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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.

Echinococcosis is a life-threatening neglected zoonotic disease. Cystic echinococcosis (CE) due to Echinococcus (E.) granulosus usually involves livestock and dogs, alveolar echinococcosis (AE) due to E. multilocularis involves rodents and canines such as foxes and dogs. Humans hosts are infected accidentally via hand to mouth and/or foodborne/waterborne pathways. Albania is deemed to be endemic for cystic echinococcosis (CE) but there is a scarcity of data to confirm this. A systematic literature search was performed in PubMed, Google Scholar and in other medical sources. Because of the scarcity of existing information data confirming CE cases were reviewed from the medical hospital records Albania`s largest Hospital, the Mother Teresa University Hospital (UHCMT) Tirana and from a large private laboratory in Tirana (Pegasus laboratory). Only 8 eligible publications on 540 CE patients were found. Further 347 cases hospitalized in UHCMT from 2011 to 2020, 36 laboratory cases and 10 Albanian cases notified in Germany were confirmed. Taking all cases into account and considering 162 overlapping cases, 771 cases are documented from 2005 to 2020. The only AE case reported was most likely a multi-organic CE. The most frequent therapy approach used was surgery (84.7%). Autochthonous human CE seems to be common and transmission is ongoing in Albanian. CE patients undergo surgery more frequently as compared with CE cases in other European countries. To enable the control of echinococcosis in Albania, obligatory notification should be re-established. In CE, stage specific therapy enables to reduce therapy cost and mortality by avoiding surgical overtreatment.

Therapy choices for cystic echinococcisis (CE) are stage-specific: surgical, minimally invasive, medical or observation without intervention. PAIR (percutaneous aspiration, instillation of a scolicide, and re-aspiration) has been considered the treatment of choice for uncomplicated echinococcal liver cysts. However, PAIR carries the risk of toxic cholangitis or hypernatremia and that the cyst frequently refills with bile after withdrawing the catheter. We treated a patient with a giant CE 1 liver cyst with puncture drainage (PD) under albendazole coverage. Drainage enabled us to monitor the morphology of protoscolices under praziquantel (PZQ) co-medication. Protoscolices degenerated within 5 days of PZQ 50 mg/kg/d. The cyst cavity solidified with no evidence of reactivation or secondary spread. Percutaneous treatments can replace surgery in a significant number or cases with hepatic CE. PD allows to assess microscopically the viability of protoscolices under co-medication with PZQ–albendazole and to avoid the instillation of topical scolicides.

PVL-positive S. aureus skin and soft tissue infections have a major impact on quality of life and mental health, often for months and beyond the period of infection. Pre-treating physicians were poorly informed about the PVL toxin. Increased awareness for early diagnosis and treatment of this yet neglected disease are required.

BackgroundBriefly before the first peak of the COVID-19 pandemic in Berlin, Germany, schools closed in mid-March 2020 for six weeks. Following re-opening, schools gradually resumed operation at a reduced level for nine weeks preceding the summer holidays.AimDuring this phase, we conducted a situational assessment in schools among students and teachers as to infection status, symptoms, affective, behavioural, educational issues, and preventive measures.MethodsAt twenty-four randomly selected primary and secondary schools, one class each was examined. Oro-nasopharyngeal swabs and capillary blood samples were collected to assess SARS-CoV-2 infection (PCR) and specific IgG (ELISA), respectively. Medical history, household and schooling characteristics, leisure time activities, fear of infection, risk perception, hand hygiene, physical distancing, and facemask wearing were assessed.ResultsAmong 535 participants (385 students, 150 staff), one teenager was SARS-CoV-2 infected (0.2%), and seven individuals exhibited specific IgG (1.3%); 16% reported symptoms upon examination, and 48% in the preceding 14 days. Compared to before the pandemic, the proportion of leisure time spent as screen-time increased, and the majority of primary school students reported reduced physical activity. Fear of infection and risk perception were relatively low, but acceptance of adapted health behaviours was high. Governmental preventive measures were adequately implemented, with primary schools performing better than secondary schools.ConclusionIn this phase of rare infection and low seroreactivity, individual and school-level infection prevention and control measures were largely adhered to. Nevertheless, vigilance, continued and proactive preventive measures, and well-rehearsed reaction options are essential to cope with increasing pandemic activity.

Background Living conditions in homeless shelters facilitate the transmission of COVID-19. Social determinants and pre-existing health conditions place homeless people at increased risk of severe disease. Described outbreaks in homeless shelters resulted in high proportions of infected residents and staff members. In addition to other infection prevention strategies, regular shelter-wide (universal) testing for COVID-19 may be valuable, depending on the level of community transmission and when resources permit. Methods This was a prospective feasibility cohort study to evaluate universal testing for COVID-19 at a homeless shelter with 106 beds in Berlin, Germany. Co-researchers were recruited from the shelter staff. A PCR analysis of saliva or self-collected nasal/oral swab was performed weekly over a period of 3 weeks in July 2020. Acceptability and implementation barriers were analyzed by process evaluation using mixed methods including evaluation sheets, focus group discussion and a structured questionnaire. Results Ninety-three out of 124 (75%) residents were approached to participate in the study. Fifty-one out of the 93 residents (54.8%) gave written informed consent; thus 41.1% (51 out of 124) of all residents were included in the study. Among these, high retention rates (88.9–93.6%) of a weekly respiratory specimen were reached, but repeated collection attempts, as well as assistance were required. Around 48 person-hours were necessary for the sample collection including the preparation of materials. A self-collected nasal/oral swab was considered easier and more hygienic to collect than a saliva specimen. No resident was tested positive by RT-PCR. Language barriers were the main reason for non-participation. Flexibility of sample collection schedules, the use of video and audio materials, and concise written information were the main recommendations of the co-researchers for future implementation. Conclusions Voluntary universal testing for COVID-19 is feasible in homeless shelters. Universal testing of high-risk facilities will require flexible approaches, considering the level of the community transmission, the available resources, and the local recommendations. Lack of human resources and laboratory capacity may be a major barrier for implementation of universal testing, requiring adapted approaches compared to standard individual testing. Assisted self-collection of specimens and barrier free communication may facilitate implementation in homeless shelters. Program planning must consider homeless people’s needs and life situation, and guarantee confidentiality and autonomy. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06945-4.

Background The Syrian conflict has led to a dramatic increase of Old World cutaneous leishmaniasis (CL), triggered by continuous population displacements, disrupted control programmes, poor shelter and sanitation. Methods A retrospective patient record study was conducted at the Institute of Tropical Medicine and International Health in Berlin. Records of all refugees from Syria treated for CL between January 2015 and March 2020 were reviewed. Results Twenty refugees from Syria were treated. Seventeen refugees (85%) had complex lesions, mainly due to previous therapy failure or localization on the face. A long disease duration (50% > 1 year), pronounced facial scarring (20%), recurrences (20%), or worsening of existing lesions (20%) were observed. Nine patients (45%) had been pretreated in Syria. Complete remission was achieved in 10 of 16 patients (63%) treated with perilesional antimony. Eight patients (40%) required systemic treatment, thereof four (20%) repeated systemic treatment. Eight patients (40%) reported a delay of therapy ≥3 months in Germany, thereof one patient with a delay of 12 months and one patient with a delay of 32 months. Conclusion Between 2015 and 2020, Syrian refugees presented with severe morbidities of CL frequently requiring systemic and even consecutive systemic treatments. We assume a combination of socioeconomic and environmental factors associated with the ongoing Syrian conflict and migration to be responsible for the complex clinical presentations in this case series. More attention should be drawn to the situation of Syrian refugees with CL in countries where they are displaced to.

Cystic echinococcosis (CE) is not covered by current refugee screening protocols. After we had detected CE among several refugees attending our clinic from Afghanistan and the Middle East, serological examinations for CE were performed for apparently healthy unaccompanied minor refugees from these regions.