Dengue infection may be the most common infection other than malaria among travelers to tropical areas. This flavivirus infection is transmitted by mosquitoes. Although it often is asymptomatic, dengue infection can lead to leukopenia, thrombocytopenia, and even hemorrhagic complications and shock. This review summarizes the current approaches to establishing the diagnosis, managing the complications, and preventing this potentially dangerous infection.

Dengue in travelers

Geographic Expansion of Dengue: The Impact of International Travel

Dengue is a vector-borne disease recognized as the major arbovirose with four immunologically distant dengue serotypes coexisting in many endemic areas. Several mathematical models have been developed to understand the transmission dynamics of dengue, including the role of cross-reactive antibodies for the four different dengue serotypes. We aimed to review deterministic models of dengue transmission, in order to summarize the evolution of insights for, and provided by, such models, and to identify important characteristics for future model development. We identified relevant publications using PubMed and ISI Web of Knowledge, focusing on mathematical deterministic models of dengue transmission. Model assumptions were systematically extracted from each reviewed model structure, and were linked with their underlying epidemiological concepts. After defining common terms in vector-borne disease modelling, we generally categorised fourty-two published models of interest into single serotype and multiserotype models. The multi-serotype models assumed either vector-host or direct host-to-host transmission (ignoring the vector component). For each approach, we discussed the underlying structural and parameter assumptions, threshold behaviour and the projected impact of interventions. In view of the expected availability of dengue vaccines, modelling approaches will increasingly focus on the effectiveness and cost-effectiveness of vaccination options. For this purpose, the level of representation of the vector and host populations seems pivotal. Since vector-host transmission models would be required for projections of combined vaccination and vector control interventions, we advocate their use as most relevant to advice health policy in the future. The limited understanding of the factors which influence dengue transmission as well as limited data availability remain important concerns when applying dengue models to real-world decision problems.

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Dynamic epidemiological models for dengue transmission: a systematic review of structural approaches.

Update on the global spread of dengue.

A review of female genital schistosomiasis

Travelers have the potential both to acquire and to spread dengue virus infection. The incidence of dengue fever (DF) among European travelers certainly is underestimated, because few centers use standardized diagnostic procedures for febrile patients. In addition, DF is currently not reported in most European public health systems. Surveillance has commenced within the framework of a European Network on Imported Infectious Disease Surveillance (TropNetEurop) to gain information on the quantity and severity of cases of dengue imported into Europe. Descriptions of 294 patients with DF were analyzed for epidemiological information and clinical features. By far the most infections were imported from Asia, which suggests a high risk of DF for travelers to that region. Dengue hemorrhagic fever occurred in 7 patients (2.4%) all of whom recovered. Data reported by member sites of the TropNetEurop can contribute to understanding the epidemiology and clinical characteristics of imported DF.

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Epidemiology and Clinical Features of Imported Dengue Fever in Europe: Sentinel Surveillance Data from TropNetEurop

Background: Schistosomiasis is a major parasitic disease, increasingly imported into temperate climates by immigrants from and travelers to endemic areas. M e t h o d : To generate valid data on imported infectious diseases to Europe and to recognize trends over time, the Euro p e a n Network on Imported Infectious Diseases Surveillance (TropNetEurop) was founded in 1999. Three hundred and thirtythree reports of schistosomiasis were analyzed for epidemiologic and clinical features. R e s u l t s : Male patients accounted for 64% of all cases. The average age of all patients was 29.5 years. The majority of patients were of European origin (53%). Europeans traveled predominantly for tourism (52%). Main reasons for travel for people f rom endemic areas were immigration and refuge (51%) and visits to relatives and friends (28%). The majority of infections w e re acquired in Africa; 92 infections were clearly attributable to Schistosoma haematobium, 130 to Schistosoma mansoni, and 4 to Schistosoma intercalatum. Praziquantel was the only treatment used. No deaths were recorded. C o n c l u s i o n : Tro p N e t E u rop sentinel provides valuable epidemiologic and clinical data on imported schistosomiasis to Europe.

U. Bronner

Papers

Epidemiology and Clinical Features of Imported Dengue Fever in Europe: Sentinel Surveillance Data from TropNetEurop

Imported schistosomiasis in Europe: sentinel surveillance data from TropNetEurop.