Journal of travel medicine
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Swift diagnosis of falciparum malaria in nonendemic areas is frequently complicated by lack of experience on the side of involved laboratory personnel. Diagnostic tools based on the dipstick principle for the detection of plasmodial histidine-rich protein 2 (HRP-2) (ICT Malaria P.f. (R)) and parasite-specific lactate-dehydrogenase (pLDH) (OptiMal(R)), respectively, have become available for the qualitative detection of falciparum malaria. ⋯ Dipstick tests have the potential of enhancing speed and accuracy of the diagnosis of falciparum malaria, especially if nonspecialized laboratories are involved. However, microscopical testing remains mandatory in every single patient with the possible diagnosis of malaria. Self-use of dipstick tests for malaria diagnosis by travelers should only be recommended after appropriate instruction and training, including a successful performance of the test procedure.
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Isolates of Vibrio cholerae other than O1 and O139 (non O1 Vibrio cholerae) are associated with sporadic diarrheal disorders, and limited outbreaks of diarrhea, and have often been reported in association with extraintestinal infections. The majority of cases of non O1 Vibrio cholerae infection involve immunocompromised patients with hematologic malignancies or cirrhosis. In Italy, very few cases of gastrointestinal and extraintestinal infections due to non O1 Vibrio cholerae have been described in the past years. We describe a case of non O1 Vibrio cholerae infection with cutaneous bullous lesions in a tourist returning from Tunisia.
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Case Reports
Intractable nausea, vomiting and diarrhea in a Mexican woman with No recent travel history.
A 45-year-old Mexican woman with a history of noninsulin dependent diabetes mellitus (NIDDM), hypertension, and coronary artery disease presented to the hospital after 2 months of intractable nausea, vomiting and diarrhea-all made worse by eating and drinking. She reported fever, chills, anorexia and a documented 50-pound weight loss during this period. ⋯ She had been hospitalized 2 weeks prior to admission with the same symptoms and a diagnosis of viral gastroenteritis. She was also treated for H. pylori, but subsequent biopsy results were negative by Steiner stain.
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Randomized Controlled Trial Clinical Trial
Double-blind, randomized, placebo controlled pilot study evaluating efficacy and reactogenicity of an oral ETEC B-subunit-inactivated whole cell vaccine against travelers' diarrhea (preliminary report).
Diarrhea caused by enterotoxigenic E.coli (ETEC) is an important health problem in developing countries and in travelers to these areas. In previous trials formulations of ETEC vaccines containing the B-subunit of cholera toxin, which is antigenically similar to the heat labile enterotoxin of ETEC, and the most prevalent colonization factor antigens of ETEC, were shown to stimulate relevant mucosal immune responses in volunteers from Sweden and Egypt.
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Acute mountain sickness (AMS), High altitude pulmonary edema (HAPE) and High Altitude Cerebral Edema (HACE) are well known problems in the high altitude region of the Nepal Himalayas. To assess the proportion of AMS, HAPE, and HACE from 1983 to 1995 in the Himalaya Rescue Association (HRA) aid posts' patients at the Everest (Pheriche 4,243 m) and Annapurna (Manang 3,499 m) regions, the two most popular trekking areas in the Himalayas. A retrospective study was conducted at the HRA medical aid posts in Manang (3,499 m) and Pheriche (4,243 m) in the Himalayas, where 4,655 trekkers (tourists, mostly Caucasians) and 4,792 Nepalis (mostly porters and villagers) were seen at the two high-altitude clinics from 1983 to 1995, for a variety of medical problems, including AMS. ⋯ HAPE and HACE are the life-threatening forms of AMS and although there is a linear increase of trekkers entering the Himalayas in Nepal, the findings revealed that HAPE and HACE have not increased over time. One possible explanation may be that awareness drives by organizations like the Himalayan Rescue Association may be effective in preventing the severe forms of AMS.