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4. Ten-Week Follow-Up of Monkeypox Case-Patient, Sweden, 2022

Author

Pettke, Aleksandra, Filen, Finn, Widgren, Katarina, Jacks, Andreas, Glans, Hedvig, Andreasson, Sofia, Muradrasoli, Shaman, Helgesson, Sofia, Hauzenberger, Elenor, Karlberg, Maria Lind, Walai, Noura, Bjerkner, Annelie, Gourle, Hadrien, Gredmark-Russ, Sara, Lindsjo, Oskar Karlsson, Sonden, Klara, and Asgeirsson, Hilmir

Subjects
Human monkeypox -- Case studies -- Diagnosis -- Patient outcomes, Health
Abstract

Monkeypox is a zoonotic infection caused by monkeypox virus (MPXV), belonging to the Orthopoxvirus genus of the Poxviridae family. Monkeypox outbreaks have historically been described mainly in central and west [...]

Published
2022
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6. Epidemiological and clinical characteristics of patients with monkeypox in the GeoSentinel Network: a cross-sectional study

Author

Blumberg, Lucille, Chaussade, Hélène, Desclaux, Arnaud, Florence, Eric, Aysel Florescu, Simin, Glans, Hedvig, Glynn, Marielle, Goorhuis, Abraham, Klein, Marina, Malvy, Denis, McCollum, Andrea, Muñoz, José, Nguyen, Duc, Quilter, Laura, Rothe, Camilla, Soentjens, Patrick, Tumiotto, Camille, Vanhamel, Jef, Angelo, Kristina M, Smith, Teresa, Camprubí-Ferrer, Daniel, Balerdi-Sarasola, Leire, Díaz Menéndez, Marta, Servera-Negre, Guillermo, Barkati, Sapha, Duvignaud, Alexandre, Huber, Kristina L B, Chakravarti, Arpita, Bottieau, Emmanuel, Greenaway, Christina, Grobusch, Martin P, Mendes Pedro, Diogo, Asgeirsson, Hilmir, Popescu, Corneliu Petru, Martin, Charlotte, Licitra, Carmelo, de Frey, Albie, Schwartz, Eli, Beadsworth, Michael, Lloveras, Susana, Larsen, Carsten S, Guagliardo, Sarah Anne J, Whitehill, Florence, Huits, Ralph, Hamer, Davidson H, Kozarsky, Phyllis, and Libman, Michael

Published
2023
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7. Epidemiology of travel-associated dengue from 2007 to 2022: A GeoSentinel analysis.

Author

Duvignaud, Alexandre, Stoney, Rhett J, Angelo, Kristina M, Chen, Lin H, Cattaneo, Paolo, Motta, Leonardo, Gobbi, Federico G, Bottieau, Emmanuel, Bourque, Daniel L, Popescu, Corneliu P, Glans, Hedvig, Asgeirsson, Hilmir, Oliveira-Souto, Ines, Vaughan, Stephen D, Amatya, Bhawana, Norman, Francesca F, Waggoner, Jesse, Díaz-Menéndez, Marta, Beadsworth, Michael, and Odolini, Silvia

Subjects
DENGUE viruses, POLYMERASE chain reaction, DENGUE hemorrhagic fever, DENGUE, CLINICAL epidemiology, ACUTE diseases
Abstract

Background Dengue is a leading cause of febrile illness among international travellers. We aimed to describe the epidemiology and clinical characteristics of imported dengue in returning travellers evaluated at GeoSentinel sites from 2007 to 2022. Methods We retrieved GeoSentinel records of dengue among travellers residing in non-endemic countries. We considered dengue confirmed when diagnosed by a positive dengue virus (DENV)–specific reverse-transcriptase polymerase chain reaction, positive NS-1 antigen and/or anti-DENV IgG seroconversion, and probable when diagnosed by single anti-DENV IgM or high-titre anti-DENV IgG detection. Severe dengue was defined as evidence of clinically significant plasma leakage or bleeding, organ failure, or shock, according to the 2009 World Health Organization guidance. Complicated dengue was defined as either severe dengue or dengue with presence of any warning sign. Analyses were descriptive. Results This analysis included 5958 travellers with confirmed (n = 4859; 81.6%) or probable (n = 1099; 18.4%) dengue. The median age was 33 years (range: <1–91); 3007 (50.5%) travellers were female. The median travel duration was 21 days (interquartile range [IQR]: 15–32). The median time between illness onset and GeoSentinel site visit was 7 days (IQR: 4–15). The most frequent reasons for travel were tourism (67.3%), visiting friends or relatives (12.2%) and business (11.0%). The most frequent regions of acquisition were South East Asia (50.4%), South Central Asia (14.9%), the Caribbean (10.9%) and South America (9.2%). Ninety-five (1.6%) travellers had complicated dengue, of whom 27 (0.5%) had severe dengue and one died. Of 2710 travellers with data available, 724 (26.7%) were hospitalized. The largest number of cases (n = 835) was reported in 2019. Conclusions A broad range of international travellers should be aware of the risk of acquiring dengue and receive appropriate pre-travel counselling regarding preventive measures. Prospective cohort studies are needed to further elucidate dengue risk by destination and over time, as well as severe outcomes and prolonged morbidity (long dengue) due to travel-related dengue. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Intestinal protozoa in returning travellers: a GeoSentinel analysis from 2007 to 2019.

Author

Weitzel, Thomas, Brown, Ashley, Libman, Michael, Perret, Cecilia, Huits, Ralph, Chen, Lin, Leung, Daniel T, Leder, Karin, Connor, Bradley A, Menéndez, Marta D, Asgeirsson, Hilmir, Schwartz, Eli, Salvador, Fernando, Malvy, Denis, Saio, Mauro, Norman, Francesca F, Amatya, Bhawana, Duvignaud, Alexandre, Vaughan, Stephen, and Glynn, Marielle

Subjects
PROTOZOAN diseases, CLINICAL epidemiology, INTESTINES, HIGH-income countries, GIARDIASIS
Abstract

Background Prolonged diarrhoea is common amongst returning travellers and is often caused by intestinal protozoa. However, the epidemiology of travel-associated illness caused by protozoal pathogens is not well described. Methods We analysed records of returning international travellers with illness caused by Giardia duodenalis , Cryptosporidium spp. Cyclospora cayetanensis or Cystoisospora belli , reported to the GeoSentinel Network during January 2007–December 2019. We excluded records of travellers migrating, with an unascertainable exposure country, or from GeoSentinel sites that were not located in high-income countries. Results There were 2517 cases, 82.3% giardiasis (n  = 2072), 11.4% cryptosporidiosis (n  = 287), 6.0% cyclosporiasis (n  = 150) and 0.3% cystoisosporiasis (n  = 8). Overall, most travellers were tourists (64.4%) on long trips (median durations: 18–30 days). Cryptosporidiosis more frequently affected people < 18 years (13.9%) and cyclosporiasis affected people ≥ 40 years (59.4%). Giardiasis was most frequently acquired in South Central Asia (45.8%) and sub-Saharan Africa (22.6%), cryptosporidiosis in sub-Saharan Africa (24.7%) and South-Central Asia (19.5%), cyclosporiasis in South East Asia (31.3%) and Central America (27.3%), and cystoisosporiasis in sub-Saharan Africa (62.5%). Cyclosporiasis cases were reported from countries of uncertain endemicity (e.g. Cambodia) or in countries with no previous evidence of this parasite (e.g. French Guiana). The time from symptom onset to presentation at a GeoSentinel site was the longest amongst travellers with giardiasis (median: 30 days). Over 14% of travellers with cryptosporidiosis were hospitalized. Conclusions This analysis provides new insights into the epidemiology and clinical significance of four intestinal protozoa that can cause morbidity in international travellers. These data might help optimize pretravel advice and post-travel management of patients with travel-associated prolonged gastrointestinal illnesses. This analysis reinforces the importance of international travel-related surveillance to identify sentinel cases and areas where protozoal infections might be undetected or underreported. [ABSTRACT FROM AUTHOR]

Published
2024
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11. Two Cases of Borrelia miyamotoi Meningitis, Sweden, 2018

Author

Henningsson, Anna J., Asgeirsson, Hilmir, Hammas, Berit, Karlsson, Elias, Parke, Asa, Hoornstra, Dieuwertje, Wilhelmsson, Peter, and Hovius, Joppe W.

Subjects
Disease transmission, Meningitis, DNA sequencing, Recurrence (Disease), Meningoencephalitis, Genotypes, Arthralgia, Liver, Headache, Thrombocytopenia, DNA, Genetic research, Relapsing fever, Myalgia, Neutropenia, Enzymes, Health
Abstract

Borrelia miyamotoi is the cause of an emerging disease in the Northern Hemisphere, transmitted by hard (Ixodes) ticks. The bacterial species, described in Japan in 1995 (1), is genetically related [...]

Published
2019
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12. Impact, health care utilization, and costs of travel-associated mosquito-borne diseases in international travellers: a prospective study

Author

Tozan, Yesim, primary, Headley, Tyler Y, additional, Javelle, Emilie, additional, Gautret, Philippe, additional, Grobusch, Martin, additional, Pijper, Cornelis, additional, Asgeirsson, Hilmir, additional, Chen, Lin H, additional, Bourque, Daniel, additional, Menéndez, Marta Diaz, additional, Moro, Lucia, additional, Gobbi, Federico, additional, Sánchez-Montalvá, Adrián, additional, Connor, Bradley A, additional, Matteelli, Alberto, additional, Crosato, Verena, additional, Huits, Ralph, additional, Libman, Michael, additional, and Hamer, Davidson H, additional

Published
2023
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13. Epidemiological and clinical characteristics of patients with monkeypox in the GeoSentinel Network: a cross-sectional study.

Author

Angelo, Kristina M, Smith, Teresa, Camprubí-Ferrer, Daniel, Balerdi-Sarasola, Leire, Díaz Menéndez, Marta, Servera-Negre, Guillermo, Barkati, Sapha, Duvignaud, Alexandre, Huber, Kristina L B, Chakravarti, Arpita, Bottieau, Emmanuel, Greenaway, Christina, Grobusch, Martin MP, Mendes Pedro, Diogo, Asgeirsson, Hilmir, Popescu, Corneliu Petru, Martin, Charlotte, Licitra, Carmelo, de Frey, Albie, Schwartz, Eli, Beadsworth, Michael, Lloveras, Susana, Larsen, Carsten S, Guagliardo, Sarah Anne SAJ, Whitehill, Florence, Huits, Ralph, Hamer, Davidson H, Kozarsky, Phyllis, Libman, Michael, GeoSentinel Network Collaborators, Angelo, Kristina M, Smith, Teresa, Camprubí-Ferrer, Daniel, Balerdi-Sarasola, Leire, Díaz Menéndez, Marta, Servera-Negre, Guillermo, Barkati, Sapha, Duvignaud, Alexandre, Huber, Kristina L B, Chakravarti, Arpita, Bottieau, Emmanuel, Greenaway, Christina, Grobusch, Martin MP, Mendes Pedro, Diogo, Asgeirsson, Hilmir, Popescu, Corneliu Petru, Martin, Charlotte, Licitra, Carmelo, de Frey, Albie, Schwartz, Eli, Beadsworth, Michael, Lloveras, Susana, Larsen, Carsten S, Guagliardo, Sarah Anne SAJ, Whitehill, Florence, Huits, Ralph, Hamer, Davidson H, Kozarsky, Phyllis, Libman, Michael, and GeoSentinel Network Collaborators

Abstract

The early epidemiology of the 2022 monkeypox epidemic in non-endemic countries differs substantially from the epidemiology previously reported from endemic countries. We aimed to describe the epidemiological and clinical characteristics among individuals with confirmed cases of monkeypox infection., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2023

14. Health care seeking during travel: an analysis by the GeoSentinel surveillance network of travel medicine providers

Author

Piyaphane, Watcharapong, Stoney, Rhett J, Asgeirsson, Hilmir, Appiah, Grace D, Díaz-Menéndez, Marta, Barnett, Elizabeth D, Gautret, Philippe, Libman, Michael, Schlagenhauf, Patricia, Leder, Karin, Plewes, Katherine, Grobusch, Martin P, Huits, Ralph, Mavunda, Kunjana, Hamer, Davidson H, Chen, Lin H, and University of Zurich

Subjects
610 Medicine & health, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI)
Published
2023
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15. Impact, healthcare utilization and costs of travel-associated mosquito-borne diseases in international travellers: a prospective study

Author

Tozan, Yesim, Headley, Tyler, Javelle, Emilie, Gautret, Philippe, Grobusch, Martin, de Pijper, Cornelis, Asgeirsson, Hilmir, Chen, Lin, Bourque, Daniel, Menéndez, Marta, Moro, Lucia, Gobbi, Federico, Sánchez-Montalvá, Adrián, Connor, Bradley, Matteelli, Alberto, Crosato, Verena, Huits, Ralph, Libman, Michael, Hamer, Davidson, New York University School of Global Public Health, New York, NY, New York University [Abu Dhabi], NYU System (NYU), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Service de Santé des Armées, Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Department of Infectious Diseases [Amsterdam, Netherlands] (Academic Medical Center), University of Amsterdam [Amsterdam] (UvA)-Center for Tropical and Travel Medicine [Amsterdam, Netherlands], University of Amsterdam, Center for Tropical and Travel Medicine, Amsterdam, Karolinska University Hospital [Stockholm], Travel Medicine Center - Mt. Auburn Hospital, Cambridge, and Harvard Medical School, Boston, MA, Travel Medicine Center - Mt. Auburn Hospital, Cambridge, and Harvard Medical School, Boston, Hospital Universitario La Paz-Carlos IIIl, Madrid, IRCCS Sacro Cuore Don Calabria Hospital [Vérone, Italie], International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain., Weill Cornell Medicine and the New York Center for Travel and Tropical Medicine, New York, Civic Hospital of Brescia, Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, J.D. MacLean Centre for Tropical Diseases, Montreal, Quebec, and Boston University [Boston] (BU)

Subjects
[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, General Medicine, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology
Abstract

Background International travellers frequently acquire infectious diseases whilst travelling, yet relatively little is known about the impact and economic burden of these illnesses on travellers. We conducted a prospective exploratory costing study on adult returning travellers with falciparum malaria, dengue, chikungunya or Zika virus. Methods Patients were recruited in eight Travel and Tropical Medicine clinics between June 2016 and March 2020 upon travellers’ first contact with the health system in their country of residence. The patients were presented with a structured 52-question self-administered questionnaire after full recovery to collect information on patients’ healthcare utilization and out-of-pocket costs both in the destination and home country, and about income and other financial losses due to the illness. Results A total of 134 patients participated in the study (malaria, 66; dengue, 51; chikungunya, 8; Zika virus, 9; all fully recovered; median age 40; range 18–72 years). Prior to travelling, 42% of patients reported procuring medical evacuation insurance. Across the four illnesses, only 7% of patients were hospitalized abroad compared with 61% at home. Similarly, 15% sought ambulatory services whilst abroad compared with 61% at home. The average direct out-of-pocket hospitalization cost in the destination country (USD $2236; range: $108–$5160) was higher than the direct out-of-pocket ambulatory cost in the destination country (USD $327; range: $0–$1560), the direct out-of-pocket hospitalization cost at home (USD $35; range: $0–$120) and the direct out-of-pocket ambulatory costs at home (US$45; range: $0–$192). Respondents with dengue or malaria lost a median of USD $570 (Interquartile range [IQR] 240–1140) and USD $240 (IQR 0–600), respectively, due to their illness, whilst those with chikungunya and Zika virus lost a median of USD $2400 (IQR 1200–3600) and USD $1500 (IQR 510–2625), respectively. Conclusion Travellers often incur significant costs due to travel-acquired diseases. Further research into the economic impact of these diseases on travellers should be conducted.

Published
2023
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16. Anakinra or tocilizumab in patients admitted to hospital with severe covid-19 at high risk of deterioration (IMMCoVA): A randomized, controlled, open-label trial.

Author

Sundén-Cullberg, Jonas, Chen, Puran, Häbel, Henrike, Skorup, Paul, Janols, Helena, Rasmuson, Johan, Niward, Katarina, Östholm Balkhed, Åse, Chatzidionysiou, Katerina, Asgeirsson, Hilmir, Blennow, Ola, Parke, Åsa, Svensson, Anna-Karin, Muvva, Jagadeeswara Rao, Ljunggren, Hans-Gustav, Horne, Anna-Carin, Ådén, Ulrika, Henter, Jan-Inge, Sönnerborg, Anders, and Vesterbacka, Jan

Subjects
SEQUENTIAL analysis, ANAKINRA, TOCILIZUMAB, HOSPITAL patients, COVID-19, LACTATE dehydrogenase
Abstract

Background: Anakinra and tocilizumab are used for severe Covid-19, but only one previous randomized controlled trial (RCT) has studied both. We performed a multi-center RCT comparing anakinra or tocilizumab versus usual care (UC) for adults at high risk of deterioration. Methods: The study was conducted June 2020 to March 2021. Eligibility required ≥ 5 liters/minute of Oxygen to maintain peripheral oxygen saturation at ≥ 93%, CRP > 70 mg/L, ferritin > 500 μg/L and at least two points where one point was awarded for lymphocytes < 1x 109/L; D-dimer ≥ 0.5 mg/L and; lactate dehydrogenase ≥ 8 microkatal/L. Patients were randomly assigned 1:1:1 to receive either a single dose of tocilizumab (8 mg/kg) or anakinra 100 mg IV QID for seven days or UC alone. The primary outcome was time to recovery. Results: Recruitment was ended prematurely when tocilizumab became part of usual care. Out of a planned 195 patients, 77 had been randomized, 27 to UC, 28 to anakinra and 22 to tocilizumab. Median time to recovery was 15, 15 and 11 days. Rate ratio for recovery for UC vs anakinra was 0.91, 0.47 to 1.78, 95% [CI], p = 0.8 and for UC vs tocilizumab 1.13, 0.55 to 2.30; p = 0.7. There were non-significant trends favoring tocilizumab (and to limited degree anakinra) vs UC for some secondary outcomes. Safety profiles did not differ significantly. Conclusion: Premature closure of trial precludes firm conclusions. Anakinra or tocilizumab did not significantly shorten time to clinical recovery compared to usual care. (IMMCoVA, NCT04412291, EudraCT: 2020–00174824). [ABSTRACT FROM AUTHOR]

Published
2023
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18. Epidemiological and clinical characteristics of patients with monkeypox in the GeoSentinel Network: a cross-sectional study

Author

Angelo, Kristina M, primary, Smith, Teresa, additional, Camprubí-Ferrer, Daniel, additional, Balerdi-Sarasola, Leire, additional, Díaz Menéndez, Marta, additional, Servera-Negre, Guillermo, additional, Barkati, Sapha, additional, Duvignaud, Alexandre, additional, Huber, Kristina L B, additional, Chakravarti, Arpita, additional, Bottieau, Emmanuel, additional, Greenaway, Christina, additional, Grobusch, Martin P, additional, Mendes Pedro, Diogo, additional, Asgeirsson, Hilmir, additional, Popescu, Corneliu Petru, additional, Martin, Charlotte, additional, Licitra, Carmelo, additional, de Frey, Albie, additional, Schwartz, Eli, additional, Beadsworth, Michael, additional, Lloveras, Susana, additional, Larsen, Carsten S, additional, Guagliardo, Sarah Anne J, additional, Whitehill, Florence, additional, Huits, Ralph, additional, Hamer, Davidson H, additional, Kozarsky, Phyllis, additional, Libman, Michael, additional, Blumberg, Lucille, additional, Chaussade, Hélène, additional, Desclaux, Arnaud, additional, Florence, Eric, additional, Aysel Florescu, Simin, additional, Glans, Hedvig, additional, Glynn, Marielle, additional, Goorhuis, Abraham, additional, Klein, Marina, additional, Malvy, Denis, additional, McCollum, Andrea, additional, Muñoz, José, additional, Nguyen, Duc, additional, Quilter, Laura, additional, Rothe, Camilla, additional, Soentjens, Patrick, additional, Tumiotto, Camille, additional, and Vanhamel, Jef, additional

Published
2023
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19. Healthcare seeking during travel: an analysis by the GeoSentinel surveillance network of travel medicine providers

Author

Piyaphanee, Watcharapong, primary, Stoney, Rhett J, additional, Asgeirsson, Hilmir, additional, Appiah, Grace D, additional, Díaz-Menéndez, Marta, additional, Barnett, Elizabeth D, additional, Gautret, Philippe, additional, Libman, Michael, additional, Schlagenhauf, Patricia, additional, Leder, Karin, additional, Plewes, Katherine, additional, Grobusch, Martin P, additional, Huits, Ralph, additional, Mavunda, Kunjana, additional, Hamer, Davidson H, additional, and Chen, Lin H, additional

Published
2023
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20. Dengue outbreak among travellers returning from Cuba—GeoSentinel surveillance network, January–September 2022

Author

Díaz-Menéndez, Marta, primary, Angelo, Kristina M, additional, Miguel Buckley, Rosa, additional, Bottieau, Emmanuel, additional, Huits, Ralph, additional, Grobusch, Martin P, additional, Gobbi, Federico Giovanni, additional, Asgeirsson, Hilmir, additional, Duvignaud, Alexandre, additional, Norman, Francesca F, additional, Javelle, Emilie, additional, Epelboin, Loïc, additional, Rothe, Camilla, additional, Chappuis, Francois, additional, Martinez, Gabriela Equihua, additional, Popescu, Corneliu, additional, Camprubí-Ferrer, Daniel, additional, Molina, Israel, additional, Odolini, Silvia, additional, Barkati, Sapha, additional, Kuhn, Susan, additional, Vaughan, Stephen, additional, McCarthy, Anne, additional, Lago, Mar, additional, Libman, Michael D, additional, and Hamer, Davidson H, additional

Published
2022
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21. Area of exposure and treatment challenges of malaria in Eritrean migrants: a GeoSentinel analysis

Author

Schlagenhauf, Patricia, Grobusch, Martin P., Hamer, Davidson H., Asgeirsson, Hilmir, Jensenius, Mogens, Eperon, Gilles, Rothe, Camilla, Isenring, Egon, Fehr, Jan, Schwartz, Eli, Bottieau, Emmanuel, Barnett, Elizabeth D., McCarthy, Anne, Kelly, Paul, Schade Larsen, Carsten, van Genderen, Perry, Stauffer, William, Libman, Michael, and Gautret, Philippe

Published
2018
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22. Travel-Associated Zika Virus Disease Acquired in the Americas Through February 2016: A GeoSentinel Analysis

Author

Hamer, Davidson H., Barbre, Kira A., Chen, Lin H., Grobusch, Martin P., Schlagenhauf, Patricia, Goorhuis, Abraham, van Genderen, Perry J.J., Molina, Israel, Asgeirsson, Hilmir, Kozarsky, Phyllis E., Caumes, Eric, Hagmann, Stefan H., Mockenhaupt, Frank P., Eperon, Gilles, Barnett, Elizabeth D., Bottieau, Emmanuel, Boggild, Andrea K., Gautret, Philippe, Hynes, Noreen A., Kuhn, Susan, Lash, R. Ryan, Leder, Karin, Libman, Michael, Malvy, Denis J.M., Perret, Cecilia, Rothe, Camilla, Schwartz, Eli, Wilder-Smith, Annelies, Cetron, Martin S., and Esposito, Douglas H.

Published
2017

23. Travel-related infections presenting in Europe: A 20-year analysis of EuroTravNet surveillance data

Author

Grobusch, Martin P, Weld, Leisa, Goorhuis, Abraham, Hamer, Davidson H, Schunk, Mirjam, Jordan, Sabine, Mockenhaupt, Frank P, Chappuis, François, Asgeirsson, Hilmir, Caumes, Eric, Jensenius, Mogens, Van Genderen, Perry JJ, Castelli, Francesco, López-Velez, Rogelio, Field, Vanessa, Bottieau, Emmanuel, Molina, Israel, Rapp, Christophe, Ménendez, Marta Díaz, Gkrania-Klotsas, Effrossyni, Larsen, Carsten S, Malvy, Denis, Lalloo, David, Gobbi, Federico, Florescu, Simin A, Gautret, Philippe, Schlagenhauf, Patricia, For EuroTravNet, Gkrania-Klotsas, Effrossyni [0000-0002-0930-8330], and Apollo - University of Cambridge Repository

Subjects
Geosentinel, Eurotravnet, Infectious diseases, Sentinel surveillance, travel
Abstract

Funder: Centers for Disease Control and Prevention, BACKGROUND: Disease epidemiology of (re-)emerging infectious diseases is changing rapidly, rendering surveillance of travel-associated illness important. METHODS: We evaluated travel-related illness encountered at EuroTravNet clinics, the European surveillance sub-network of GeoSentinel, between March 1, 1998 and March 31, 2018. FINDINGS: 103,739 ill travellers were evaluated, including 11,239 (10.8%) migrants, 89,620 (86.4%) patients seen post-travel, and 2,880 (2.8%) during and after travel. Despite increasing numbers of patient encounters over 20 years, the regions of exposure by year of clinic visits have remained stable. In 5-year increments, greater proportions of patients were migrants or visiting friends and relatives (VFR); business travel-associated illness remained stable; tourism-related illness decreased. Falciparum malaria was amongst the most-frequently diagnosed illnesses with 5,254 cases (5.1% of all patients) and the most-frequent cause of death (risk ratio versus all other illnesses 2.5:1). Animal exposures requiring rabies post-exposure prophylaxis increased from 0.7% (1998-2002) to 3.6% (2013-2018). The proportion of patients with seasonal influenza increased from zero in 1998-2002 to 0.9% in 2013-2018. There were 44 cases of viral haemorrhagic fever, most during the past five years. Arboviral infection numbers increased significantly as did the range of presenting arboviral diseases, dengue and chikungunya diagnoses increased by 2.6% and 1%, respectively. INTERPRETATION: Travel medicine must adapt to serve the changing profile of travellers, with an increase in migrants and persons visiting relatives and friends and the strong emergence of vector-borne diseases, with potential for further local transmission in Europe. FUNDING: This project was supported by a cooperative agreement (U50CK00189) between the Centers for Disease Control and Prevention to the International Society of Travel Medicine (ISTM) and funding from the ISTM and the Public Health Agency of Canada.

Published
2022
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24. Comparison of Lung-Homing Receptor Expression and Activation Profiles on NK Cell and T Cell Subsets in COVID-19 and Influenza

Author

Brownlie, Demi, primary, Rødahl, Inga, additional, Varnaite, Renata, additional, Asgeirsson, Hilmir, additional, Glans, Hedvig, additional, Falck-Jones, Sara, additional, Vangeti, Sindhu, additional, Buggert, Marcus, additional, Ljunggren, Hans-Gustaf, additional, Michaëlsson, Jakob, additional, Gredmark-Russ, Sara, additional, Smed-Sörensen, Anna, additional, and Marquardt, Nicole, additional

Published
2022
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25. Acute hepatitis a in international Travelers: A GeoSentinel analysis, 2008–2020

Author

Balogun, Oluwafemi, primary, Brown, Ashley, additional, Angelo DO, Kristina M, additional, Hochberg, Natasha S, additional, Barnett, Elizabeth D, additional, Nicolini, Laura Ambra, additional, Asgeirsson, Hilmir, additional, Grobusch, Martin P, additional, Leder, Karin, additional, Salvador, Fernando, additional, Chen, Lin, additional, Odolini, Silvia, additional, Díaz-Menéndez, Marta, additional, Gobbi, Federico, additional, Connor, Bradley A, additional, Libman, Michael, additional, and Hamer, Davidson H, additional

Published
2022
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26. Dengue outbreak amongst travellers returning from Cuba—GeoSentinel surveillance network, January–September 2022.

Author

Díaz-Menéndez, Marta, Angelo, Kristina M, Buckley, Rosa de Miguel, Bottieau, Emmanuel, Huits, Ralph, Grobusch, Martin P, Gobbi, Federico Giovanni, Asgeirsson, Hilmir, Duvignaud, Alexandre, Norman, Francesca F, Javelle, Emilie, Epelboin, Loïc, Rothe, Camilla, Chappuis, Francois, Martinez, Gabriela Equihua, Popescu, Corneliu, Camprubí-Ferrer, Daniel, Molina, Israel, Odolini, Silvia, and Barkati, Sapha

Subjects
DENGUE, DENGUE viruses, VIRUS diseases, TRAVELERS
Abstract

Increasing numbers of travellers returning from Cuba with dengue virus infection were reported to the GeoSentinel Network from June to September 2022, reflecting an ongoing local outbreak. This report demonstrates the importance of travellers as sentinels of arboviral outbreaks and highlights the need for early identification of travel-related dengue. [ABSTRACT FROM AUTHOR]

Published
2023
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27. Association between administration of IL-6 antagonists and mortality among patients hospitalized for COVID-19 : a meta-analysis

Author

The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group, [missing], Domingo, Pere, Mur, Isabel, Mateo, Gracia María, Gutierrez, Maria del Mar, Pomar, Virginia, de Benito, Natividad, Corbacho, Noemí, Herrera, Silvia, Millan, Lucia, Muñoz, Jessica, Malouf, Jorge, Molas, Maria Ema, Asensi, Victor, Horcajada, Juan Pablo, Estrada, Vicente, Gutierrez, Felix, Torres, Ferran, Perez-Molina, Jose A, Fortun, Jesús, Villar, Luisa M, Hohenthal, Ulla, Marttila, Harri, Vuorinen, Tytti, Nordberg, Marika, Valtonen, Mika, Frigault, Matthew J, Mansour, Michael K, Patel, Naomi J, Fernandes, Ana, Harvey, Liam, Foulkes, Andrea S, Healy, Brian C, Shah, Ruta, Bensaci, Ana Maria, Woolley, Ann E., Nikiforow, Sarah, Lin, Nina, Sagar, Manish, Shrager, Harry, Huckins, David S., Axelrod, Matthew, Pincus, Michael D, Fleisher, Jorge, Lampa, Jon, Nowak, Piotr, Vesterbacka, Jan C., Rasmuson, Johan, Skorup, Paul, Janols, Helena, Niward, Katarina F, Chatzidionysiou, Katerina, Asgeirsson, Hilmir, Parke, Åsa, Blennow, Ola, Svensson, Anna-Karin, Aleman, Soo, Sönnerborg, Anders, Henter, Jan-Inge, Horne, Anna Carin, Al-Beidh, Farah, Angus, Derek, Annane, Djillali, Arabi, Yaseen, Beane, Abigail, Berry, Scott, Bhimani, Zahra, Bonten, Marc, Bradbury, Charlotte, Brunkhorst, Frank, Buxton, Meredith, Cheng, Allen, Cove, Matt, De Jong, Menno, Derde, Lennie, Estcourt, Lise, Goossens, Herman, Gordon, Anthony, Green, Cameron, Haniffa, Rashan, Ichihara, Nao, Lamontagne, Francois, Lawler, Patrick, Litton, Ed, Marshall, John, McArthur, Colin, McAuley, Daniel, McGuinness, Shay, McVerry, Bryan, Montgommery, Stephanie, Mouncey, Paul, Murthy, Srinivas, Nichol, Alistair, Parke, Rachael, Parker, Jane, Reyes, Felipe, Rowan, Kathryn, Saito, Hiroki, Santos, Marlene, Seymour, Chris, Shankar-Hari, Manu, Turgeon, Alexis, Turner, Anne, van Bentum-Puijk, Wilma, van de Veerdonk, Frank, Webb, Steve, Zarychanski, Ryan, Baillie, J Kenneth, Beasley, Richard, Cooper, Nichola, Fowler, Robert, Galea, James, Hills, Thomas, King, Andrew, Morpeth, Susan, Netea, Mihai, Ogungbenro, Kayode, Pettila, Ville, Tong, Steve, Uyeki, Tim, Youngstein, Taryn, Higgins, Alisa, Lorenzi, Elizabeth, Berry, Lindsay, Salama, Carlos, Rosas, Ivan O., Ruiz-Antorán, Belén, Muñez Rubio, Elena, Ramos Martínez, Antonio, Campos Esteban, José, Avendaño Solá, Cristina, Pizov, Reuven, Sanz Sanz, Jesus, Abad-Santos, Francisco, Bautista-Hernández, Azucena, García-Fraile, Lucio, Barrios, Ana, Gutiérrez Liarte, Ángela, Alonso Pérez, Tamara, Rodríguez-García, Sebastian C, Mejía-Abril, Gina, Prieto, Jose Carlos, Leon, Rafael, VEIGA, VIVIANE C., SCHEINBERG, PHILLIP, FARIAS, DANIELLE L.C., PRATS, JOÃO G., CAVALCANTI, ALEXANDRE B., MACHADO, FLAVIA R., ROSA, REGIS G., BERWANGER, OTÁVIO, AZEVEDO, LUCIANO C.P., LOPES, RENATO D., DOURADO, LETICIA K., CASTRO, CLAUDIO G., ZAMPIERI, FERNANDO G., AVEZUM, ALVARO, LISBOA, THIAGO C., ROJAS, SALOMÓN S.O., COELHO, JULIANA C., LEITE, RODRIGO T., CARVALHO, JULIO CESAR, ANDRADE, LUIS E.C., SANDES, ALEX R., PINTÃO, MARIA CAROLINA T., SANTOS, SUELI V., ALMEIDA, THIAGO M.L., COSTA, ANDRÉ N., GEBARA, OTAVIO C.E., FREITAS, FLAVIO G.R., PACHECO, EDUARDO S., MACHADO, DAVID J.B., MARTIN, JOSIANE, CONCEIÇÃO, FABIO G., SIQUEIRA, SUELLEN R.R., DAMIANI, LUCAS P., ISHIHARA, LUCIANA M., SCHNEIDER, DANIEL, DE SOUZA, DENISE, Hermine, Olivier, Mariette, Xavier, Tharaux, Pierre Louis, Resche Rigon, Matthieu, Porcher, Raphael, Ravaud, Philippe, Azoulay, Elie, Cadranel, Jacques, Emmerich, Joseph, Fartoukh, Muriel, Guidet, Bertrand, Humbert, Marc, Lacombe, Karine, Mahevas, Matthieu, Pene, Frédéric, Pourchet-Martinez, Valérie, Schlemmer, Frédéric, Tibi, Annick, Yazdanpanah, Yazdan, Dougados, Maxime, Bureau, Serge, Horby, Peter W, Landray, Martin J, Baillie, Kenneth J, Buch, Maya H, Chappell, Lucy C, Day, Jeremy N, Faust, Saul N, Haynes, Richard, Jaki, Thomas, Jeffery, Katie, Juszczak, Edmund, Lim, Wei Shen, Mafham, Marion, Montgomery, Alan, Mumford, Andrew, Thwaites, Guy, Kamarulzaman, Adeeba, Syed Omar, Sharifah Faridah, Ponnampalavanar, Sasheela, Raja Azwa, Raja Iskandar Syah, Wong, Pui Li, Kukreja, Anjanna, Ong, Hang Cheng, Sulaiman, Helmi, Basri, Sazali, Ng, Rong Xiang, Megat Johari, Bushra, Rajasuriar, Reena, Chong, Meng Li, Neelamegam, Malinee, Syed Mansor, Syed Mukhtar, Zulhaimi, Nurul Syuhada, Lee, Cheng Siang, Altice, Frederick, Price, Christina, Malinis, Maricar, Hasan, Mohd Shahnaz, Wong, Chee Kuan, Chidambaram, Suresh, Misnan, Nor Arisah, Mohd Thabit, Alif Adlan, Sim, Benedict, Bidin, Farah Nadiah, Mohd Abd Rahim, Mohd Abd Hafiz, Saravanamuttu, Sujana, Tuang, Wei Xuan, Mohamed Gani, Yasmin, Thangavelu, Suvintheran, Tay, Kim Heng, Ibrahim, Nur Munirah, Halid, Luqman Alhakim, Tan, Kok Tong, Mukri, Mohd Noor Azreet, Arip, Masita, Koh, Hui Moon, Syed Badaruddin, Syarifah Nurul Ain, Raja Sureja, Letchumi, Chun, Geok Ying, TORRE-CISNEROS, JULIAN, MERCHANTE, NICOLAS, LEON, RAFAEL, CARCEL, SHEILA, GARRIDO, JOSE CARLOS, Galun, Eitan, Soriano, Alex, Martínez, José Antonio, Castán, Clara, Paredes, Roger, Dalmau, David, Carbonell, Cristina, Espinosa, Gerard, Castro, Pedro, Muñóz, José, Almuedo, Alex, Prieto, Sergio, Pacheco, Iván, Ratain, Mark, Pisano, Jennifer, Strek, Mary, Adegunsoye, Ayodeji, Karrison, Theodore, Declercq, Jozefien, Van Damme, Karel, De Leeuw, Elisabeth, Bosteels, Cedric, Maes, Bastiaan, Vale, Claire L., Godolphin, Peter J., Fisher, David, Higgins, Julian P. T., Spiga, Francesca, Savovic, Jelena, Tierney, Jayne, Baron, Gabriel, Benbenishty, Julie S., Berry, Lindsay R., Broman, Niklas, Cavalcanti, Alexandre Biasi, Colman, Roos, De Buyser, Stefanie, Derde, Lennie P. G., Omar, Sharifah Faridah, Fernandez-Cruz, Ana, Feuth, Thijs, Garcia, Felipe, Garcia-Vicuna, Rosario, Gonzalez-Alvaro, Isidoro, Gordon, Anthony C., Horby, Peter W., Horick, Nora K., Kumar, Kuldeep, Lambrecht, Bart, Landray, Martin J., Leal, Lorna, Lederer, David J., Merchante, Nicolas, Mohan, Shalini V., Nivens, Michael C., Oksi, Jarmo, Perez-Molina, Jose A., Postma, Simone, Ramanan, Athimalaipet V., Reid, Pankti D., Rutgers, Abraham, Sancho-Lopez, Aranzazu, Seto, Todd B., Sivapalasingam, Sumathi, Soin, Arvinder Singh, Staplin, Natalie, Stone, John H., Strohbehn, Garth W., Sunden-Cullberg, Jonas, Torre-Cisneros, Julian, Tsai, Larry W., van Hoogstraten, Hubert, van Meerten, Tom, Veiga, Viviane Cordeiro, Westerweel, Peter E., Diaz, Janet V., Marshall, John C., Sterne, Jonathan A. C., Translational Immunology Groningen (TRIGR), Stem Cell Aging Leukemia and Lymphoma (SALL), World Health Organization, and Group, WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working

Subjects
Male, medicine.medical_specialty, Randomization, Secondary infection, Placebo, Antibodies, Monoclonal, Humanized, Internal medicine, Cause of Death, Medicine and Health Sciences, Medicine, Humans, Prospective Studies, Prospective cohort study, Glucocorticoids, METAANALYSIS, Cause of death, Aged, Randomized Controlled Trials as Topic, business.industry, Coinfection, Interleukin-6, COVID-19, Odds ratio, General Medicine, Middle Aged, Respiration, Artificial, COVID-19 Drug Treatment, Clinical trial, Hospitalization, Meta-analysis, Disease Progression, Drug Therapy, Combination, Female, business
Abstract

[Importance] Clinical trials assessing the efficacy of IL-6 antagonists in patients hospitalized for COVID-19 have variously reported benefit, no effect, and harm., [Objective] To estimate the association between administration of IL-6 antagonists compared with usual care or placebo and 28-day all-cause mortality and other outcomes., [Data Sources] Trials were identified through systematic searches of electronic databases between October 2020 and January 2021. Searches were not restricted by trial status or language. Additional trials were identified through contact with experts., [Study Selection] Eligible trials randomly assigned patients hospitalized for COVID-19 to a group in whom IL-6 antagonists were administered and to a group in whom neither IL-6 antagonists nor any other immunomodulators except corticosteroids were administered. Among 72 potentially eligible trials, 27 (37.5%) met study selection criteria., [Data Extraction and Synthesis] In this prospective meta-analysis, risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool. Inconsistency among trial results was assessed using the I2 statistic. The primary analysis was an inverse variance–weighted fixed-effects meta-analysis of odds ratios (ORs) for 28-day all-cause mortality., [Main Outcomes and Measures] The primary outcome measure was all-cause mortality at 28 days after randomization. There were 9 secondary outcomes including progression to invasive mechanical ventilation or death and risk of secondary infection by 28 days., [Results] A total of 10 930 patients (median age, 61 years [range of medians, 52-68 years]; 3560 [33%] were women) participating in 27 trials were included. By 28 days, there were 1407 deaths among 6449 patients randomized to IL-6 antagonists and 1158 deaths among 4481 patients randomized to usual care or placebo (summary OR, 0.86 [95% CI, 0.79-0.95]; P = .003 based on a fixed-effects meta-analysis). This corresponds to an absolute mortality risk of 22% for IL-6 antagonists compared with an assumed mortality risk of 25% for usual care or placebo. The corresponding summary ORs were 0.83 (95% CI, 0.74-0.92; P, [Conclusions and Relevance] In this prospective meta-analysis of clinical trials of patients hospitalized for COVID-19, administration of IL-6 antagonists, compared with usual care or placebo, was associated with lower 28-day all-cause mortality., [Trial Registration] PROSPERO Identifier: CRD42021230155., Funding for administrative and communications support was provided by the World Health Organization.

Published
2021

29. Multidrug-resistant tuberculosis imported into low-incidence countries—a GeoSentinel analysis, 2008–2020

Author

Eimer, Johannes, primary, Patimeteeporn, Calvin, additional, Jensenius, Mogens, additional, Gkrania-Klotsas, Effrossyni, additional, Duvignaud, Alexandre, additional, Barnett, Elizabeth D, additional, Hochberg, Natasha S, additional, Chen, Lin H, additional, Trigo-Esteban, Elena, additional, Gertler, Maximilian, additional, Greenaway, Christina, additional, Grobusch, Martin P, additional, Angelo, Kristina M, additional, Hamer, Davidson H, additional, Caumes, Eric, additional, and Asgeirsson, Hilmir, additional

Published
2021
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30. Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data

Author

Grobusch, Martin P., Weld, Leisa, Goorhuis, Abraham, Hamer, Davidson H., Schunk, Mirjam, Jordan, Sabine, Mockenhaupt, Frank P., Chappuis, François, Asgeirsson, Hilmir, Caumes, Eric, Jensenius, Mogens, van Genderen, Perry J.J., Castelli, Francesco, López-Velez, Rogelio, Field, Vanessa, Bottieau, Emmanuel, Molina, Israel, Rapp, Christophe, Ménendez, Marta Díaz, Gkrania-Klotsas, Effrossyni, Larsen, Carsten S., Malvy, Denis, Lalloo, David, Gobbi, Federico, Florescu, Simin A., Gautret, Philippe, Schlagenhauf, Patricia, Stijnis, Kees, van Vugt, Michèle, Rothe, Camilla, von Sonnenburg, Frank, Vinnemeier, Christof, Ramharter, Michael, Equihua Martinez, Gabriela, Gertler, Maximilian, Eperon, Gilles, Ursing, Johan, Glans, Hedvig, Hægeland, Arnhild, Joof, Mona, Stuij, Corine, Odolini, Silvia, Tomasoni, Lina, Chamorro, Sandra, Lankester, Ted, Salvador, Fernando, Serre-Delcor, Nuria, Ficko, Cécile, Trigo, Elena, Warne, Benjamin, Jespersen, Sanne, Weijse, Christian, Duvignaud, Alexandre, Pistone, Thierry, Beeching, Nicholas, Beadsworth, Mike, Rodari, Paola, Moro, Lucia, Popescu, Corneliu P., Zaharia, Mihaela F., Javelle, Emilie, Parola, Philippe, Weber, Rainer, and Schmid-Stoll, Sabine

Subjects
wa_108
Abstract

Background\ud Disease epidemiology of (re-)emerging infectious diseases is changing rapidly, rendering surveillance of travel-associated illness important.\ud \ud Methods\ud We evaluated travel-related illness encountered at EuroTravNet clinics, the European surveillance sub-network of GeoSentinel, between March 1, 1998 and March 31, 2018.\ud \ud Findings\ud 103,739 ill travellers were evaluated, including 11,239 (10.8%) migrants, 89,620 (86.4%) patients seen post-travel, and 2,880 (2.8%) during and after travel. Despite increasing numbers of patient encounters over 20 years, the regions of exposure by year of clinic visits have remained stable. In 5-year increments, greater proportions of patients were migrants or visiting friends and relatives (VFR); business travel-associated illness remained stable; tourism-related illness decreased. Falciparum malaria was amongst the most-frequently diagnosed illnesses with 5,254 cases (5.1% of all patients) and the most-frequent cause of death (risk ratio versus all other illnesses 2.5:1). Animal exposures requiring rabies post-exposure prophylaxis increased from 0.7% (1998-2002) to 3.6% (2013-2018). The proportion of patients with seasonal influenza increased from zero in 1998-2002 to 0.9% in 2013-2018. There were 44 cases of viral haemorrhagic fever, most during the past five years. Arboviral infection numbers increased significantly as did the range of presenting arboviral diseases, Dengue and chikungunya diagnoses increased by 2.6% and 1%, respectively.\ud \ud Interpretation\ud Travel medicine must adapt to serve the changing profile of travellers, with an increase in migrants and persons visiting relatives and friends and the strong emergence of vector-borne diseases, with potential for further local transmission in Europe.\ud \ud Funding\ud This project was supported by a cooperative agreement (U50CK00189) between the Centers for Disease Control and Prevention to the International Society of Travel Medicine (ISTM) and funding from the ISTM and the Public Health Agency of Canada.

Published
2020

31. Flera svenska fall av infektion med rävens dvärgbandmask [Echinococcus multilocularis infection - six cases during two years in Sweden]

Author

Bläckberg, Jonas, Asgeirsson, Hilmir, Glimåker, Kajsa, Lier, Tore, Sasor, Agata, Bläckberg, Jonas, Asgeirsson, Hilmir, Glimåker, Kajsa, Lier, Tore, and Sasor, Agata

Abstract

Alveolar echinococcosis (AE) caused by the fox tapeworm Echinococcus multilocularis is a zoonosis presenting with focal liver lesions and has a poor prognosis without treatment. The disease is common in Central and Eastern Europe but has been highly unusual in Sweden. A suspicion of AE usually arises through radiology and the diagnosis may be confirmed by histology and/or serological antibody detection. AE is treated with radical surgery in combination with anti-helminthic drug therapy. During the last two years six cases of AE have been diagnosed in Sweden. In no case was AE suspected clinically before biopsy. A heightened awareness of AE is needed among Swedish physicians, including radiologists, surgeons and pathologists., Echinococcus multilocularis (rävens dvärgbandmask) är en bandmask med livscykel hos räv och gnagare. Människan kan bli accidentell mellanvärd och då utveckla en levertumör (alveolär ekinokockos) med allvarlig prognos utan behandling. Från att mycket sällan ha diagnostiserats tidigare har under de senaste två åren sex fall av infektion med E multilocularis påvisats i Sverige. Leverförändringen misstolkas ofta radiologiskt såsom en malign tumör. Diagnosen ställs med hjälp av radiologi och serologi men kan bekräftas med histopatologi och PCR av vävnad. Behandlingen är kirurgisk och medikamentell.

Published
2020

32. Travel-related infections presenting in Europe: A 20-year analysis of EuroTravNet surveillance data

Author

Grobusch, Martin P., primary, Weld, Leisa, additional, Goorhuis, Abraham, additional, Hamer, Davidson H., additional, Schunk, Mirjam, additional, Jordan, Sabine, additional, Mockenhaupt, Frank P., additional, Chappuis, François, additional, Asgeirsson, Hilmir, additional, Caumes, Eric, additional, Jensenius, Mogens, additional, van Genderen, Perry J.J., additional, Castelli, Francesco, additional, López-Velez, Rogelio, additional, Field, Vanessa, additional, Bottieau, Emmanuel, additional, Molina, Israel, additional, Rapp, Christophe, additional, Ménendez, Marta Díaz, additional, Gkrania-Klotsas, Effrossyni, additional, Larsen, Carsten S., additional, Malvy, Denis, additional, Lalloo, David, additional, Gobbi, Federico, additional, Florescu, Simin A., additional, Gautret, Philippe, additional, and Schlagenhauf, Patricia, additional

Published
2021
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33. Distinct lung-homing receptor expression and activation profiles on NK cell and T cell subsets in COVID-19 and influenza

Author

Brownlie, Demi, primary, Rødahl, Inga, additional, Varnaite, Renata, additional, Asgeirsson, Hilmir, additional, Glans, Hedvig, additional, Falck-Jones, Sara, additional, Vangeti, Sindhu, additional, Buggert, Marcus, additional, Ljunggren, Hans-Gustaf, additional, Michaëlsson, Jakob, additional, Gredmark-Russ, Sara, additional, Smed-Sörensen, Anna, additional, and Marquardt, Nicole, additional

Published
2021
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34. Quinacrine Treatment of Nitroimidazole-Refractory Giardiasis.

Author

Ydsten, Karin A, Hellgren, Urban, and Asgeirsson, Hilmir

Subjects
ANTIPROTOZOAL agents, GIARDIASIS, RETROSPECTIVE studies, IMIDAZOLES, METRONIDAZOLE, ANTIMALARIALS
Abstract

Background: Limited evidence exists on efficacy and tolerability of quinacrine for nitroimidazole-refractory giardiasis.Methods: Nitroimidazole-refractory giardiasis cases, defined as microbiologically (microscopy and/or PCR) confirmed treatment failure after 2 courses, during 2008-2020, were retrospectively identified.Results: Of 87 patients, 54 (62%) had visited India. Quinacrine was used in 54 (62%); 51 received monotherapy and 3 combined with metronidazole. Only 3 had positive stool samples with persisting symptoms after quinacrine treatment (94% parasitological efficacy) and all were cured after a second treatment. One (1.9%) had mild adverse effects recorded.Conclusions: Quinacrine is an effective treatment for nitroimidazole-refractory giardiasis with good tolerability. [ABSTRACT FROM AUTHOR]

Published
2022
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35. Expansion of SARS-CoV-2–Specific Antibody-Secreting Cells and Generation of Neutralizing Antibodies in Hospitalized COVID-19 Patients

Author

Varnaitė, Renata, primary, García, Marina, additional, Glans, Hedvig, additional, Maleki, Kimia T., additional, Sandberg, John Tyler, additional, Tynell, Janne, additional, Christ, Wanda, additional, Lagerqvist, Nina, additional, Asgeirsson, Hilmir, additional, Ljunggren, Hans-Gustaf, additional, Ahlén, Gustaf, additional, Frelin, Lars, additional, Sällberg, Matti, additional, Blom, Kim, additional, Klingström, Jonas, additional, and Gredmark-Russ, Sara, additional

Published
2020
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36. Epidemiological and Clinical Characteristics of International Travelers with Enteric Fever and Antibiotic Resistance Profiles of Their Isolates: a GeoSentinel Analysis

Author

Hagmann, Stefan H. F., primary, Angelo, Kristina M., additional, Huits, Ralph, additional, Plewes, Katherine, additional, Eperon, Gilles, additional, Grobusch, Martin P., additional, McCarthy, Anne, additional, Libman, Michael, additional, Caumes, Eric, additional, Leung, Daniel T., additional, Asgeirsson, Hilmir, additional, Jensenius, Mogens, additional, Schwartz, Eli, additional, Sánchez-Montalvá, Adrian, additional, Kelly, Paul, additional, Pandey, Prativa, additional, Leder, Karin, additional, Bourque, Daniel L., additional, Yoshimura, Yukihiro, additional, Mockenhaupt, Frank P., additional, van Genderen, Perry J. J., additional, Odolini, Silvia, additional, Schlagenhauf, Patricia, additional, Connor, Bradley A., additional, and Hamer, Davidson H., additional

Published
2020
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37. Travel-related hepatitis E: a two-decade GeoSentinel analysis

Author

Nicolini, Laura Ambra P, primary, Stoney, Rhett J, additional, Della Vecchia, Andrea, additional, Grobusch, Martin, additional, Gautret, Philippe, additional, Angelo, Kristina M, additional, van Genderen, Perry J J, additional, Bottieau, Emmanuel, additional, Leder, Karin, additional, Asgeirsson, Hilmir, additional, Leung, Daniel T, additional, Connor, Bradley, additional, Pandey, Prativa, additional, Toscanini, Federica, additional, Gobbi, Federico, additional, Castelli, Francesco, additional, Bassetti, Matteo, additional, and Hamer, Davidson H, additional

Published
2020
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38. Chikungunya resurgence in the Maldives and risk for importation via tourists to Europe in 2019–2020: A GeoSentinel case series

Author

Dudouet, Pierre, primary, Gautret, Philippe, additional, Larsen, Carsten Schade, additional, Díaz-Menéndez, Marta, additional, Trigo, Elena, additional, von Sonnenburg, Frank, additional, Gobbi, Federico, additional, Grobusch, Martin P., additional, Malvy, Denis, additional, Field, Vanessa, additional, Asgeirsson, Hilmir, additional, Souto, Inés Oliveira, additional, Hamer, Davidson H., additional, Parola, Philippe, additional, and Javelle, Emilie, additional

Published
2020
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39. Cutaneous and mucocutaneous leishmaniasis in travellers and migrants: a 20-year GeoSentinel Surveillance Network analysis

Author

Boggild, Andrea K, Caumes, Eric, Grobusch, Martin P, Schwartz, Eli, Hynes, Noreen A, Libman, Michael, Connor, Bradley A, Chakrabarti, Sumontra, Parola, Philippe, Keystone, Jay S, Nash, Theodore, Showler, Adrienne J, Schunk, Mirjam, Asgeirsson, Hilmir, Hamer, Davidson H, Kain, Kevin C, Schlagenhauf, Patricia, University of Zurich, and Boggild, Andrea K

Subjects
610 Medicine & health, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), 2739 Public Health, Environmental and Occupational Health, 2725 Infectious Diseases
Published
2019
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40. Cutaneous and mucocutaneous leishmaniasis in travellers and migrants: a 20-year GeoSentinel Surveillance Network analysis

Author

Boggild, Andrea, Caumes, Eric, Grobusch, Martin, Schwartz, Eli, Hynes, Noreen, Libman, Michael, Connor, Bradley, Chakrabarti, Sumontra, Parola, Philippe, Keystone, Jay, Nash, Theodore, Showler, Adrienne, Schunk, Mirjam, Asgeirsson, Hilmir, Hamer, Davidson, Kain, Kevin, Von Sonnenburg, Frank, Rothe, Camilla, Jordan, Sabine, Vinnemeier, Christof, Yansouni, Cedric, McCarthy, Anne, Jensenius, Mogens, Goorhuis, Abraham, Coyle, Christina, Mockenhaupt, Frank, Harms-Zwingengerger, Gundel, Leung, Daniel, Benson, Scott, Gautret, Philippe, Javelle, Emilie, Chappuis, François, Rapp, Christophe, Ficko, Cécile, Van Genderen, Perry, Glans, Hedvig, Beadsworth, Michael, Beeching, Nicholas, Castelli, Francesco, Matteelli, Alberto, Plewes, Katherine, Mirzanejad, Yazdan, López-Vélez, Rogelio, Chamorro, Sandra, Waggoner, Jesse, Wu, Henry, Leder, Karin, Torresi, Joseph, Bottieau, Emmanuel, Huits, Ralph, Chen, Lin, Bourque, Daniel, Alpern, Jonathan, Stauffer, William, Cahill, John, Wyler, Ben, Haulman, Jean, Terry, Anne, Licitra, Carmelo, Taylor, Ashley, Perret Perez, Cecilia, Weitzel, Thomas, Gkrania-Klotsas, Effrossyni, Warne, Ben, Schlagenhauf, Patricia, Weber, Rainer, Schade Larsen, Carsten, Wejse, Christian, Barnett, Elizabeth, Hochberg, Natasha, Barkati, Sapha, Vincelette, Jean, Molina, Israel, Malvy, Denis, Duvignaud, Alexandre, Mendelson, Marc, Parker, Salim, Johnston, Victoria, Field, Vanessa, Kuhn, Susan, Piyaphanee, Watcharapong, Silachamroon, Udomsak, Diaz-Menendez, Marta, Kelly, Paul, Blumberg, Lucille, de Frey, Albie, Pandey, Prativa, Amatya, Bhawana, Mavunda, Kunjana, Saio, Mauro, CHU Pitié-Salpêtrière [APHP], Department of Infectious Diseases [Amsterdam, Netherlands] (Academic Medical Center), University of Amsterdam [Amsterdam] (UvA)-Center for Tropical and Travel Medicine [Amsterdam, Netherlands], Laboratoire de Photophysique et Photochimie Supramoléculaires et Macromoléculaires (PPSM), École normale supérieure - Cachan (ENS Cachan)-Centre National de la Recherche Scientifique (CNRS), Centre for Tropical Diseases [Montréal] (TDC), McGill University, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Department of Tropical Medicine and Infectious Diseases, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany, Bernhard-Nocht-Institute for Tropical Medicine, Tropical Disease Unit [Toronto, Canada], University of Toronto, Hôpital d'Instruction des Armées Laveran, Service de Santé des Armées, Geneva University Hospitals - HUG [Switzerland], Hôpital d'Instruction des Armées Begin, Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia, Monash University [Clayton], Addenbrooke's Hospital, Cambridge University NHS Trust, Service de médecine interne et maladies infectieuses, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Université Paris Descartes - Paris 5 (UPD5), University of Cape Town, National Institute for Communicable Diseases (NICD), CIWEC Clinic Travel Medicine Center, Katmandu, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), École normale supérieure - Cachan (ENS Cachan)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), McGill University = Université McGill [Montréal, Canada], Bernhard Nocht Institute for Tropical Medicine - Bernhard-Nocht-Institut für Tropenmedizin [Hamburg, Germany] (BNITM), National Institute for Communicable Diseases [Johannesburg] (NICD), Infectious diseases, AII - Infectious diseases, APH - Aging & Later Life, APH - Global Health, and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)

Subjects
Leishmaniasis, Mucocutaneous, Male, Immigration, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Epidemiology, Species identification, 030212 general & internal medicine, Political instability, Child, ComputingMilieux_MISCELLANEOUS, media_common, Aged, 80 and over, Transients and Migrants, Cutaneous leishmaniasis, Geosentinel, Mucosal leishmaniasis, Skin lesions after travel, Tegumentary leishmaniasis, Vector-borne disease, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, General Medicine, Middle Aged, 3. Good health, Child, Preschool, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, Original Article, Travel-Related Illness, Adult, Costa Rica, Bolivia, Canada, medicine.medical_specialty, Adolescent, media_common.quotation_subject, 030231 tropical medicine, Young Adult, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine, Leishmania (Viannia) braziliensis, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Aged, Syria, business.industry, Afghanistan, Infant, Leishmaniasis, Mucocutaneous leishmaniasis, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, business, Demography
Abstract

Background Cutaneous leishmaniasis (CL) may be emerging among international travellers and migrants. Limited data exist on mucocutaneous leishmaniasis (MCL) in travellers. We describe the epidemiology of travel-associated CL and MCL among international travellers and immigrants over a 20-year period through descriptive analysis of GeoSentinel data. Methods Demographic and travel-related data on returned international travellers diagnosed with CL or MCL at a GeoSentinel Surveillance Network site between 1 September 1997 and 31 August 2017 were analysed. Results A total of 955 returned travellers or migrants were diagnosed with travel-acquired CL (n = 916) or MCL during the study period, of whom 10% (n = 97) were migrants. For the 858 non-migrant travellers, common source countries were Bolivia (n = 156, 18.2%) and Costa Rica (n = 97, 11.3%), while for migrants, they were Syria (n = 34, 35%) and Afghanistan (n = 22, 22.7%). A total of 99 travellers (10%) acquired their disease on trips of ≤ 2 weeks. Of 274 cases for which species identification was available, Leishmania Viannia braziliensis was the most well-represented strain (n = 117, 42.7%), followed by L. major (n = 40, 14.6%) and L. V. panamensis (n = 38, 13.9%). Forty cases of MCL occurred, most commonly in tourists (n = 29, 72.5%) and from Bolivia (n = 18, 45%). A total of 10% of MCL cases were acquired in the Old World. Conclusions Among GeoSentinel reporting sites, CL is predominantly a disease of tourists travelling mostly to countries in Central and South America such as Bolivia where risk of acquiring L. V. braziliensis and subsequent MCL is high. The finding that some travellers acquired leishmaniasis on trips of short duration challenges the common notion that CL is a disease of prolonged travel. Migrants from areas of conflict and political instability, such as Afghanistan and Syria, were well represented, suggesting that as mass migration of refugees continues, CL will be increasingly encountered in intake countries.

Published
2019
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41. International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study

Author

Gautret, Philippe, Angelo, Kristina M, Asgeirsson, Hilmir, Duvignaud, Alexandre, van Genderen, Perry J J, Bottieau, Emmanuel, Chen, Lin H, Parker, Salim, Connor, Bradley A, Barnett, Elizabeth D, Libman, Michael, Hamer, Davidson H, Schlagenhauf, Patricia, University of Zurich, and Gautret, Philippe

Subjects
610 Medicine & health, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), 2739 Public Health, Environmental and Occupational Health, 2725 Infectious Diseases
Published
2019

43. Two Cases of Borrelia miyamotoi Meningitis, Sweden, 2018

Author

Jonsson Henningsson, Anna, Asgeirsson, Hilmir, Hammas, Berit, Karlsson, Elias, Parke, Asa, Hoornstra, Dieuwertje, Wilhelmsson, Peter, Hovius, Joppe W., Jonsson Henningsson, Anna, Asgeirsson, Hilmir, Hammas, Berit, Karlsson, Elias, Parke, Asa, Hoornstra, Dieuwertje, Wilhelmsson, Peter, and Hovius, Joppe W.

Abstract

We report 2 human cases of Borrelia miyamotoi disease diagnosed in Sweden, including 1 case of meningitis in an apparently immunocompetent patient. The diagnoses were confirmed by 3 different independent PCR assays and DNA sequencing from cerebrospinal fluid, supplemented by serologic analyses., Funding Agencies|EU Interreg V program as part of the project ScandTick Innovation [20200422, 2015-000167]; ZonMW as part of the project "Ticking on Pandoras Box, a study into tick-borne pathogens in Europe" [50-52200-98-313]

Published
2019
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44. MOESM2 of Area of exposure and treatment challenges of malaria in Eritrean migrants: a GeoSentinel analysis

Author

Schlagenhauf, Patricia, Grobusch, Martin, Hamer, Davidson, Asgeirsson, Hilmir, Jensenius, Mogens, Eperon, Gilles, Rothe, Camilla, Isenring, Egon, Fehr, Jan, Schwartz, Eli, Bottieau, Emmanuel, Barnett, Elizabeth, McCarthy, Anne, Kelly, Paul, Larsen, Carsten Schade, Genderen, Perry, Stauffer, William, Libman, Michael, and Gautret, Philippe

Abstract

Additional file 2. Availability of primaquine and G6PDH deficiency testing at GeoSentinel sites.

Published
2018
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45. International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study

Author

Gautret, Philippe, primary, Angelo, Kristina M., additional, Asgeirsson, Hilmir, additional, Duvignaud, Alexandre, additional, van Genderen, Perry J.J., additional, Bottieau, Emmanuel, additional, Chen, Lin H., additional, Parker, Salim, additional, Connor, Bradley A., additional, Barnett, Elizabeth D., additional, Libman, Michael, additional, and Hamer, Davidson H., additional

Published
2019
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46. Increased risk of chikungunya infection in travellers to Thailand during ongoing outbreak in tourist areas: cases imported to Europe and the Middle East, early 2019

Author

Javelle, Emilie, primary, Florescu, Simin-Aysel, additional, Asgeirsson, Hilmir, additional, Jmor, Shilan, additional, Eperon, Gilles, additional, Leshem, Eyal, additional, Blum, Johannes, additional, Molina, Israel, additional, Field, Vanessa, additional, Pietroski, Nancy, additional, Eldin, Carole, additional, Johnston, Victoria, additional, Cotar, Ioana Ani, additional, Popescu, Corneliu, additional, Hamer, Davidson H, additional, and Gautret, Philippe, additional

Published
2019
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47. Rabies post-exposure prophylaxis started during or after travel: A GeoSentinel analysis

Author

Gautret, Philippe, Angelo, Kristina M, Asgeirsson, Hilmir, Lalloo, David G, Shaw, Marc, Schwartz, Eli, Libman, Michael, Kain, Kevin C, Piyaphanee, Watcharapong, Murphy, Holly, Leder, Karin, Vincelette, Jean, Jensenius, Mogens, Waggoner, Jesse, Leung, Daniel, Borwein, Sarah, Blumberg, Lucille, Schlagenhauf, Patricia, Barnett, Elizabeth D, Hamer, Davidson H, Gautret, Philippe, Angelo, Kristina M, Asgeirsson, Hilmir, Lalloo, David G, Shaw, Marc, Schwartz, Eli, Libman, Michael, Kain, Kevin C, Piyaphanee, Watcharapong, Murphy, Holly, Leder, Karin, Vincelette, Jean, Jensenius, Mogens, Waggoner, Jesse, Leung, Daniel, Borwein, Sarah, Blumberg, Lucille, Schlagenhauf, Patricia, Barnett, Elizabeth D, and Hamer, Davidson H

Abstract

BACKGROUND Recent studies demonstrate that rabies post-exposure prophylaxis (RPEP) in international travelers is suboptimal, with only 5-20% of travelers receiving rabies immune globulin (RIG) in the country of exposure when indicated. We hypothesized that travelers may not be receiving RIG appropriately, and practices may vary between countries. We aim to describe the characteristics of travelers who received RIG and/or RPEP during travel. METHODOLOGY/PRINCIPAL FINDINGS We conducted a multi-center review of international travelers exposed to potentially rabid animals, collecting information on RPEP administration. Travelers who started RPEP before (Group A) and at (Group B) presentation to a GeoSentinel clinic during September 2014-July 2017 were included. We included 920 travelers who started RPEP. About two-thirds of Group A travelers with an indication for rabies immunoglobulin (RIG) did not receive it. Travelers exposed in Indonesia were less likely to receive RIG in the country of exposure (relative risk: 0.30; 95% confidence interval: 0.12-0.73; P = 0.01). Travelers exposed in Thailand [Relative risk (RR) 1.38, 95% Confidence Interval (95% CI): 1.0-1.8; P = 0.02], Sri Lanka (RR 3.99, 95% CI: 3.99-11.9; P = 0.013), and the Philippines (RR 19.95, 95% CI: 2.5-157.2; P = 0.01), were more likely to receive RIG in the country of exposure. CONCLUSIONS/SIGNIFICANCE This analysis highlights gaps in early delivery of RIG to travelers and identifies specific countries where travelers may be more or less likely to receive RIG. More detailed country-level information helps inform risk education of international travelers regarding appropriate rabies prevention.

Published
2018

48. Area of exposure and treatment challenges of malaria in Eritrean migrants: a GeoSentinel analysis

Author

Schlagenhauf, Patricia; https://orcid.org/0000-0002-1075-7010, Grobusch, Martin P, Hamer, Davidson H, Asgeirsson, Hilmir, Jensenius, Mogens, Eperon, Gilles, Rothe, Camilla, Isenring, Egon, Fehr, Jan, Schwartz, Eli, Bottieau, Emmanuel, Barnett, Elizabeth D, McCarthy, Anne, Kelly, Paul, Schade Larsen, Carsten, van Genderen, Perry, Stauffer, William, Libman, Michael, Gautret, Philippe, Schlagenhauf, Patricia; https://orcid.org/0000-0002-1075-7010, Grobusch, Martin P, Hamer, Davidson H, Asgeirsson, Hilmir, Jensenius, Mogens, Eperon, Gilles, Rothe, Camilla, Isenring, Egon, Fehr, Jan, Schwartz, Eli, Bottieau, Emmanuel, Barnett, Elizabeth D, McCarthy, Anne, Kelly, Paul, Schade Larsen, Carsten, van Genderen, Perry, Stauffer, William, Libman, Michael, and Gautret, Philippe

Abstract

BACKGROUND Recent reports highlight malaria as a frequent diagnosis in migrants who originate from Eritrea. A descriptive analysis of GeoSentinel cases of malaria in Eritrean migrants was done together with a literature review to elucidate key attributes of malaria in this group with a focus on possible areas of acquisition of malaria and treatment challenges. RESULTS A total of 146 cases were identified from the GeoSentinel database from 1999 through September 2017, with a marked increase in 2014 and 2015. All patients originated from Eritrea and the main reporting GeoSentinel sites were in Norway, Switzerland, Sweden, Israel and Germany. The majority of patients (young adult males) were diagnosed with malaria following arrival in the host country. All patients had a possible exposure in Eritrea, but may have been exposed in documented transit countries including Ethiopia, Sudan and possibly Libya in detention centres. Most infections were due to Plasmodium vivax (84.2%), followed by Plasmodium falciparum (8.2%). Two patients were pregnant, and both had P. vivax malaria. Some 31% of the migrants reported having had malaria while in transit. The median time to onset of malaria symptoms post arrival in the host country was 39 days. Some 66% of patients were hospitalized and nine patients had severe malaria (according to WHO criteria), including five due to P. vivax. CONCLUSIONS The 146 cases of mainly late onset, sometimes severe, P. vivax malaria in Eritrean migrants described in this multi-site, global analysis reflect the findings of single-centre analyses identified in the literature search. Host countries receiving asylum-seekers from Eritrea need to be prepared for large surges in vivax and, to a lesser extent, falciparum malaria, and need to be aware and prepared for glucose-6-phosphate dehydrogenase deficiency testing and primaquine treatment, which is difficult to procure and mainly unlicensed in Europe. There is an urgent need to explore the molecular epide

Published
2018

49. Low mortality but increasing incidence of Staphylococcus aureus endocarditis in people who inject drugs

Author

Asgeirsson, Hilmir, Thalme, Anders, and Weiland, Ola

Subjects
Adult, Male, Staphylococcus aureus, Urban Population, Observational Study, intravenous drug abuse, Kaplan-Meier Estimate, Risk Assessment, Statistics, Nonparametric, Cohort Studies, Tertiary Care Centers, Age Distribution, Cause of Death, Prevalence, Humans, Hospital Mortality, Cardiac Surgical Procedures, Sex Distribution, Infusions, Intravenous, Substance Abuse, Intravenous, Retrospective Studies, Sweden, infective endocarditis, Endocarditis, Bacterial, Middle Aged, Staphylococcal Infections, mortality, Combined Modality Therapy, Anti-Bacterial Agents, Survival Rate, referral centre, incidence, Female, cardiac surgery, Research Article
Abstract

Staphylococcus aureus is a leading cause of infective endocarditis in people who inject drugs (PWID). The management of S aureus endocarditis (SAE) in PWID can be problematic. The objective of this retrospective observational study was to assess the epidemiology, clinical characteristics, and mortality of S aureus endocarditis (SAE) in PWID in Stockholm, Sweden. The Department of Infectious Diseases at the Karolinska University Hospital serves as a regional referral center for drug users with severe infections. Patients with active intravenous drug use treated for SAE at the department between January 2004 and December 2013 were retrospectively identified. Clinical and microbiological data were obtained from medical records and the diagnosis verified according to the modified Duke criteria. In total, 120 SAE episodes related to intravenous drug use were identified. Its incidence in Stockholm was 0.76/100,000 adult person-years for the entire period, increasing from 0.52/100,000 person-years in 2004 to 2008 to 0.99 in 2009 to 2013 (P = 0.02). The SAE incidence among PWID specifically was 249 (range 153–649) /100,000 person-years. Forty-two (35%) episodes were left-sided, and multiple valves were involved in 26 (22%). Cardiac valve surgery was performed in 10 (8%) episodes, all left-sided. The in-hospital and 1-year mortality rates were 2.5% (3 deaths) and 8.0% (9 deaths), respectively. We noted a high and increasing incidence over time of SAE related to intravenous drug use in Stockholm. The increased incidence partly reflects a rising number of PWID during the study period. The low mortality noted, despite a substantial proportion with left-sided endocarditis, probably in part reflects the quality of care obtained at a large and specialized referral center for drug users with severe infections.

Published
2016

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