14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 32.030 Session: Travel Medicine and Travel Health Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Hookworm-related cutaneous Larva Migrans: An annoying souvenir of some trips S. Lloveras 1 , S. E. Echazarreta 2 , T. Orduna 1 1 Corunna, Argentina, 2 Hospital F.J.Muñiz, Buenos Aires, Argentina Background: Hookworm-related Cutaneous Larva Migrans (HrCLM) in travellers is a common but neglected parasitic skin disease that results from a zoonotic nematode infection and shows a characteristic creeping eruption due to penetration and migration of the larva within the epidermis. Methods: We performed a retrospective survey of patients with this illness assisted at our Unit from 1999 trough 2008. Results: A total of 64 individuals received a diagnosis of HrCLM, and among them there were 55 (85.93 %) who had acquired it in the Brazilian beaches, but also in Costa Rica, Paraguay, Peru, Senegal, Thailand and Venezuela. Three patients were domestic travelers and they had acquired the creeping eruption in Argentina. Fifty percent of the 64 affected patients were young adults between 20–39 years. Lesions were mainly unique (90.6%) and affected feet (82.75%). The symptoms appeared to 70.35% (n=45) of patients, between 3 and 7 days after returning from the trip. Eleven (17.18%) patients had secondary bacterial infection. Out of 64 patients assisted, 62 (96.87%) were cured by a single course of treatment: 48 patients with ivermectin, 11 with oral thiabendazole plus topics of 10% thiabendazole cream; one received oral albendazole, 400 mg a day for 3 days and one patient’s treatment was not recorded. Two patients (3.12%) required a second course of therapy. Conclusion: As travel to the tropics increases, many travelers may be returning to their countries with this infection, which is often misdiagnosed or incorrectly treated. Although there are various treatments available, it is necessary to have prospective and randomized controlled trial to compare their efficacy. Among the preventive measures, that can be suggested to travelers, are to avoid walking barefoot has proved to decrease the disease impact and also reduce the contact of skin areas with contaminated soil or beaches, by lying on a canvas for sunbathing or to rest. Furthermore, Public Health measures must be put into practice to avoid the presence of loose animals and to promote deworming of the same.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 32.031 Session: Travel Medicine and Travel Health Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Immunocompromised travellers in the pre-travel appointment: A report from Portugal R. COELHO 1 , C. abreu 2 , F. Danina 1 , J. Nuak 1 , C. Caldas 1 , E. Quintas 1 , N. Darwich 1 , A. Sarmento 3 1 Hospital Sao Joao, Porto, Portugal, 2 hospital s. joão, Porto, Portugal, 3 Hospital S. João, Porto, Portugal Background: As both international travel and the number of immunocompromised travellers increase, concerns related to the efficacy of immunizations and malaria prophylaxis, drug interactions and worse of the basal medical condition in this population are a challenge for practitioners. Methods: The charts from pre-traveller appointments of consecutive travellers were reviewed selecting our target population: those with HIV infection, malignant diseases in treatment, solid organ or stem cell receptors, under immunossupressive therapy and splenectomized. Demografic data, destination, duration and reasons of travel, malaria quimioprophylaxis and immunizations were considered. Results: From the 2101 travelers 23 (1,1%) meet criteria for immunosuppression. Eleven (48%) had HIV infection (all with CD4+ counts between 200-500/ul, 5 AIDS, 8 under HAART, 3 HCV co-infected), 10 (43%) were under immunosuppressive drugs (7 had autoimmune diseases, 2 solid organ transplant receptors, 1 under systemic corticotherapy for severe asthma), 2 (9%) were splenectomized. Their ages ranged from 21-56 years, mean 41; 17 (74%) were man. Mean time between the consultation and the date of travel was 23 days. Africa was the destination of 16 (70%) travelers (13 for Angola), tropical South America in 5 (22%), Indian subcontinent and Central America in 1 each. Excluding 2 travelers (one emigrant and one who lived in the country of destination) the duration of travel ranged from 3-180 days, mean 29days. The reason for travelling was work in 12 (52%), tourism in 9 (39%), humanitarian mission in 1 and 1 was resident. Malaria quimioprophylaxis was indicated in 12 (52%) and in 3 drug interactions changed the the first choice. Yellow fever vacination was required for 12 travelers, in 6 a medical excuse was done, 4 were vaccinated (2 HIV not severe immunosuppressed, 1 was splenectomized, 1 before immunosuppressive drugs ) and 2 had actualized vaccination. Conclusion: Immunosupressed represent 1% of our travellers ; HIV infected travellers are common, followed by patients under immunosuppressive drugs for autoimmune diseases. More frequently the traveler is a young male, travelling for a month to Africa for work. The excuse for yellow fever vaccination and the possibility of drug to drug interaction in malaria prohylaxis makes the medical prevention less than optimal in this vulnerable population.
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