Executive summary of imported infectious diseases after returning from foreign travel: Consensus document of the Spanish Society for Infectious Diseases and Clinical Microbiology (SEIMC) / Resumen ejecutivo de las enfermedades infecciosas importadas después de regresar de viajes en el extranjero: Documento de consenso de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica

In a global world, knowledge of imported infectious diseases is essential in daily practice, both for the microbiologist-parasitologist and the clinician who diagnoses and treats infectious diseases in returned travelers. Tropical and subtropical countries where there is a greater risk of contracting an infectious disease are among the most frequently visited tourist destinations. The SEIMC considers it appropriate to produce a consensus document that will be useful to primary care physicians as well as specialists in internal medicine, infectious diseases and tropical medicine who help treat travelers returning from tropical and sub-tropical areas with infections. Preventive aspects of infectious diseases and infections imported by immigrants are explicitly excluded here, since they have been dealt with in other SEIMC documents. Various types of professionals (clinicians, microbiologists, and parasitologists) have helped produce this consensus document by evaluating the available evidence-based data in order to propose a series of key facts about individual aspects of the topic. The first section of the document is a summary of some of the general aspects concerning the general assessment of travelers who return home with potential infections. The main second section contains the key facts (causative agents, diagnostic procedures and therapeutic measures) associated with the major infectious syndromes affecting returned travelers [gastrointestinal syndrome (acute or persistent diarrhea); febrile syndrome with no obvious source of infection; localized cutaneous lesions; and respiratory infections]. Finally, the characteristics of special traveler subtypes, such as pregnant women and immunocompromised travelers, are described (AU)

En el mundo global, el conocimiento de las enfermedades infecciosas importadas es esencial en la práctica diaria, tanto para el microbiólogo-parasitólogo como para el clínico en enfermedades infecciosas que atiende a viajeros internacionales. Entre los destinos turísticos más visitados se encuentran muchos países tropicales o subtropicales, donde el riesgo de contraer una enfermedad infecciosa es más elevado. La SEIMC ha considerado pertinente la elaboración de un documento de consenso que sirva de ayuda tanto a médicos de Atención Primaria como a especialistas en Medicina Interna, Enfermedades Infecciosas y Medicina Tropical que atienden a viajeros que regresan con infecciones tras un viaje a zonas tropicales y subtropicales. Se han excluido de forma explícita los aspectos de prevención de estas y las infecciones importadas por inmigrantes, objeto de otros documentos de la SEIMC. Varios tipos de profesionales (clínicos, microbiólogos y parasitólogos) han desarrollado este documento de consenso tras evaluar los datos disponibles basados en la evidencia para proponer una serie de datos clave acerca de este aspecto. Inicialmente se revisan los aspectos generales acerca de la evaluación general del viajero que regresa con una potencial infección. En un segundo bloque se señalan los datos clave (agentes causales, procedimientos diagnósticos y medidas terapéuticas) de los síndromes infecciosos principales en el viajero que regresa (síndrome gastrointestinal (diarrea aguda o persistente), síndrome febril sin foco aparente, lesiones cutáneas localizadas e infecciones respiratorias). Finalmente se describen las características en viajeros especiales como la viajera embarazada y el viajero inmunodeprimido (AU)

Executive summary of imported infectious diseases after returning from foreign travel: Consensus document of the Spanish Society for Infectious Diseases and Clinical Microbiology (SEIMC).

In a global world, knowledge of imported infectious diseases is essential in daily practice, both for the microbiologist-parasitologist and the clinician who diagnoses and treats infectious diseases in returned travelers. Tropical and subtropical countries where there is a greater risk of contracting an infectious disease are among the most frequently visited tourist destinations. The SEIMC considers it appropriate to produce a consensus document that will be useful to primary care physicians as well as specialists in internal medicine, infectious diseases and tropical medicine who help treat travelers returning from tropical and sub-tropical areas with infections. Preventive aspects of infectious diseases and infections imported by immigrants are explicitly excluded here, since they have been dealt with in other SEIMC documents. Various types of professionals (clinicians, microbiologists, and parasitologists) have helped produce this consensus document by evaluating the available evidence-based data in order to propose a series of key facts about individual aspects of the topic. The first section of the document is a summary of some of the general aspects concerning the general assessment of travelers who return home with potential infections. The main second section contains the key facts (causative agents, diagnostic procedures and therapeutic measures) associated with the major infectious syndromes affecting returned travelers [gastrointestinal syndrome (acute or persistent diarrhea); febrile syndrome with no obvious source of infection; localized cutaneous lesions; and respiratory infections]. Finally, the characteristics of special traveler subtypes, such as pregnant women and immunocompromised travelers, are described.

First case of imported Zika virus infection in Spain / Primer caso importado de infección por virus Zika en España

We report a case of Zika virus (ZIKV) infection in a patient with diarrhea, fever, synovitis, non-purulent conjunctivitis, and with discreet retro-orbital pain, after returning from Colombia in January 2016. The patient referred several mosquito bites. Presence of ZIKV was detected by PCR (polymerase chain reaction) in plasma. Rapid microbiological diagnosis of ZIKV infection is needed in European countries with circulation of its vector, in order to avoid autochthonous circulation. The recent association of ZIKV infection with abortion and microcephaly, and a Guillain-Barré syndrome highlights the need for laboratory differentiation of ZIKV from other virus infection. Women with potential risk for Zika virus infection who are pregnant or planning to become pregnant must mention that fact during prenatal visits in order to be evaluated and properly monitored

Presentamos un caso de infección por virus Zika (ZIKV) en un paciente con diarrea, fiebre, sinovitis, conjuntivitis no purulenta, con discreto dolor retroorbital, después de regresar de Colombia en enero de 2016. El paciente refería múltiples picaduras de mosquito. La presencia de ZIKV fue detectada en plasma por reacción en cadena de la polimerasa (PCR). En los países europeos en los que exista circulación de su vector es necesario un diagnóstico microbiológico rápido de la infección por ZIKV para evitar transmisión autóctona. La asociación reciente de la infección por ZIKV con abortos y microcefalia y síndrome de Guillén-Barré pone de relieve la necesidad de la diferenciación de ZIKV de otras infecciones por virus. Las mujeres con riesgo potencial de infección por el virus Zika que están embarazadas o que planeen quedar embarazadas deben mencionar esa circunstancia durante las visitas prenatales con el fin de ser evaluadas y monitorizadas adecuadamente

First case of imported Zika virus infection in Spain.

We report a case of Zika virus (ZIKV) infection in a patient with diarrhea, fever, synovitis, non-purulent conjunctivitis, and with discreet retro-orbital pain, after returning from Colombia in January 2016. The patient referred several mosquito bites. Presence of ZIKV was detected by PCR (polymerase chain reaction) in plasma. Rapid microbiological diagnosis of ZIKV infection is needed in European countries with circulation of its vector, in order to avoid autochthonous circulation. The recent association of ZIKV infection with abortion and microcephaly, and a Guillain-Barré syndrome highlights the need for laboratory differentiation of ZIKV from other virus infection. Women with potential risk for Zika virus infection who are pregnant or planning to become pregnant must mention that fact during prenatal visits in order to be evaluated and properly monitored.

Diagnóstico microbiológico de arbovirosis y robovirosis emergentes / Microbiological diagnosis of emerging arboviral and rodent borne diseases

Los virus transmitidos por artrópodos (arbovirus) y los transmitidos por roedores (robovirus) o por otros animales se engloban en el epígrafe «virus transmitidos por vector» (VTV). En nuestro entorno son 3 los principales VTV autóctonos que causan enfermedad: los virus Toscana, West Nile y de la coriomeningitis linfocitaria; además, se diagnostican enfermedades por VTV importados (virus dengue, chikungunya) que actualmente suponen un riesgo de asentamiento por la circulación de vectores competentes de transmisión en nuestro territorio, como es el mosquito Aedes albopictus. La Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica se ha hecho eco de la emergencia de las enfermedades por VTV y ha redactado un procedimiento sobre diagnóstico microbiológico de arbovirosis y robovirosis emergentes que supone una actualización sobre los VTV con mayor sospecha diagnóstica en nuestro entorno y los métodos de detección disponibles para el diagnóstico de las enfermedades que producen

Vector borne viruses (VBV) include viruses transmitted by arthropods, rodents and other animals. In Spain the three main autochthonous VBVs causing human diseases are: Toscana, West Nile and Lymphocytic Choriomeningitis viruses. There are also other imported viruses that are potential threats to our public health, due to the presence of competent transmission vectors (dengue and chikungunya viruses in areas infested with Aedes albopictus), or due to the potential person-to-person transmission (Lassa and other viruses causing haemorrhagic fever). The Spanish Society for Infectious Diseases and Clinical Microbiology has responded to the emergence of VBVs by publishing a special issue of Microbiological Proceedings focused on the diagnosis of those emerging vector borne viruses of major concern in our country

[Microbiological diagnosis of emerging arboviral and rodent borne diseases]. / Diagnóstico microbiológico de arbovirosis y robovirosis emergentes.

Vector borne viruses (VBV) include viruses transmitted by arthropods, rodents and other animals. In Spain the three main autochthonous VBVs causing human diseases are: Toscana, West Nile and Lymphocytic Choriomeningitis viruses. There are also other imported viruses that are potential threats to our public health, due to the presence of competent transmission vectors (dengue and chikungunya viruses in areas infested with Aedes albopictus), or due to the potential person-to-person transmission (Lassa and other viruses causing haemorrhagic fever). The Spanish Society for Infectious Diseases and Clinical Microbiology has responded to the emergence of VBVs by publishing a special issue of Microbiological Proceedings focused on the diagnosis of those emerging vector borne viruses of major concern in our country.

[Biodefense: a new challenge for microbiology and public health]. / Biodefensa: un nuevo desafío para la microbiología y la salud pública.

Bioterrorism and the potential use of biological weapons has become an important concern of governments and responsible authorities. An example of this threat occurred in 2001 in the USA, when letters were sent containing spores of the agent that produces anthrax; this resulted in some deaths, and caused panic and negative effects on the world economy. If this small-scale event was able to cause such a huge impact, the repercussions of a massive attack could be catastrophic. In many countries, these events have resulted in the implementation of measures directed toward preventing and responding to bioterrorist threats and acts. As a whole, these measures are known as biodefense. This article briefly analyzes several aspects related to detecting and identifying acts of bioterrorism, and considers the biological agents that are implicated. The microbiological diagnosis that allows identification of the causal agent, a key point for taking suitable control measures, is also included.

Biodefensa: un nuevo desafío para la microbiología y la salud pública / Biodefense: a new challenge for microbiology and public health

El bioterrorismo y el uso potencial de armas biológicas se ha convertido en una preocupación importante de los gobiernos y autoridades competentes. Como ejemplo, el envío de cartas con esporas del agente causante del carbunco en Estados Unidos en 2001 ocasionó varias muertes, causó pánico y tuvo repercusiones negativas en la economía mundial. Si este incidente, a pequeña escala, produjo semejante impacto, los efectos de un ataque masivo podrían ser catastróficos. En muchos países éste fue el punto que marcó el inicio de la toma de medidas encaminadas a prevenir y responder ante amenazas y actos bioterroristas, acciones que, en su conjunto, se conocen como biodefensa. Este artículo pretende analizar someramente algunos aspectos relacionados con la detección e identificación de este tipo de acciones y los agentes biológicos implicados. Se considera el diagnóstico microbiológico que permite la identificación del agente causal, punto clave para la toma de medidas de control adecuadas (AU)

Bioterrorism and the potential use of biological weapons has become an important concern of governments and responsible authorities. An example of this threat occurred in 2001 in the USA, when letters were sent containing spores of the agent that produces anthrax; this resulted in some deaths, and caused panic and negative effects on the world economy. If this small-scale event was able to cause such a huge impact, the repercussions of a massive attack could be catastrophic. In many countries, these events have resulted in the implementation of measures directed toward preventing and responding to bioterrorist threats and acts. As a whole, these measures are known as biodefense. This article briefly analyzes several aspects related to detecting and identifying acts of bioterrorism, and considers the biological agents that are implicated. The microbiological diagnosis that allows identification of the causal agent, a key point for taking suitable control measures, is also included (AU)