Publications by authors named "Michael Libman"

Background: Cutaneous larva migrans (CLM) is one of the most common dermatoses affecting travellers to the tropics.

Objective: To describe demographic and travel correlates of travellers returning to Canada from the Caribbean with CLM over a 10-year pre-pandemic period.

Methods: Demographic and travel-related data on ill travellers encountered either during or after completion of their travel/migration and seen in any of eight CanTravNet sites from January 1, 2009, to December 31, 2018, with a final diagnosis of CLM were extracted and analyzed.

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Background: The global resurgence of measles is a threat to measles elimination campaigns. Measles importations by international travelers have been identified as a risk factor for outbreaks.

Methods: We reviewed measles cases among international travelers and migrants reported to the GeoSentinel network.

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Background: Presymptomatic or asymptomatic immune system signals and subclinical physiological changes might provide a more objective measure of early viral upper respiratory tract infections (VRTIs) compared with symptom-based detection. We aimed to use multimodal wearable sensors, host-response biomarkers, and machine learning to predict systemic inflammation following controlled exposure to a live attenuated influenza vaccine, without relying on symptoms.

Methods: WE SENSE study is a single-centre (McGill University Health Center, Montreal, QC, Canada), prospective controlled trial that recruited healthy adults aged 18-59 years who had not received or were not planning to receive the seasonal influenza vaccine or any other vaccine during the study period.

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In the wake of a large outbreak in Reunion and Mayotte the GeoSentinel network has been signalling chikungunya cases among returning travellers acquired in multiple African and Asian countries between August 1st 2024 and June 10th 2025. These surveillance data suggest a resurgence of chikungunya in the Indian Ocean Region.

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Article Synopsis
  • The COVID-19 pandemic highlighted the urgent need for effective triage tools in healthcare to identify patients vulnerable to severe infections.
  • Researchers studied COVID-19 patients at multiple sites, analyzing plasma markers to link their levels to mortality and severity of illness within set timeframes.
  • Their findings showed higher suPAR levels correlated with increased mortality risk and severity, supporting the use of specific biomarkers like suPAR and sTREM-1 for better patient triage and hospital resource management.
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We used cross-sectional data from 226 patients with monkeypox virus to investigate the association between anatomic exposure site and lesion development. Penile, anorectal, and oral exposures predicted lesion presence at correlating anatomic sites. Exposure site also predicted the first lesion site of the penis and anus.

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Background: Canadian Arctic communities have experienced sustained syphilis transmission, with diagnoses rates 18-times higher than the national average. Remoteness from laboratory facilities leads to delays between syphilis screening and treatment, contributing to onward transmission. Rapid diagnostic tests can eliminate treatment delays via testing at the point-of-care.

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Background: Antimicrobial resistance (AMR) is a global health crisis, with Enterobacterales, including Escherichia coli and Klebsiella pneumoniae, playing significant roles. While international travel to low- and middle-income countries is linked to colonization with AMR Enterobacterales, the clinical implications, particularly the risk of subsequent infection, remain unclear due to limited data. We aimed to characterize E.

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Article Synopsis
  • Dengue poses a significant health risk to international travelers, with 5,958 cases reported from 2007 to 2022 at GeoSentinel sites, where 81.6% were confirmed cases.
  • The study revealed that the median age of affected travelers was 33 years, with the majority traveling for tourism and acquiring the virus primarily in South East Asia.
  • Complicated cases of dengue were rare, with only 1.6% of travelers experiencing complications; however, there is a crucial need for awareness and preventive measures among travelers heading to endemic areas.
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Background: Prolonged diarrhoea is common amongst returning travellers and is often caused by intestinal protozoa. However, the epidemiology of travel-associated illness caused by protozoal pathogens is not well described.

Methods: We analysed records of returning international travellers with illness caused by Giardia duodenalis, Cryptosporidium spp.

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Background: Chikungunya is an important travel-related disease because of its rapid geographical expansion and potential for prolonged morbidity. Improved understanding of the epidemiology of travel-related chikungunya infections may influence prevention strategies including education and vaccination.

Methods: We analysed data from travellers with confirmed or probable chikungunya reported to GeoSentinel sites from 2005 to 2020.

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Background: Tegumentary leishmaniasis is often subject to limited funding, underpowered studies, and a paucity of high-quality interventional studies. Intravenous liposomal amphotericin B (L-AmB) has been increasingly used to treat cutaneous and mucosal leishmaniasis (CL and ML, respectively) despite the lack of well-conducted interventional studies. We conducted a systematic review to consolidate the descriptive evidence on the efficacy and safety of L-AmB in treating CL and ML.

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Problem/condition: During 2012-2021, the volume of international travel reached record highs and lows. This period also was marked by the emergence or large outbreaks of multiple infectious diseases (e.g.

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Background: Dengue virus is a flavivirus transmitted by mosquitoes and is an important cause of illness worldwide. Data on the severity of travel-associated dengue illness are limited.

Objective: To describe the epidemiology, clinical characteristics, and outcomes among international travelers with severe dengue or dengue with warning signs as defined by the 2009 World Health Organization classification (that is, complicated dengue).

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Objectives: We evaluated the field diagnostic accuracy of a syphilis rapid test (RDT), using serum and whole blood by non-laboratorians in two Canadian Arctic communities.

Methods: We implemented a multisite prospective field evaluation wherein patients were screened by an RDT containing treponemal and non-treponemal components (Chembio DPP® Syphilis Screen & Confirm) between January 2020 and December 2021. Venous whole blood and serum were collected for rapid testing and compared with laboratory-based serology reference testing using a reverse sequence algorithm of treponemal and rapid plasma reagin (RPR) testing.

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Article Synopsis
  • Professional soccer players are at risk for SARS-CoV-2, and Major League Soccer (MLS) has implemented strict testing protocols based on vaccination status to monitor and prevent outbreaks.
  • In a study involving one MLS team in fall 2021, a player who traveled to Africa tested positive, leading to 10 additional infections among teammates and staff, with genome sequencing revealing Delta variants and potential transmission links.
  • Whole genome sequencing (WGS) proved effective in tracking virus spread and identifying infection sources within the team, highlighting its value in managing COVID-19 in sports environments.
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Background: Viral respiratory tract infections (VRTI) are extremely common. Considering the profound social and economic impact of COVID-19, it is imperative to identify novel mechanisms for early detection and prevention of VRTIs, to prevent future pandemics. Wearable biosensor technology may facilitate this.

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Background: International travellers frequently acquire infectious diseases whilst travelling, yet relatively little is known about the impact and economic burden of these illnesses on travellers. We conducted a prospective exploratory costing study on adult returning travellers with falciparum malaria, dengue, chikungunya or Zika virus.

Methods: Patients were recruited in eight Travel and Tropical Medicine clinics between June 2016 and March 2020 upon travellers' first contact with the health system in their country of residence.

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Purpose Of Review: Strongyloidiasis is a soil-transmitted helminthiasis, a neglected tropical disease that affects 300-900 million individuals globally. Strongyloides stercoralis is associated with cutaneous, respiratory, and gastrointestinal clinical manifestations. Chronicity is due to an autoinfective cycle, and host immunosuppression can lead to severe and fatal disease.

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