Enteropathogens and Chronic Illness in Returning Travelers

Cabada, Miguel M.; Okhuysen, Pablo C.; White, A. Clinton

doi:10.1056/nejmc1308293

Cited by 5 publications

(3 citation statements)

References 66 publications

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“…It is estimated that over 220 million people are currently infected with schistosomes, with more than 70 million new infections and thousands of deaths occurring annually [1]. The majority of human infections and morbidity are caused by three main schistosome species: Schistosoma mansoni, S. haematobium, and S. japonicum [2], among which S. japonicum is the only human blood fluke that is endemic in China [3]. China once profoundly suffered from schistosomiasis, termed 'the God of Plague' [4].…”

Section: Introductionmentioning

confidence: 99%

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Meta-analyses of Schistosoma japonicum infections in wild rodents across China over time indicates a potential challenge to the 2030 elimination targets

Zou

Qiu

et al. 2020

PLoS Negl Trop Dis

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China once suffered greatly from schistosomiasis japonica, a major zoonotic disease. Nearly 70 years of multidisciplinary efforts have achieved great progress in disease control, with infections in both humans and bovines significantly reduced to very low levels. However, reaching for the target of complete interruption of transmission at the country level by 2030 still faces great challenges, with areas of ongoing endemicity and/or re-emergence within previously 'eliminated' regions. The objectives of this study were, by using meta-analytical methods, to estimate the overall prevalence of Schistosoma japonicum infections in abundant commensal rodent species in mainland China after the introduction of praziquantel for schistosomiasis treatment in humans and bovines in 1980s. In doing so we thereby aimed to further assess the role of wild rodents as potential reservoirs in ongoing schistosome transmission. Published studies on infection prevalence of S. japonicum in wild rodents in mainland China since 1980 were searched across five electronic bibliographic databases and lists of article references. Eligible studies were selected based on inclusion and exclusion criteria. Risks of within and across study biases, and the variations in prevalence estimates attributable to heterogeneities were assessed. The pooled infection prevalence and its 95% confidence intervals (CIs) were calculated with the Freeman-Tukey double arcsine transformation. We identified a total of 37 relevant articles involving 61 field studies which contained eligible data on 8,795 wild rodents across mainland China. The overall pooled infection prevalence was 3.86% (95% CI: 2.16-5.93%). No significant change in the overall pooled prevalence was observed between 1980-2003 (n = 23 studies) and 2004-current (n = 38 studies). However, whilst the estimated prevalence decreased over time in the marshland and lake regions, there was an apparent increase in prevalence within hilly and mountainous regions. Among seven provinces, a significant prevalence reduction was only seen in Jiangsu where most endemic settings are classified as the marshland and lakes. These estimates changed over season, ranging from 0.58% in spring

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Section: Introductionmentioning

confidence: 99%

“…haematobium , and S . japonicum [ 2 ], among which S . japonicum is the only human blood fluke that is endemic in China [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Meta-analyses of Schistosoma japonicum infections in wild rodents across China over time indicates a potential challenge to the 2030 elimination targets

Zou

Qiu

et al. 2020

PLoS Negl Trop Dis

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“…Unfortunately, in most cases, the etiology of these complaints remains unknown, partially due to the low sensitivity of current tests. In only about a third of the cases pathogens can be identified, the most common being Giardia [9]. Although the majority of returning travelers with chronic complaints remain undiagnosed, many of them nonetheless respond to anti-parasitic treatment [8].…”

Section: Introductionmentioning

confidence: 99%

Giardia lamblia miRNAs as a new diagnostic tool for human giardiasis

et al. 2019

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Background Giardia lamblia is a very common cause of gastrointestinal symptoms worldwide. There are several methods for the diagnosis of Giardia infection, however none are ideal. We aim to find a new, microRNA-based method that will improve the currently available diagnostic methods for giardiasis. Methods Deep-sequence profiling of Giardia small-RNA revealed that miR5 and miR6 are highly expressed in Giardia . These miRNAs were tested by qRT-PCR in duodenal biopsies of patients with giardiasis who were positive by microscopic pathological evaluation. The gastric biopsies of the same patients served as negative control tissues. Additionally, these miRNAs were evaluated in stool samples of patients with proven giardiasis. Results All histologically proven duodenal biopsies of patients with Giardia infection were positive for Giardia miR5, with a mean threshold cycle (Ct) of 23.7, as well as for Giardia DNA qPCR (16S-like gene, mean Ct 26.3). Gastric biopsies which were tested as a control all were negative. Stool evaluation of miR6 in patients with giardiasis showed 90% specificity but only 66% sensitivity, and a lower accuracy rate was obtained with miR5. Conclusion Giardia miR5 testing in duodenal biopsies may be a new method for the diagnosis of giardiasis. It seems to be more sensitive when compared with testing for Giardia DNA by qPCR in duodenal biopsies. It will be important to investigate the contribution of routine Giardia miRNA testing in duodenal biopsies from patients with persistent abdominal symptoms

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Advising the traveller

Herman¹,

Hill²

2014

Medicine

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Global travel continues to increase, particularly to tropical destinations that have different health risks from those encountered closer to home. Currently, over a billion people travel annually, with over 65 million visits made from the UK. Seeking pre-travel advice should be an essential part of any trip for a traveller. The key elements of pretravel advice are health risk assessment, health promotion and risk management; this involves advice on prevention of malaria, travellers' diarrhoea, sexually transmitted infections and accidents, as well as appropriate vaccinations. Higher risk groups of travellers, such as those visiting friends and relatives, those with co-morbidities, pregnant women and very young or elderly individuals, particularly need to be targeted.

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Enteropathogens and Chronic Illness in Returning Travelers

Abstract: Bacterium Figure 1. Relative Risk of Chronic Enteropathogenic Infections Acquired during Travel Abroad.

Cited by 5 publications

References 66 publications

Meta-analyses of Schistosoma japonicum infections in wild rodents across China over time indicates a potential challenge to the 2030 elimination targets

Meta-analyses of Schistosoma japonicum infections in wild rodents across China over time indicates a potential challenge to the 2030 elimination targets

Giardia lamblia miRNAs as a new diagnostic tool for human giardiasis

Advising the traveller

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