International travel linked to spread of multidrug-resistant STIs
International travel may play a critical role in the spread of multidrug-resistant (MDR) sexually transmitted infections (STIs), according to a study published late last week in Travel Medicine and Infectious Disease.
In a systematic review and meta-analysis of studies on gonococcal infection, antibiotic resistance, and international travel that were published from 2010 to 2021, a team of Spanish researchers found that 16 of 18 studies described a probable link between international travel and transmission of MDR Neisseria gonorrhoeae from the country of travel to the country of return, as the index cases reported unprotected sexual intercourse at their place of destination. Travelers mainly visited Southeast Asian countries (66.7%) and returned to the United Kingdom (38.9%).
Half of the studies (9) reported N gonorrhoeae strains with resistance to ciprofloxacin, while 7 described cephalosporin resistant and 4 described decreased sensitivity to penicillin and azithromycin. The most frequently prescribed antibiotic for treatment was ceftriaxone.
The meta-analysis also found that men in their 30s are more likely to be infected by an MDR STI.
"As no vaccinations are currently available for these infections, sexual education should therefore play an important role in the routine pre-travel consultation," the study authors concluded. "Returned travelers who present with gonococcal infection should be screened for antibiotic resistance to avoid transmitting drug-resistant pathogens to other worldwide locations."
Jul 16 Travel Med Infect Dis abstract
Ghana declares Marburg fever outbreak
After tests confirmed two Marburg virus cases from Ghana, the country declared an outbreak, its first involving the virus, which causes a hemorrhagic illness similar to Ebola.
In a statement, the World Health Organization (WHO) African regional office said the Pasteur Institute in Senegal confirmed the preliminary findings from Ghana. The patients are two unrelated men who sought care at the same hospital in Ashanti region, both of whom died from their infections. Ashanti region is located in the southern part of the country.
The first patient is a 26-year-old man who was hospitalized on Jun 26 and died the next day. The second is a 51-year-old man who was hospitalized on Jun 28 and died the same day. So far, 90 contacts—some of them health workers—have been identified and are being monitored.
Ghana's Marburg outbreak is only the second to occur in West Africa. The other occurred in Guinea in 2021, resulting in one confirmed case. The virus is transmitted from fruit bats to people and can spread among humans through direct contact with body fluids.
Jul 17 WHO African regional office statement
Unexplained illness cluster in Tanzania linked to leptospirosis
An unexplained cluster of hemorrhagic illnesses in Tanzania has been identified as leptospirosis, the country's health minister said today at a briefing, according to The Citizen, an Africa-based news outlet.
Three deaths were reported earlier this month, and nosebleed symptoms prompted suspicion about a potential hemorrhagic fever outbreak.
At today's briefing, health minister Ummy Mwalimu said more than 20 cases have been reported, 3 of them fatal. Two people are hospitalized. The outbreak is centered in Lindi region in the country's southeast.
The disease—caused by Leptospira interrogans—spreads from animals to humans through contact with the urine of infected animals. Mwalimu said it's rare for the bacterium to spread from person to person.
Jul 18 Citizen story
Jul 14 CIDRAP News scan