Heukelbach Jörg, Gomide Marcia, Araújo Francisco, Pinto Nathalia S R, Santana Rafael D, Brito João R M, Feldmeier Hermann
Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
J Travel Med. 2007 Nov-Dec;14(6):374-80. doi: 10.1111/j.1708-8305.2007.00156.x.
BACKGROUND: Hookworm-related cutaneous larva migrans (CLM) and tungiasis are commonly diagnosed in travelers returning from endemic areas, but reliable data on disease occurrence do not exist. To describe the occurrence of CLM and tungiasis in international travelers, a cross-sectional study was done. METHOD: We conducted an airport survey in European travelers exiting northeast Brazil. Questionnaires were distributed at the departure gate of the international airport of Fortaleza (Ceará State) while passengers were waiting to board their plane. The questionnaire included questions on personal characteristics, pretravel health advice, acquired parasitic skin diseases during their stay in Brazil, and clinical characteristics of the infestation. To help identify CLM and tungiasis, photographs of the typical appearances of the infestations were presented. RESULTS: Data from 372 tourists (aged 16-76 y, median = 40 y) were available for analysis; 45% had obtained pretravel health advice, usually from travel clinics (46.2%) and Internet sites (39.6%). Only 14% of those who obtained advice had been informed about CLM as a travel health risk and 22% about tungiasis. During their stay in Brazil, 12 (3.2%) tourists had experienced tungiasis and 3 (0.8%) CLM. In all cases, lesions were confined to the feet. The three travelers with CLM complained of irritability; itching was present in two cases. Pain (58.3%) and itching (50%) were the most common symptoms in travelers with tungiasis. The length of stay was a clear predictor for tungiasis, with a 20 times higher occurrence in travelers who had stayed for more than 4 weeks in Brazil. CONCLUSIONS: Tungiasis and CLM are not rare in international tourists departing from Brazil, and pretravel counseling is insufficient. Pretravel health advice should include information on the risk of acquiring tungiasis and CLM and how to prevent an infestation. Airport surveys using questionnaires can be used to obtain incidence data on both parasitic infestations.
背景:钩虫相关的皮肤幼虫移行症(CLM)和潜蚤病在从流行地区返回的旅行者中很常见,但关于疾病发生情况的可靠数据并不存在。为了描述国际旅行者中CLM和潜蚤病的发生情况,我们进行了一项横断面研究。 方法:我们在离开巴西东北部的欧洲旅行者中进行了一项机场调查。问卷在福塔莱萨(塞阿拉州)国际机场的登机口发放,乘客在候机时填写。问卷包括个人特征、旅行前健康建议、在巴西停留期间获得的寄生虫性皮肤病以及感染的临床特征等问题。为了帮助识别CLM和潜蚤病,展示了感染的典型外观照片。 结果:372名游客(年龄16 - 76岁,中位数 = 40岁)的数据可供分析;45%的人获得了旅行前健康建议,通常来自旅行诊所(46.2%)和网站(39.6%)。在获得建议的人中,只有14%被告知CLM是一种旅行健康风险,22%被告知潜蚤病。在巴西停留期间,12名(3.2%)游客感染了潜蚤病,3名(0.8%)感染了CLM。所有病例中,病变均局限于足部。三名感染CLM的旅行者抱怨易怒;两例伴有瘙痒。疼痛(58.3%)和瘙痒(50%)是感染潜蚤病旅行者最常见的症状。停留时间是潜蚤病的一个明确预测因素,在巴西停留超过4周的旅行者中发病率高出20倍。 结论:对于从巴西出发的国际游客来说,潜蚤病和CLM并不罕见,而且旅行前咨询不足。旅行前健康建议应包括感染潜蚤病和CLM的风险以及如何预防感染的信息。使用问卷进行机场调查可用于获取这两种寄生虫感染的发病率数据。
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