Clinical outcome was good for all patients after 15 days. The limitations of this study resided in its retrospective nature and the small number of cases. However, it may serve as a reminder to clinicians of epidemiological, clinical, and laboratory data associated

with this uncommon but potentially lethal disease. It also shows that the risk would appear to be significant in Africa and that lymphocytopenia is a common feature of leptospirosis. The authors state that they have no conflicts of interest. “
“Background. Imported diseases recorded in the European Union (EU) increasingly involve traveling immigrants returning from visits to their relatives and friends (VFR). Children of these immigrant families can represent a population of extreme vulnerability. Methods. A randomized cross-sectional ABT-263 purchase study of 698 traveling children under the age of 15 was performed. VFR traveling children and non-VFR (or tourist) children groups were compared. Results. A total of 698 individuals were analyzed: 354 males (50.7%) and 344 females (49.3%), with a median age (interquartile range) of 4 (2–9) years. Of these, 578 (82.8%)

had been born in the EU with 542 (77.7%) being considered as VFR, whereas 156 (22.3%) were considered tourists. VFR children were younger (4.7 vs 8.2 yr; p < 0.001), they had more frequently Tanespimycin been born in the EU (62.8% vs 20.1%; p < 0.01) and were more frequently lodged in 17-DMAG (Alvespimycin) HCl private homes (76.6% vs 3.2%: p < 0.001) and rural areas (23.2% vs 1.6%; p < 0.001). Furthermore, VFR remained abroad longer (51.6 vs 16.6 d; p < 0.001), the visit/travel time interval was shorter

(21.8 vs 32.2 d; p < 0.001) than tourists, and consultation was within 10 days prior to the departure (26.4% vs 2.7%; p < 0.001). The risk factor most differentiating VFR children from tourists was accommodation in a rural setting [odds ratio(OR) = 5.26;95%CI = 2.704–10.262;p < 0.001]. Conclusions. VFR traveling children showed a greater risk of exposure to infectious diseases compared with tourists. Immigrant families may represent a target group to prioritize international preventive activities. Despite an overall stagnation in arrivals since 2008, the European Union (EU) has remained the world’s largest destination during the 21st century.1 Tourism, international business travel, and migration make up this intense traffic, resulting in greater vulnerability to old, new, or re-emerging infectious diseases. Immigrants who have settled in the EU commonly travel to their native countries after having resided for long periods in the EU or other Western-style nations.2 Thus, a steady increase has been recorded in the cases of imported diseases among immigrants from the EU visiting friends and relatives (VFR immigrants).