Emerging and Re-emerging Infections in Travellers (May 24, 2024)_(3031494741)_(Springer).pdf

This book provides essential information on the epidemiology, diagnosis and management of common and some rare infections in travellers. It will equip readers with key knowledge on clinically important emerging and re-emerging infections caused by wide variety of bacteria, viruses and parasites. The coverage ranges from influenza, hepatitis, malaria and tuberculosis to Ebola virus disease, Lassa fever, Crimean Congo haemorrhagic fever, dengue, Zika virus infection and many other important diseases. The emergence and spread of antimicrobial-resistant microorganisms is discussed, and practical advice is included regarding disease prevention in travellers and humanitarian aid workers. Other generic chapters address the clinical approach to fever in the returning traveller, and preparedness and response to emerging infectious diseases. This comprehensive, up-to-date book will be an excellent source of information and guidance for all clinicians and researchers with an interest in infectious diseases, microbiology, epidemiology, and travel medicine. Preface Contents 1: Approach to Fever in the Returning Traveller 1.1 Initial Evaluation 1.1.1 Does the Patient Have a Travel History? 1.1.2 Is the Patient Seriously Ill? 1.1.3 Medical Emergencies and Life-threatening Diseases 1.1.4 Isolation 1.1.5 Presenting Symptoms and Physical Examination 1.1.6 Host Factors 1.1.7 Pretravel Advice 1.1.8 Travel History 1.2 Differential Diagnosis 1.2.1 Clinical Findings 1.2.2 Locations of Exposure 1.2.3 Incubation Period 1.3 Investigation 1.3.1 First-Tier Laboratory Tests 1.3.2 Second-Tier Laboratory Tests 1.4 Conclusion References 2: Preparedness and Response for Emerging Infectious Diseases 2.1 Background 2.2 Clinical Preparedness and Response 2.3 Laboratory Preparedness and Response 2.4 Public Health Preparedness and Response 2.4.1 The Role of Clinicians, Microbiologists and Communities in Public Health Surveillance and Response 2.4.2 Outbreak Response 2.5 Global Health Security and the International Health Regulations (IHR) 2.6 Clinical Research During Epidemics 2.7 Challenges and Actions Needed References 3: Mass Gathering and Infectious Diseases 3.1 Introduction 3.2 Definition 3.3 Brief Description of Major Mass Gathering Events 3.4 Evaluating the Risk During Mass Gathering 3.5 Risk of Respiratory Illness 3.6 Outbreaks of Meningococcal Disease 3.7 Middle East Respiratory Syndrome Coronavirus (MERS-CoV) During Mass Gatherings 3.8 Risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During Mass Gatherings 3.9 Measles Outbreaks During Mass Gatherings 3.10 Risk of Diarrhoeal Disease 3.11 Risk of Spread of Antimicrobial Resistance 3.12 Travel Advice for Those Attending Mass Gatherings References 4: Advice for Humanitarian Aid Workers 4.1 Background 4.2 Pre-travel Advice and Considerations 4.3 On-site Measures to Prevent Transmission of Pathogens: The Case of Ebola 4.4 Post-deployment Advice 4.5 Conclusions References 5: Health Tourism and Infectious Diseases 5.1 Background 5.1.1 Definition 5.1.2 A Brief History of Health Tourism 5.1.3 Importance of Health Tourism 5.2 Health Tourism and Infectious Diseases 5.2.1 Transplantation 5.2.2 Cosmetic Surgery and Arthroplasty 5.2.3 Resistant Organisms 5.2.4 Other Concerns 5.3 Prevention and Advice for Healthcare Workers and Travellers 5.4 Gaps in Knowledge that Need to Be Addressed References 6: Emergence and Spread of Resistant Microorganisms, Related to Travel 6.1 Background 6.1.1 Brief History 6.1.1.1 Importance of the Disease 6.2 Aetiology 6.2.1 Gram-Negative Rods 6.2.1.1 ESBL 6.2.1.2 Carbapenemases KPC OXA Metallo-Beta-Lactamases NDM 6.2.1.3 Colistin Resistance 6.2.2 MRSA 6.2.3 Vancomycin-Resistant Enterococci (VRE) 6.2.4 Neisseria gonorrhoeae 6.2.5 TBC 6.3 Dissemination 6.4 Epidemiology 6.4.1 Geographic Distributions 6.4.2 Recent Epidemics/Outbreaks 6.4.3 Risk Factors 6.5 Clinical Findings 6.6 Laboratory Diagnosis 6.7 Differential Diagnosis and Diagnostic Hints 6.8 Management 6.9 Public Health Responses 6.10 Prevention and Advice for Travellers 6.11 Gaps in Knowledge that Need to Be Addressed References 7: Filovirus Infections in Travellers 7.1 Background 7.2 Etiology 7.3 Transmission 7.4 Epidemiology 7.5 Pathogenesis 7.6 Clinical Findings 7.7 Laboratory Diagnosis 7.8 Differential Diagnosis 7.9 Treatment 7.10 Prevention and Advice for Travellers References 8: Crimean-Congo Haemorrhagic Fever in Travellers 8.1 Introduction 8.2 The Disease 8.2.1 Epidemiology 8.2.1.1 Africa 8.2.1.2 Asia 8.2.1.3 Europe 8.2.1.4 Middle East 8.2.2 Clinical Findings 8.2.3 Laboratory Diagnosis 8.2.4 The Pathogenesis 8.2.5 The Differential Diagnosis 8.2.6 The Management 8.2.7 Antiviral Treatment 8.2.8 CCHF as an Emerging and/or Reemerging Disease 8.3 Travel and CCHF 8.3.1 Types of Travel-Related CCHF Cases 8.3.2 Characteristics of Cases with CCHF Acquired Abroad 8.3.3 Number of Travel-Related CCHF Cases 8.3.4 Cross-Border Travel 8.3.5 Outcome of Cases 8.3.6 Source and Destination Countries 8.3.7 Risk Occupations or Activities for Travel-Related CCHF 8.3.8 The Index of Suspicion for CCHF in Non-endemic Countries’ Healthcare Services 8.3.9 Prevention of Travellers from the Disease References 9: Severe Fever with Thrombocytopenia Syndrome in Travellers 9.1 Background 9.2 Aetiology 9.3 Transmission 9.4 Epidemiology 9.4.1 Geographic Distribution 9.4.2 Recent Epidemics/Outbreaks 9.4.3 Risk Factors 9.4.4 Risks for International Travellers 9.4.5 Pathogenesis 9.4.6 Clinical Findings 9.4.7 Laboratory Diagnosis 9.4.8 Differential Diagnosis 9.5 Management 9.6 Public Health Response 9.7 Prevention and Advice for Travellers 9.8 Gaps in Knowledge that Need to Be Addressed References 10: Alkhurma Haemorrhagic Fever in Travellers 10.1 Background 10.2 Aetiology 10.3 Transmission 10.4 Epidemiology 10.5 Pathogenesis 10.6 Clinical Findings 10.7 Laboratory Diagnosis 10.8 Differential Diagnosis 10.9 Treatment 10.10 Public Health Responses Around the Management of an Individual Case 10.11 Prevention 10.12 Advice for Travellers 10.13 Gaps in Knowledge That Need to Be Addressed References 11: Rift Valley Fever in Travellers 11.1 Background 11.2 Epidemiology 11.3 RVF as an Emerging Disease 11.4 Risks for Travellers 11.5 Pathogenesis 11.6 Clinical Findings 11.7 Laboratory Diagnosis 11.8 Differential Diagnosis 11.9 Management 11.10 Outbreak Prevention and Response 11.11 Prevention and Advice for Travellers 11.12 Vaccines References 12: Yellow Fever in Travellers 12.1 Background 12.2 Aetiology 12.3 Transmission 12.3.1 Epidemiology 12.3.1.1 Geographic Distributions 12.3.1.2 Recent Outbreaks 12.3.1.3 Risks for International Travellers 12.4 Pathogenesis 12.5 Clinical Findings 12.6 Diagnosis 12.7 Management 12.8 Prevention and Advice for Travellers 12.8.1 Vaccine 12.8.2 Mosquito Protection Measures 12.8.3 General Advice Pre-travel and During Travel 12.8.4 Specific Advice for Healthcare Workers 12.8.5 Specific Advice for Special People (e.g. Pregnant, Immunocompromised, Very Young, Elderly) 12.9 Gaps in Knowledge that Need to Be Addressed References 13: Viral Hepatitis in Travellers 13.1 Introduction 13.2 Hepatitis A 13.2.1 Transmission and Epidemiology 13.2.2 Clinical Course 13.2.3 Diagnosis 13.2.4 Therapy 13.3 Hepatitis B and D 13.3.1 Transmission and Epidemiology 13.3.2 Diagnosis 13.3.3 Clinical Course 13.4 Hepatitis C 13.4.1 Transmission and Epidemiology 13.4.2 Diagnosis 13.4.3 Clinical Course 13.4.4 Treatment 13.5 Hepatitis E 13.5.1 Transmission and Epidemiology 13.5.2 Diagnosis 13.5.3 Clinical Course 13.5.4 Treatment References 14: Chikungunya Virus Infection in Travellers 14.1 Background 14.1.1 Brief History 14.1.2 Importance of the Disease 14.1.3 Why Is It Classified as Emerging and/or Reemerging? 14.2 Aetiology 14.3 Transmission 14.4 Epidemiology 14.4.1 Geographic Distributions 14.4.2 Recent Epidemics/Outbreaks 14.4.3 Risk Factors 14.4.4 Risks for International Travelers 14.4.5 Considerations in Migrants 14.5 Pathogenesis 14.6 Clinical Findings 14.7 Laboratory Diagnosis 14.8 Differential Diagnosis 14.9 Treatment 14.10 Prevention 14.11 Advice for Travellers 14.11.1 General Advice 14.11.2 Specific Advice for Healthcare Workers 14.11.3 Specific Advice for Special People (e.g. Pregnant, Immunocompromised) References 15: Dengue in Travellers 15.1 Background 15.1.1 Brief History 15.1.2 Importance of the Disease 15.1.3 Why It Is Classified as Emerging and/or Re-emerging 15.2 Aetiology 15.2.1 Transmission 15.2.2 Epidemiology 15.2.2.1 Geographic Distributions 15.2.2.2 Recent Epidemics/Outbreaks 15.2.2.3 Risk Factors 15.2.2.4 Risks for International Travellers 15.2.2.5 Differing Issues for Migrants and Those “visiting Friends and Relations” (VFR) 15.2.3 Pathogenesis 15.2.4 Clinical Findings 15.2.5 Laboratory Diagnosis 15.2.6 Differential Diagnosis 15.2.6.1 Diagnostic Hints 15.3 Management 15.4 Infection Control in the Hospital/Lab 15.5 Prevention and Advice for Travellers 15.6 Gaps in Knowledge that Need to Be Addressed References 16: Zika Virus Infection in Travellers 16.1 Background 16.2 Aetiology 16.3 Transmission 16.4 Epidemiology 16.5 Clinical Findings 16.5.1 Adult Infection 16.5.2 Congenital Infection 16.6 Pathogenesis 16.6.1 Virus Life Cycle 16.6.2 Joints 16.6.3 Eyes 16.6.4 Male Reproductive Tract (MRT) 16.6.5 Female Reproductive Tract (FRT) 16.6.6 Neurotropism 16.6.7 GBS 16.6.8 Vertical Transmission 16.6.9 Microcephaly 16.6.10 Antibody-Dependent Enhancement (ADE) 16.6.11 Role of Viral Proteins 16.7 Laboratory Diagnosis 16.7.1 Virus Culture 16.7.2 Virus Detection by PCR 16.7.3 Serology 16.8 Differential Diagnosis 16.9 Management 16.10 Prevention and Control 16.11 Knowledge Gaps That Need to be Addressed References 17: West Nile Virus Infection in Travellers 17.1 Background 17.2 Aetiology and Transmission 17.3 Epidemiology 17.3.1 Africa 17.3.2 Europe and the Mediterranean Region 17.3.3 Asia 17.3.4 Americas 17.4 Pathogenesis 17.5 Clinical Findings 17.6 Laboratory Diagnosis 17.7 Differential Diagnosis 17.8 Management 17.9 Public Health Responses around Management of an Individual Case 17.10 Prevention and Advice for Travellers 17.11 Gaps in Knowledge that Need to be Addressed References 18: Meningococcal Diseases in Travellers 18.1 Background 18.2 Aetiology 18.3 Transmission 18.4 Epidemiology 18.5 Pathogenesis 18.6 Clinical Findings 18.6.1 Meningitis 18.6.2 Septicemia 18.6.3 Meningitis and Septicemia 18.6.4 Other Clinical Forms of Meningococcal Diseases 18.7 Laboratory Diagnosis 18.8 Differential Diagnosis 18.9 Management 18.9.1 Antibiotic Therapy 18.9.2 Hypotension and Shock Treatment 18.9.3 Glucocorticoid Treatment 18.9.4 Treatment of Brain Oedema 18.9.5 Additional Treatments 18.10 Complications and Sequelae 18.11 Prevention 18.11.1 Antimicrobial Chemoprophylaxis 18.11.2 Immunoprophylaxis 18.11.3 Other Precautions 18.11.4 Gaps in Knowledge That Need to be Addressed References 19: Influenza in Travellers 19.1 Background 19.2 Aetiology 19.3 Transmission 19.4 Epidemiology 19.4.1 Avian Influenza 19.4.2 Seasonal Influenza 19.5 Clinical Presentation 19.6 Risks for International Travellers 19.7 Laboratory Diagnosis 19.8 Prevention Advice for Travellers 19.8.1 Respiratory and Hand Hygiene 19.8.2 Contact with Poultry (in Affected Countries) 19.8.3 Vaccination 19.8.4 Antivirals 19.9 Management Advice for Health Care Workers 19.10 Conclusions References 20: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Travellers 20.1 Background 20.1.1 Brief History 20.1.2 Importance of the Disease 20.1.3 Why It Is Classified as Emerging and/or Reemerging 20.2 Aetiology 20.3 Transmission 20.4 Epidemiology 20.4.1 Geographic Distributions 20.4.2 Recent Epidemics/Outbreaks 20.4.3 Risk Factors 20.4.4 Risks for International Travellers 20.4.5 Differing Issues for Migrants and Those “Visiting Friends and Relations” (VFR) 20.5 Pathogenesis 20.6 Clinical Findings 20.7 Laboratory Diagnosis 20.8 Differential Diagnosis 20.8.1 Diagnostic Hints 20.9 Management 20.10 Prevention and advice for travellers: 20.11 Gaps in Knowledge that Need to be Addressed References 21: Multi-drug Resistant Tuberculosis in Travellers 21.1 Background 21.2 Aetiology 21.3 Transmission 21.4 Epidemiology 21.5 Pathogenesis 21.6 Clinical Findings 21.7 Laboratory Diagnosis 21.8 Differential Diagnosis 21.9 Management 21.10 Prevention and Advice for Travellers 21.11 Knowledge Gaps That Need to Be Addressed References 22: Malaria in Travellers 22.1 Introduction 22.2 Epidemiology of Imported Malaria 22.2.1 Rare Modes of Transmission 22.3 Clinical Symptoms 22.3.1 Clinical Symptoms in Non-immune Individuals (Persons Not Born and Raised in Endemic Areas) 22.3.2 Clinical Symptoms in Persons Migrating from Malaria-Endemic Areas 22.4 Indications for Malaria Diagnostics 22.4.1 Non-specific Laboratory Results 22.4.2 Malaria-Specific Diagnostics 22.5 Treatment of Uncomplicated P. Falciparum Malaria 22.5.1 Treatment of Complicated Falciparum Malaria 22.5.2 Intravenous Artesunate (IVA) 22.6 Paediatric Malaria 22.7 Pregnant Women 22.7.1 Treatment of P. Vivax, P. Ovale, P. Malariae and P. Knowlesi 22.7.2 Primaquine Treatment to Prevent Relapse in P. Vivax and P. Ovale Infections References