Background: Leishmaniasisis an emerging infectious disease reported in the north and south of Thailand of which patients with HIV/AIDS are a high risk group for acquiring the infection. A lack of information regarding prevalence, and the risk association ofLeishmaniainfection among asymptomatic immunocompetent hosts needs further investigation. Information on potential vectors and animal reservoirs in the affected areas is also important to control disease transmission.Methods: An outbreak investigation and a cross-sectional study were conducted following one index case of cutaneous leishmaniasis (CL) caused byL.martiniquensisin an immunocompetent male patient reported in August 2015, Chiang Rai Province, Thailand. From September to November 2015, a total of 392 participants at two study areas who were related to the index case, 130 students at a semi-boarding vocational school and 262 hill tribe villagers in the patient’s hometown, were recruited in this study. The nested internal transcribed spacer 1-PCR (ITS1-PCR) was performed to detectLeishmaniaDNA in buffy coat, and nucleotide sequencing was used to identify species. Antibody screening in plasma was performed using the Direct Agglutination Test (DAT), and associated risk factors were analyzed using a standardized questionnaire. Captured sandflies within the study areas were identified and detected forLeishmaniaDNA using nested ITS1-PCR. Moreover, the animal reservoirs in the study areas were also explored forLeishmaniainfection.Results: Of 392 participants, 28 (7.1%) were positive forLeishmaniainfection of which 1 (4.8%) wasL.martiniquensis, 12 (57.1%) wereL.orientalisand 8 (38.1%) wereLeishmaniaspp. Of 28, 15 (53.6%) were DAT positive. None showed any symptoms of CL or visceral leishmaniasis. Risk factors were associated with being female (adjusted odds ratio, AOR 2.52, 95%CI 1.01–6.26), increasing age (AOR 1.05, 95%CI 1.02–1.08), having an animal enclosure in a housing area (AOR 3.04, 95%CI 1.13–8.22), being exposed to termite mounds (AOR 3.74, 95%CI 1.11–12.58) and having domestic animals in a housing area (AOR 7.11, 95%CI 2.08–24.37). At the semi-boarding vocational school, sixSergentomyia gemmeasamples were PCR positive for DNA ofL.orientalisand oneS.gemmeawas PCR positive for DNA ofL.donovani/L.infantum. Additionally, onePhlebotomus stantoniwas PCR positive for DNA ofL.martiniquensis, and one black rat (Rattus rattus) was PCR positive for DNA ofL.martiniquensis.Conclusion: This information could be useful for monitoringLeishmaniainfection among immunocompetent hosts in affected areas and also setting up strategies for prevention and control. A follow-up study of asymptomatic individuals with seropositive results as well as those with positive PCR results is recommended.

Artesunate is the drug of choice for treating patients with severe malaria. Post-artesunate delayed hemolysis (PADH) is an uncommon adverse event from malaria treatment. Most patients with PADH are non-immune travelers. The pathophysiology of PADH is not fully understood, but the most likely mechanism is “pitting”, in which red blood cells carrying dead parasites killed by artesunate’s action are directed to the spleen for clearing the dead parasites. After the cleansing process, these red blood cells re-enter the circulation but with a smaller size and impaired integrity, resulting in a shortened lifespan of 7–21 days. Therefore, most patients with PADH usually present with clinical features of hemolytic anemia 7 days or later after the initiation of artesunate. To date, the benefits of artesunate treatment outweigh its adverse events, and no fatal cases have resulted from PADH. However, the hematological follow-up of patients with malaria treated with artesunate is recommended for clinicians to detect any delayed hemolytic event early and prevent potentially serious consequences.

Climate change has led to an increase in average global temperatures, with the last 8 years being the warmest on record. Global temperatures have risen significantly over the past two decades, compared to the average temperature during 1910–2000 (https://www.ncei.noaa.gov/access/monitoring/climate-at-a-glance/global/time-series). Asia has experienced the highest increase at 1.78°C per century, followed by Europe at 1.51°C ( Figure 1). The United Nations World Meteorological Organization recently reported that the probability of El Niño developing this year is growing. ¹ El Niño is an irregularly occurring climate pattern of unusual warming of sea surface temperatures in the central and eastern tropical Pacific Ocean, occurring every 2–7 years. ¹ El Niño can disrupt normal weather patterns globally, and is forecasted to drive global temperatures even higher than the already occurring human-induced warming from greenhouse gases. ¹ In combination with El Niño, 2023 and 2024 are predicted to be amongst the warmest years in almost two centuries. Tropical regions appear to be significantly impacted, with several countries in South America, South and Southeast Asia, Southwestern Europe and Northern Africa experiencing summer temperatures that exceed 35°C and can easily surpass 40°C. The extreme heat effects of El Niño have already been witnessed this year with record shattering temperatures recorded this April in Peru, Spain, Portugal, Morocco and Algeria. As a result, the impact of heat on health is unavoidable for both locals and travellers, particularly those travelling to hot climate destinations who are not acclimatized.

Background: Drug tourism reflects the expanding illicit drug market, posing health risks in unfamiliar travel settings. Existing knowledge specifically addressing substance use among international travellers is sparse and has not been reviewed to date. This review aimed to describe the recreational substance abuse in international travellers. Methods: A literature search was conducted on PubMed, Google Scholar and Scopus using keywords related to recreational substances and international travellers. A total of 11 021 articles were reviewed, charted and summarized for the evidence on prevalence, patterns and characteristics of substance abuse and their health- and non-health-related problems on international travellers. Results: A total of 58 articles were included. Most were cross-sectional studies and review articles. In total, 20 articles addressed the prevalence of substance abuse in travellers, 33 looked at characteristics and patterns of substance abuse in travellers and 39 investigated the health- and non-health-related problems from substance abuse. Estimated prevalence of recreational substances abuse varied from 0.7% to 55.0%. Rates of substances abuse were 9.45–34.5% for cannabis, 20.4–35.9% for alcohol intoxication, 2.82–40.5% for MDMA, 2–22.2% for cocaine, 2–15% for psychedelic agents and 2% for methamphetamine. The prevalence varied according to travellers’ characteristics and travel destinations. Direct health problems included neuropsychiatric problems. Indirect problems included accident and unintentional injuries, crime and violence, risky sexual behaviours and sexual violence and blood-borne infections. Non-health-related problems included air rage, deportation and violation of local laws. Conclusion: Substance abuse among international travellers is an underestimated problem that requires intervention. These findings emphasize the importance of addressing this issue to mitigate both health and well-being problems among travellers whilst promoting safer and more responsible travel experiences. In the context of travel health practices, practitioners should counsel travellers whose itineraries may include substance abuse, informing them about associated risks and consequences.

: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease primarily reported in Asia. This review aims to summarize studies on the epidemiological characteristics of SFTS. Literature from PubMed and Scopus was searched up to February 14, 2024. A total of 76 articles were eligible. Infections were reported in China, Japan, South Korea, and several other countries in Asia. The incidence of SFTS has been rising and reported from new areas across Asia. The incidence rate was highest in China, ranging from fewer than 0.1 to 4.2 cases per 100,000 population and reaching up to 127.6 cases per 100,000 population in some areas. Most cases occurred between April and December. Elderly farmers and veterinarians were the most affected group. Key epidemiological factors included direct contact with animals, outdoor work, vegetation near homes, rural or hilly residency, tick bites, and direct contact with blood or saliva from infected animals or humans.