Free living amoebae encephalitis infection in a child who travelled to Peru

Abstract

Background: The risk of meningococcal disease to travelers has been of increased interest in the past few decades due to the well-known risk in Hajj pilgrims following outbreaks of invasive disease caused by serogroup W-135. In addition, cases have been associated with air travel Currently, preventive vaccination against appropriate serogroups is recommended for travelers to regions with hyperendemic or epidemic disease such as the ‘‘meningitis belt’’ in Africa. Methods: As part of an ongoing project on the history of meningococcal disease in Novartis Vaccines and Diagnostics, we investigated the occurrence of invasive disease in travelers in historical documents and recent historical reviews gleaned from various sources, including Medline, Google, and Web of Science. Disease entities such as sinking typhus, cerebral typhus, spotted fever, cerebrospinal fever, epidemic cerebro-spinal meningitis, which have been strongly associated with meningococcal disease, were investigated. Results: Several case histories and historical events place meningococcal disease as a recognized risk of travel in the late nineteenth century, shortly after the first isolation of the bacterium. Dissemination across large distances was well-recognized by the beginning of the twentieth century, particularly among the military, in which small outbreaks were observed periodically. The first clear mention of the disease as associated with travel dates from 1898, when several authors describe outbreaks in ships carrying Indian laborers from Calcutta to East Africa and the West Indies (specifically Jamaica and the then British Guyana). Following the increased development of institutions of public health and epidemiology in the United States, an epidemic of meningococcal disease in Asia in 1928-1929 was tied to cases in the West Coast, carried by steerage passengers from the Philippines. In addition to new rules for steerage, the National Origins Formula of 1929 drastically restricted immigration and travel from Asia to the US. Conclusion: Literature about travel and meningococcal disease shows clear evidence of risks to travelers for at least 110 years. The long-standing nature of invasive meningococcal disease as a human-specific pathogen causing potentially fatal illness is of interest when investigating new options for prevention and control.