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Acute muscular sarcocystosis : an international investigation among ill travelers returning from tioman island, malaysia, 2011-2012

Esposito, Douglas H. and Stich, August and Epelboin, Loïc and Malvy, Denis and Han, Pauline V. and Bottieau, Emmanuel and da Silva, Alexandre and Zanger, Philipp and Slesak, Günther and van Genderen, Perry J. J. and Rosenthal, Benjamin M. and Cramer, Jakob P. and Visser, Leo G. and Muñoz, José and Drew, Clifton P. and Goldsmith, Cynthia S. and Steiner, Florian and Wagner, Noémie and Grobusch, Martin P. and Plier, D. Adam and Tappe, Dennis and Sotir, Mark J. and Brown, Clive and Brunette, Gary W. and Fayer, Ronald and von Sonnenburg, Frank and Neumayr, Andreas and Kozarsky, Phyllis E. and Tioman Island Sarcocystosis Investigation Team, . (2014) Acute muscular sarcocystosis : an international investigation among ill travelers returning from tioman island, malaysia, 2011-2012. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol. 59, H. 10. pp. 1401-1410.

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Official URL: http://edoc.unibas.ch/dok/A6319239

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Abstract

Through 2 international traveler-focused surveillance networks (GeoSentinel and TropNet), we identified and investigated a large outbreak of acute muscular sarcocystosis (AMS), a rarely reported zoonosis caused by a protozoan parasite of the genus Sarcocystis, associated with travel to Tioman Island, Malaysia, during 2011-2012.; Clinicians reporting patients with suspected AMS to GeoSentinel submitted demographic, clinical, itinerary, and exposure data. We defined a probable case as travel to Tioman Island after 1 March 2011, eosinophilia (<5%), clinical or laboratory-supported myositis, and negative trichinellosis serology. Case confirmation required histologic observation of sarcocysts or isolation of Sarcocystis species DNA from muscle biopsy.; Sixty-eight patients met the case definition (62 probable and 6 confirmed). All but 2 resided in Europe; all were tourists and traveled mostly during the summer months. The most frequent symptoms reported were myalgia (100%), fatigue (91%), fever (82%), headache (59%), and arthralgia (29%); onset clustered during 2 distinct periods: "early" during the second and "late" during the sixth week after departure from the island. Blood eosinophilia and elevated serum creatinine phosphokinase (CPK) levels were observed beginning during the fifth week after departure. Sarcocystis nesbitti DNA was recovered from 1 muscle biopsy.; Clinicians evaluating travelers returning ill from Malaysia with myalgia, with or without fever, should consider AMS, noting the apparent biphasic aspect of the disease, the later onset of elevated CPK and eosinophilia, and the possibility for relapses. The exact source of infection among travelers to Tioman Island remains unclear but needs to be determined to prevent future illnesses.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Neumayr, Andreas
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Oxford University Press
ISSN:1058-4838
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:16 Feb 2018 14:05
Deposited On:09 Jan 2015 09:24

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