Onchocerciasis in members of an expedition to Cameroon: role of advice before travel and long term follow up.

Abstract

Delayed heart repolarisation is marked by prolonged QT interval on electrocardiography and may be complicated by ventricular arrhythmias, syncope, and sudden death.' Such events have recently been associated with severe malnutrition, as occurs in anorexia nervosa2 and after ileojejunal bypass.3 These reports have prompted us to measure QT interval in adult patients with coeliac disease, a condition which often presents with nutritional impairment.

Differences in the Clinical and Laboratory Features of Imported Onchocerciasis in Endemic Individuals and Temporary Residents

“…Eye disease occurred in only one TR, whereas 23% of endemic patients had ocular involvement on slit-lamp examination. One-eighth of TRs were clinically asymptomatic, consistent with the 9-21% prevalence of asymptomatic infection in other expatriate cohorts 12,14 ; unexpectedly, all ENDs had at least one characteristic O. volvulus symptom. Most ENDs were symptomatic at the time of immigration, but in those who developed symptoms postimmigration, median time to symptom onset was close to 3 years after leaving the endemic area.…”

“…The substantial number of asymptomatic expatriates supports O. volvulus screening based on epidemiologic exposure and an active case-finding approach in travelers to the same destination. 12 Onchocerciasis should be considered in all patients with a history of travel to focal endemic areas, regardless of eosinophil count, which was normal in one-third of both ENDs and TRs.…”

“…A recent analysis of all case reports of imported O. volvulus infection corroborates that eye involvement, onchocercal nodules, lymphadenopathy, and skin lichenification and atrophy occur almost entirely in immigrants/refugees, whereas travelers have more acute unilateral limb swelling and papular rash. 11,12 By contrast, historical expatriate cohorts noted ocular disease in 20-34% of TRs, 13,14 although these expatriates had longer exposure periods without access to treatment, suggesting that disease burden and chronicity may influence clinical phenotype.…”

Eosinophilia in Infectious Diseases

“…The most common manifestations are pruritus, rash (commonly a papular dermatitis), and fixed extremity swelling [79-82]. In 80% of travelers, marked eosinophilia is seen (1,000-2,000/μL) [55, 80, 81], but microfilariae are difficult to find in skin snips from travelers due to the relatively low burden of infection that results from a short exposure [80, 83]. …”

Filariosis por onchocerca volvulus , loa loa y mansonella pers tans. Analisis epidemiológico, clínico, anal ítico y parasitológico

“…En la literatura, se considera que para contraer los diferentes tipos de filariosis se requieren exposiciones repetidas a los vectores y estancias prolongadas en zona endémica de filariosis En nuestra serie, de los 17 VIAJ con oncocercosis, hay tres con estancias en ZEF inferiores a un año, uno de ellos de solo medio mes. En la serie de Pryce et al (1992), de 22 casos de oncocercosis en VIAJ, la duración media del viaje fue de 3 meses (rango: 27 días 15 meses), haciendo hincapié en que la oncocercosis se puede adquirir en viajes de poca duración a zonas endémicas. En la serie de Encarnación et al (1994), de cuatro casos de oncocercosis en VIAJ, el tiempo de estancia de un paciente fue 6 semanas y en otro 3 meses.…”