Infectious diseases among travellers and migrants in Europe, EuroTravNet 2010.

To investigate trends in travel-associated morbidity with particular emphasis on emerging infections with the potential for introduction into Europe, diagnoses of 7,408 returning travellers presenting to 16 EuroTravNet sites in 2010 were compared with 2008 and 2009. A significant increase in reported Plasmodium falciparum malaria (n=361 (6% of all travel-related morbidity) vs. n=254 (4%) and 260 (5%); p<0.001), P. vivax malaria (n=51 (1%) vs. n=31 (0.5%) and 38 (1%); p=0.027) and dengue fever (n=299 (5%) vs. n=127 (2%) and 127 (2%); p<0.001) was observed. Giardia lamblia was identified in 16% of patients with acute diarrhoea, with no significant annual variation. The proportion of acute diarrhoea due to Campylobacter increased from 7% in 2008 to 12% in 2010 (p=0.001). We recorded 121 patients with pulmonary tuberculosis in 2010, a threefold increase in the proportionate morbidity from 2008 to 2010. In 2010, 60 (0.8%) cases of chronic Chagas disease, 151 (2%) cases of schistosomiasis and 112 (2%) cases of cutaneous larva migrans were reported. Illness patterns in sentinel travellers, captured by EuroTravnet, continue to highlight the potential role of travellers in the emergence of infectious diseases of public health concern in Europe and the relevance of offering medical travel advice and enforcing specific and adequate prophylaxis.

Follow-up clinic and ambulatory blood pressure in untreated white-coat hypertensive patients (evaluation after 2-5 years).

BACKGROUND: It is still under debate whether subjects with persistently elevated clinic blood pressure but normal ambulatory blood pressure, [white-coat hypertensives (WCH)] have a higher propensity for further development of ambulatory hypertension. METHODS: We prospectively evaluated for 3.5 years (from 26 up to 59 months) the transition of clinic and ambulatory blood pressure values in 36 untreated subjects (17-65 years) with WCH (clinic blood pressure > 140/90 and awake ambulatory blood pressure < 132/84 mmHg and without any other major cardiovascular risk factors) and of 52 clinic and ambulatory normotensive subjects (clinic blood pressure < 140/90 mmHg and awake blood pressure < 132/84 mmHg, 24-61 years). RESULTS: Average values of clinic blood pressure, 24 h blood pressure and awake blood pressure values did not differ from baseline to the end of the follow-up period in both populations. Development of ambulatory hypertension occurred in four out of 36 (11%) subjects with WCH and in three out of 52 (6%) normotensives if defined by awake blood pressure >/= 140/90 mmHg and in eight out of 36 (22%) subjects with WCH and in eight out of 52 (15%) normotensives if defined by awake blood pressure >/= 132/84 mmHg, respectively. Patients who reached ambulatory hypertension had baseline awake blood pressure values within the upper quintile of distribution of blood pressure in their respective group. CONCLUSION: After an average of 3.5 years of follow-up, a transition to ambulatory hypertension occurred in a similar way in normotensives and subjects with WCH without any other cardiovascular risk. A small propensity for the development of sustained hypertension may affect patients with higher initial ambulatory blood pressure values. Although a slow evolution towards sustained hypertension cannot be excluded in subjects with WCH, these findings suggest that this transition might be similar to that in normotensive subjects.