Dataset Information

Yellow fever in a traveller returning from Suriname to the Netherlands, March 2017.

ABSTRACT: A Dutch traveller returning from Suriname in early March 2017, presented with fever and severe acute liver injury. Yellow fever was diagnosed by (q)RT-PCR and sequencing. During hospital stay, the patient's condition deteriorated and she developed hepatic encephalopathy requiring transfer to the intensive care. Although yellow fever has not been reported in the last four decades in Suriname, vaccination is recommended by the World Health Organization for visitors to this country.

SUBMITTER: Wouthuyzen-Bakker M

PROVIDER: S-EPMC5356427 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Yellow fever in a traveller returning from Suriname to the Netherlands, March 2017.

Wouthuyzen-Bakker Marjan M Knoester Marjolein M van den Berg Aad P AP GeurtsvanKessel Corine H CH Koopmans Marion Pg MP Van Leer-Buter Coretta C Oude Velthuis Bob B Pas Suzan D SD Ruijs Wilhelmina Lm WL Schmidt-Chanasit Jonas J Vreden Stephen Gs SG van der Werf Tjip S TS Reusken Chantal Bem CB Bierman Wouter Fw WF

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 20170301 11

A Dutch traveller returning from Suriname in early March 2017, presented with fever and severe acute liver injury. Yellow fever was diagnosed by (q)RT-PCR and sequencing. During hospital stay, the patient's condition deteriorated and she developed hepatic encephalopathy requiring transfer to the intensive care. Although yellow fever has not been reported in the last four decades in Suriname, vaccination is recommended by the World Health Organization for visitors to this country. ...[more]

PMID: 28333617

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Project description:BackgroundPlasmodium falciparum strains with mutations/deletions of the genes encoding the histidine-rich proteins 2/3 (pfhrp2/3) have emerged during the last 10 years leading to false-negative results in HRP2-based rapid diagnostic tests (RDTs). This can lead to unrecognized infections in individuals and to setbacks in malaria control in endemic countries where RDTs are the backbone of malaria diagnostics and control.Case descriptionHere the detection of a pfhrp2/3-negative P. falciparum infection acquired in Ethiopia by a 63-year old female traveller is presented. After onset of symptoms during travel, she was first tested negative for malaria, most probably by RDT, at a local hospital in Harar, Ethiopia. Falciparum malaria was finally diagnosed microscopically upon her return to Germany, over 4 weeks after infection. At a parasite density of approximately 5387 parasites/µl, two different high-quality RDTs: Palutop + 4 OPTIMA, NADALRMalaria PF/pan Ag 4 Species, did not respond at their respective P. falciparum test lines. pfhrp2/3 deletion was confirmed by multiplex-PCR. The patient recovered after a complete course of atovaquone and proguanil. According to the travel route, malaria was acquired most likely in the Awash region, Central Ethiopia. This is the first case of imported P. falciparum with confirmed pfhrp2/3 deletion from Ethiopia.ConclusionHRP2-negative P. falciparum strains may not be recognized by the presently available HRP2-based RDTs. When malaria is suspected, confirmation by microscopy and/or qPCR is necessary in order to detect falciparum malaria, which requires immediate treatment. This case of imported P. falciparum, non-reactive to HRP2-based RDT, possibly underlines the necessity for standardized, nationwide investigations in Ethiopia and should alert clinicians from non-endemic countries to the possibility of false-negative RDT results which may increase in returning travellers with potentially life-threatening infections.

Dataset Information

Yellow fever in a traveller returning from Suriname to the Netherlands, March 2017.

Publications

Yellow fever in a traveller returning from Suriname to the Netherlands, March 2017.

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