1. In healthy young adults, pre-exposure immunisation against rabies can most likely be accomplished with only a single injection, irrespective of intramuscular or intradermal route.2. Intradermal... Show more1. In healthy young adults, pre-exposure immunisation against rabies can most likely be accomplished with only a single injection, irrespective of intramuscular or intradermal route.2. Intradermal injection of a fractional dose of conjugated meningococcal vaccine is safe and likely elicits an antibody response comparable to intramuscular injection with a standard dose.3. A single subcutaneous vaccination with yellow fever vaccine provides a duration of protection well in excess of 10 years.4. Oral vaccination against cholera solicits an antibody response in most kidney transplant patients, but this response is clearly stratified by immunosuppressive regime. Show less
Background: Medical schools offer students the opportunity to perform international electives. This study aimed to assess health risks among medical students, to tailor institutional guidelines... Show moreBackground: Medical schools offer students the opportunity to perform international electives. This study aimed to assess health risks among medical students, to tailor institutional guidelines.Methods: Multicenter study at Dutch and Belgian universities, among medical students who visited low- or middle-income countries. Students completed four questionnaires: once before the elective and two weeks, three- and six months after return.Results: Data was complete for 479 students (follow-up rate 84%). Most traveled to Surinam (29%) and South-Africa (14%). Half of the students encountered difficulties in adapting to local culture. Almost 40% visited malaria endemic countries. Nearly all (87%) used chemoprophylaxis as prescribed. Definite needle-stick or splash injuries were reported by 7%. All were dealt with adequately in accordance with national guidelines. However, less than half of 24 possible incidents were handled adequately. Two-and-a-half percent had unprotected sex with a new partner. The incidence of travelers' diarrhea (TD) was 46%. In those with TD, the incidence of post-travel new-onset abdominal complaints was 3%. Three percent were involved in a minor traffic accident, 18% were injured during leisure activities, 5% were threatened or experienced physical violence. Only half of the students visiting a highly endemic country were screened for tuberculosis post-travel. For schistosomiasis this was 6%.Conclusions: Students abroad are exposed to medical and non-medical challenges, which should be addressed during pre-travel counseling. Contact details of a professional back home should be provided, so students can confer in case of problems while abroad. Lastly, we recommend a centrally organized post-travel health check. Show less
Jonker, E.F.F.; Uijlings, M.A.C.; Visser, L.G.; Soonawala, D. 2019
Conclusion: These results imply that YF vaccination is effective despite certain immunosuppressive drug regimens. An early-differentiated memory-like phenotype persisted, which is associated with... Show moreConclusion: These results imply that YF vaccination is effective despite certain immunosuppressive drug regimens. An early-differentiated memory-like phenotype persisted, which is associated with effective expansion upon re-encounter with antigen, suggesting a potent memory T-cell pool remains. (C) 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved. Show less
The presence of a functionally competent YF-specific memory T-cell pool 18 years and sufficient titers of neutralizing antibodies 35-40 years after first vaccination suggest that single vaccination... Show moreThe presence of a functionally competent YF-specific memory T-cell pool 18 years and sufficient titers of neutralizing antibodies 35-40 years after first vaccination suggest that single vaccination may be sufficient to provide long-term immunity. Show less
Conclusions: All immune-compromised patients mounted an adequate response with protective levels of virus neutralizing antibodies to the 17-D YF vaccine. No adverse effects were reported. Compared... Show moreConclusions: All immune-compromised patients mounted an adequate response with protective levels of virus neutralizing antibodies to the 17-D YF vaccine. No adverse effects were reported. Compared to the plaque reduction neutralization test, the sensitivity of the Immune Fluorescence Assay test was low. Further research is needed to ascertain that 17D vaccination in immune-compromised patients is safe. (C) 2016 Elsevier Ltd. All rights reserved. Show less