German National Reference Center for Tropical Pathogens in Hamburg, Germany), 59 residual samples from a previous study in the Colombian tropics [42], 140 residual samples from migrants [43], 195 residual samples from German policemen deployed in the tropics [44], 22 residual samples from German soldiers [45] returning from tropical deployments, and 903 residual DNA samples from African HIV-positive patients from previous studies from Ghana [46,47]. The samples were chosen to ensure a sufficient likelihood of intestinal carriage of microsporidia as associated with the history of travel [18] or immunosuppression [10].…”

Comparison of two commercial and one in-house real-time PCR assays for the diagnosis of bacterial gastroenteritis

“…Anonymized nucleic acid extraction residuals from stool samples assessed at the diagnostic laboratory of the Tropical Microbiology Subdepartment of the Bundeswehr Hospital Hamburg, Germany, located at the German National Reference Centre for Tropical Pathogens Bernhard Nocht Institute for Tropical Medicine Hamburg, were included in the test comparison. Those residual sample materials were either from screening assessments of German soldiers and policemen returning from tropical deployments [ 5 , 6 ], from migrants travelling under poor hygiene conditions [ 7 ] or from studies conducted in resource-limited tropical settings (unpublished data) to ensure high proportions of positive samples for test comparison purposes. In addition, well-characterized sample materials from German external laboratory control schemes (“Ringversuche” by INSTAND e.V., Düsseldorf, Germany) were included.…”