Objectives. To identify hazardous migration experiences among asylum seekers and associations with psychiatric illness. Methods. We conducted a cross-sectional study of asylum seekers in a federally qualified health center in New York City from January 1 to November 30, 2023, to determine the frequency of and factors associated with hazardous migration events: physical or sexual assault, kidnapping, extortion, illnesses, and incarceration. Results. Of 530 people (median age = 28 years, 55.5% female), most were from Venezuela (38.5%), Ecuador (20.0%), and other countries in South America (27.0%). They reported physical assault (24.9%), sexual assault (1.9%), kidnapping (4.7%), extortion (48.3%), and illness (19.4%) during migration. Crossing the Darien Gap was independently associated with experiencing physical or sexual violence (as a composite outcome, adjusted odds ratio [AOR] = 2.71; 95% confidence interval [CI] = 1.47, 5.10), illness (AOR = 3.71; 95% CI = 1.70, 8.58), and extortion (AOR = 1.94; 95% CI = 1.12, 3.34). Among adults, 10.7% (95% CI = 7.7%, 14.3%) were diagnosed with psychiatric illness during their initial evaluation, and this was more common in those who were incarcerated in immigration detention centers (OR = 2.02; 95% CI = 1.13, 3.66). Conclusions. Asylum seekers journeying through the Darien Gap frequently encounter hazardous traumatic events. Detention by immigration authorities is associated with psychiatric illnesses. (Am J Public Health. 2025;115(10):1691-1699. https://doi.org/10.2105/AJPH.2025.308065).

Background:People seeking humanitarian protections in the United States often have complex ecologic exposures during their migration, as in the Darién Jungle, a rainforest between Colombia and Panama. We characterized eosinophilia and select parasitic infections in this population. Methods:We conducted a cross-sectional study of clinical evaluations of unhoused people seeking humanitarian protection in Boston and New York City. Patients underwent laboratory testing based on clinician discretion. We extracted data regarding migration history and testing for eosinophilia (>500 cells/μL), Strongyloides infection, and Chagas disease. We used χ2 testing to evaluate the association between exposure to the Darién Jungle and test results. Results:Our sample included 632 people (median age, 27 years; 55.0% female), primarily from Venezuela (32.0%), Ecuador (16.6%), Colombia (14.7%), and Haiti (13.3%). Of these, 411 people (65.0%) crossed the Darién Jungle. The median (IQR) duration in the Darién Jungle was 5 (4-7) days. We found that 71 people (11.2%) had eosinophilia. Of 438 people who completed testing for Strongyloides infection, 21 (4.8%) were positive, which occurred more frequently in people with eosinophilia (P = .006). Testing for Chagas was negative in all people. Children were more likely to have eosinophilia as compared with adults (odds ratio, 1.76; 95% CI, 1.04-2.95). There was no statistically significant association between crossing the Darién Jungle and eosinophilia (odds ratio, 1.13; 95% CI, .67-1.95). Conclusions:Eosinophilia and Strongyloides infection are common among unhoused persons seeking humanitarian protections in the United States, particularly children. Clinicians should screen for these conditions and be vigilant for migration-related exposures.

We report a patient with lobomycosis caused by Paracoccidioides loboi fungi in the Andes-Amazon region of Bolivia. We examined clinical, epidemiologic, and phylogenetic data and describe potential transmission/environmental aspects of infection. Continued surveillance and identification of lobomycosis cases in South America are crucial to prevent the spread of this disease.

Chagas disease, or American trypanosomiasis, is a zoonotic tropical disease caused by Trypanosoma cruzi (T. cruzi), a flagellate protozoan parasite found only in the Americas. Many infections occur through vector-borne transmission by triatomine insects in endemic areas but also often occur orally by ingestion of food or liquid contaminated with T. cruzi, blood transfusion or organ transplantation, vertically from mother to unborn infant, or accidents among laboratory personnel who work with live parasites. Since its discovery in Brazil by Carlos Chagas in 1909, the lack of effective vaccines, screening programmes, or evidence-based chemotherapy continues to place Chagas disease as one of the most important historical public health challenges in the Americas. Chagas disease is a neglected tropical disease because of its substantial impact in terms of premature mortality and its associated disability. More than 70 million people remain at risk of infection in endemic countries. After exposure to the parasite, a minority of patients will develop an acute syndrome of 4–8 weeks’ duration that is rarely fatal. Roughly, 30–40% of infected individuals will subsequently develop the cardiac or digestive forms of chronic Chagas disease, usually 10–30 years after the initial exposure. Chagas heart disease is the most common aetiology of cardiomyopathy in Latin America, and a major cause of cardiovascular death among middle-aged individuals in endemic areas. It manifests as three major syndromes that often coexist in the same patient: arrhythmic, heart failure, and thromboembolism. Chronic Chagas disease in the gastrointestinal tract leads mostly to megaoesophagus, megacolon, or both. Reactivation disease can occur in immunocompromised patients producing dermatologic manifestations, myocarditis, or meningoencephalitis.

Journal Article Berenice's Legacy, Ending Silence, and Serving Justice: A Call for Comprehensive Chagas Testing in the US Pediatric Population Get access Priya Mallikarjuna, Priya Mallikarjuna Department of Pediatric Infectious Diseases, Mount Sinai Hospital, New York, NY, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Nicholas DeFelice, Nicholas DeFelice Mount Sinai Department of Environmental Medicine and Public Health, New York, NY, USAArnhold Institute for Global Health at Mount Sinai, New York, NY, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Matthew J Ward, Matthew J Ward Mount Sinai Department of Environmental Medicine and Public Health, New York, NY, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Jose A Suarez, Jose A Suarez Department of Immunology, Universidad de Panama, Panamanian Investigation System and CIDES, Panama City, Panama Search for other works by this author on: Oxford Academic PubMed Google Scholar Juan David Ramirez, Juan David Ramirez Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USACentro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Universidad del Rosario, Bogota, Colombia Search for other works by this author on: Oxford Academic PubMed Google Scholar Alberto Paniz-Mondolfi Alberto Paniz-Mondolfi Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA Corresponding Author: Alberto Paniz Mondolfi, MD, PhD, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, Atran Building, 2nd Floor, Suite B2-15, New York, NY 10029 USA. E-mail: Alberto.Paniz-Mondolfi@mountsinai.org. Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of the Pediatric Infectious Diseases Society, Volume 13, Issue 4, April 2024, Page 263, https://doi.org/10.1093/jpids/piae019 Published: 04 March 2024

ABSTRACT. Snakebites still constitute a significant public health problem in developing countries and are considered a neglected tropical condition by the WHO. Snake accidents are associated with substantial morbidity and mortality and may produce secondary complications, such as severe infections. The objective of this systematic review was to determine the prevalence of snakebite infections and characterize the bacteria isolated from these infections. A systematic literature review in five databases was carried out to assess the prevalence of snakebite infection. A meta-analysis was performed using a random-effects model to calculate the pooled prevalence and 95% CIs. Cochran’s Q test and the I 2 statistic were used to assess between-study heterogeneity. The pooled prevalence of infection due to snakebite was 27.0% (95% CI: 22.0–32.0%), with high heterogeneity among studies ( I 2 = 99.7%). The prevalence was higher in Asia (32%) than in the Americas (21%). Snakebite infections required surgical interventions in 68% (95% CI: 37.0–98.0%). The leading group of pathogens identified corresponded to Gram-negative bacteria (63%), particularly Morganella morganii (32%), but also, Gram-positive cocci (40%), especially Enterococcus spp. (23%) and Staphylococcus aureus (15%). However, multiple other pathogens, including anaerobes, were found. A high prevalence of snakebite-associated infection has been described, primarily due to M. morganii , with the corresponding implications for empirical therapy. Rational use of antimicrobials is recommended, and this should guide initial empirical treatment. Moreover, isolation and identification of the possible bacteria present in snakebite wounds is recommended in all cases to confirm or rule out associated infection.

We describe a recent case of lymphatic filariasis in Colombia caused by Wuchereria bancrofti nematodes. Our study combines clinical-epidemiologic findings with phylogenetic data. Resurgence of lymphatic filariasis may be linked to increasing urbanization trends and migration from previously endemic regions. Fieldwork can be a beneficial tool for screening and containing transmission.

We report an isolated outbreak of Rickettsia rickettsii in the Nga center dot be-Bugle ' indigenous region, located 750 m (tropical wet) above sea level, in a jungle and mountainous area of Western Panama. Seven members of a family were infected simultaneously, resulting in four deaths. Family outbreaks have been previously described and are responsible for 4-8% of the cases described [1-4]. The simultaneous onset of symptoms in the affected popu-lation group is extremely unusual [1,5], but it should not dissuade the clinician from considering the possibility of Rickettsia rickettsii infection.

Many people from poverty-stricken countries are migrating across South and Central America to reach the México-United States border, a movement exacerbated by the COVID-19 pandemic. Migrant people who begin their northbound journey in South America must transit across a significant geographic bottleneck, the Darién Gap, a mountainous rainforest region between Colombia and Panama. Most migrant people crossing this region originate from Cuba, Haiti, and Venezuela. Other people reach the shores of South American countries from west and central Africa or central and southeastern Asia and continue to the Darién Gap. Poverty and violence drive families with children to flee their homes and endure incalculable risks in their path. Children traveling with their families or as unaccompanied minors across the Darién Gap are exposed to life-threatening situations and human rights violations, including abuse, exploitation, malnourishment, and limited access to medical care. In addition to experiencing untreated medical illnesses, children experience mental health disorders during migration and after they reach their destination as a result of victimization and adverse traumatic experiences. Therefore, providing migrants, especially children, with rapid medical screenings and mental health support when they arrive at their destination is critical to reduce health inequities. Furthermore, making these interventions available during their transit and ensuring their safety may prevent further human rights abuses in children and families. Latin American governments must address the ongoing humanitarian crisis endured by migrants throughout their migratory path by offering access to essential healthcare services and safeguarding the rights and security of children and vulnerable groups.

Hyper-reactive malarial splenomegaly (HMS), or tropical splenomegaly syndrome, is a severe complication of chronic and recurrent infections caused by Plasmodium spp. This condition typically results in splenomegaly greater than or equal to 10 cm and a constellation of laboratory findings, including the absence of identifiable parasites in peripheral blood smears. However, patients with HMS demonstrate serological or molecular evidence of infection. Despite being a familiar entity in malaria holoendemic countries in Africa, and regions of Papua New Guinea, the pathophysiology, natural history, and treatment of the syndrome remains to be fully elucidated. Herein, we describe a highly suggestive case of HMS in a Senegalese patient migrating northbound to reach the U.S.-Mexico border and for whom we provided medical care during his crossing of the Darien Gap in Panama. We also reviewed the literature on diagnosing and treating HMS in-depth.

Human migration has shaped the distribution and patterns of infectious diseases transmission throughout history. Migration is one of the contributing factors that has played an important role in the dissemination of drug-resistant Plasmodium falciparum. Central America and Mexico are important transit points of an increasing migrant flow originating from countries where chloroquine-resistant P. falciparum and vivax are prevalent. Surveillance systems, as well as detection and diagnostic capacities in the Central American region, are limited. The additional challenges imposed by the increasingly mobile population in the region are creating the perfect scenario for the emergence or re-emergence of infectious diseases, such as the introduction of chloroquine-resistant malaria. The development and implementation of transborder, collaborative, and ethical migrant health initiatives in the region are urgently needed. The health of migrant people in transit during their migratory route is of our collective interest and responsibility; their exclusion from health programs based on their legal status contradicts international human rights treaties and is inconsistent with ethical global public health practice.

We detected Leishmania RNA virus 1 (LRV1) in 11 isolates of Leishmania (Viannia) panamensis collected during 2014–2019 from patients from different geographic areas in Panama. The distribution suggested a spread of LRV1 in L. (V.) panamensis parasites. We found no association between LRV1 and an increase in clinical pathology.

We report a patient from Panama who had lobomycosis caused by Paracoccidioides (Lacazia) loboi. We used combined clinical-epidemiologic and phylogenetic data, including a new gene sequence dataset on this fungus in Panama, for analysis. Findings contribute useful insights to limited knowledge of this fungal infection in the Mesoamerican Biologic Corridor.

Caterpillar venom has the potential to cause acute pain and systemic symptoms in individuals seeking medical attention in the jungles of Panama.Although this is not an obligatory notifiable disease, the hazards associated with exposure to this animal are widely recognized within the local community.Here, we present a case of a patient who sought medical attention after being rescued from a river in a Panamanian jungle after feeling acute pain in an upper extremity associated with shortness of breath and how tropical medicine teleconsult allowed for quick identification of the cause and assisted in the management.About his case, we examine the phenomenon of caterpillar envenomation and suggest that further research is needed to assess the potential impact of climate change on this disease.Of particular concern is the likelihood of an increase in contact accidents.We recommend that scientists and public health officials work together to understand the mechanisms of this disease better and to develop effective strategies for prevention and treatment.Our analysis underscores the importance of ongoing monitoring and surveillance to ensure we are prepared for future outbreaks.