Publications by authors named "Ralph Huits"

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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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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Determining the incubation period of Oropouche virus disease can inform clinical and public health practice. We analyzed data from 97 travel-associated cases identified by the Centers for Disease Control and Prevention (n = 74) or the GeoSentinel Network (n = 13) and 10 cases from published literature. Using log-normal interval-censored survival analysis, we estimated the median incubation period to be 3.

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Background: Local transmission of dengue, chikungunya, and Zika infection is an emerging public health threat in Europe. Monitoring the epidemiological trends can help define the intervention strategy. The aim of this work was to analyse epidemiological characteristics of autochthonous transmission of -borne arboviruses in Europe.

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In a longitudinal study in a first-level hospital in Luanda, Angola, we found rifampin-resistant and multidrug-resistant tuberculosis (TB) in 38 (8%, 95% CI 5.7-10.8) of 474 patients with no previous history of TB.

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Background: The diagnostic and treatment approaches for schistosomiasis in individual patients, outside endemic areas, are not standardised. This study aimed to appraise the reference documents that the experts from the TropNet and GeoSentinel networks use in practice as guidance for the clinical management of their patients with (suspect) schistosomiasis.

Methods: We systematically appraised the following data from the referenced guidance documents: i) document type, ii) case definitions, iii) diagnostic techniques envisaged; iv) treatment recommendations; v) follow-up recommendations; vi) screening recommendations, and vii) symptom-based diagnostic suspicion.

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Several Flaviviridae constitute an emerging threat to global health because of their continuing spread and the expansion of vector habitats, largely driven by climate change and intensified global travel. Infections can result in severe neurological or visceral pathologies. The relationship between oxidative stress (OS), an imbalance between generated reactive oxygen species and the antioxidant defences of the host, and flavivirus infection has been repeatedly demonstrated in in vitro and animal studies, but measuring biomarkers of oxidative stress in vivo could prove useful in clinical patient management.

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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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On 27 May 2024, the Cuban Ministry of Health reported the first outbreak of Oropouche fever on the island. The etiologic agent, Oropouche virus (OROV), is a poorly understood arbovirus that has been known since the 1960s and represents a public health burden in Latin America. We report the whole-genome characterization of the first European OROV isolate from a returning traveler from Cuba with Oropouche fever-like symptoms.

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A febrile man in Italy who had traveled to Cuba in July 2024 was diagnosed with Oropouche fever. Reverse transcription PCR detected prolonged shedding of Oropouche virus RNA in whole blood, serum, urine, and semen. Sixteen days after symptom onset, replication-competent virus was detected in semen, suggesting risk for sexual transmission.

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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: Physical symptoms of dengue have been documented extensively, but knowledge gaps on dengue-associated mental health hazards remain. We investigated the frequency of psychiatric symptoms (depression, anxiety, and stress) and neurocognitive performance during the first year after a dengue episode.

Methods: Using DASS-21 scores at 3, 6, and 12 months, we assessed depression, anxiety, and stress in anti-dengue IgM-positive adults and matched controls during the 2021 dengue season in Esmeraldas Province, Ecuador.

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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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Oropouche fever is caused by Oropouche virus (OROV), transmitted primarily through the bite of infected midges, particularly of the genus . The virus is mainly circulating in Central and South America where several countries reported an ongoing outbreak. We report here two imported cases of OROV infection identified in Italy, late May-early June 2024.

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Dengue is the most prevalent mosquito-borne viral disease in humans, and cases are continuing to rise globally. In particular, islands in the Caribbean have experienced more frequent outbreaks, and all four dengue virus (DENV) serotypes have been reported in the region, leading to hyperendemicity and increased rates of severe disease. However, there is significant variability regarding virus surveillance and reporting between islands, making it difficult to obtain an accurate understanding of the epidemiological patterns in the Caribbean.

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Article Synopsis
  • Terminology inconsistencies in schistosomiasis cause confusion in data interpretation and clinical descriptions, prompting this study to establish consensus definitions for clinical aspects of the disease in migrants and travelers.
  • The Delphi method was utilized, involving a group of experts from GeoSentinel and TropNet who provided input on the definitions, which were revised and pilot-tested.
  • After several rounds of feedback and analysis, a high level of consensus (79-100% agreement) was achieved for all proposed definitions, which will enhance communication and support future research and guidelines for managing schistosomiasis.
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  • Airport malaria, while rare, is becoming more common in Europe and presents diagnostic challenges, as seen in a cluster of cases among employees at Frankfurt International Airport in 2022.
  • Three employees were diagnosed with malaria despite no recent travel to affected areas, with two cases occurring within a week and one after ten weeks, but all individuals fully recovered.
  • Investigations revealed flights from malaria-endemic countries and a parcel from Ghana, but efforts to identify the source were inconclusive; genomic analysis linked the cases and emphasized the need for effective outbreak response to prevent severe malaria.
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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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