Intercontinental Travel Research Articles

Antimicrobial resistance genes acquisition among Dutch intercontinental travellers: a prospective multicentre study.

Antimicrobial resistance (AMR) is a significant global health threat. People often acquire AMR bacteria during travel and import them into their home countries. This large-scale cohort study among intercontinental travellers identified destination, diarrhoea, antibiotic use, and shellfish consumption during travel as significant risk factors for acquisition of various AMR genes.

Arthropod-Borne Viruses of Human and Animal Importance: Overwintering in Temperate Regions of Europe during an Era of Climate Change.

The past three decades have seen an increasing number of emerging arthropod-borne viruses in temperate regions This process is ongoing, driven by human activities such as inter-continental travel, combined with the parallel emergence of invasive arthropods and an underlying change in climate that can increase the risk of virus transmission and persistence. In addition, natural events such as bird migration can introduce viruses to new regions. Despite the apparent regularity of virus emergence, arthropod-borne viruses circulating in temperate regions face the challenge of the late autumn and winter months where the arthropod vector is inactive. Viruses therefore need mechanisms to overwinter or they will fail to establish in temperate zones. Prolonged survival of arthropod-borne viruses within the environment, outside of both vertebrate host and arthropod vector, is not thought to occur and therefore is unlikely to contribute to overwintering in temperate zones. One potential mechanism is continued infection of a vertebrate host. However, infection is generally acute, with the host either dying or producing an effective immune response that rapidly clears the virus. There are few exceptions to this, although prolonged infection associated with orbiviruses such as bluetongue virus occurs in certain mammals, and viraemic vertebrate hosts therefore can, in certain circumstances, provide a route for long-term viral persistence in the absence of active vectors. Alternatively, a virus can persist in the arthropod vector as a mechanism for overwintering. However, this is entirely dependent on the ecology of the vector itself and can be influenced by changes in the climate during the winter months. This review considers the mechanisms for virus overwintering in several key arthropod vectors in temperate areas. We also consider how this will be influenced in a warming climate.

Antimicrobial Resistance in Gonorrhea.

Antimicrobial resistance is a global public health emergency. The World Health Organization recently highlighted the growing number of new sexually transmitted infections such as gonorrhea, syphilis, and Chlamydia, which are resistant to common antibiotics. The phenomenon is also on the rise due to increasing intercontinental travel. Emerging antibiotic-resistant strains of gonorrhea are particularly associated with international spread from Southeast Asian travelers. Infection with Neisseria gonorrhoeae can cause a wide spectrum of associated diseases such as dermatitis, arthritis and septic arthritis, and pelvic inflammatory disease, and can even lead to serious health consequences for the individual. Natural infection confers no immunity, and vaccination is not available currently, although in several countries, it has been reported that the antimeningococcal vaccine may protect against gonorrhea. Implementing all necessary preventive measures is crucial, as well as appropriate and timely diagnostic methods and effective antimicrobial therapeutic treatments in the correct modalities to avoid the increase of forms of gonorrhea that are resistant to common antibiotics and difficult to eradicate.

Prevalence of infection with Dirofilaria immitis and Dirofilaria repens in dogs from the South-Eastern part of Romania

As a result of global warming, the change in the biological cycle of vectors and the increase in intercontinental travels, we are now facing an increase in the number of cases of vector-borne diseases. Among these, heartworm disease has escalated in recent years in Romania, with cases increasing in many parts of our country. Our study was carried out in the South-Eastern part of Romania, with the aim of establishing the prevalence of heartworm disease in dogs, with the identification of the two species Dirofilaria immitis and Dirofilaria repens. Blood samples were collected during the period May - July 2022 and January - July 2023, from 220 dogs with and without an owner from Tulcea county, from places such as Tulcea, Murighiol, Somova, Mineri, Niculițel. The blood samples were tested through the Knott method, which is considered as the reference method in the diagnosis of dirofilariosis in dogs. The results show a prevalence of Dirofilaria spp. infection of 11.36% in dogs. Of the 220 samples examined by the Knott test, 25 were positive for circulating microfilariae, of which 21 showed infestations with Dirofilaria immitis and 4 with co-infection with Dirofilaria immitis and Dirofilaria repens. The study underlines the importance of introducing monitoring and control programs for heartworm disease in dogs in Romania.

Post-infectious irritable bowel syndrome after intercontinental travel: a prospective multicentre study.

By longitudinally following a large cohort of intercontinental travellers, this study highlights the importance of considering multiple risk factors to comprehend post-infectious Irritable Bowel Syndrome (PI-IBS). Stomach cramps, antibiotic use and nausea during travel were among the variables that predicted PI-IBS development following an episode of traveller's diarrhoea.

Potential Impacts on Ozone and Climate From a Proposed Fleet of Supersonic Aircraft

AbstractThere has been renewed interest in developing commercial supersonic transport aircraft due to the increased overall demands by the public for air travel, the aspiration for more intercontinental travel, and the desire for shorter flight times. Various companies and academic institutions have been actively considering the designs of such supersonic aircraft. As these new designs are developed, the environmental impact on ozone and climate of these fleets need to be explored. This study examines one such proposed commercial supersonic fleet of 55‐seater that is projected to fly at Mach 2.2, corresponding to cruise altitudes of 17–20 km, and which would burn 122.32 Tg of fuel and emit 1.78 Tg of NOx each year. Our analyses indicate this proposed fleet would cause a 0.74% reduction in global column ozone (∼2 Dobson Units), which is mainly attributed to the large amounts of nitrogen oxides released in the atmosphere from the supersonic aircraft. The maximum ozone loss occurs at the tropics in the fall season, with a reduction of −1.4% in the total column ozone regionally. The stratospheric‐adjusted radiative forcing on climate from this fleet was derived based on changes in atmospheric concentrations of ozone (59.5 mW/m2), water vapor (10.1 mW/m2), black carbon (−3.9 mW/m2) and sulfate aerosols (−20.3 mW/m2), resulting in a net non‐CO2, non‐contrail forcing of 45.4 mW/m2, indicating an overall warming effect.

Subregional origins of emerging SARS-CoV-2 variants during the second pandemic wave in Côte d’Ivoire

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with increased transmissibility, virulence and immune escape abilities have heavily altered the COVID-19 pandemic’s course. Deciphering local and global transmission patterns of those variants is thus key in building a profound understanding of the virus’ spread around the globe. In the present study, we investigate SARS-CoV-2 variant epidemiology in Côte d’Ivoire, Western sub-Saharan Africa. We therefore generated 234 full SARS-CoV-2 genomes stemming from Central and Northern Côte d’Ivoire. Covering the first and second pandemic wave the country had been facing, we identified 20 viral lineages and showed that in Côte d’Ivoire the second pandemic wave in 2021 was driven by the spread of the Alpha (B.1.1.7) and Eta (B.1.525) variant. Our analyses are consistent with a limited number of international introductions of Alpha and Eta into Côte d’Ivoire, and those introduction events mostly stemmed from within the West African subregion. This suggests that subregional travel to Côte d’Ivoire had more impact on local pandemic waves than direct intercontinental travel.

Isolation of Methicillin-Resistant Staphylococcus aureus from Wound Samples during the COVID-19 Pandemic: A Retrospective Study

Introduction: On March 11th, 2020, the World Health Organisation (WHO) declared the outbreak of the novel coronavirus disease caused by the Severe Acute Respiratory Syndrome Corona Virus 2 (SARSCoV-2) virus as a pandemic. This recently discovered β-coronavirus spread instantaneously across mainland China due to human-tohuman transmission and crossed international borders aided by intercontinental travel. In most nations, the logarithmic growth of the cases very quickly overwhelmed the healthcare system which led to the overcrowding of the hospitals and led to a sudden surge in Hospital-Acquired Infections (HAIs). Implementation of contact precautions was implemented to control cross-infection. Aim: To determine the effect of Coronavirus Disease-2019 (COVID-19) on the prevalence of HAIs with special emphasis on Staphylococcus aureus (S. aureus). Materials and Methods: This three-year retrospective study (September 2018-August 2021) was undertaken at an apex tertiary care institute in Northern India. Wound swabs were collected and processed in the laboratory for the presence of aerobic bacterial isolates. S. aureus was identified using conventional methods and antimicrobial sensitivity was performed by the Kirby-Bauer disc diffusion method. Data was entered in Microsoft Excel and later analysed in International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 22.0. Results: A steady increase in the isolation of MethicillinResistant Staphylococcus aureus (MRSA) was noted during the study period (60.5% in 2018 to 78.1% in 2021). A statistically significant increase was noted in the detection of MRSA after the onset of the COVID-19 pandemic (p=0.018) despite the reduced number of surgeries conducted in the institution and rigorous execution of contact precautions. Conclusion: There was an increase in the rate of MRSA isolation during the study period. The increase was significantly affected by the onset of COVID-19. To contain the spread of MRSA, novel methods including preoperative screening of patients undergoing elective surgeries and periodic screening of hospital staff need to be implemented along with standard infection control precautions at all times.

Collateral effects of the COVID-19 pandemic on the practice of tropical and travel medicine

Undoubtedly, the COVID-19 pandemic has had impacts in many areas, including travel and by extension on daily practice in tropical and travel medicine. The intercontinental travelers in decline have been replaced by a new population of travelers who previously did not require specific consultations. SARS-CoV-2 has earned its place in the pre-travel consultation in view of the medical and administrative implications. Furthermore, the global health effects of the pandemic are broader than its direct medical consequences and should not be underestimated. The increase in malaria mortality worldwide is just one example. Preventive measures prior to exposure are more important than ever.

Climate irresponsibility on social media. A critical approach to “high-carbon visibility discourse”

ABSTRACT Human GHG emissions are entering networked everyday relations. On social media, users potentially “reveal” their carbon footprints when they post pictures of a beef-based dinner or intercontinental travel. As the increasing urgency of climate change coincides with people's increasingly online-oriented lifestyles, we suggest that social-media research should devote attention to the ways in which users overlook, hide, limit, or casually articulate their high-carbon oriented lifestyles in digital space. This would contribute important knowledge about the role of social-media communication concerning climate change as an individual responsibility, and requires a concentration on how status updates become loaded with ideological meaning (high-carbon visibility discourse). The purpose is to present a framework for critical analyses of visual disclosure of carbon footprints in social media use. Media theory, semiotics, network theory and critical theory are combined to theorize how users’ activities on social media become high-carbon oriented; their promotion of a business-as-usual stance; and how this operates ideologically through reification, legitimation and unification.

Investigating the possible origin and transmission routes of SARS-CoV-2 genomes and variants of concern in Bangladesh.

The COVID-19 pandemic induced by the SARS-CoV-2 virus and its variants has ravaged most countries around the world including Bangladesh. We have analyzed publicly available genomic data to understand the current COVID-19 outbreak scenario as well as the evolutionary origin and transmission routes of SARS-CoV-2 isolates in Bangladesh. All the early isolates as well as recent B.1.1.7 and B.1.351 variants had already spread across the major divisional cities of Bangladesh. A sex biasness towards male COVID-19 patient samples sequencing has been observed over female patient samples in all age-group, that could be the trend in infection rate. Phylogenetic analysis indicated a total of 13 estimated countries, including Italy, India, United Kingdom, Saudi Arabia, United Arab Emirates, Germany, Australia, New Zealand, South Africa, Democratic Republic of the Congo, United States, Russia, and Denmark, could be the possible origin introduced SARS-CoV-2 isolates in Bangladesh because of regional and intercontinental travel. Recent, B.1.1.7 variant could be imported from a total of 7 estimated countries including UK, India, Nigeria, Spain, Ireland, Australia, and Indonesia, while South Africa and the United States are the most likely sources of B.1.351 variant in Bangladesh. Based on these findings, public health strategies could be designed and implemented to reduce the local transmission of the virus.

Cutaneous leishmaniasis in Germany-still atravel-related disease

Cutaneous leishmaniasis is an infectious disease caused by several Leishmania species. It is transmitted to humans by the bite of the infected female phlebotomus sandfly. Today, more than 1billion people in leishmaniasis endemic areas are at risk of infection. More than 1.5million new cases of cutaneous leishmaniasis occur every year. On the basis of two cases, we show that cutaneous leishmaniasis is still an imported tropical disease in Germany. However, due to the increasing intercontinental travel, cases may increase. Therefore, cutaneous leishmaniasis should be considered in the differential diagnosis in patients with nonhealing wounds, ulcers, papules or nodules and the corresponding travel history.

The secret enemy during a flight: Economy class syndrome.

Deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) are the major causes of morbidity and mortality in immobile patients. There is observational evidence that intercontinental air travel is associated with a high incidence of DVT and PTE during or within 48 hours of long-distance flights. This situation is known as the economy class syndrome and can affect both the cabin crew and passengers. The term "economy class syndrome" refers to the occurrence of thrombotic events that mainly occur in passengers in the economy class of the aircraft during long-haul flights. This syndrome results from several factors related to the aircraft cabin and the passenger, acting together to predispose to excessive blood coagulation, which can result in venous thromboembolism. In this review, we have shared the relationship between air travel and the formation of DVT and PTE.

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3-5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant's success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes.

From Space Tourism to Commercial Suborbital Travel

After several announcements last years, the recent successful flights with Jeff Bezos and Richard Branson as passengers have brought the space tourism topic back at the top of news headlines. Indeed, several projects have undergone incremental and careful development steps last years to ensure a sufficient reliability of such flights with passengers on board. The perfect re-entry of both the New Shepard system of Blue Origin and the Unity system of Virgin Orbit in July 2021 are now opening the path for commercial space tourism flights, with several hundreds of candidates having paid either substantial advance payments or even the total ticket price and a rising demand after these demonstrations. This evolution can be compared with the first flights in the aeronautical field starting in 1919, when, at the end of WW1, experienced pilots and proven (ex-military) planes were used to carry air tourists at short turn-around flights. This rapidly evolved a few years later in regular commercial Point-to-Point air traffic, with the first air connection Paris London Paris. We can easily forecast a similar evolution in suborbital transport of cargo and passengers after the first wave of space tourism. Similar as with the first aviation tourism, where passengers got a first sensation of flying and were then brought back to the starting point after a few minutes, suborbital space experience will soon evolve in so called pointto-point suborbital flights, covering intercontinental travel in 60-80 minutes in one go, which now takes up more than 21 hours, like a trip London-Sydney with one stopover. This article will focus on the feasibility of such development, focusing in the first place on the potential business case and the economic rationale. It will be demonstrated that for ‘time-poor, cash-rich’ people such suborbital intercontinental travel will be a viable option and a potential market.

Transmission potential of Mayaro virus by Aedes albopictus, and\xa0Anopheles quadrimaculatus from the USA

BackgroundMayaro virus (MAYV; Alphavirus, Togaviridae) is an emerging pathogen endemic in South American countries. The increase in intercontinental travel and tourism-based forest excursions has resulted in an increase in MAYV spread, with imported cases observed in Europe and North America. Intriguingly, no local transmission of MAYV has been reported outside South America, despite the presence of potential vectors.MethodsWe assessed the vector competence of Aedes albopictus from New York and Anopheles quadrimaculatus for MAYV.ResultsThe results show that Ae. albopictus from New York and An. quadrimaculatus are competent vectors for MAYV. However, Ae. albopictus was more susceptible to infection. Transmission rates increased with time for both species, with rates of 37.16 and 64.44% for Ae. albopictus, and of 25.15 and 48.44% for An. quadrimaculatus, respectively, at 7 and 14 days post-infection.ConclusionsOur results suggest there is a risk of further MAYV spread throughout the Americas and autochthonous transmission in the USA. Preventive measures, such as mosquito surveillance of MAYV, will be essential for early detection.

A systematic review of worldwide data on tinea capitis: analysis of the last 20years.

Dermatophyte infections are the most common fungal infections in humans; among them, tinea capitis (TC) - the most contagious fungal infection - is caused by anthropophilic, zoophilic and geophilic dermatophytes. The purpose of this systematic review was to determine the different aetiological variants involved in TC and the overall epidemiology of the causes of this infection in the last two decades. We searched the MEDLINE (PubMed) and Embase databases for articles published from July 2000 to August 2019 using the following search terms: 'Tinea capitis', 'Africa', 'America', 'Asia', 'Europe', 'Oceania', and the names of the countries on each continent. The flow of information through the different phases in this systematic review was depicted using a PRISMA flow diagram, which mapped the number of records identified, included and excluded, and the reasons for exclusion. Our findings indicate that the frequency of different aetiologic agents of TC in the reported studies varied globally, from 0.4-87.7% in Africa, 0.2-74.0% in North America, 0.0-91.2% in Eastern Asia, 0.0-69.0% in Eastern Europe and 2.9-86.4% in Oceania. Microsporum canis is the most frequent reported zoophilic agent worldwide, while Trichophyton violaceum and Trichophyton tonsurans are the predominant anthropophilic agents. Over time, the frequency of these latter fungal infections has increased globally, and these fungi have become the major species globally. Anthropophilic transmission - the most prevalent type of transmission - could be explained by two factors: (i) the socioeconomic status of affected countries and population groups with associated risk factors and (ii) movement of populations importing new causes of infection to areas where they had not been encountered previously. We observed that intercontinental migration and travel; globalization; environmental, climatic and ecological changes; and accelerated evolution of health technologies may influence the observed epidemiological changes and, consequently, contributed to the variations in the global status of TC.

Language in Limbo: Being Suspended between Consolation and Control

ABSTRACT Forced by the COVID-19 pandemic into lockdown during intercontinental travels, the author finds herself in limbo. With help from literary precedents such as Dante, Boccaccio, and Defoe supported by a brief interrogation of contemporary utterances surrounding the master trope “virus,” she claims a chiasmic relation between the concepts “consolation” and “control.”

Imported infections of the central nervous system : Migration and travel neurology

The numbers of migrants, refugees and asylum seekers reached an unprecedented high in Europe in 2015 and 2016 but in 2019 they are back to the average numbers of the last 30 years. In contrast, frequencies of international and intercontinental travelers have continuously increased over the past decades and will continue to do so in the coming years. In 2018 more than 1.35 billion incoming travelers were reported worldwide by international organizations. Detailed knowledge of the epidemiology, transmission types, risk behavior and clinical presentation of acute and chronic central nervous system (CNS) infections enables timely diagnosis and initiation of potentially life-saving emergency treatment. Acute infections of the CNS, e.g. cerebral Plasmodium falciparum malaria or arboviral encephalitis, are seen most frequently and almost exclusively in travelers returning from tropical countries, whereas chronic CNS infections, e.g. tuberculous meningitis or neurocysticercosis, are typically seen in migrants and refugees. Beside CNS infections genetic diseases, environment-associated, nutrition-related, metabolic or cerebrovascular diseases also need to be considered when discussing differential diagnostic possibilities.

Smallpox in the Post-Eradication Era.

Widespread vaccination programmes led to the global eradication of smallpox, which was certified by the World Health Organisation (WHO), and, since 1978, there has been no case of smallpox anywhere in the world. However, the viable variola virus (VARV), the causative agent of smallpox, is still kept in two maximum security laboratories in Russia and the USA. Despite the eradication of the disease smallpox, clandestine stocks of VARV may exist. In a rapidly changing world, the impact of an intentional VARV release in the human population would nowadays result in a public health emergency of global concern: vaccination programmes were abolished, the percentage of immunosuppressed individuals in the human population is higher, and an increased intercontinental air travel allows for the rapid viral spread of diseases around the world. The WHO has authorised the temporary retention of VARV to enable essential research for public health benefit to take place. This work aims to develop diagnostic tests, antiviral drugs, and safer vaccines. Advances in synthetic biology have made it possible to produce infectious poxvirus particles from chemicals in vitro so that it is now possible to reconstruct VARV. The status of smallpox in the post-eradication era is reviewed.