Showing papers by "Ole Wichmann published in 2003"

Dengue - the underestimated risk in travellers.

Abstract: In recent decades, the incidence, distribution and clinical severity of dengue have increased dramatically in most tropical and subtropical areas worldwide. As a consequence, and due to the expanding international tourism, health care providers in European travel clinics are more and more confronted with dengue, reflecting its global impact. Based on data of the European Network on Imported Infectious Disease Surveillance (TropNetEurop) and the German Surveillance Network on Imported Infectious Diseases (SIMPID), a total of 483 confirmed and probable cases of dengue fever, including 13 cases of dengue haemorrhagic fever were reported to the networks’ coordination centre between January 1999 and December 2002. There was a wide range of epidemiological and clinical features. Non-European travellers (immigrants or foreign visitors) were at 4.3-times higher risk of developing dengue haemorrhagic fever compared to European travellers. Infections were acquired in all endemic regions of the world, with highest frequencies in South-East Asian countries. Persons travelling to areas where dengue is endemic should avoid exposure to mosquitoes, and health care providers should consider dengue as a differential diagnosis in febrile travellers returning from the tropics after discounting malaria. Surveillance of imported dengue is crucial to monitor the risk of infection for travellers and to strengthen clinical awareness of the disease.

Fatal malaria in a German couple returning from Burkina Faso.

Abstract: We report on a German couple found dead at home 7 days after returning from Burkina Faso Postmortem evaluation revealed Plasmodium falciparum infection with a parasitemia of approximately 80% in both cases No pathological findings of the organs were present at autopsy except moderate splenomegaly in both cases and myocarditis in one case Typical findings of fatal malaria like petechial hemorrhages of the brain or other organs, or sequestration of parasitized erythrocytes in venules and capillaries were absent Lack of sequestration with excessive hyperparasitemia leading to systemic hypoxemia and host cytokine release may have contributed to the rapid fatal course in these nonimmune patients

Molecular surveillance of the antifolate-resistant mutation I164L in imported african isolates of Plasmodium falciparum in Europe: sentinel data from TropNetEurop

Abstract: Malaria parasites that carry the DHFR-mutation I164L are not only highly resistant to sulfadoxine-pyrimethamine but also to the new antimalarial drug chlorproguanil-dapsone. The spread of this mutation in Africa would result in a public health disaster since there is a lack of effective alternatives that are both affordable and safe. Up to now, this mutation has only been described in Asian and Latin-American countries. The objective of this study was to assess the prevalence of this mutation in African isolates of Plasmodium falciparum that have been imported into Europe through travellers. TropNetEurop is a network for the surveillance of travel-associated diseases and seems to cover approximately 12% of all malaria cases imported into Europe. Within this network we screened 277 imported African isolates of P. falciparum with the help of PCR- and enzyme-digestion-methods for the antifolate-resistant mutation I164L. The I164L mutation was not detected in any of the isolates tested. Continuous molecular surveillance of mutations in P. falciparum, as it is practised within TropNetEurop, is an essential tool for the understanding and early detection of the spread of antimalarial drug resistance in Africa.