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Leishmaniasis acquired by travellers to endemic regions in Europe: a EuroTravNet multi-centre study.
Travel Med Infect Dis. 2014 Mar-Apr; 12(2):167-72.TM

Abstract

BACKGROUND

Leishmaniasis is a disease caused by protozoan parasites of the genus Leishmania. Clinical manifestations of leishmaniasis include cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL). About 90% of cases occur in the tropics or subtropics but the disease is also endemic in the Mediterranean area. No systematic analysis on leishmaniasis in travellers visiting endemic areas in Europe is available.

METHODS

Within the European travel medicine network EuroTravNet, we performed a retrospective analysis in travellers who acquired leishmaniasis within Europe diagnosed between 2000 and 2012.

RESULTS

Forty cases of leishmaniasis (30 CL and 10 VL) were identified; the majority were acquired in Spain (n = 20, 50%), Malta and Italy (each n = 7, 18%). Median age was 48 years (range 1-79). Three of eight (37.5%) of the VL patients were on immunosuppressive therapy. The most frequent reason for travel was tourism (83%). Median duration of travel for patients with CL and VL was 2 weeks with ranges of 1-21 weeks in CL and 1-67 weeks in VL, respectively (P = 0.03).

CONCLUSIONS

Health professionals should include leishmaniasis in the differential diagnosis in patients returning from southern Europe - including short-term travellers - with typical skin lesions or systemic alterations like fever, hepatosplenomegaly and pancytopenia.

Authors+Show Affiliations

Section Tropical Medicine, University Medical Center Hamburg-Eppendorf, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany.Department of Infectious Diseases and Tropical Medicine, Ludwig-Maximilians University of Munich, Leopoldstrasse 5, 80802 Munich, Germany.Department of Infectious Diseases, Oslo University Hospital and University of Oslo, Post Box 4956 Nydalen, NO-0424 Oslo, Norway.Institute for Tropical Diseases, Harbor Hospital, Haringvliet 72, 3011 TG Rotterdam, The Netherlands.Department of Infectious Diseases, Addenbrooke's Hospital, Cambridge, United Kingdom.Division of International and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland.Division of Epidemiology and Communicable Disease, Institute for Social and Preventive Medicine, World Health Organization Collaborating Centre for Travellers' Health, University of Zurich Centre for Travel Medicine, Hirschengraben 84, 8001 Zurich, Switzerland.University Division of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Carretera de Colmenar 9,1, 28034 Madrid, Spain.University Hospital Institute in Infectious Diseases, Tropical Medicine Unit, Aix-Marseille-Université and Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France.Section Tropical Medicine, University Medical Center Hamburg-Eppendorf, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany; Section Clinical Research, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany.Section Tropical Medicine, University Medical Center Hamburg-Eppendorf, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany; Section Clinical Research, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany. Electronic address: cramer@bni-hamburg.de.

Pub Type(s)

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

Language

eng

PubMed ID

24388687

Citation

Ehehalt, Urs, et al. "Leishmaniasis Acquired By Travellers to Endemic Regions in Europe: a EuroTravNet Multi-centre Study." Travel Medicine and Infectious Disease, vol. 12, no. 2, 2014, pp. 167-72.
Ehehalt U, Schunk M, Jensenius M, et al. Leishmaniasis acquired by travellers to endemic regions in Europe: a EuroTravNet multi-centre study. Travel Med Infect Dis. 2014;12(2):167-72.
Ehehalt, U., Schunk, M., Jensenius, M., van Genderen, P. J., Gkrania-Klotsas, E., Chappuis, F., Schlagenhauf, P., Castelli, F., Lopez-Velez, R., Parola, P., Burchard, G. D., & Cramer, J. P. (2014). Leishmaniasis acquired by travellers to endemic regions in Europe: a EuroTravNet multi-centre study. Travel Medicine and Infectious Disease, 12(2), 167-72. https://doi.org/10.1016/j.tmaid.2013.12.003
Ehehalt U, et al. Leishmaniasis Acquired By Travellers to Endemic Regions in Europe: a EuroTravNet Multi-centre Study. Travel Med Infect Dis. 2014 Mar-Apr;12(2):167-72. PubMed PMID: 24388687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Leishmaniasis acquired by travellers to endemic regions in Europe: a EuroTravNet multi-centre study. AU - Ehehalt,Urs, AU - Schunk,Mirjam, AU - Jensenius,Mogens, AU - van Genderen,Perry J J, AU - Gkrania-Klotsas,Effrossyni, AU - Chappuis,François, AU - Schlagenhauf,Patricia, AU - Castelli,Francesco, AU - Lopez-Velez,Rogelio, AU - Parola,Philippe, AU - Burchard,Gerd D, AU - Cramer,Jakob P, Y1 - 2013/12/19/ PY - 2013/10/01/received PY - 2013/12/02/revised PY - 2013/12/03/accepted PY - 2014/1/7/entrez PY - 2014/1/7/pubmed PY - 2014/12/19/medline KW - Cutaneous KW - Europe KW - Leishmaniasis KW - Traveller KW - Visceral SP - 167 EP - 72 JF - Travel medicine and infectious disease JO - Travel Med Infect Dis VL - 12 IS - 2 N2 - BACKGROUND: Leishmaniasis is a disease caused by protozoan parasites of the genus Leishmania. Clinical manifestations of leishmaniasis include cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL). About 90% of cases occur in the tropics or subtropics but the disease is also endemic in the Mediterranean area. No systematic analysis on leishmaniasis in travellers visiting endemic areas in Europe is available. METHODS: Within the European travel medicine network EuroTravNet, we performed a retrospective analysis in travellers who acquired leishmaniasis within Europe diagnosed between 2000 and 2012. RESULTS: Forty cases of leishmaniasis (30 CL and 10 VL) were identified; the majority were acquired in Spain (n = 20, 50%), Malta and Italy (each n = 7, 18%). Median age was 48 years (range 1-79). Three of eight (37.5%) of the VL patients were on immunosuppressive therapy. The most frequent reason for travel was tourism (83%). Median duration of travel for patients with CL and VL was 2 weeks with ranges of 1-21 weeks in CL and 1-67 weeks in VL, respectively (P = 0.03). CONCLUSIONS: Health professionals should include leishmaniasis in the differential diagnosis in patients returning from southern Europe - including short-term travellers - with typical skin lesions or systemic alterations like fever, hepatosplenomegaly and pancytopenia. SN - 1873-0442 UR - https://www.unboundmedicine.com/medline/citation/24388687/Leishmaniasis_acquired_by_travellers_to_endemic_regions_in_Europe:_a_EuroTravNet_multi_centre_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-8939(13)00217-2 DB - PRIME DP - Unbound Medicine ER -