Chagas disease is currently present in many non-endemic countries and remains a neglected tropical disease globally. A review of the literature identified significant gaps and scarcity of updated information from European countries, with most studies reporting data from Spain and Italy. The index of underdiagnosis may be as high as 70%, affecting mainly females of child-bearing age. Standardized screening of fertile, non-pregnant, women from endemic countries and subsequent treatment is considered an essential strategy to control transmission and prevent new cases, yet no uniform legislation for screening risk groups exists. There is heterogeneity in Europe in terms of preventive strategies to avoid transfusion-related transmission of Chagas disease, not necessarily in line with the European directives, with some countries conducting systematic screening for T. cruzi infection in blood donors, whilst others rely on pre-transfusion questionnaires. The growing burden of the infection in resource-rich areas may provide an opportunity for progress in certain aspects of control and prevention. Options for improving screening strategies, management and linkage to care are reviewed.

Endemic in over 45 countries globally, recent reports of locally acquired melioidosis in novel geographical areas, such as the Southern US, have highlighted the expanding geographical range of Burkholderia pseudomallei. Climate change and severe weather events have been linked to an increase in cases of melioidosis, which follows environmental exposure to the bacterium. Healthcare professionals should be aware of the possibility of the disease, with its diverse and often delayed presentations, even in areas not previously known to have risk. Over 200 cases of travel-associated melioidosis have been reported in the literature, highlighting the need to consider this disease in non-endemic areas, as diagnostic delays of up to 18 months have been identified. The review updates the global epidemiology of melioidosis, focusing on new geographical areas where cases have been diagnosed and imported cases, unusual clinical presentations and co-infections, and less frequent modes of transmission (laboratory exposures and the risk of acquisition due to imported infected animals and contaminated products).

The World Health Organization has identified Crimean-Congo hemorrhagic fever (CCHF) as a priority disease for research and development in emergency contexts. The epidemiology of CCHF is evolving and this review highlights travel-associated cases and focuses on the need for a One Health approach in Europe. For this narrative review, two searches were performed in PubMed and Google Scholar for the period 1980-October 2024. The first search identified travel-associated CCHF cases globally, additional cases were identified in the ProMED mail database and through healthmap.org. The second search, with a focus on the European region, aimed to analyse reports of CCHF virus (CCHFV) detected in ticks, CCHF seroprevalence studies in animals and/or humans, and autochthonous CCHF cases. Seventeen cases of imported CCHF, the majority acquired in Africa, were identified. Importation to European countries accounted for eight of the cases. Most patients presented with fever and hemorrhagic manifestations and the estimated case fatality rate was 35 %. In the WHO European region, at least 13 countries have reported ticks infected with different genotypes of CCHFV; 17 countries were found to have animals/humans with positive CCHF serology. Finally, 16 countries in the WHO European region have notified human cases of CCHF. The Russian Federation, Turkey, and several former USSR countries are considered highly endemic, followed by the Balkanic region, with sporadic cases emerging in Bulgaria, Greece, Spain, and recently Portugal. Travel-associated CCHF is infrequent. However, given the recently reported increased geographical distribution in ticks and animals in the European region, additional human cases may be anticipated in the near future. Europe receives over half of all international tourist arrivals annually, so healthcare professionals should be aware of risk factors and current protocols for the management of suspected and confirmed cases.

Endemic in over 45 countries globally, recent reports of locally acquired melioidosis in novel geographical areas, such as Southern US, have highlighted the expanding geographical range of Burkholderia pseudomallei. Climate change and severe weather events have been linked to an increase in cases of melioidosis, which follows environmental exposure to the bacterium. Healthcare professionals should be aware of the possibility of the disease, with its diverse and often delayed presentations, even in areas not previously known to have risk. Over 200 cases of travel-associated melioidosis have been reported in the literature, highlighting the need to consider this disease in non-endemic areas, as diagnostic delays of up to 18 months have been identified. The review updates the global epidemiology of melioidosis focusing on new geographical areas where cases have been diagnosed and imported cases, unusual clinical presentations and co-infections, and less frequent modes of transmission (laboratory exposures and the risk of acquisition due to imported infected animals and contaminated products).