Human parasitism by the exotic tick Dermacentor variabilis (Parasitiformes: Ixodida) in Brazil: report of an imported case / Parasitismo humano pelo carrapato exótico Dermacentor variabilis (Parasitiformes: Ixodida) no Brasil: relato de um caso importado

Abstract In June 2012, a tick was found parasitizing a man in the city of São Paulo, who had recently returned from a visit to Pennsylvania, in the northeast of the United States. The tick was removed and sent to the São Paulo State Department of Health, where it was identified as a male of the species Dermacentor variabilis (Say, 1821), according to the literature and taxonomic keys. The tick was subjected to a PCR test to search for rickettsiae, but the result was negative. The fact that a human entered Brazilian territory unaware that he was parasitized by a hard tick not belonging to the national tick fauna is significant because of the possibility that an exotic species could be introduced and take hold in this country. Another major risk to public health is that this arthropod could be infected with the bacterium Rickettsia rickettsii, as this ectoparasite is the main vector of Spotted Fever on the East Coast of North America.

Resumo Em junho de 2012, foi enviado ao serviço da Secretaria de Estado da Saúde de São Paulo um carrapato que foi encontrado em parasitismo sobre um homem adulto na cidade de São Paulo, que havia chegado recentemente de uma viagem de turismo aos Estados Unidos, onde visitou o estado da Pensilvânia, situado na região Nordeste Americana. O carrapato foi identificado como um macho da espécie Dermacentor variabilis, (Say, 1821), de acordo com a literatura e chaves taxonômicas, sendo submetido ao teste da PCR para pesquisa de riquétsias, porém o resultado foi negativo. O fato de um ser humano ter cruzado a fronteira do Brasil, parasitado, sem o seu prévio conhecimento, por um carrapato duro, não pertencente à ixodofauna nacional, é de grande importância pela chance de introdução e estabelecimento no território brasileiro de uma espécie exótica. Outro grande risco para a saúde pública é que esse artrópode poderia estar infectado com a bactéria Rickettsia rickettsii, pois esse ectoparasito é o principal vetor da Febre Maculosa na costa Leste Norte Americana.

A flora da antiga capitania de Porto Seguro na viagem de Wied-Neuwied, 1815-1817: prática científica, inventário naturalista e colaboração indígena / The flora of the former Captaincy of Porto Seguro in the journey of Wied-Neuwied, 1815-1817: scientific practice, naturalistic inventory, and indigenous collaboration

Resumo O artigo revisita o relato da Viagem ao Brasil (1815-1817) de Maximiliano de Wied na perspectiva de valorizar as contribuições dos registros da expedição do príncipe naturalista para a história natural, especialmente no levantamento da flora do atual extremo sul da Bahia. A abordagem perpassa a análise das características gerais da produção científica no campo da história natural e dos relatos de viagens do século XIX, bem como do perfil biobibliográfico do viajante. O objetivo central é demonstrar como se deu a relação do naturalista com as populações indígenas na produção do seu inventário florístico, destacando a importância dos saberes e fazeres dos índios para o trabalho do naturalista europeu.

Abstract This article revisits Maximilian zu Wied's Viagem ao Brasil (1815-1817) in terms of the value of this naturalist prince's expedition records for natural history, especially the survey of flora in what is currently south Bahia. The general characteristics of scientific production in the field of natural history and nineteenth-century travel reports are analyzed, as well as the bibliographic profile of the traveler. The main objective is to demonstrate how the naturalist's relationship with indigenous peoples emerged in producing the flora inventory, highlighting the importance of indigenous knowledge and practices to the European naturalist's work.

Travelers' malaria-related knowledge, attitudes and behavior on the north coast of Peru / Conocimientos, actitudes y comportamientos de los viajeros en relación con la malaria en la costa norte de Perú

Introduction: An increase in interprovincial travel has been registered annually during the last decade on the north and northeast coast of Peru, resulting in the spread of vector-borne diseases such as malaria. Therefore, travelers using interprovincial transport should be informed about the impact of infectious diseases in endemic regions and be aware of the risk of acquiring a travel-related condition. Objective: Examine travelers' malaria-related knowledge, attitudes, and practices. Methods: A cross-sectional study was conducted from January to March 2019 of a random sample of individuals who attended bus stations classed as areas with a higher risk of malaria selected at random in Chiclayo, Peru. The study was conducted reliably through a survey consisting of 29 questions: 18 about knowledge and 11 about attitudes. Results: Of the 250 participants in the study, knowledge was found to be good in 29.13 percent, practices in 14.74 percent, and attitudes in 18.33 percent. People with a higher education degree had a better level of knowledge and attitudes. Also, 60 people were asked about their self-perception of knowledge about malaria and said their knowledge about the subject was adequate. Of the 190 who reported not having enough knowledge about malaria, 49.47 percent were interested in learning about malaria practices and 25.26 percent were interested in learning about treatment. Conclusions: Most of the knowledge, attitudes, and practices of people who travel to endemic areas are not adequate(AU)

Introducción: En la última década se ha registrado un incremento anual de los viajes interprovinciales en la costa norte y noreste de Perú, lo que ha provocado la propagación de enfermedades transmitidas por vectores, como es el caso de la malaria. Es por eso que los usuarios del transporte interprovincial deben estar informados sobre el impacto de las enfermedades infecciosas en las regiones endémicas y sobre el riesgo de adquirir una enfermedad relacionada con los viajes. Objetivo: Examinar los conocimientos, actitudes y prácticas de los viajeros en relación con la malaria. Métodos: En el período comprendido de enero a marzo de 2019, se realizó un estudio transversal de una muestra aleatoria de personas que visitaban estaciones de ómnibus clasificadas como áreas de alto riesgo de malaria, seleccionadas aleatoriamente en Chiclayo, Perú. El estudio se llevó a cabo mediante un procedimiento confiable basado en una encuesta de 29 preguntas: 18 sobre conocimientos y 11 sobre actitudes. Resultados: De los 250 participantes en el estudio, 29,13 por ciento mostraron buen dominio de los conocimientos, 14,74 por ciento de las prácticas y 18,33 por ciento de las actitudes. Los graduados de la educación superior tenían un mejor nivel de conocimientos y actitudes. Además, a 60 personas se les preguntó sobre la percepción que tenían acerca de sus propios conocimientos sobre la malaria, y respondieron que estos eran apropiados. De los 190 que declararon no tener suficientes conocimientos sobre la malaria, 49,47 por ciento mostraron interés en aprender sobre prácticas relacionadas con la enfermedad y 25,26 por ciento sobre el tratamiento de la misma. Conclusiones: La mayor parte de los conocimientos, actitudes y prácticas de las personas que viajan en regiones endémicas no es adecuada(AU)

Factores asociados a la diarrea del viajero en Quito, Provincia de Pichincha, Ecuador / Factors associated with traveler's diarrhea in Quito, Pichincha Province, Ecuador

La diarrea del viajero (DV) es la complejidad más común y su repercusión varía en función de muchas variables: edad, lugar de destino, estación del año, tipo de residencia, origen del viajero y, por supuesto, la dieta durante el viaje, en definición es la emisión de heces sueltas tres o más veces al día, se adquiere mayormente al consumir alimentos y bebidas contaminados con patógenos que ocasionen diarrea. A nivel mundial, las causas más comunes de DV son dos patotipos de Escherichia coli (enterotoxigénica y enteroagregativa) y Campylobacter, aunque existen variaciones significativas según el área geográfica visitada. Algunos autores han detectado la presencia de diarrea en más de la mitad de los viajeros a países en vías de desarrollo. Se realizó un estudio descriptivo de corte transversal en 15 hospitales centinelas de la zona 9 del Sistema de Vigilancia de la resistencia antimicrobiana, en la provincia de Pichincha Quito, Ecuador entre enero 2019 a enero 2020, con el objeto de caracterizar los eventos de DV. 517 registros, solo en 298 se asento la procedencia, pudiendo atribuirse a ese 42,34% la procedencia por nacionalidad, se estimó que 108 casos presentaron infección mixta de al menos una bacteria y otro tipo de agresor, lo que representa 36,24%, siendo el agente causal principalmente involucrado ETEC, seguida de E. coli H7:O157 (N=60)(AU)

Traveler's diarrhea (DV) is the most common complexity and its impact varies depending on many variables: age, place of destination, season of the year, type of residence, origin of the traveler and, of course, the diet during the trip, In definition, it is the emission of loose stools three or more times a day, it is acquired mostly by consuming food and beverages contaminated with pathogens that cause diarrhea. Worldwide, the most common causes of DV are two Escherichia coli pathotypes (enterotoxigenic and enteroaggregative) and Campylobacter, although there are significant variations depending on the geographic area visited. Some authors have detected the presence of diarrhea in more than half of the travelers to developing countries. A descriptive cross-sectional study was carried out in 15 sentinel hospitals in zone 9 of the Antimicrobial Resistance Surveillance System, in the province of Pichincha Quito, Ecuador between January 2019 and January 2020, in order to characterize VD events. 517 records, only in 298 the origin was established, and that 42.34% can be attributed the origin by nationality, it was estimated that 108 cases presented mixed infection of at least one bacterium and another type of aggressor, which represents 36.24% , the causative agent being mainly involved ETEC, followed by E. coli H7: O157 (N = 60). Likewise, ETEC is responsible for the greatest severity in clinical pictures, being responsible for 50.00% of the cases in this category(AU)

Progress of researches on traveler’s diarrhea caused by parasitic infections / 中国血吸虫病防治杂志

With the rapid development of global tourism, traveling gradually becomes an important part of daily lives, and travelers’health is paid more and more attention. Traveler’s diarrhea (TD) is one of the most common diseases among international or trans-regional travelers, which causes great disease and economic burdens. Currently, there is still a lack of systematic studies on the correlation between parasites and TD. The review mainly summarizes intestinal protozoa and helminth infections among patients with TD, so as to provide insights into the development of the control measures for parasitic diseases associated with TD and the prevention of risk factors before the journey to and during the journey of the areas endemic for parasitic diseases.

Características sociodemográficas y clínico-epidemiológicas de los pacientes adultos ingresados por diarrea del viajero en la Clínica Internacional Trinidad, 2015-2017 / Sociodemographic and clinical-epidemiological characteristics of patients admitted for traveler's diarrhea to Trinidad International Clinic, 2015-2017

Introducción: La diarrea del viajero es causa frecuente de hospitalización en turistas internacionales. Objetivo: Describir las características sociodemográficas y clínico-epidemiológicas de los pacientes adultos ingresados por diarrea del viajero en la Clínica Internacional de Trinidad durante los años 2015 al 2017. Métodos: Estudio descriptivo de los 699 pacientes adultos con diarrea del viajero que requirieron de ingreso en el periodo de estudio. Se revisaron sus historias clínicas para analizar la frecuencia en que estuvieron presentes algunas variables sociodemográficas y clínico-epidemiológicas. Para analizar los datos se utilizó la estadística descriptiva con distribución de frecuencias y porcentajes. Resultados: El grupo etario entre 19 y 40 años tuvo un 60,52 por ciento de pacientes afectados; el 58,23 por ciento en el sexo femenino, con una incidencia mayor en los meses de julio (12,88 por ciento) y febrero (12,44 por ciento). Los viajeros procedentes de países europeos representaron el 76,97 por ciento ; el 74,96 por ciento se hospedó en casas particulares. El 1,85 por ciento de los afectados presentaba antecedentes de enfermedad gastrointestinal; el 76,11 por ciento requirió de 1 a 6 h de observación, con deshidratación leve (59,66 por ciento) y moderada (21,75 por ciento). El vómito y las náuseas se presentaron en el 58,37 por ciento de los pacientes y en el 60,73 por ciento la causa no fue precisada. Conclusiones: Las variables sociodemográficas y clínico-epidemiológicas seleccionadas permitieron describir características de los pacientes adultos ingresados por diarrea del viajero. Se recomienda profundizar en el estudio para contribuir a su prevención y optimizar la atención(AU)

Introduction: Traveler's diarrhea is a frequent cause of hospitalization of international tourists. Objective: Describe the sociodemographic and clinical-epidemiological characteristics of adult patients admitted for traveler's diarrhea to Trinidad International Clinic in the period 2015-2017. Methods: A descriptive study was conducted of the 699 adult patients with traveler's diarrhea who required hospitalization in the study period. The patients' medical records were reviewed to analyze the frequency of some sociodemographic and clinical-epidemiological variables. Data analysis was based on descriptive statistics with frequency and percentage distribution. Results: 60.52 percent of the patients affected were in the 19-40 years age group, 58.23 percent were female, and the highest incidence was observed in the months of July (12.88 percent) and February (12.4 4 percent ). Travelers from European countries represented 76.97 percent, and 74.96 percent were staying in private dwellings. Of the patients affected, 1.85 percent had a history of gastrointestinal disease; 76.11percent required 1-6 hours of observation; dehydration was mild in 59.66 percent and moderate in 21.75 percent. Vomiting and nausea were present in 58.37 percent of the patients; in 60.73 percent the cause was not determined. Conclusions: The sociodemographic and clinical-epidemiological variables selected made it possible to characterize the adult patients admitted for traveler's diarrhea. Further research is recommended to contribute to the prevention this disease. Further research is recommended to contribute to the prevention this disease and optimize care(AU)

A Case of Severe Falciparum Malaria in a Returned Traveler

@#Primary care providers should be alert to travel-related infections. Around 10-40% of returning travelers from all destinations and 15-70% of travelers from tropical settings experience ill health, either overseas or upon returning home.1 A systematic approach concentrating on possible infections should be undertaken based on the patient’s travel location, immunization history, presence of malaria chemoprophylaxis at the destination, other potential exposures, incubation period, and clinical presentation.2-3 The World Health Organization (WHO) website is constantly being updated on specific travel-related infections and recent geographical outbreaks. In this paper, we report a case of severe falciparum malaria in a returned traveler.

Problems for uninsured traveler in availing medical treatment: Case study of a person who suffered cerebral infarction / 国際保健医療

Background  The number of foreign tourists visiting Japan has increased to about 30 million people per year. 1.5% of them were injured or became sick during their travelin Japan and had to undergo medical treatment. Among the foreign tourists, 27% were not covered by travel health insurance.Case  A 40-year-old man from Southeast Asia who was visiting his relative in Japan experienced sudden hemiparesis and was diagnosed with cerebral infarction. During the initial treatment, it was found that the patient did not have health insurance and the relatives could not afford to pay the treatment costs. No other source of financial support was available to him During our consultations with the patient and his relatives about the medical treatment including medical expenses, he continued to be treated as an outpatient and it was aimed at an early return to his home country.Discussion  Foreigners, who are not covered under travel health insurance, could fall ill or sustain an injury during their stay in Japan. Appropriate medical care should be provided regardless of their ability to pay. However, a situation that could lead them to incur huge medical expenses from availing medical care should be avoided. For medical consultations of non-insured foreigners, it is better to consult the available systems and pay attention about feasible medical expenses. There is a need for a long-term vision of medical care to make a smooth transition from medical treatment in Japan to treatment in their home country.Conclusion  Although medical institutions can offer only a limited response, it is necessary to accumulate case examples from across the nation and prepare specific countermeasures and counselors.

PLECT: enfermedades tropicales de manifestación verrucosa / PLECT: tropical manifestation diseases verrucosa

Cada día es más habitual ver en nuestra consulta médica enfermedades dermatológicas endémicas de zonas tropicales, gracias a los flujos migratorios recientes y aumento del turismo hacia el extranjero. Presentamos un acrónimo muy utilizado en Brasil, PLECT, que reúne a enfermedades infecciosas que deben tenerse en mente en el diferencial de lesiones verrucosas, a saber, Paracoccidiodomicosis, Leishmaniasis Tegumentar, Esporotricosis, Cromomicosis y Tuberculosis Cutánea.

Increasingly, it is more common to see dermatological diseases that are endemic in tropical areas in our medical practice, thanks to recent migratory flows and increased tourism abroad. We present an acronym widely used in Brazil, PLECT, which brings together infectious diseases that should be borne in mind in the differential of verrucous lesions, namely, Paracoccidiodomicosis, Cutaneous Leishmaniasis, Sporotrichosis, Chromomycosis and Cutaneous Tuberculosis.

Development of Molecular Diagnosis Using Multiplex Real-Time PCR and T4 Phage Internal Control to Simultaneously Detect Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis from Human Stool Samples

This study aimed to develop a new multiplex real-time PCR detection method for 3 species of waterborne protozoan parasites (Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis) identified as major causes of traveler's diarrhea. Three target genes were specifically and simultaneously detected by the TaqMan probe method for multiple parasitic infection cases, including Cryptosporidium oocyst wall protein for C. parvum, glutamate dehydrogenase for G. lamblia, and internal transcribed spacer 1 for C. cayetanensis. Gene product 21 for bacteriophage T4 was used as an internal control DNA target for monitoring human stool DNA amplification. TaqMan probes were prepared using 4 fluorescent dyes, FAM™, HEX™, Cy5™, and CAL Fluor Red® 610 on C. parvum, G. lamblia, C. cayetanensis, and bacteriophage T4, respectively. We developed a novel primer-probe set for each parasite, a primer-probe cocktail (a mixture of primers and probes for the parasites and the internal control) for multiplex real-time PCR analysis, and a protocol for this detection method. Multiplex real-time PCR with the primer-probe cocktail successfully and specifically detected the target genes of C. parvum, G. lamblia, and C. cayetanensis in the mixed spiked human stool sample. The limit of detection for our assay was 2×10 copies for C. parvum and for C. cayetanensis, while it was 2×10³ copies for G. lamblia. We propose that the multiplex real-time PCR detection method developed here is a useful method for simultaneously diagnosing the most common causative protozoa in traveler's diarrhea.

An Overview of Fish-borne Nematodiases among Returned Travelers for Recent 25 Years– Unexpected Diseases Sometimes Far Away from the Origin

Along with globalization of traveling and trading, fish-borne nematodiases seems to be increasing in number. However, apart from occasional and sporadic case reports or mini-reviews of particular diseases in particular countries, an overview of fish-borne nematodiasis among travelers have never been performed. In this review, we gathered fish-borne nematodiasis among travelers for recent 25 years by an extensive global literature survey using appropriate keywords, e.g. travelers diseases, human infection, anisakiasis, gnathostomiasis, capillariasis, sushi, sashimi, ceviche, Gnathostoma, Pseudoterranova, Anisakis, Capillaria, etc., as well as various combinations of these key words. The Internet search engines PubMed, Medline, Google and Googler Scholar were used as much as possible, and the references of every paper were checked in order to identify useful and reliable publications. The results showed unexpectedly high incidence of gnathostomiasis and low incidence of anisakidosis. The different incidence values of the infection with several fish-borne zoonotic nematode species are discussed, as well as some epidemiological aspects of the infections. The difficulties of differential diagnosis in non-endemic countries are emphasized. It is concluded that travelers must avoid risky behaviors which can lead to infection and that physicians and health authorities must advice travelers on the risks of eating behaviors during travel.

Epidemiology of vaccine-preventable diseases in Japan: considerations for pre-travel advice for the 2019 Rugby World Cup and 2020 Summer Olympic and Paralympic Games

Introduction@#In 2019 and 2020, Japan will host two international sporting events estimated to draw a combined 22 million visitors. Mass gatherings like these ones increase the risk of spread of infectious disease outbreaks and international transmission. Pre-travel advice reduces that risk. @*Methods@#To assist ministries of health and related organizations in developing pre-travel advice, we summarized national surveillance data in Japan (2000–2016, to the extent available) for rubella, invasive pneumococcal disease, measles, non-A and non-E viral hepatitis, hepatitis A, invasive Haemophilus influenzae disease, tetanus, typhoid fever, invasive meningococcal disease, Japanese encephalitis, influenza, varicella, mumps and pertussis by calculating descriptive statistics of reported cases and reviewing trends. (See Annex A for details of reviewed diseases.)@*Results@#Our findings showed notable incidences of rubella (1.78 per 100 000 person-years), influenza (243.5 cases per sentinel site), and mumps (40.1 per sentinel site); seasonal increases for influenza (November–May) and Japanese encephalitis (August–November); and a geographical concentration of Japanese encephalitis in western Japan. Measles cases decreased from 11 013 in 2008 to 35 in 2015, but outbreaks (n = 165 cases) associated with importation occurred in 2016. Though invasive meningococcal disease incidence was only 0.03 per 100 000, international transmission occurred at a mass gathering in Japan in 2015.@*Discussion@#Ministries of health and related organizations should use these findings to develop targeted pre-travel advice for travellers to the 2019 Rugby World Cup and the 2020 Summer Olympic and Paralympic Games, especially for mumps, measles, rubella, influenza, and meningitis. Travellers with increased exposure risk should also be advised about hepatitis A and Japanese encephalitis.

Miasis foruncular por Dermatobia Hominis: un diagnóstico emergente en Chile / Foruncular myiasis due to Dermatobia Hominis: a diagnosis emerging in Chile

Las lesiones cutáneas son causa frecuente de consulta en viajeros siendo las picaduras de insectos unas de las más prevalentes. Damos a conocer un caso de paciente que presenta una lesión dolorosa en cuero cabelludo, tras viaje a la selva boliviana, refractario a tratamiento antibiótico empírico y con estudio complementario inconcluyente. Finalmente, se realizó estudio macroscópico de la costra, que determinó que se trataba de una larva de Dermatobia Hominis. Este caso demuestra la importancia de tomar en cuenta estos agentes no presentes en Chile y que son causantes de patologías dermatológicas del viajero.

Cutaneous lesions are frequent cause of consultation in travelers, being insect bites one of the most prevalent. We present a case of a patient with a painful lesion on the scalp, after a trip to the Bolivian jungle, refractory to empirical antibiotic treatment and with an inconclusive complementary study. Finally, macroscopic study of the crust was carried out, which determined that it was a larva of Dermatobia Hominis. This case demonstrates the importance of taking into account these agents not present in Chile and that are the cause of dermatological pathologies of the traveler.

A Case of Furuncular Myiasis Due to Cordylobia anthropophaga in a Korean Traveler Returning from Uganda

A fly larva was recovered from a boil-like lesion on the left leg of a 33-year-old male on 21 November 2016. He has worked in an endemic area of myiasis, Uganda, for 8 months and returned to Korea on 11 November 2016. The larva was identified as Cordylobia anthropophaga by morphological features, including the body shape, size, anterior end, posterior spiracles, and pattern of spines on the body. Subsequent 28S rRNA gene sequencing showed 99.9% similarity (916/917 bp) with the partial 28S rRNA gene of C. anthropophaga. This is the first imported case of furuncular myiasis caused by C. anthropophaga in a Korean overseas traveler.

Loiasis in a Japanese traveler returning from Central Africa

We encountered a probable case ofloiasis in a returned traveler from Central Africa. A 52-year-old Japanese womanpresented to our hospital complaining of discomfort in her eyes and skin. She reportedhaving frequently visited Central Africa over many years and having been extensivelyexposed to the rainforest climate and ecosystem. Although no microfilariae werefound in her blood, there was an elevated level of IgG antibodies against thecrude antigens of<i> Brugia pahangi</i>,which have cross-reactivity with <i>Loa loa</i>.She was treated with albendazole for 21 days, after which the antigen-specificIgG level decreased and no relapse occurred.

Loiasis in a Japanese Traveler Returning from Central Africa

We encountered a probable case of loiasis in a returned traveler from Central Africa. A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin. She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem. Although no microfilariae were found in her blood, there was an elevated level of IgG antibodies against the crude antigens of <i>Brugia pahangi</i>, which have cross-reactivity with <i>Loa loa</i>. She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred.

Health problems awareness during travel among faculty members of a large university in Latin America: preliminary report / Preocupação com problemas de saúde durante viagens em professores de uma grande universidade na América Latina: descrição preliminar

Health safety during trips is based on previous counseling, vaccination and prevention of infections, previous diseases or specific problems related to the destination. Our aim was to assess two aspects, incidence of health problems related to travel and the traveler's awareness of health safety. To this end we phone-interviewed faculty members of a large public University, randomly selected from humanities, engineering and health schools. Out of 520 attempts, we were able to contact 67 (12.9%) and 46 (68.6%) agreed to participate in the study. There was a large male proportion (37/44, 84.1%), mature adults mostly in their forties and fifties (32/44, 72.7%), all of them with higher education, as you would expect of faculty members. Most described themselves as being sedentary or as taking occasional exercise, with only 15.9% (7/44) taking regular exercise. Preexisting diseases were reported by 15 travelers. Most trips lasted usually one week or less. Duration of the travel was related to the destination, with (12h) or longer trips being taken by 68.2% (30/44) of travelers, and the others taking shorter (3h) domestic trips. Most travelling was made by air (41/44) and only 31.8% (14/44) of the trips were motivated by leisure. Field research trips were not reported. Specific health counseling previous to travel was reported only by two (4.5%). Twenty seven of them (61.4%) reported updated immunization, but 11/30 reported unchecked immunizations. 30% (9/30) reported travel without any health insurance coverage. As a whole group, 6 (13.6%) travelers reported at least one health problem attributed to the trip. All of them were males travelling abroad. Five presented respiratory infections, such as influenza and common cold, one neurological, one orthopedic, one social and one hypertension. There were no gender differences regarding age groups, destination, type of transport, previous health counseling, leisure travel motivation or pre-existing diseases. Interestingly, the two cases of previous health counseling were made by domestic travelers. Our data clearly shows that despite a significant number of travel related health problems, these highly educated faculty members, had a low awareness of those risks, and a significant number of travels are made without prior counseling or health insurance. A counseling program conducted by a tourism and health professional must be implemented for faculty members in order to increase the awareness of travel related health problems.

A segurança sanitária em viagens é baseada no aconselhamento, vacinação e orientação do viajante para a prevenção de doenças em viagens, genéricas ou específicas de seu destino. Visando avaliar a preocupação, providências preventivas e problemas relativos à saúde e à prevenção de doenças, entrevistamos professores universitários de uma grande universidade pública, distribuídos aleatoriamente entre as áreas de Exatas, Humanidades e da Saúde, selecionados por interesse e por relato de problemas de saúde em viagens no ano antecedente à pesquisa. Após amostragem e sorteio, foram tentadas 520 entrevistas por telefone, sendo encontrados 67 (12,9%) docentes e 46 (68,6%) concordaram com a entrevista, sendo que dois foram excluídos por ausência de viagem no ultimo ano. Esta amostragem tinha predominância de homens (37/44, 84,1%), entre os 40 e 50 anos de idade (32/44, 72,7%) todos com educação superior como esperado. A maioria era sedentária ou referia exercício ocasional, com apenas 15,9% (7/44) informando exercício regular. Doenças pré-existentes foram referidas por 15 viajantes. A maioria das viagens durou uma semana ou menos no destino. A duração da viagem estava relacionada ao destino sendo que viagens com mais de 12 h eram sempre relacionadas a destinos no exterior, 68,2% (30/44) das viagens, sendo mais rápidas (< 3h ) as viagens domésticas. A maioria das viagens foi aérea (41/44) e o lazer motivou 31,8% (14/44) delas. Aconselhamento de saúde anterior à viagem foi descrito apenas por 2 (4,5%) e a maioria (61,4% ou 27/44) referia vacinação embora 11/30 apenas descrevia vacinação não atualizada. 30% (9/30) viajaram sem nenhum tipo de seguro de saúde. Como um grupo total, seis homens (13,6%) viajando ao exterior apresentaram pelo menos um problema de saúde atribuído à viagem. Cinco apresentaram problemas respiratórios, como influenza ou resfriado, sendo que ocorreram problemas neurológicos, ortopédicos, de hipertensão em viajantes isolados, com um caso de problema de crime. Não houve diferenças quanto ao gênero ou grupo etário, destinos ou tipo de transporte, aconselhamento prévio, motivação da viagem, ou doenças preexistentes. É interessante notar que os dois aconselhamentos prévios foram feitos apenas para viagens de destinos nacionais. Nossos dados mostram que há problemas de saúde em viagens em um número significante de viajantes altamente educados, apesar da pequena amostra, e eles têm despreocupação com saúde, com número significante de viagens sem aconselhamento prévio ou seguro de saúde. Sugere-se a implantação de um programa de aconselhamento para segurança quanto aos problemas de saúde em viagens.

Vulnerabilidade e problemas de saúde em viagem: a visão do turista na cidade do Rio de Janeiro / /Vulnerability and health problems while traveling: the viewpoint of the tourist in the city of Rio de Janeiro

Este artigo analisa como um grupo de turistas compreende a questão da saúde em viagem segundo aspectos de segurança, prevenção e busca de atendimento de saúde. Foram entrevistados turistas brasileiros visitando a cidade do Rio de Janeiro e cariocas saindo de viagem. Os depoimentos foram analisados segundo as dimensões de vulnerabilidade; informação; prevenção e assistência em saúde, das quais a vulnerabilidade emergiu como categoria de análise. O relato das trajetórias dos turistas permitiu identificar nós e percursos que poderiam ser utilizados pelo setor saúde para ações de prevenção e promoção. O meio de transporte condiciona o trajeto dos turistas e suas alternativas de atenção. A viagem em grupo e para locais conhecidos foram destacadas como fatores de proteção, o que reforça o papel da informação e de redes de apoio social como recursos utilizados pelos turistas na ausência de políticas específicas voltadas para estes grupos populacionais de grande mobilidade e vulnerabilidade.

This article examines how a group of tourists perceives health issues related to safety, prevention and health care during their travels. Interviews were conducted with Brazilian tourists visiting the city of Rio de Janeiro, as well as local residents leaving the city on trips. The interviews were analyzed in accordance with the dimensions of vulnerability, information, prevention and health care, from which vulnerability emerged as a category of analysis. The reports of the trajectory of the tourists made it possible to identify problems and opportunities that could be used by the health sector for actions of prevention and promotion. The means of transport determines the trajectory of tourists and their security alternatives. Traveling in groups and visiting tourist attractions are seen as protective factors, which reinforces the role of information and social support networks as resources used by tourists in the absence of specific policies geared to this highly mobile and vulnerable population group.

First report of furuncular myiasis caused by the larva of botfly, Dermatobia hominis, in a Taiwanese traveler

A case of furuncular myiasis was reported for the first time in a 29-year-old young Taiwanese traveler returning from an ecotourism in Peru. Furuncle-like lesions were observed on the top of his head and he complained of crawling sensations within his scalp. The invasive larva of botfly, Dermatobia hominis, was extruded from the furuncular lesion of the patient. Awareness of cutaneous myiasis for clinicians should be considered for a patient who has a furuncular lesion and has recently returned from a botfly-endemic area.

First report of furuncular myiasis caused by the larva of botfly, Dermatobia hominis, in a Taiwanese traveler

A case of furuncular myiasis was reported for the first time in a 29-year-old young Taiwanese traveler returning from an ecotourism in Peru. Furuncle-like lesions were observed on the top of his head and he complained of crawling sensations within his scalp. The invasive larva of botfly, Dermatobia hominis, was extruded from the furuncular lesion of the patient. Awareness of cutaneous myiasis for clinicians should be considered for a patient who has a furuncular lesion and has recently returned from a botfly-endemic area.