Disseminated Cutaneous Mycobacterium chelonae Infection in a Patient With Acute Myeloid Leukemia.

We report a case of disseminated cutaneous Mycobacterium chelonae infection in a patient who was treated with chemotherapy for acute myeloid leukemia. We discuss the clinical manifestations, diagnosis, and treatment of this unusual infection in neutropenic patients.

Advances and controversies in yellow fever vaccination.

Ever since its development in 1937, the live-attenuated 17D yellow fever (YF) vaccine has been one of the most effective vaccines available to man. In this review we highlight the major steps in the development of 17D YF vaccine. We discuss the use of neutralizing antibodies as a surrogate marker for protection, and explore the strengths and weaknesses of the current plaque reduction neutralization test (PRNT), a technique developed in the 1960s that continues to be superior to every modern test in both sensitivity and specificity.

Elderly subjects have a delayed antibody response and prolonged viraemia following yellow fever vaccination: a prospective controlled cohort study.

Background: Yellow fever vaccination (YF-17D) can cause serious adverse events (SAEs). The mechanism of these SAEs is poorly understood. Older age has been identified as a risk factor.

Knowledge, attitudes, and practices toward malaria risk and prevention among frequent business travelers of a major oil and gas company.

Background: Despite significant morbidity and mortality among business travelers due to malaria, very little has been published on knowledge, attitudes, and practices (KAP) toward malaria risk. The aim of this study was to assess KAP among frequent international business travelers (FBT) and to identify recommendations for improving malaria prevention that could be applied to the wider FBT community in occupational health.

Methods: A retrospective web-based survey was conducted in 2005 among self-registered FBT of an oil and gas company based in the Netherlands.

Symptoms of infectious diseases in immunocompromised travelers: a prospective study with matched controls.

Background: Immunocompromised travelers to developing countries are thought to have symptomatic infectious diseases more often and longer than non-immunocompromised travelers. Evidence for this is lacking. This study evaluates whether immunocompromised short-term travelers are at increased risk of diseases.

Hepatitis B vaccination strategy in vaccine low and non-responders: a matter of quantity of quality?

Hepatitis B virus infection can lead to chronic infection and liver failure. Transmission of the virus is preventable though vaccination. Unfortunately, 5-10% of healthy individuals and 40-50% of haemodialysis patients do not develop an adequate immune response against the vaccine.

Symptoms of infectious diseases in travelers with diabetes mellitus: a prospective study with matched controls.

Background: Travelers with diabetes mellitus to developing countries are thought to have symptomatic infectious diseases more often and longer than travelers without diabetes. Evidence for this is needed. This study evaluates whether travelers with diabetes are at increased risk of symptomatic infectious diseases.

Intradermal hepatitis B vaccination in non-responders after topical application of imiquimod (Aldara).

Background: Five to ten percent of immunocompetent persons fail to develop a protective immune response to hepatitis B vaccination, and are defined non-responders (NR). We investigated the immune response to intradermal hepatitis B vaccination after pre-treatment of the skin with the TLR7 agonist imiquimod.

Methods: Twenty-one non-responders (anti-HBs <10 IU/l after at least 6 intramuscular hepatitis B vaccinations) were randomly assigned to the control group (N=11) or the experimental group (N=10).

Reduced intradermal test dose of yellow fever vaccine induces protective immunity in individuals with egg allergy.

The neutralising antibody response after the yellow fever vaccine (YF-17D) skin test was measured in 7 egg allergic persons in whom further vaccination was abandoned because of a strong local urticarial reaction to the YF-17D vaccine test dose. We found that this test dose of 0.1mL of YF-17D vaccine was sufficient to induce a protective antibody response in all 7 subjects.

Yellow fever vaccine: past, present and future.

Background: Yellow fever is a re-emerging infectious disease, as vector control and routine immunisation have dwindled in endemic areas in the last few decades. There is a constant threat of outbreaks in the large susceptible non-immune population of the megacities in tropical countries with an ongoing virus life cycle in the rainforests. For this population and for travellers to endemic areas, vaccination is the only effective protective measure against the disease and the spread of the virus.

Performance of self-diagnosis and standby treatment of malaria in international oilfield service employees in the field.

Background: Falciparum malaria remains a major occupational illness that accounts for several deaths per year and numerous lost working days among the expatriate population, working or living in high-risk malarious areas. Compliance to preventive strategies is poor in travellers, especially business travellers, expatriates and long-term travellers.

Methods: In this cross-sectional, web-based study the adherence to and outcome of a preventive malaria programme on knowledge, attitudes and practices, including the practice of self-diagnosis and standby treatment (curative malaria kit, CMK) was evaluated in 2,350 non-immune expatriates, who had been working in highly malaria endemic areas.

Intradermally administered yellow fever vaccine at reduced dose induces a protective immune response: a randomized controlled non-inferiority trial.

Background: Implementation of yellow fever vaccination is currently hampered by limited supply of vaccine. An alternative route of administration with reduced amounts of vaccine but without loss of vaccine efficacy would boost vaccination programmes.

Methods And Findings: A randomized, controlled, non-inferiority trial was conducted in a Dutch university center between August 2005 and February 2007.