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Source of many myths, French Guiana represents an exceptional territory due to the richness of its biodiversity and the variety of its communities. The only European territory in Amazonia, surrounded by the Brazilian giant and the little-known Suriname, Ariane 6 rockets are launched from Kourou while 50% of the population lives below the poverty line. This paradoxical situation is a source of health problems specific to this territory, whether they be infectious diseases with unknown germs, intoxications or chronic pathologies.Some infectious diseases such as Q fever, toxoplasmosis, cryptococcosis or HIV infection are in common with temperate countries, but present specificities leading to sometimes different management and medical reasoning. In addition to these pathologies, many tropical diseases are present in an endemic and / or epidemic mode such as malaria, leishmaniasis, Chagas disease, histoplasmosis or dengue. Besides, Amazonian dermatology is extremely varied, ranging from rare but serious pathologies (Buruli ulcer, leprosy) to others which are frequent and benign such as agouti lice (mites of the family Trombiculidae) or papillonitis. Envenomations by wild fauna are not rare, and deserve an appropriate management of the incriminated taxon. Obstetrical, cardiovascular and metabolic cosmopolitan pathologies sometimes take on a particular dimension in French Guiana that must be taken into account in the management of patients. Finally, different types of intoxication are to be known by practitioners, especially due to heavy metals.European-level resources offer diagnostic and therapeutic possibilities that do not exist in the surrounding countries and regions, thus allowing the management of diseases that are not well known elsewhere.Thanks to these same European-level resources, research in Guyana occupies a key place within the Amazon region, despite a smaller population than in the surrounding countries. Thus, certain pathologies such as histoplasmosis of the immunocompromised patient, Amazonian toxoplasmosis or Q fever are hardly described in neighboring countries, probably due to under-diagnosis linked to more limited resources. French Guiana plays a leading role in the study of these diseases.The objective of this overview is to guide health care providers coming to or practicing in French Guiana in their daily practice, but also practitioners taking care of people returning from French Guiana.
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Doenças Transmissíveis , Cuniculidae , Infecções por HIV , Histoplasmose , Doenças não Transmissíveis , Febre Q , Toxoplasmose , Animais , Humanos , Guiana Francesa/epidemiologia , Toxoplasmose/diagnósticoRESUMO
The objectives were to estimate hepatitis A virus seroprevalence in subjects attending to a travel medicine and immunization clinic in Rio de Janeiro, Brazil, and to develop a prediction model for hepatitis A virus seroprevalence. This retrospective research included individuals sequentially from April 2011 to June 2019 at a travel medicine and special population immunization clinic with an anti-hepatitis A virus IgG chemiluminescence result. Participants' data were verified via electronic medical records. Data were split into development and validation set taking 2018 as the date break. A cross-validated elastic generalized linear model with binomial distribution was performed. In total, 2,944 subjects were analyzed. Hepatitis A virus overall seroprevalence was 67.8%. Health professionals, travelers, and those who had contact with immunocompromised subjects had lower seroprevalence (40%-55%), whereas subjects with chronic conditions (heart, lung, and liver) ranged from 89% to 94%. The retained predictors in the final model were sex, age, year of birth, travelers, HIV/AIDS, spleen dysfunction, transplant candidates, household communicators, cancer-related immunosuppression, health care professionals. Area under the curve was 0.836 and maximum error was 0.051. Users can make predictions with the following calculator: https://pedrobrasil.shinyapps.io/INDWELL/. The groups with lower seroprevalence should be evaluated more carefully regarding need for hepatitis A virus vaccination even when they seek immunization clinics for other purposes.
Este estudo teve como objetivo estimar a soroprevalência do vírus da hepatite A, em indivíduos atendidos em uma clínica de medicina de viagem e imunização no Rio de Janeiro, Brasil, e desenvolver um modelo de predição para a soroprevalência do vírus da hepatite A. Esta pesquisa retrospectiva incluiu indivíduos sequencialmente de abril de 2011 a junho de 2019, em uma clínica de medicina de viagem e uma clínica de vacinação de população especial, que, por qualquer motivo, tem um resultado de quimioluminescência IgG antivírus da hepatite A . Os dados dos participantes foram verificados em prontuário eletrônico. Os dados foram divididos em desenvolvimento e validação, tomando 2018 como data limite da divisão. Um modelo linear generalizado elástico com distribuição binomial submetido a validação cruzada foi aplicado. Foram analisados 2.944 indivíduos atendidos. A soroprevalência geral do vírus da hepatite A foi de 67,8%. Profissionais de saúde, viajantes e contatantes de indivíduos imunocomprometidos apresentaram menor soroprevalência, variando de 40% a 55%, enquanto indivíduos com condições crônicas (coração, pulmão e fígado) tiveram soroprevalência variando de 89% a 94%. Os preditores retidos no modelo final foram sexo, idade, ano de nascimento, viajantes, HIV/aids, asplenia funcional, candidatos a transplante, comunicante domiciliar, imunossupressão relacionada ao câncer e profissionais de saúde. A área sob a curva foi de 0,836 e o erro máximo foi de 0,051. Os usuários podem fazer previsões com uma calculadora (https://pedrobrasil.shinyapps.io/INDWELL/). Os grupos com menor soroprevalência devem ser avaliados com mais cuidado quanto à necessidade de vacinação contra o vírus da hepatite A, mesmo quando procuram clínicas de vacinação para outros fins.
Los objetivos del estudio son estimar la seroprevalencia de hepatitis A en sujetos que asisten a una clínica de medicina para viajeros e inmunización en Río de Janeiro, Brasil, y desarrollar un modelo de predicción de la seroprevalencia de hepatitis A. Esta investigación de seguimiento retrospectivo incluyó a individuos de forma secuencial desde abril de 2011 hasta junio de 2019 en una clínica de medicina para viajeros y de vacunación de poblaciones especiales que por cualquier motivo tienen un resultado de quimioluminiscencia IgG anti-hepatitis A. Los datos de los participantes se verificaron en los registros médicos electrónicos. Los datos se dividieron en conjunto de desarrollo y validación tomando 2018 como fecha de corte. Se realizó un modelo lineal generalizado validado cruzado elástico con distribución binomial. Se analizaron un total de 2.944 sujetos atendidos. La seroprevalencia global del hepatitis A fue del 67,8%. Los profesionales sanitarios, los viajeros y las personas en contacto con sujetos inmunodeprimidos presentaron una seroprevalencia más baja, que osciló entre el 40% y el 55%, mientras que los sujetos con afecciones crónicas (cardíacas, pulmonares y hepáticas) presentaron una seroprevalencia que varió entre el 89% y el 94%. Los predictores retenidos en el modelo final fueron el sexo, la edad, el año de nacimiento, los viajeros, el VIH/SIDA, la disfunción del bazo, los candidatos a trasplante, los comunicadores domésticos, la inmunosupresión relacionada con el cáncer y los profesionales sanitarios. Su área bajo la curva fue de 0,836 y el error máximo de 0,051. Los usuarios pueden hacer predicciones con una calculadora (https://pedrobrasil.shinyapps.io/INDWELL/). Los grupos con menor seroprevalencia deben ser evaluados más cuidadosamente en cuanto a la necesidad de vacunación contra hepatitis A, incluso cuando acudan a las clínicas de vacunación con otros fines.
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Abstract American Tegumentary Leishmaniasis (ATL) is an infectious disease affecting the skin and mucous membranes. ATL is caused by parasites of the Leishmania genus with around one million cases are reported each year worldwide. This paper describes three rare cases of tegumentary leishmaniasis treated at a tropical disease research center.
Resumen La Leishmaniasis Tegumentaria Americana es una enfermedad infecciosa que afecta la piel y las mucosas. La ATL es causada por parásitos del género Leishmania y cada año se reportan alrededor de un millón de casos en todo el mundo. Este artículo describe tres casos raros de leishmaniasis tegumentaria tratados en un centro de investigación de enfermedades tropicales.
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A rapidly emerging global outbreak of monkeypox virus infection (MPXV) in over 50 non-endemic countries was identified in May 2022. We report the case and images of a patient with MPXV presenting with genital lesions later complicated by superimposed cellulitis in Colorado, USA. MPXV lesions are susceptible to bacterial superinfection, and with the advent of new cases, the early identification of skin lesions and their evolution during MPXV are imperative for treating clinicians. Clinicians should consider MPXV in differential diagnoses of sexually transmitted diseases presenting with genital lesions.
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INTRODUCTION: SARS-CoV-2 continues to have a high rate of contagion worldwide. The new variant of concern, Omicron, has mutations that decrease the effectiveness of vaccines and evade antibodies from previous infections resulting in a fourth wave of the pandemic. It was identified in Mexico in December 2021. METHODS: The Traveler's Preventive Care Clinic from the Faculty of Medicine UNAM at Mexico City International Airport has performed rapid antigen and PCR SARS CoV2 tests since January 2021 to comply with the new travel requirements. Demographic and clinical characteristics were collected from each passenger and the fourth wave of the pandemic in Mexico mainly caused by Omicron was analyzed in the travelers. RESULTS: A total of 5176 travelers attended the clinic between the second half of December 2021 and January 2022. Ten percent of all the tests performed were positive (13% of PCR and 9.3% of antigens, p = 0.001). Most of the SARS CoV2 positive cases were asymptomatic (78%), with a ratio of 3.5:1 over the symptomatic. By age groups, this ratio was higher for those under 20 years old (8.7:1). DISCUSSION: This study shows the rapid escalation of positivity that occurred in Mexico, detected in travelers, from the second half of December 2020 and throughout the month of January 2021. The incidence of COVID-19 was extremely high in travelers who were mostly asymptomatic for the period under study.
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COVID-19 , Adulto , Aeroportos , COVID-19/epidemiologia , Humanos , México/epidemiologia , Prevalência , SARS-CoV-2 , Adulto JovemRESUMO
Introduction: Travel Medicine specialty has existed for more than 40 years. However, this is practically unknown by Dominicans despite the large number of people who travel to and from our country. Methods: With the objective of determining the knowledge of Dominicans about the existence of Travel Medicine specialty and their attitudes in relation to it, we conducted a virtual survey of 8 questions, in which 2,584 Dominicans participated. Results: Despite the fact that more than 80 % of those surveyed knew that to travel to certain countries they had to take certain vaccines, less than 25 % had heard of the specialty of Traveler's Medicine. After knowing the definition and objectives of the specialty, more than 90 % of the participants considered it important to consult a specialist prior to the trip. Conclusion: The lack of knowledge of the specialty and the absence of this service in the public health system are the main barriers to the access of Dominicans to the Travel Medicine consultation. It is necessary to publicize the specialty, using scientific evidence and taking as an example the worldwide dissemination of COVID-19 through travelers, to make the population aware of the importance of pre and post-trip consultation, as well as the creation of this service in public hospitals
Introducción: la especialidad Medicina del Viajero existe hace más de 40 años. Sin embargo, esta es prácticamente desconocida por los dominicanos a pesar de la gran cantidad de personas que viajan desde y hacia nuestro país. Material y métodos: Con el objetivo de determinar el conocimiento de los dominicanos sobre la existencia de la Medicina del Viajero y sus actitudes en relación a esta, realizamos una encuesta virtual de 8 preguntas, de la cual participaron 2,584 dominicanos. Resultados: a pesar de que más del 80 % de los encuestados sabían que para viajar a determinados países debían tomar ciertas vacunas, menos del 25 % había escuchado hablar de la especialidad Medicina del Viajero. Tras conocer la definición y objetivos de la especialidad más del 90 % de los participantes consideró importante realizar una consulta previa al viaje con un especialista. Conclusión: el desconocimiento de la especialidad y la ausencia de este servicio en el sistema público de salud son las principales barreras para el acceso de los dominicanos a la consulta de Medicina del Viajero. Es necesario dar a conocer la especialidad, utilizando evidencia científica y tomando como ejemplo la difusión mundial de la COVID-19 a través de los viajeros, concienciar a la población de la importancia de la consulta pre y post viaje, así como la creación de este servicio en hospitales públicos
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Humanos , Vacinas , Medicina de Viagem , Viagem , Controle de Doenças Transmissíveis , República DominicanaRESUMO
Resumen Introducción: En la última década, millones de venezolanos han emigrado de su país; Colombia ha sido su principal destino. Es importante evaluar las repercusiones de la migración sobre eventos de interés en salud pública como la infección por el VIH, a fin de adoptar políticas pertinentes para atender la epidemia. Sin embargo, la información del estado de salud de la población migrante y su impacto sobre la salud pública en Colombia es escasa. Objetivos: Evaluar el papel de los casos de VIH importados desde Venezuela en el comportamiento del evento VIH/SIDA/ mortalidad por VIH en Colombia. Metodología: Mediante cálculo integral se compara el área bajo las curvas de casos de VIH totales e importados notificados al Sistema Nacional de Vigilancia en Salud Pública de Colombia. Resultados: La curva de casos de VIH importados desde Venezuela tiene una contribución menor (2,26 %) en el incremento de casos notificados en Colombia. Conclusiones: La migración venezolana no es el principal factor responsable del incremento de casos de VIH en Colombia, deben evaluarse otros factores involucrados en la difusión de la pandemia a nivel local.
Abstract Introduction: Millions of Venezuelans have emigrated due to their country's socio-economic crisis in the last decade; Colombia has been their main destination. To adopt relevant policies to address the problem, it is important to assess the impact of migration on public health interest events such as HIV infection. However, information on the health status of immigrants and its repercussions on public health in Colombia is scarce. Objective: Outline how the Venezuelan migration phenomenon has impacted HIV notification within Colombia. Methodology: Through an integral calculation, the area under the curves of total and imported HIV cases reported to the National Public Health Surveillance System of Colombia are compared. Incidence measures are carried out among the migrant population and the Colombian regions with the highest concentration of migrants are analyzed in greater depth. Results: The curve of HIV cases imported from Venezuela has a smaller contribution (2.26%) in the increase of cases notified in Colombia. Conclusions: The migratory crisis is not the main cause responsible for the increase in cases in Colombia. Other factors involved in the spread of the pandemic at the local level must be evaluated.
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Humanos , Masculino , Feminino , Soroprevalência de HIV , Síndrome da Imunodeficiência Adquirida , HIV , Migração Humana , Venezuela , ColômbiaRESUMO
This is the first detection and genomic analysis of an OXA-181-carbapenemase-producing E. coli in Brazil, from a traveler returning from Sub-Saharan Africa. The ST167 isolate carries blaOXA-181 inserted in an IncX3 plasmid. This report illustrates the potential role of travelers as silent vectors for dissemination of high-risk resistant clones.
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Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla/genética , Proteínas de Escherichia coli/genética , Escherichia coli/genética , beta-Lactamases/genética , Adulto , África Subsaariana , Brasil/epidemiologia , Fezes/microbiologia , Genoma Bacteriano , Humanos , Masculino , Testes de Sensibilidade Microbiana , PlasmídeosAssuntos
Doença de Lyme , Dor nas Costas , Florestas , Alemanha , Humanos , Doença de Lyme/complicações , Doença de Lyme/diagnósticoRESUMO
Phylogenetic analysis of a clinical isolate associated with subclinical Burkholderia pseudomallei infection revealed probable exposure in the British Virgin Islands, where reported infections are limited. Clinicians should consider this geographic distribution when evaluating possible infection among persons with compatible travel history.
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Burkholderia pseudomallei , Melioidose , Ilhas Virgens Britânicas , Burkholderia pseudomallei/genética , Humanos , Melioidose/diagnóstico , Melioidose/epidemiologia , Filogenia , ViagemRESUMO
INTRODUCTION: The high transmissibility and infectivity of the new coronavirus, the high proportion of asymptomatic transmitters and the rapid and continuous spatial displacement of people, by the different mechanisms of locomotion, are elements that can contribute to the dissemination of COVID-19. This study aims to describe the geographical dispersion of COVID-19 in the state of Bahia and the importance of major airports and highways in the dynamics of disease transmission. METHODS: This is an ecological study involving all cases of COVID-19 registered in the state of Bahia between March 6, date of the first registered case and May 16, 2020. After collection, an exploratory spatial analysis was performed, considering the cases accumulated on the last day of each epidemiological week. RESULTS: The first cases of COVID-19 were concentrated in areas served by three important airport complexes in the state, located in Salvador, Ilhéus and Porto Seguro. From week 16-20, there was a more intense expansion of COVID-19 to the interior of the state. A global spatial autocorrelation was observed (I Moran 0.2323; p = 0.01), with the influence of distance: positive correlation at distances less than 205.8 km (I Moran 0.040; p = 0.01) and greater than 800 km (I Moran 0.080; p = 0.01). CONCLUSIONS: Based on the spatial dispersion pattern of COVID-19 in the state of Bahia, airports and highways that cross the state were responsible for the interiorization of the disease.
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RESUMEN INTRODUCCIÓN : Los envenenamientos producidos por escorpiones son un problema de salud pública en constante aumento en Argentina y el mundo. Por diversas causas, los ensambles de animales venenosos de una región varían en el tiempo. El objetivo de este trabajo fue presentar la información reciente y actualizar el elenco de escorpiones de la provincia de Misiones. MÉTODOS : Se realizó un estudio descriptivo observacional a partir de la revisión de los ejemplares depositados en la Colección de Herpetología y Arácnidos del Instituto Nacional de Medicina Tropical. RESULTADOS : Se obtuvieron los primeros registros para la provincia de Títyusconfluens, mientras que nuevos registros de accidentes con Títyus trívíttatus ampliaron la zona de presencia de la especie en la provincia. El ensamble de escorpiones de Misiones reúne a las cuatro especies de interés médico del país. DISCUSIÓN : La detección del elenco de escorpiones de interés médico más importante del país fue consecuencia del trabajo conjunto entre los especialistas de los distintos grupos de animales ponzoñosos y los profesionales de la salud. Es importante generar y profundizar los espacios de interacción de saberes, con el objetivo de mejorar la Vigilancia de la Salud.
ABSTRACT INTRODUCTION : Scorpíon poísoníng ís a growíng publíc health problem ín Argentina and around the world. For varíous reasons, the poísonous animal assemblages ín a regíon vary over tíme. The aím of thís work was to present recent ínformatíon and update the assemblage of scorpions ín the province of Misiones. METHODS : An observatíonal descríptíve study was carríed out by revíewíng the specímens deposíted ín the Collectíon of Herpetology and Arachníds of the National Instítute of Tropical Medicine. RESULTS : The first records of Tityus confluens were obtaíned for the province, whíle new records of accídents wíth Tityus trivittatus extended the area of presence of the specíes ín the province. The scorpíon assemblage of Misiones gathers all the four specíes of medical interest ín the country. DISCUSSION : The detectíon of the most ímportant assemblage of scorpions of medical interest ín the country arose from the joínt work between specíalísts ín the dífferent groups of poísonous anímals and health professíonals. It ís ímportant to generate and deepen the spaces of knowledge ínteractíon, wíth the objectíve of ímprovíng Health Surveíllance.
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We report the case of a 69-year-old man, who presented in the UK with a short history of deteriorating vision and clinical features of bilateral atypical retinochoroiditis, after travelling to South America. Vitreous samples demonstrated Toxoplasma gondii DNA by PCR. Serology tests demonstrated recent acquired Toxoplasma gondii infection with IgM antibodies. He responded well to treatment with trimethoprim-sulfamethoxazole, azithromycin and oral steroids.This case is a reminder of the global importance of Toxoplasma related eye disease, and its uncommon bilateral severe presentation in a returning traveller, where the risk factors were age and the route of infection likely to be a virulent parasite oocyst from vegetables or water rather than undercooked meat or direct contact with cats.
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Toxoplasmose Ocular/diagnóstico , Doença Relacionada a Viagens , Fatores Etários , Idoso , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Fundo de Olho , Glucocorticoides/uso terapêutico , Humanos , Masculino , América do Sul , Tomografia de Coerência Óptica , Toxoplasmose Ocular/tratamento farmacológico , Toxoplasmose Ocular/patologia , Toxoplasmose Ocular/transmissão , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Reino UnidoRESUMO
Introduction: Presidential medical units are intended to protect the dignitary's health in multiple aspects and work in close relationship with security. There are three central areas of coverage: myocardial infarction, stroke and trauma. By 2016 we had not found information about the resources on medical centers in Argentina and their integration into healthcare networks. Objective: Describe the relevant medical centers and their available resources for the medical coverage areas mentioned. Methods: It is a descriptive, cross-sectional study between 12/2016 and 8/2019. The sampling was not probabilistic and for convenience. Variables were reported as proportions and comparisons were made using the chi-square test or Fischer. Results: 232 centers were entered, 66.8% in capital cities and 67% in the public sector. Capitals were associated with a greater presence of resources: category 3 centers (OR 7.85; 95% CI 3.66-16.84; p <0.000001), angiography (OR 5.94; 95% CI 3.24-10.28; p <0.000001 ), tomography (OR 3.41; 95% CI 1.51-7.69; p=0.002), thrombolytics (OR 3.24; 95% CI 1.37-7.76; p=0.005); except trauma surgery (OR 1.83; 95% CI 0.75-4.46; p=0.17). Private centers were associated with greater resources for reperfusion; and public centers for trauma treatment. Conclusions: There is an unbalanced distribution of key resources between capital and non-capital cities in large geographical areas that makes it impossible to develop an adequate network for the treatment of heart attack, stroke and trauma. The best quality of care requires combining public and private networks.
Introducción: Las unidades médicas presidenciales están destinadas a proteger la salud del dignatario en múltiples aspectos y en íntima relación con la seguridad. Existen tres áreas centrales de cobertura: el infarto de miocardio, el accidente cerebrovascular y trauma. Hacia el año 2016 no hemos hallado información sobre los recursos de los centros médicos en Argentina y su integración en redes de atención. Objetivo: Describir los centros médicos relevados y sus recursos para las áreas médicas de cobertura mencionadas. Métodos: Es un estudio descriptivo, de corte trasversal entre 12/2016 y 8/2019. El muestreo fue no probabilístico y por conveniencia. Las variables se reportaron como proporciones y las comparaciones se realizaron mediante el test de chi cuadrado o Fischer. Resultados: Ingresaron 232 centros, 66.8% en ciudades capitales y 67% del ámbito público. Las capitales se asociaron con mayor presencia de recursos: centros categoría 3 (OR 7.85; IC del 95% 3.66-16.84; p<0,000001), angiografía (OR 5.94; IC del 95% 3.24-10.28; p<0,000001), tomografía (OR 3.41; IC del 95% 1.51-7.69; p=0,002), trombolíticos (OR 3.24; IC del 95% 1.37-7.76; p=0,005); excepto cirugía de trauma (OR 1.83; IC del 95% 0.75-4.46; p=0,17). Los centros privados se asociaron con mayores recursos para la reperfusión; y los centros públicos para el tratamiento del trauma. Conclusiones: Se observa una desbalanceada distribución de recursos claves entre ciudades capitales y no capitales en extensas áreas geográficas que imposibilita el desarrollo de una adecuada red para el tratamiento del infarto, accidente cerebrovascular y trauma. La mejor calidad de atención requiere combinar redes públicas y privadas.
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Infarto Cerebral/terapia , Instalações de Saúde/estatística & dados numéricos , Infarto do Miocárdio/terapia , Alocação de Recursos/estatística & dados numéricos , Ferimentos e Lesões/terapia , Argentina , Estudos Transversais , Geografia , Pesquisas sobre Atenção à Saúde , Humanos , Setor Privado , Estudos Prospectivos , Setor PúblicoRESUMO
BACKGROUND: Rabies causes thousands of deaths worldwide and trips to rabies endemic countries are popular. Travellers are often uncertain whether pre-exposure prophylaxis (PrEP) is advisable since they find it difficult to estimate the exposure risk during travel and the availability of post-exposure prophylaxis in endemic regions. The aim of this study was to determine the potential rabies exposures in travellers and to assess their knowledge on rabies. Secondly, we explored the access to appropriate post-exposure medical care in respective countries. METHODS: We conducted a cross-sectional study at Frankfurt Airport. Returning adult travellers arriving from Asia, the Middle East, Africa, South and Central America were invited to participate in this questionnaire-based study while waiting in the baggage claim area. RESULTS: Over a one-month recruitment phase in March 2019, we enrolled 3066 travellers; 2929 were included in the analysis. The gender ratio was balanced; the median age was 42 years (range 18-83 years). Participants arrived from Asia (46%), Africa (29%), Central/South America (13%), the Middle East (8%) and the Caribbean (8%). Forty-five per cent sought pretravel advice and 22% received ≥2 injections of rabies PrEP. Travellers with pretravel advice from tropical medicine specialists reached significantly higher knowledge scores than others. We found that potential rabies exposure occurred in 2.0% (57/2915) of travellers with 31% (13/42) of the contacts being unprovoked; 19% (8/42) of the exposed sought medical care and 3/8 were adequately treated before returning to Germany. Risk factors for animal exposure were: male sex, young age, trips to Asia and a long stay abroad (>4 weeks). CONCLUSIONS: A total of 2% of returning travellers (n = 2915) experienced a potential rabies exposure during their journey. A majority of the exposed individuals did not seek medical care; those seeking medical care were often treated inadequately. Rabies information must be emphasised during pretravel counselling and PrEP should be offered generously, especially to travellers with high exposure risks.
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Raiva , Adolescente , Adulto , África , Idoso , Idoso de 80 Anos ou mais , Aeroportos , Animais , Ásia , Região do Caribe , América Central , Estudos Transversais , Alemanha , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Oriente Médio/epidemiologia , Raiva/epidemiologia , Raiva/prevenção & controle , América do Sul , Viagem , Adulto JovemRESUMO
With an increasing number of international journeys occurring daily, there is also an increase in the need for appropriate medical advice for patients who will undertake such travel. In this context, the lupus patient presents a great challenge to the rheumatologist. However, the demand for such information by patients is low, and it has proven difficult for the medical community to adequately provide it. In this article, we carried out a literature review of the medical recommendations made for the lupus patient in order to guide the rheumatologist through the topic of travel medicine.
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Lúpus Eritematoso Sistêmico , Reumatologia , Viagem , Vacinação , Humanos , Guias de Prática Clínica como Assunto , Medicina de Viagem/educaçãoRESUMO
We report the case of a returning traveller, a woman in her early 20s, who presents with chronic inflammation and infection of her left foot following a stingray strike. Surgery was performed to remove foreign material a remarkable 9 months after the initial injury. The case highlights the importance of the initial assessment and early management of stingray attacks and illustrates the potential need for exploration and debridement of problematic stingray wounds.