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Cutaneous larva migrans and tungiasis in international travelers exiting Brazil: an airport survey.
J Travel Med. 2007 Nov-Dec; 14(6):374-80.JT

Abstract

BACKGROUND

Hookworm-related cutaneous larva migrans (CLM) and tungiasis are commonly diagnosed in travelers returning from endemic areas, but reliable data on disease occurrence do not exist. To describe the occurrence of CLM and tungiasis in international travelers, a cross-sectional study was done.

METHOD

We conducted an airport survey in European travelers exiting northeast Brazil. Questionnaires were distributed at the departure gate of the international airport of Fortaleza (Ceará State) while passengers were waiting to board their plane. The questionnaire included questions on personal characteristics, pretravel health advice, acquired parasitic skin diseases during their stay in Brazil, and clinical characteristics of the infestation. To help identify CLM and tungiasis, photographs of the typical appearances of the infestations were presented.

RESULTS

Data from 372 tourists (aged 16-76 y, median = 40 y) were available for analysis; 45% had obtained pretravel health advice, usually from travel clinics (46.2%) and Internet sites (39.6%). Only 14% of those who obtained advice had been informed about CLM as a travel health risk and 22% about tungiasis. During their stay in Brazil, 12 (3.2%) tourists had experienced tungiasis and 3 (0.8%) CLM. In all cases, lesions were confined to the feet. The three travelers with CLM complained of irritability; itching was present in two cases. Pain (58.3%) and itching (50%) were the most common symptoms in travelers with tungiasis. The length of stay was a clear predictor for tungiasis, with a 20 times higher occurrence in travelers who had stayed for more than 4 weeks in Brazil.

CONCLUSIONS

Tungiasis and CLM are not rare in international tourists departing from Brazil, and pretravel counseling is insufficient. Pretravel health advice should include information on the risk of acquiring tungiasis and CLM and how to prevent an infestation. Airport surveys using questionnaires can be used to obtain incidence data on both parasitic infestations.

Authors+Show Affiliations

Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil. heukelbach@web.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17995532

Citation

Heukelbach, Jörg, et al. "Cutaneous Larva Migrans and Tungiasis in International Travelers Exiting Brazil: an Airport Survey." Journal of Travel Medicine, vol. 14, no. 6, 2007, pp. 374-80.
Heukelbach J, Gomide M, Araújo F, et al. Cutaneous larva migrans and tungiasis in international travelers exiting Brazil: an airport survey. J Travel Med. 2007;14(6):374-80.
Heukelbach, J., Gomide, M., Araújo, F., Pinto, N. S., Santana, R. D., Brito, J. R., & Feldmeier, H. (2007). Cutaneous larva migrans and tungiasis in international travelers exiting Brazil: an airport survey. Journal of Travel Medicine, 14(6), 374-80.
Heukelbach J, et al. Cutaneous Larva Migrans and Tungiasis in International Travelers Exiting Brazil: an Airport Survey. J Travel Med. 2007 Nov-Dec;14(6):374-80. PubMed PMID: 17995532.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cutaneous larva migrans and tungiasis in international travelers exiting Brazil: an airport survey. AU - Heukelbach,Jörg, AU - Gomide,Marcia, AU - Araújo,Francisco,Jr AU - Pinto,Nathalia S R, AU - Santana,Rafael D, AU - Brito,João R M, AU - Feldmeier,Hermann, PY - 2007/11/13/pubmed PY - 2008/2/22/medline PY - 2007/11/13/entrez SP - 374 EP - 80 JF - Journal of travel medicine JO - J Travel Med VL - 14 IS - 6 N2 - BACKGROUND: Hookworm-related cutaneous larva migrans (CLM) and tungiasis are commonly diagnosed in travelers returning from endemic areas, but reliable data on disease occurrence do not exist. To describe the occurrence of CLM and tungiasis in international travelers, a cross-sectional study was done. METHOD: We conducted an airport survey in European travelers exiting northeast Brazil. Questionnaires were distributed at the departure gate of the international airport of Fortaleza (Ceará State) while passengers were waiting to board their plane. The questionnaire included questions on personal characteristics, pretravel health advice, acquired parasitic skin diseases during their stay in Brazil, and clinical characteristics of the infestation. To help identify CLM and tungiasis, photographs of the typical appearances of the infestations were presented. RESULTS: Data from 372 tourists (aged 16-76 y, median = 40 y) were available for analysis; 45% had obtained pretravel health advice, usually from travel clinics (46.2%) and Internet sites (39.6%). Only 14% of those who obtained advice had been informed about CLM as a travel health risk and 22% about tungiasis. During their stay in Brazil, 12 (3.2%) tourists had experienced tungiasis and 3 (0.8%) CLM. In all cases, lesions were confined to the feet. The three travelers with CLM complained of irritability; itching was present in two cases. Pain (58.3%) and itching (50%) were the most common symptoms in travelers with tungiasis. The length of stay was a clear predictor for tungiasis, with a 20 times higher occurrence in travelers who had stayed for more than 4 weeks in Brazil. CONCLUSIONS: Tungiasis and CLM are not rare in international tourists departing from Brazil, and pretravel counseling is insufficient. Pretravel health advice should include information on the risk of acquiring tungiasis and CLM and how to prevent an infestation. Airport surveys using questionnaires can be used to obtain incidence data on both parasitic infestations. SN - 1195-1982 UR - https://www.unboundmedicine.com/medline/citation/17995532/Cutaneous_larva_migrans_and_tungiasis_in_international_travelers_exiting_Brazil:_an_airport_survey_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/j.1708-8305.2007.00156.x DB - PRIME DP - Unbound Medicine ER -