open access
Chronic symptoms persisting after travel-related infections
Affiliations- Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine, Gdynia, Faculty of Health Sciences, Medical University of Gdańsk, Powstania Slyczniowego 9b, 81-519 Gdynia, Poland
- Outpatient Clinic of Hepatology, Voivodship Hospital, Szczecin, Poland
open access
Abstract
The authors present the current state of knowledge about the long term sequelae of the common travel-related infections associated with immunological dysregulation. Travellers’ diarrhoea, chikungunya and dengue are common in travellers and protracted manifestations such as post-infectious irritable bowel syndrome (travellers’ diarrhoea), arthritis (chikungunya) or post-dengue syndrome may be more prevalent than previously thought. Attention should be paid to active prevention of the infections during travel, especially when an effective treatment against long-term sequelae has not been established. Further studies should be designed in order to determine the interactions between the host, the environment and the pathogens, as well as to identify the prognostic factors for developing long-term manifestations after infections in a large group of travellers.
Abstract
The authors present the current state of knowledge about the long term sequelae of the common travel-related infections associated with immunological dysregulation. Travellers’ diarrhoea, chikungunya and dengue are common in travellers and protracted manifestations such as post-infectious irritable bowel syndrome (travellers’ diarrhoea), arthritis (chikungunya) or post-dengue syndrome may be more prevalent than previously thought. Attention should be paid to active prevention of the infections during travel, especially when an effective treatment against long-term sequelae has not been established. Further studies should be designed in order to determine the interactions between the host, the environment and the pathogens, as well as to identify the prognostic factors for developing long-term manifestations after infections in a large group of travellers.
Keywords
Travel-Related Illness; Immunology, Communicable Diseases, Imported; Long-Term Complications
About this articleTitle
Chronic symptoms persisting after travel-related infections
Journal
Issue
Article type
Review article
Pages
207-212
Published online
2018-09-27
Page views
1361
Article views/downloads
1314
DOI
Pubmed
Bibliographic record
IMH 2018;69(3):207-212.
Keywords
Travel-Related Illness
Immunology
Communicable Diseases
Imported
Long-Term Complications
Authors
Anna Kuna
Michał Gajewski
References (62)- DuPont HL, Ericsson CD. Prevention and treatment of traveler's diarrhea. N Engl J Med. 1993; 328(25): 1821–1827.
- CDC CDC. Yellow Book 2018: Health Information for International Travel. Oxford University Press, New York. 2017.
- Neal KR, Barker L, Spiller RC. Prognosis in post-infective irritable bowel syndrome: a six year follow up study. Gut. 2002; 51(3): 410–413.
- Chaudhary N, Truelove SC. The irritable colon syndrome. A study of the clinical features, predisposing causes, and prognosis in 130 cases. Q J Med. 1962; 31: 307–322.
- DuPont AW. Postinfectious irritable bowel syndrome. Clin Infect Dis. 2008; 46(4): 594–599.
- DuPont HL, Galler G, Garcia-Torres F, et al. Travel and travelers' diarrhea in patients with irritable bowel syndrome. Am J Trop Med Hyg. 2010; 82(2): 301–305.
- Wang LH, Fang XC, Pan GZ. Bacillary dysentery as a causative factor of irritable bowel syndrome and its pathogenesis. Gut. 2004; 53(8): 1096–1101.
- Spiller RC, Jenkins D, Thornley JP, et al. Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome. Gut. 2000; 47(6): 804–811.
- Gwee KA, Collins SM, Rajnakova A, et al. Increased rectal mucosal expression of interleukin 1beta in recently acquired post-infectious irritable bowel syndrome. Gut. 2003; 52(4): 523–526.
- Stiff RE, Davies AP, Mason BW, et al. Long-term health effects after resolution of acute Cryptosporidium parvum infection: a 1-year follow-up of outbreak-associated cases. J Med Microbiol. 2017; 66(11): 1607–1611.
- Litleskare S, Rortveit G, Eide GE, et al. Prevalence of Irritable Bowel Syndrome and Chronic Fatigue 10 Years After Giardia Infection. Clin Gastroenterol Hepatol. 2018; 16(7): 1064–1072.e4.
- Drossman DA, Camilleri M, Mayer EA, et al. AGA technical review on irritable bowel syndrome. Gastroenterology. 2002; 123(6): 2108–2131.
- Porter CK, Faix DJ, Shiau D, et al. Postinfectious gastrointestinal disorders following norovirus outbreaks. Clin Infect Dis. 2012; 55(7): 915–922.
- Dunlop SP, Jenkins D, Spiller RC. Distinctive clinical, psychological, and histological features of postinfective irritable bowel syndrome. Am J Gastroenterol. 2003; 98(7): 1578–1583.
- Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016; 150(6): 1257–1261.
- Neal KR, Hebden J, Spiller R. Prevalence of gastrointestinal symptoms six months after bacterial gastroenteritis and risk factors for development of the irritable bowel syndrome: postal survey of patients. BMJ. 1997; 314(7083): 779–782.
- Borgaonkar MR, Ford DC, Marshall JK, et al. The incidence of irritable bowel syndrome among community subjects with previous acute enteric infection. Dig Dis Sci. 2006; 51(5): 1026–1032.
- Nair P, Okhuysen PC, Jiang ZD, et al. Persistent abdominal symptoms in US adults after short-term stay in Mexico. J Travel Med. 2014; 21(3): 153–158.
- Spiller R, Lam C. An update on post-infectious irritable bowel syndrome: role of genetics, immune activation, serotonin and altered microbiome. J Neurogastroenterol Motil. 2012; 18(3): 258–268.
- Parry SD, Barton JR, Welfare MR. Factors associated with the development of post-infectious functional gastrointestinal diseases: does smoking play a role? Eur J Gastroenterol Hepatol. 2005; 17(10): 1071–1075.
- Taylor DN, Houston R, Shlim DR, et al. Etiology of diarrhea among travelers and foreign residents in Nepal. JAMA. 1988; 260(9): 1245–1248.
- Dunlop SP, Jenkins D, Neal KR, et al. Relative importance of enterochromaffin cell hyperplasia, anxiety, and depression in postinfectious IBS. Gastroenterology. 2003; 125(6): 1651–1659.
- Gwee KA, Leong YL, Graham C, et al. The role of psychological and biological factors in postinfective gut dysfunction. Gut. 1999; 44(3): 400–406.
- Okhuysen PC, Jiang ZD, Carlin L, et al. Post-diarrhea chronic intestinal symptoms and irritable bowel syndrome in North American travelers to Mexico. Am J Gastroenterol. 2004; 99(9): 1774–1778.
- Thornley JP, Jenkins D, Neal K, et al. Relationship of Campylobacter toxigenicity in vitro to the development of postinfectious irritable bowel syndrome. J Infect Dis. 2001; 184(5): 606–609.
- Spiller RC. Infection as a cause of irritable bowel syndrome. Hosp Med. 2003; 64(5): 270–274.
- Guilarte M, Santos J, de Torres I, et al. Diarrhoea-predominant IBS patients show mast cell activation and hyperplasia in the jejunum. Gut. 2007; 56(2): 203–209.
- Lee KJ, Kim YB, Kim JH, et al. The alteration of enterochromaffin cell, mast cell, and lamina propria T lymphocyte numbers in irritable bowel syndrome and its relationship with psychological factors. J Gastroenterol Hepatol. 2008; 23(11): 1689–1694.
- Barbara G, Stanghellini V, De Giorgio R, et al. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome. Gastroenterology. 2004; 126(3): 693–702.
- Barbara G, Wang B, Stanghellini V, et al. Mast cell-dependent excitation of visceral-nociceptive sensory neurons in irritable bowel syndrome. Gastroenterology. 2007; 132(1): 26–37.
- Dinan TG, Clarke G, Quigley EMM, et al. Enhanced cholinergic-mediated increase in the pro-inflammatory cytokine IL-6 in irritable bowel syndrome: role of muscarinic receptors. Am J Gastroenterol. 2008; 103(10): 2570–2576.
- Dunlop SP, Jenkins D, Neal KR, et al. Randomized, double-blind, placebo-controlled trial of prednisolone in post-infectious irritable bowel syndrome. Aliment Pharmacol Ther. 2003; 18(1): 77–84.
- Hungin APS, Chang L, Locke GR, et al. Irritable bowel syndrome in the United States: prevalence, symptom patterns and impact. Aliment Pharmacol Ther. 2005; 21(11): 1365–1375.
- Couturier E, Guillemin F, Mura M, et al. Impaired quality of life after chikungunya virus infection: a 2-year follow-up study. Rheumatology (Oxford). 2012; 51(7): 1315–1322.
- Javelle E, Ribera A, Degasne I, et al. Specific management of post-chikungunya rheumatic disorders: a retrospective study of 159 cases in Reunion Island from 2006-2012. PLoS Negl Trop Dis. 2015; 9(3): e0003603.
- Rodriguez-Morales AJ, Gil-Restrepo AF, Ramírez-Jaramillo V, et al. Post-chikungunya chronic inflammatory rheumatism: results from a retrospective follow-up study of 283 adult and child cases in La Virginia, Risaralda, Colombia. F1000Res. 2016; 5: 360.
- Zeana C, Kelly P, Heredia W, et al. Post-chikungunya rheumatic disorders in travelers after return from the Caribbean. Travel Med Infect Dis. 2016; 14(1): 21–25.
- Brighton SW, Simson IW. A destructive arthropathy following Chikungunya virus arthritis — a possible association. Clin Rheumatol. 1984; 3(2): 253–258.
- Bouquillard E, Combe B. A report of 21 cases of rheumatoid arthritis following Chikungunya fever. A mean follow-up of two years. Joint Bone Spine. 2009; 76(6): 654–657.
- Mathew AJ, Goyal V, George E, et al. Rheumatic-musculoskeletal pain and disorders in a naïve group of individuals 15 months following a Chikungunya viral epidemic in south India: a population based observational study. Int J Clin Pract. 2011; 65(12): 1306–1312.
- Ribéra A, Degasne I, Jaffar Bandjee MC, et al. [Chronic rheumatic manifestations following chikungunya virus infection: clinical description and therapeutic considerations]. Med Trop (Mars). 2012; 72 Spec No: 83–85.
- Renault P, Solet JL, Sissoko D, et al. A major epidemic of chikungunya virus infection on Reunion Island, France, 2005-2006. Am J Trop Med Hyg. 2007; 77(4): 727–731.
- Assunção-Miranda I, Cruz-Oliveira C, Da Poian AT. Molecular mechanisms involved in the pathogenesis of alphavirus-induced arthritis. Biomed Res Int. 2013; 2013: 973516.
- Foissac M, Javelle E, Ray S, et al. Post-Chikungunya rheumatoid arthritis, Saint Martin. Emerg Infect Dis. 2015; 21(3): 530–532.
- Weaver SC, Lecuit M. Chikungunya virus and the global spread of a mosquito-borne disease. N Engl J Med. 2015; 372(13): 1231–1239.
- Guo C, Zhou Z, Wen Z, et al. Global Epidemiology of Dengue Outbreaks in 1990-2015: A Systematic Review and Meta-Analysis. Front Cell Infect Microbiol. 2017; 7: 317.
- Seet RCS, Quek AML, Lim ECH. Post-infectious fatigue syndrome in dengue infection. J Clin Virol. 2007; 38(1): 1–6.
- García G, González N, Pérez AB, et al. Long-term persistence of clinical symptoms in dengue-infected persons and its association with immunological disorders. Int J Infect Dis. 2011; 15(1): e38–e43.
- Halstead SB. Observations related to pathogensis of dengue hemorrhagic fever. VI. Hypotheses and discussion. Yale J Biol Med. 1970; 42(5): 350–362.
- van de Velde NC, Mottram PL, Hogarth PM. FcgammaRII and multi-system autoimmune disease. Springer Semin Immunopathol. 2006; 28(4): 329–338.
- Lei HY, Yeh TM, Liu HS, et al. Immunopathogenesis of dengue virus infection. J Biomed Sci. 2001; 8(5): 377–388.
- Sjöwall C, Wetterö J. Pathogenic implications for autoantibodies against C-reactive protein and other acute phase proteins. Clin Chim Acta. 2007; 378(1-2): 13–23.
- Nanda SK, Jayalakshmi S, Mohandas S. Pediatric ischemic stroke due to dengue vasculitis. Pediatr Neurol. 2014; 51(4): 570–572.
- Yoganathan S, Sudhakar SV, Priyambada L, et al. Stroke in a child with dengue encephalopathy. Ann Indian Acad Neurol. 2017; 20(3): 329–331.
- Bopeththa BV, Ralapanawa U. Post encephalitic parkinsonism following dengue viral infection. BMC Res Notes. 2017; 10(1): 655.
- Lana-Peixoto MA, Pedrosa D, Talim N, et al. Myelitis and cauda equina involvement following dengue fever. A case report and review of the literature. Mult Scler Relat Disord. 2018; 20: 48–50.
- Puccioni-Sohler M, Ornelas AMM, de Souza AS, et al. First report of persistent dengue-1-associated autoimmune neurological disturbance: neuromyelitis optica spectrum disorder. J Neurovirol. 2017; 23(5): 768–771.
- Lana-Peixoto MA, Pedrosa D, Talim N, et al. Neuromyelitis optica spectrum disorder associated with dengue virus infection. J Neuroimmunol. 2018; 318: 53–55.
- Kamoi K, Mochizuki M, Ohno-Matsui K. Dengue fever-associated necrotizing scleritis: A case report with long-term follow-up. Medicine (Baltimore). 2018; 97(32): e11875.
- Kamath SJ, Nayak MK, Gour R, et al. Dengue stings the eye! J Clin Diagn Res. 2017; 11(9): ND03–ND05.
- Fang PP, Pfau M, Holz FG, et al. Persistent visual loss in dengue fever due to outer retinal damage. Clin Exp Ophthalmol. 2017; 45(7): 747–749.
- Levaggi ND, Lucas AN, Barletta JÁ. Bilateral acute angle closure in a patient with dengue fever: a case report. Arq Bras Oftalmol. 2017; 80(4): 266–267.
