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      Infections associated with adventure travel: A systematic review

      review-article
      , M.D. , ,
      Travel Medicine and Infectious Disease
      Elsevier Ltd.

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          Abstract

          Aim

          To review infections associated with adventure travel.

          Methods

          The PubMed, Embase and Scopus databases were searched combining the words infection with the following keywords: rafting, whitewater, surfing, (surfer* or windsurf*), (caves or caving or spelunking), (triathlon or trekking) or (hiking or adventure race), bicycling, backpacking, (mountain climb* or bouldering), horseback riding, orienteering, trekking, and skiing.

          Results

          Adventure travel is becoming much more common among travelers and it is associated with a subset of infectious diseases including: leptospirosis, schistosomiasis, viral hemorrhagic fevers, rickettsial diseases and endemic mycosis. Caving and whitewater rafting places individuals at particular risk of leptospirosis, schistosomiasis and endemic mycosis, while adventure races also place individuals at high risk of a variety of infections including campylobacter, norovirus and leptospirosis.

          Conclusion

          Travel practitioners need to be aware of the risks associated with adventure travel and should educate individuals about the risks associated with various activities. Doxycycline prophylaxis should be considered for travelers who are susceptible to leptospirosis due to participation in high-risk sports such as whitewater rafting, caving or adventure races.

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          Most cited references107

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          Bats as reservoirs of severe emerging infectious diseases

          Highlights • Bats has been considered as natural reservoirs of several highly pathogenic viruses, including Ebola virus, SARS-CoV, MERS-CoV, Nipah virus, and Hendra viruses. • Social, biological and immunological features of bats play an important role in virus maintenance and transmission. • Spillover of viruses from bats to intermediate animal hosts are thought to be the most likely route to cause human infection. • Social and cultural factors can drive the spread of bat-borne viruses in humans.
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            :{unav)

            Experimental and Applied Acarology, 23(9), 685-715
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              Is Open Access

              Leptospirosis in “Eco-Challenge” Athletes, Malaysian Borneo, 2000

              Adventure travel is becoming more popular, increasing the likelihood of contact with unusual pathogens. We investigated an outbreak of leptospirosis in “Eco-Challenge” multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from the United States and 26 other countries. Eighty (42%) athletes met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming in the Segama River (relative risk [RR]=2.0; 95% confidence interval [CI]=1.3 to 3.1) to be an independent risk factor. Twenty-six (68%) of 38 case-patients tested positive for leptospiral antibodies. Taking doxycycline before or during the race was protective (RR=0.4, 95% CI=0.2 to 1.2) for the 20 athletes who reported using it. Increased adventure travel may lead to more frequent exposure to leptospires, and preexposure chemoprophylaxis for leptospirosis (200 mg oral doxycycline/week) may decrease illness risk. Efforts are needed to inform adventure travel participants of unique infections such as leptospirosis.
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                Author and article information

                Contributors
                Journal
                Travel Med Infect Dis
                Travel Med Infect Dis
                Travel Medicine and Infectious Disease
                Elsevier Ltd.
                1477-8939
                1873-0442
                27 March 2017
                March-April 2017
                27 March 2017
                : 16
                : 3-10
                Affiliations
                [1]University of Alabama at Birmingham, 1900 University Blvd, THT 229, Birmingham, AL 35294, United States
                Author notes
                []Corresponding author. ngundacker@ 123456uabmc.edu
                Article
                S1477-8939(17)30041-8
                10.1016/j.tmaid.2017.03.010
                7185378
                28351605
                575e2029-9c64-4283-b3e2-b465a0dcf02d
                © 2017 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 21 November 2016
                : 20 March 2017
                : 21 March 2017
                Categories
                Article

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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