[Consensus document for the detection and management of Chagas disease in primary health care in a non-endemic areas]. / Documento de consenso sobre el abordaje de la enfermedad de Chagas en atención primaria de salud de áreas no endémicas.

Chagas disease is caused by the protozoan Trypanosoma cruzi. Although it is commonly transmitted by an insect vector in continental Latin-America, in recent decades, due migration, has been diagnosed in other countries such Spain, the European country with a largest immigrant population of Latin American. For a long time, the patient remains asymptomatic, but some years after this stage, the symptoms can be serious (dilated cardiomyopathy, megacolon, megaesophagus). In addition, detection in pregnant women has a high priority because of the route of vertical transmission. Several specific guidelines about Chagas disease has been developed on the Banks of blood, maternal hospitals, HIV co-infection, organ transplant. But due to the detection of lack of information to primary care professionals, we consider to will be useful this document written and agreed to by family phisicians, pediatricians and specialists in International Health.

[Global HIV epidemiology and current migration]. / Epidemiologia del VIH/sida en el mundo y el fenómeno migratorio actual.

One of the current characteristics of migration is its tendency to concentrate in industrialized countries, as well as its feminization and diversity. From a healthcare point of view, the phenomenon of migration has aroused interest in the possible transfer of transmissible infectious diseases from some regions to others and the impact that this could have on public health. When discussing immigration and AIDS, there is a risk of stigmatizing vulnerable people, who are generally healthy. Some of the infectious diseases these people contract are partly due to the conditions experienced on the journey or once they are settled in the host country. The epidemiological pattern of HIV transmission in immigrants is the same as that in their countries of origin. Although the distribution of HIV subtypes is more or less localized, there is a tendency toward progressive dispersion of all subtypes in different geographical areas and toward new recombinant subtypes.

Persistence of Zika virus in semen 93 days after the onset of symptoms.

INTRODUCTION: Zika virus is mainly transmitted through the bites of infected Aedes mosquitoes, although mother-to-child and sexual transmission have also been described. The presence of Zika virus in semen after infection seems to be not uncommon, but the duration of viral persistence has not been well-determined. METHODS: Molecular, serological and cell culture methods were used for the diagnosis and follow up of a case of Zika virus infection imported from Venezuela. Serial samples of serum, urine and semen were analyzed to investigate the persistence of the Zika virus. RESULTS: Zika virus was detected in semen samples up to 93 days after the onset of symptoms. CONCLUSIONS: Our results confirm the persistence of Zika virus in semen samples for long periods after infection.

[Imported parasitic diseases in the immigrant population in Spain]. / Parasitosis importadas en la población inmigrante en España.

BACKGROUND: Migration has contributed to the emergence of certain infectious diseases in host countries. In Spain the number of immigrants has increased exponentially in recent decades. The aim of this review is to identify and analyze the available information on imported parasitic diseases in immigrant population in our country. METHODS: A scope review of original articles published on imported parasitic diseases between 1998 and 2012. Study populations from Latin America, Africa, Asia, Eastern Europe and individuals who are under the definition of an immigrant from International Organization for Migration were included. The literature search was performed in the Medline and MEDES-MEDicina databases. RESULTS: A total of 51 descriptive studies were included in the analysis. Most immigrants attended at referral health facilities were originally from sub-Saharan Africa (between 16%-87%), followed by Latin America (13%-37%), while Asia was the region less represented (0.2%-8.8%). A considerable proportion (6.5-31%) of immigrants that attended to referral units of tropical medicine or inmigrant health, and that were originally from Latin America, particularly those from Bolivia, are affected by the Chagas disease, and several cases of mother-to-child transmission have been registered in our country. CONCLUSION: Imported parasitosis is a frequent diagnosis among migrant population. This review highlight the impact that migration has had on the emergence of certain imported parasitic diseases, being Chagas disease the most paradigmatic example.

Persistence of Zika virus in semen 93 days after the onset of symptoms / Persistencia del virus Zika en semen 93 días tras el comienzo de los síntomas

Introduction: Zika virus is mainly transmitted through the bites of infected Aedes mosquitoes, although mother-to-child and sexual transmission have also been described. The presence of Zika virus in semen after infection seems to be not uncommon, but the duration of viral persistence has not been well-determined. Methods: Molecular, serological and cell culture methods were used for the diagnosis and follow up of a case of Zika virus infection imported from Venezuela. Serial samples of serum, urine and semen were analyzed to investigate the persistence of the Zika virus. Results: Zika virus was detected in semen samples up to 93 days after the onset of symptoms. Conclusions: Our results confirm the persistence of Zika virus in semen samples for long periods after infection (AU)

Introducción: El virus Zika se transmite fundamentalmente por la picadura de mosquitos Aedes infectados, aunque también es posible la transmisión de madre a hijo y la transmisión sexual. La presencia del virus Zika en semen tras la infección parece ser algo relativamente frecuente, pero la duración de la persistencia viral no es bien conocida. Métodos: Mediante técnicas moleculares, serológicas y cultivo celular se diagnosticó un caso de Zika importado de Venezuela y se tomaron muestra seriadas de suero, orina y semen para investigar la persistencia del virus. Resultados: El virus Zika fue detectado en muestras de semen recogidas 93días después del inicio de los síntomas. Conclusiones: Nuestros resultados confirman la persistencia del virus Zika en semen por períodos prolongados de tiempo después de la infección (AU)

Documento de consenso sobre el abordaje de la enfermedad de Chagas en atención primaria de salud de áreas no endémicas / Consensus document for the detection and management of Chagas disease in primary health care in a non-endemic areas

La tripanosomiasis americana o enfermedad de Chagas es una enfermedad infecciosa endémica en América Latina continental, causada por el protozoo Trypanosoma cruzi. En las últimas décadas, debido a los movimientos poblacionales, se ha expandido más allá de las zonas endémicas, siendo España el país europeo con más inmigrantes latinoamericanos. Durante años puede permanecer asintomática, pero cuando se manifiesta clínicamente puede ser grave (miocardiopatía dilatada, megacolon, megaesófago), así como, debido a su transmisión vertical, la detección en embarazadas es una alta prioridad. Se han elaborado guías de detección de Trypanosoma cruzi en circunstancias específicas (bancos de sangre, maternidades, coinfección con el VIH, trasplante de órganos); pero detectamos falta de información dirigida a los profesionales de atención primaria. Para facilitar la detección y manejo de esta enfermedad se consideró la necesidad de realizar este documento, redactado y consensuado por médicos de familia, pediatras de atención primaria y especialistas en salud internacional

Chagas disease is caused by the protozoan Trypanosoma cruzi. Although it is commonly transmitted by an insect vector in continental Latin-America, in recent decades, due migration, has been diagnosed in other countries such Spain, the European country with a largest immigrant population of Latin American. For a long time, the patient remains asymptomatic, but some years after this stage, the symptoms can be serious (dilated cardiomyopathy, megacolon, megaesophagus). In addition, detection in pregnant women has a high priority because of the route of vertical transmission. Several specific guidelines about Chagas disease has been developed on the Banks of blood, maternal hospitals, HIV co-infection, organ transplant. But due to the detection of lack of information to primary care professionals, we consider to will be useful this document written and agreed to by family phisicians, pediatricians and specialists in International Health

Prevalence of Chagas disease in the Latin American immigrant population in a primary health centre in Barcelona (Spain).

A cross-sectional descriptive study was carried out to detect the seroprevalence of chagasic infection in children and women of child-bearing age in a primary care health centre in Barcelona (Spain). Serological screening was performed with an immunochromatography (IC) test (Stat Pak Chagas de Chembio) and all positive and doubtful results were confirmed by two ELISA tests using recombinant and whole Trypanosoma cruzi antigens. Prevalence of 4.3% was detected in the child-bearing age group women. General practitioners and paediatricians are concerned by Chagas disease, now an emergent health disease in non-endemic countries.

Parasitosis importadas en la población inmigrante en España / Imported parasitic diseases in the immigrant population in Spain

Fundamentos: La migración ha contribuido a la emergencia de ciertas enfermedades infecciosas en los países receptores de inmigrantes. En España el número de inmigrantes ha crecido exponencialmente en las últimas décadas. El objetivo de esta revisión es identificar y analizar la información disponible sobre parasitosis importadas en población inmigrante en nuestro país. Métodos: Revisión de conjunto de artículos originales publicados sobre parasitosis importadas publicados entre 1998 y 2012. Se incluyeron trabajos realizados con poblaciones procedentes de Latinoamérica, África, Asia y Europa del Este o que cumplieran la definición de inmigrante de la Organización Internacional de Migraciones. La búsqueda bibliográfica se realizó en Medline y MEDES-MEDicina. Resultados: Se incluyó un total de 51 estudios descriptivos en el análisis. La mayor parte de los inmigrantes atendidos procedieron del África Subsahariana (16%-87% según estudios), seguidos de América Latina (13%-37%), siendoAsia la región menos representada (0,2%-8,8%). Destaca que el 6,5-31% de los inmigrantes atendidos en unidades de medicina tropical o de atención al inmigrante y procedentes de América Latina, en particular de Bolivia, están afectados por la enfermedad de Chagas y la existencia en nuestro país de casos de transmisión congénita de esta enfermedad. Conclusiones: Las parasitosis importadas son un diagnóstico frecuente entre la población inmigrante. Esta revisión pone de manifiesto el impacto que ha tenido la migración en la emergencia de ciertas enfermedades parasitarias importadas, siendo un ejemplo paradigmático la enfermedad de Chagas (AU)

Background: Migration has contributed to the emergence of certain infectious diseases in host countries. In Spain the number of immigrants has increased exponentially in recent decades. The aim of this review is to identify and analyze the available information on imported parasitic diseases in immigrant population in our country. Methods: A scope review of original articles published on imported parasitic diseases between 1998 and 2012. Study populations from Latin America, Africa, Asia, Eastern Europe and individuals who are under the definition of an immigrant from International Organization for Migration were included. The literature search was performed in the Medline and MEDES-MEDicina databases. Results: A total of 51 descriptive studies were included in the analysis. Most immigrants attended at referral health facilities were originally from sub-SaharanAfrica (between 16%-87%), followed by LatinAmerica (13%-37%), while Asia was the region less represented (0.2%-8.8%). A considerable proportion (6.5-31%) of inmigrants that attended to referal units of tropical medicine or inmigrant health, and that were originally from Latin America, particularly those from Bolivia, are affected by the Chagas disease, and several cases of mother-to-child transmission have been registered in our country. Conclusion: Imported parasitosis is a frequent diagnosis among migrant population. This review highlight the impact that migration has had on the emergence of certain imported parasitic diseases, being Chagas disease the most paradigmatic example (AU)

Epidemiologia del VIH/sida en el mundo y el fenómeno migratorio actual / Global HIV epidemiology and current migration

Una de las características actuales de la inmigración es su tendencia a concentrarse en los países industrializados, así como su feminización y su diversidad. Desde el punto de vista sanitario, el fenómeno migratorio ha despertado interés por el posible trasvase de enfermedades infecciosas transmisibles de unas zonas a otras, y el impacto que ello puede suponer en el ámbito de la salud pública. Cuando se habla de inmigración y sida se corre el peligro de estigmatizar a unas personas vulnerables, que generalmente son una población sana. Algunas enfermedades infecciosas que estos pacientes acaban presentando, en parte, se deben a las condiciones que experimentan durante el periplo migratorio o una vez establecidos en el país de acogida. Los inmigrantes siguen el patrón epidemiológico de transmisión del virus de la inmunodeficiencia humana (VIH) de su país de origen. A pesar de la distribución más o menos localizada de los subtipos del VIH, la tendencia es la de la dispersión progresiva de todos ellos en distintas áreas geográficas y hacia nuevos subtipos recombinantes

One of the current characteristics of migration is its tendency to concentrate in industrialized countries, as well as its feminization and diversity. From a healthcare point of view, the phenomenon of migration has aroused interest in the possible transfer of transmissible infectious diseases from some regions to others and the impact that this could have on public health. When discussing immigration and AIDS, there is a risk of stigmatizing vulnerable people, who are generally healthy. Some of the infectious diseases these people contract are partly due to the conditions experienced on the journey or once they are settled in the host country. The epidemiological pattern of HIV transmission in immigrants is the same as that in their countries of origin. Although the distribution of HIV subtypes is more or less localized, there is a tendency toward progressive dispersion of all subtypes in different geographical areas and toward new recombinant subtypes