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Post-Travel Screening of Asymptomatic Long-Term Travelers to the Tropics for Intestinal Parasites Using Molecular Diagnostics

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  • Department of Infectious and Tropical Diseases, Leiden University Medical Center, Leiden, The Netherlands; Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands; Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands; Student Health Department, Wageningen University, Wageningen, The Netherlands

The incidence of asymptomatic travel-related parasitic infection is uncertain. Previous studies did not distinguish new incident infections, from past infections. Regardless of symptoms, we performed multiplex real-time polymerase chain reaction on pre- and post-travel stool samples of Dutch long-term travelers to the (sub)tropics. Serological screening for Schistosoma spp. was only performed in travelers to sub-Saharan Africa. In total, 679 travelers were included in the study. The follow-up rate was 82% (556 of 679). Participants' median travel duration was 12 weeks. There was one incident infection with Strongyloides stercoralis; there were none with Entamoeba histolytica, 4 with Cryptosporidium spp. (1%), and 22 with Giardia lamblia (4%). Nine of 146 travelers (6%) seroconverted for Schistosoma spp. Routine screening of stool samples for parasitic infection is not indicated for asymptomatic people, who travel to the (sub)tropics for up to 3 months. Screening for Schistosoma spp. should be offered to travelers with fresh-water contact in endemic regions.

Author Notes

* Address correspondence to Darius Soonawala, Department of Infectious Diseases and Tropical Medicine C5-P, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: d.soonawala@lumc.nl

Financial support: Support for this work was provided by the Department of Medical Microbiology at LUMC.

Authors' addresses: Darius Soonawala, Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands, E-mail: d.soonawala@lumc.nl. Lisette van Lieshout, Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands, E-mail: e.a.van_lieshout@lumc.nl. Marion A. M. den Boer and Leo G. Visser, Department of Infectious Diseases and Tropical Medicine, Leiden, The Netherlands, E-mails: a.m.den_boer@lumc.nl and l.g.visser@lumc.nl. Eric C. J. Claas, Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands, E-mail: e.c.j.claas@lumc.nl. Jaco J. Verweij, Laboratory for Medical Microbiology and Immunology, St. Elisabeth Hospital, Tilburg, The Netherlands, E-mail: j.verweij@elisabeth.nl. André Godkewitsch and Marchel Ratering, Vaccinatiecentrum Wageningen, Wageningen, The Netherlands, E-mails: godkewitsch@ezorg.nl and marchel@vaccinatiecentrum.nl.

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