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1.
Euro Surveill ; 25(1)2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31937394

RESUMO

Eighteen cases of chikungunya virus infection in travellers returning from Myanmar were reported to the GeoSentinel Surveillance Network, its subnetwork EuroTravNet and TropNet in 2019, reflecting an ongoing local outbreak. This report reinforces the importance of travellers as sentinels of emerging arboviral outbreaks and highlights the importance of vigilance for imported cases, due to the potential for dissemination of the virus into areas with competent local vectors and conducive environmental conditions.

2.
Med Clin (Barc) ; 154(2): 55-58, 2020 Jan 24.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30795908

RESUMO

BACKGROUND: Rabies represents a major public health issue for travellers because pretravel preexposure (PrEP) rabies vaccination is not routinely indicated. For those unvaccinated, adequate postexposure prophylaxis (PEP), including rabies immunoglobulin (RIG) if needed, is the only effective method to prevent this fatal disease. METHODS: Descriptive retrospective study at a National Referral Unit for Tropical and Travel Medicine in Madrid, Spain, among travellers treated with PEP for rabies (January 2012-December 2017). Demographic, clinical and management data were reviewed. RESULTS: 168 patients were treated for possible rabies exposure (53% females, median age 35 years; IQR: 31-42). Southeast Asia accounted for more than half of the cases (N=86, 57.3%; CI 95% 49-65%). Dogs were the primary animal involved (n=67, 44.9%; CI 37-53%). After the bite, in half of the cases (n=88, 52.4%; CI 44-60%) PEP rabies vaccine was started abroad, and the vaccine plus RIG in about 10% (n=22, 13.1%; CI: 8-19%). Most of patients classified as category III did not received RIG at all (n=88, 69.3% CI: 60-77%). CONCLUSIONS: Although indicated, most travellers did not receive RIG abroad, nor appropriate first doses of PEP. Clinicians should be aware of the importance of appropriate PrEP in selected individuals.

3.
Travel Med Infect Dis ; : 101543, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31805400

RESUMO

BACKGROUND: From the first Zika virus (ZIKV) description, it has progressively widespread worldwide. We analyzed demographic, clinical, microbiologic and travel-related characteristic from returned patients from a ZIKV endemic country in a referral Tropical Medicine Unit. METHOD: A prospective cohort study performed in a Spanish referral center with the aim of determining the significant factors associated with confirmed Zika virus (ZIKV) infection. RESULTS: 817 patients, (56% women, median age 36 [IQR, Interquartile Range: 32-42]) were enrolled. Most had returned from Latin America (n = 486; 59.4%), travelled for tourism (n = 404; 49.4%) and stayed a median of 18 days (IQR: 10-30). 602 (73.6%) presented symptoms, but only 25 (4%) were finally diagnosed with confirmed ZIKV infection (including two pregnant women, without adverse fetal outcomes), 88% (n:22) presented with fever and 92% (n:23) with rash. 56% (n:14) arthralgia and/or myalgia and 28% (n:7) conjunctivitis. The presence of conjunctivitis, fever and rash were associated with an 8.9 (95% CI: 2.2-34.9), 6.4 (95% CI: 1.2-33.3) and 72.3 (95% CI: 9.2-563.5) times greater probability of confirmed ZIKV infection, respectively. CONCLUSION: Travel characteristics and clinical presentation may help clinicians to optimize requests for microbiological testing. Diagnosis of arboviriasis in travellers arriving form endemic areas remains a challenge for clinicians, but must be detected for the possible transmission outside endemic areas, where the vector is present.

6.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 36(8): 517-522, oct. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-176811

RESUMO

La fiebre hemorrágica de Crimea-Congo afecta a más de 30 países de África, Asia, Europa oriental y Oriente Medio, con una creciente incidencia durante los últimos años, especialmente en Europa. Sin un tratamiento específico eficaz, las medidas terapéuticas de soporte son fundamentales, así como disponer de un centro con los medios adecuados para garantizar la seguridad de los trabajadores. La monitorización analítica es esencial para el manejo de la trombocitopenia, la coagulopatía grave o el fallo hepático. La atención a los pacientes con fiebre hemorrágica de Crimea-Congo debe llevarse a cabo en Unidades de Aislamiento de Alto Nivel, capaces de aplicar procedimientos de biocontención que eviten la transmisión nosocomial a través de fluidos infectados o accidentes con material contaminado. En caso de exposiciones de alto riesgo podría plantearse la administración precoz de ribavirina


Crimean-Congo haemorrhagic fever has been reported in more than 30 countries in Africa, Asia, the Middle East and Eastern Europe, with an increasing incidence in recent years, especially in Europe. Because no specific treatments have demonstrated efficacy, supportive treatment is essential, as well as the provision of a centre with the appropriate means to guarantee the safety of its healthcare professionals. Laboratory monitoring of thrombocytopenia, severe coagulopathy or liver failure is of critical importance. Patients with Crimean-Congo haemorrhagic fever should be admitted to High Level Isolation Units where appropriate biocontainment procedures can prevent nosocomial transmission through infected fluids or accidents with contaminated material. In case of high-risk exposures, early administration of ribavirin should be considered


Assuntos
Humanos , Febre Hemorrágica da Crimeia/terapia , Prognóstico
7.
J Infect Dis ; 217(12): 1952-1956, 2018 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-29584885

RESUMO

The use of ribavirin to treat Crimean-Congo hemorrhagic fever virus (CCHFV) infection has been controversial, based on uncertainties about its antiviral efficacy in clinical case studies. We studied the effect of ribavirin treatment on viral populations in a recent case by deep-sequencing analysis of plasma samples obtained from a CCHFV-infected patient before, during, and after a 5-day regimen of ribavirin treatment. The CCHFV load dropped during ribavirin treatment, and subclonal diversity (transitions) and indels increased in viral genomes during treatment. Although the results are based on a single case, these data demonstrate the mutagenic effect of ribavirin on CCHFV in vivo.


Assuntos
Vírus da Febre Hemorrágica da Crimeia-Congo/efeitos dos fármacos , Febre Hemorrágica da Crimeia/tratamento farmacológico , Ribavirina/uso terapêutico , Anticorpos Antivirais/imunologia , Antivirais/imunologia , Vírus da Febre Hemorrágica da Crimeia-Congo/imunologia , Febre Hemorrágica da Crimeia/imunologia , Humanos
9.
Med. clín (Ed. impr.) ; 150(6): 233-239, mar. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-171547

RESUMO

El número de viajeros internacionales bajo inmunodepresión farmacológica (IDF) ha aumentado debido a la mejor expectativa y calidad de vida que proporcionan estas terapias. La complejidad de la asesoría previaje en estos pacientes radica en su mayor susceptibilidad y gravedad ante determinadas infecciones relacionadas con el viaje, así como en las contraindicaciones e interacciones de determinadas vacunas y/o profilaxis con sus terapias de base. El consejo al viajero representa un reto para el clínico, que tiene que adaptar las vacunas y otras medidas preventivas a los pacientes inmunodeprimidos. Por ello, la valoración previa al viaje en pacientes con IDF debe realizarse en una unidad de medicina del viajero, de forma coordinada con el médico especialista que maneja su enfermedad de base. El objetivo de este artículo es revisar la evidencia disponible sobre las recomendaciones sanitarias indicadas en viajeros bajo tratamiento inmunosupresor en relación con la aplicación de vacunas, quimioprofilaxis antimalárica y otras medidas de prevención de enfermedades transmisibles (AU)


There is an increasing number of international travelers receiving immunosuppressive therapy due to the better life expectation and quality offered by this kind of treatment. The complexity of pre-travel counseling in these patients lies in their greater susceptibility to certain travel-related infections and the potential severity of these, as well as in the contraindications and interactions that may occur between certain vaccines and/or prophylaxis and their base therapy. Counseling the traveler represents a challenge for clinicians who have to tailor vaccinations and other recommended preventive measures to the immunosuppressed patients. Thus, pre-travel assessment of patients receiving immunosuppressive therapy should be performed in a specialized Traveler's Medical Unit, working closely with the specialist doctor in charge of treating the patient's underlying medical condition. The purpose of this article is to review available evidence on the health recommendations indicated in the pre-travel administration of vaccines, antimalarial chemoprophylaxis and other measures to prevent communicable diseases in travelers receiving immunosuppressive therapy (AU)


Assuntos
Humanos , Masculino , Feminino , Medicina de Viagem/organização & administração , Qualidade de Vida , Vacinas/imunologia , Imunossupressores/uso terapêutico , Hospedeiro Imunocomprometido/imunologia , Saúde do Viajante , Doenças Transmissíveis/imunologia , Programas de Imunização/tendências , Hepatite A/imunologia , Encefalite Japonesa/imunologia , Raiva/imunologia , Poliomielite/imunologia , Hepatite B/imunologia , Cólera/imunologia , Vacinas de Produtos Inativados/uso terapêutico
10.
Emerg Infect Dis ; 24(3): 602-603, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29460761

RESUMO

Knowing the mode of transmission of a disease can affect its control and prevention. Here, we identify 5 protozoan parasites with demonstrated presence in seminal fluid, only 1 of which has been identified as a sexually transmitted disease among humans.


Assuntos
Doenças Parasitárias/diagnóstico , Doenças Parasitárias/parasitologia , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/parasitologia , Feminino , Humanos , Masculino , Doenças Parasitárias/transmissão , Sêmen/parasitologia , Doenças Sexualmente Transmissíveis/transmissão , Testículo/parasitologia
11.
PLoS Negl Trop Dis ; 12(2): e0006272, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29474356

RESUMO

INTRODUCTION: Strongyloides stercoralis is a globally distributed nematode that causes diverse clinical symptoms in humans. Spain, once considered an endemic country, has experienced a recent increase in imported cases. The introduction of serology helps diagnosis and is currently replacing microbiological techniques in some settings, but its sensitivity is variable and can be low in immunocompromised patients. Diagnosis can only be confirmed by identification of larvae. Often, this "gold standard" can only be achieved in severe cases, such as disseminated S.stercoralis infection, or S.stercoralis hyperinfection syndrome, where parasite load is high. In addition, these clinical presentations are not well-defined. Our aim is to describe severe cases of S.stercoralis, their epidemiological profile, and their clinical details. METHODS: An observational retrospective study of disseminated S.stercoralis infection, or hyperinfection syndrome. Inclusion criteria: aged over 18, with a diagnosis of disseminated S.stercoralis infection, or hyperinfection syndrome, confirmed by visualization of larvae. Patients were identified through revision of clinical records for the period 2000-2015, in collaboration with eight reference centers throughout Spain. RESULTS: From the period 2000-2015, eighteen cases were identified, 66.7% of which were male, with a median age of 40 (range 21-70). Most of them were foreigners (94.4%), mainly from Latin America (82.3%) or Western Africa (17.6%). Only one autochthonous case was identified, from 2006. Immunosuppressive conditions were present in fourteen (77%) patients, mainly due steroids use and to retroviral coinfections (four HIV, two HTLV). Transplant preceded the clinical presentation in four of them. Other comorbidities were coinfection with HBV, Trypanosoma cruzi, Mycobacterium leprae or Aspergillus spp. All presented with digestive disorders, with 55.6% also presenting malaise. 44.4% of cases had fever, 27.8% skin complaints, and 16.7% respiratory or neurological disorders. One patient presented anemia, and one other nephrotic syndrome. Diagnosis was confirmed by identification of larvae in fresh stool samples (n = 16; 88.9%), concentration techniques (n = 6; 33.3%), larval culture (n = 5; 29.4%), or digestive biopsies (n = 8; 44%). S.stercoralis forms were identified during necropsy in one case. In addition, ten (55%) had a positive serology. All the cases were treated with ivermectin, six (33%) also received albendazole and one case received thiabendazole followed by ivermectin. All needed inpatient management, involving a mean hospitalization stay of 25 days (range 1-164). Two cases received intensive care and eventually died. CONCLUSIONS: Only eighteen cases of disseminated S.stercoralis infection/hyperinfection syndrome were identified from the 15-year period, most of which were considered to have been imported cases. Among those, immunosuppression was frequent, and mortality due to S.stercoralis was lower than previously described.


Assuntos
Doenças Transmissíveis Importadas/terapia , Gerenciamento Clínico , Strongyloides stercoralis/efeitos dos fármacos , Estrongiloidíase/epidemiologia , Estrongiloidíase/terapia , Adulto , Idoso , Albendazol/administração & dosagem , Albendazol/uso terapêutico , Animais , Antiparasitários/administração & dosagem , Antiparasitários/uso terapêutico , Doenças Transmissíveis Importadas/tratamento farmacológico , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , Comorbidade , Emigrantes e Imigrantes , Fezes/parasitologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Ivermectina/administração & dosagem , Ivermectina/uso terapêutico , Larva/fisiologia , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Estudos Retrospectivos , Espanha/epidemiologia , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/diagnóstico , Estrongiloidíase/tratamento farmacológico , Adulto Jovem
12.
Artigo em Inglês | IBECS | ID: ibc-170107

RESUMO

Introduction: A considerable increase of imported Zika virus (ZIKV) infection has been reported in Europe in the last year. This is the result of the large outbreak of the disease in the Americas, along with the increase in the numbers of travellers and immigrants arriving from ZIKV endemic areas. Methods: A descriptive study was conducted in the Tropical Medicine Unit of Hospital La Paz-Carlos III in Madrid on travellers returning from an endemic area for ZIKV from January to April 2016. Demographic, clinical and microbiological data were analyzed. Results: A total of 185 patients were screened for ZIKV (59.9% women, median age of 37.7±10.3 years). Main purpose of the travel was tourism to Colombia, Brazil, and México. Just under three-quarters (73%) were symptomatic, mostly with fever and headache. A total of 13 patients (7% of those screened) were diagnosed with ZIKV infections, of which four of them were pregnant. All of them were symptomatic patients, the majority immigrants, and mainly from Colombia. Diagnostic tests were based on positive neutralization antibodies (8 cases, 61.6%) and a positive RT-PCR in different organic fluids (7 cases, 53.8%) The four infected pregnant women underwent a neurosonography every 3 weeks, and no alterations were detected. RT-PCR in amniotic fluid was performed in three of them, with negative results. One of the children has already been born healthy. Conclusions: Our cases series represents the largest cohort of imported ZIKV to Spain described until now. Clinicians must increase awareness about the progression of the ZIKV outbreak and the affected areas so that they can include Zika virus infection in their differential diagnosis for travellers from those areas (AU)


Introducción: En el último año se ha registrado un importante aumento de casos de infección por virus Zika (ZIKV) importados en Europa. Este hecho es un reflejo de la epidemia que actualmente se está produciendo en las Américas, así como del aumento del número de viajeros e inmigrantes que proceden de zonas endémicas. Métodos: Estudio descriptivo de los viajeros retornados de área endémica para ZIKV en la Unidad de Medicina Tropical del Hospital La Paz-Carlos III en Madrid, de enero a abril de 2016. Se recogieron y analizaron datos demográficos, clínicos y microbiológicos. Resultados: Se cribaron para ZIKV un total de 185 pacientes (59,9% mujeres, mediana de edad de 37,7±10,3 años). El propósito por el que habían realizado el viaje fue por turismo a Colombia, Brasil y México. El 73% de los inicialmente cribados presentaron síntomas, fundamentalmente fiebre y cefalea. Se diagnosticó infección por ZIKV a 13 pacientes (7% de los cribados); 4 de ellos eran gestantes. Todos los casos con infección confirmada estaban sintomáticos, y la mayoría eran inmigrantes colombianos. El diagnóstico se basó en la presencia de anticuerpos neutralizantes positivos (8 casos, 61,6%) y RT-PCR positiva en diferentes fluidos orgánicos (7 casos, 53,8%). A las 4 gestantes infectadas se les realizó neurosonografía fetal seriada cada 3 semanas, no detectándose alteraciones en ninguna de ellas. En 3 casos se realizó RT-PCR en líquido amniótico, que fue negativo. Uno de los niños ha nacido, y está completamente sano. Conclusiones: Nuestra serie representa la cohorte más grande de infección por ZIKV importada en España hasta la fecha. Los clínicos deben estar alerta sobre la evolución de la epidemia del ZIKV y las zonas a las que afecta, para poder incluir la infección por ZIKV dentro del diagnóstico diferencial de viajeros que regresan de esas áreas (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/prevenção & controle , Doenças Endêmicas/prevenção & controle , Medicina de Viagem/métodos , Infecções por Arbovirus/diagnóstico , Infecções por Arbovirus/microbiologia , Infecção por Zika virus/microbiologia , Espanha/epidemiologia , Medicina de Viagem/história , Medicina de Viagem/tendências , Infecções por Arbovirus/epidemiologia , Arbovirus/isolamento & purificação , Estudos Retrospectivos
13.
Enferm Infecc Microbiol Clin ; 36(1): 4-8, 2018 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27743683

RESUMO

INTRODUCTION: A considerable increase of imported Zika virus (ZIKV) infection has been reported in Europe in the last year. This is the result of the large outbreak of the disease in the Americas, along with the increase in the numbers of travellers and immigrants arriving from ZIKV endemic areas. METHODS: A descriptive study was conducted in the Tropical Medicine Unit of Hospital La Paz-Carlos III in Madrid on travellers returning from an endemic area for ZIKV from January to April 2016. Demographic, clinical and microbiological data were analyzed. RESULTS: A total of 185 patients were screened for ZIKV (59.9% women, median age of 37.7±10.3 years). Main purpose of the travel was tourism to Colombia, Brazil, and México. Just under three-quarters (73%) were symptomatic, mostly with fever and headache. A total of 13 patients (7% of those screened) were diagnosed with ZIKV infections, of which four of them were pregnant. All of them were symptomatic patients, the majority immigrants, and mainly from Colombia. Diagnostic tests were based on positive neutralization antibodies (8 cases, 61.6%) and a positive RT-PCR in different organic fluids (7 cases, 53.8%) The four infected pregnant women underwent a neurosonography every 3 weeks, and no alterations were detected. RT-PCR in amniotic fluid was performed in three of them, with negative results. One of the children has already been born healthy. CONCLUSIONS: Our cases series represents the largest cohort of imported ZIKV to Spain described until now. Clinicians must increase awareness about the progression of the ZIKV outbreak and the affected areas so that they can include Zika virus infection in their differential diagnosis for travellers from those areas.


Assuntos
Doenças Transmissíveis Importadas , Infecção por Zika virus , Adulto , Américas , Doenças Transmissíveis Importadas/diagnóstico , Doenças Transmissíveis Importadas/epidemiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Espanha/epidemiologia , Viagem , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia
15.
Enferm Infecc Microbiol Clin ; 36(8): 517-522, 2018 10.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28669587

RESUMO

Crimean-Congo haemorrhagic fever has been reported in more than 30 countries in Africa, Asia, the Middle East and Eastern Europe, with an increasing incidence in recent years, especially in Europe. Because no specific treatments have demonstrated efficacy, supportive treatment is essential, as well as the provision of a centre with the appropriate means to guarantee the safety of its healthcare professionals. Laboratory monitoring of thrombocytopenia, severe coagulopathy or liver failure is of critical importance. Patients with Crimean-Congo haemorrhagic fever should be admitted to High Level Isolation Units where appropriate biocontainment procedures can prevent nosocomial transmission through infected fluids or accidents with contaminated material. In case of high-risk exposures, early administration of ribavirin should be considered.


Assuntos
Febre Hemorrágica da Crimeia/terapia , Humanos
16.
Med Clin (Barc) ; 150(6): 233-239, 2018 03 23.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29096964

RESUMO

There is an increasing number of international travelers receiving immunosuppressive therapy due to the better life expectation and quality offered by this kind of treatment. The complexity of pre-travel counseling in these patients lies in their greater susceptibility to certain travel-related infections and the potential severity of these, as well as in the contraindications and interactions that may occur between certain vaccines and/or prophylaxis and their base therapy. Counseling the traveler represents a challenge for clinicians who have to tailor vaccinations and other recommended preventive measures to the immunosuppressed patients. Thus, pre-travel assessment of patients receiving immunosuppressive therapy should be performed in a specialized Traveler's Medical Unit, working closely with the specialist doctor in charge of treating the patient's underlying medical condition. The purpose of this article is to review available evidence on the health recommendations indicated in the pre-travel administration of vaccines, antimalarial chemoprophylaxis and other measures to prevent communicable diseases in travelers receiving immunosuppressive therapy.


Assuntos
Controle de Doenças Transmissíveis/métodos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Doença Relacionada a Viagens , Antimaláricos/uso terapêutico , Aconselhamento Diretivo , Saúde Global , Humanos , Malária/prevenção & controle , Medicina de Viagem , Vacinação
17.
Gac. sanit. (Barc., Ed. impr.) ; 31(6): 531-534, nov.-dic. 2017. mapas, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-168545

RESUMO

La actual epidemia por virus Zika ha generado gran alarma social, favorecida en parte por la falta de información de la población general. Para proporcionar información veraz y contrastada, la Unidad de Medicina Tropical y del Viajero del Hospital Carlos III-La Paz (Madrid) puso en marcha una línea de atención telefónica sobre la infección por el virus Zika. En este artículo se presentan los datos relativos a los primeros 6 meses de su funcionamiento. El perfil predominante de llamadas corresponde a mujeres solicitando información previa a la realización del viaje. Los destinos sobre los que más información se ha demandado han sido Brasil, Méjico y Colombia. La mayoría de las llamadas se resolvieron ofreciendo información exclusivamente. La implementación de dispositivos de atención telefónica que ofrezcan información contrastada y fiable en el contexto de enfermedades asociadas a gran alarma social es de gran interés sanitario, reduce el número de consultas innecesarias y ahorra costes (AU)


The current outbreak of Zika virus has caused great social alarm, generated in part by the lack of information in the general population. In order to provide accurate and verified information, the Tropical and Travel Medicine Unit of Hospital Carlos III-La Paz (Madrid, Spain) established a hotline for Zika virus infection. We present the data concerning the first 6 months of operation of the telephone hotline. The predominant call profile consisted of women seeking information about the risk of acquiring the disease before travelling. Brazil, Mexico and Colombia were the destinations for which the most information was requested. Most of the consultations were resolved by providing information only. The implementation of call devices that provide confirmed and reliable information on diseases associated with great alarm are of significant public health interest, as they reduce the number of unnecessary medical consultations and save on medical costs (AU)


Assuntos
Humanos , Infecção por Zika virus/epidemiologia , Telefone , Saúde do Viajante , Saúde Global/normas , Epidemias , Medicina Tropical/métodos , Brasil/epidemiologia , México/epidemiologia , Colômbia/epidemiologia , Análise Estatística
18.
J Travel Med ; 24(5)2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28931128

RESUMO

Background: Understanding and detecting imported diseases is a priority in the prevention and management of prevalent and emergent infectious diseases acquired abroad. The +Redivi network measures the burden of imported infections in Spain and is essential for closing the gap in travel medicine. Methods: Demographic characteristics, travel information, syndromes and confirmed travel-related diagnoses were registered in a standardised online database. Results: A total of 10 767 cases of imported infectious diseases were registered between October 2009 and December 2015. Of these, 60.8% of cases were immigrants seen for the first time after arrival, 20.6% were travellers, and 18.4% were individuals visiting friends and relatives (VFR [immigrants and travellers]). The median time between arrival and medical consultation was 5.5 years for immigrants, 2.0 weeks for travellers, 3.1 weeks for VFR-travellers and 11.4 for VFR-immigrants. The most prevalent diagnoses were Chagas disease in immigrants and nonspecific acute diarrhoea in travellers. Malaria by P. falciparum was one of the most prevalent diagnoses among VFR. More than half the travellers saw a physician before travelling, although one-third of those for whom antimalarial medication was indicated did not take their medication correctly. As for VFR, only 10.4% of VFR-immigrants and 32.5% of VFR-travellers sought pre-travel advice. Only 23 and 21%, respectively, of those for whom antimalarial prophylaxis was indicated took the medication properly. Conclusions : +Redivi provides a clear picture of the prevalence of imported infectious diseases among travellers and immigrants in Spain. The data collected could be used to improve everyday health care provided to travellers and immigrants after travel, to guide pre-travel consultations and to monitor the potential occurrence of tropical or exotic infectious diseases.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Viagem , Adulto , Idoso , Doenças Transmissíveis Importadas/etiologia , Doenças Transmissíveis Importadas/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros , Espanha/epidemiologia
19.
Gac Sanit ; 31(6): 531-534, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-28645459

RESUMO

The current outbreak of Zika virus has caused great social alarm, generated in part by the lack of information in the general population. In order to provide accurate and verified information, the Tropical and Travel Medicine Unit of Hospital Carlos III-La Paz (Madrid, Spain) established a hotline for Zika virus infection. We present the data concerning the first 6 months of operation of the telephone hotline. The predominant call profile consisted of women seeking information about the risk of acquiring the disease before travelling. Brazil, Mexico and Colombia were the destinations for which the most information was requested. Most of the consultations were resolved by providing information only. The implementation of call devices that provide confirmed and reliable information on diseases associated with great alarm are of significant public health interest, as they reduce the number of unnecessary medical consultations and save on medical costs.


Assuntos
Linhas Diretas , Medicina de Viagem/organização & administração , Medicina Tropical/organização & administração , Infecção por Zika virus , Surtos de Doenças , Feminino , Humanos , América Latina , Masculino , Espanha , Fatores de Tempo , Doença Relacionada a Viagens , Infecção por Zika virus/prevenção & controle
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