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Case Report: Infectious Diseases in Pilgrims Visiting the Holy Land
Orna Nitzan1,2, Arnon Blum3,1, Esther Marva4
1Faculty of Medicine in the Galilee, Bar Ilan University, Ramat Gan, Israel.
Insights
Christian pilgrims visiting Israel can contract rare zoonotic diseases abroad. Prompt diagnosis and testing are crucial for treating these challenging imported infections in travelers.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Travel Medicine
Background:
- Christian pilgrims frequently visit holy sites around the Sea of Galilee.
- Some pilgrims are hospitalized at Poriya Medical Center with infectious diseases acquired in their home countries.
- Diagnosing these imported zoonotic diseases presents challenges due to language barriers and limited availability of specific diagnostic tests in Israel.
Observation:
- A review of 2015 hospital records identified three Holy Land tourists with laboratory-confirmed, diagnostically challenging zoonotic infectious diseases.
- Cases included relapsing fever due to *Borrelia recurrentis*, human granulocytic anaplasmosis, and leptospirosis.
- Patients were from Ethiopia, New Hampshire (USA), and Brazil, highlighting diverse geographic origins.
Findings:
- The study successfully identified and confirmed three distinct imported zoonotic diseases in international travelers.
- Each case presented unique diagnostic hurdles, emphasizing the need for specialized medical consideration.
- The findings underscore the occurrence of rare infections among tourists visiting Israel.
Implications:
- Healthcare providers in Israel should consider imported zoonotic diseases in returning travelers, especially those with relevant travel history.
- Availability and utilization of appropriate diagnostic tests are critical for accurate and timely diagnosis.
- This highlights the importance of travel medicine awareness for clinicians managing infectious disease cases in international visitors.
Abstract:
Every year Christian pilgrims from around the world visit the holy sites located around the Sea of Galilee. Some become ill during their stay with infectious diseases that were acquired in their country of origin, and are hospitalized at Poriya Medical Center. They pose a diagnostic challenge due to language barriers, the rarity of these infections in Israel, and the fact that diagnostic tests are not readily available. All patient records from 2015 of Holy Land tourists hospitalized at Poriya Medical Center were screened for the diagnosis of imported zoonotic diseases that are not commonly diagnosed in Israel. Three patients who were on a Holy Land tour were hospitalized during 2015 with laboratory-confirmed diagnostically challenging zoonotic infectious diseases: a 91-year-old priest from Ethiopia diagnosed with relapsing fever due to Borrelia recurrentis, an 85-year-old retired mountaineer from New Hampshire diagnosed with human granulocytic anaplasmosis, and a 57-year-old farmer from central Brazil diagnosed with leptospirosis. These case reports emphasize the importance of considering imported zoonotic infectious diseases and obtaining appropriate diagnostic tests when treating Holy Land travelers to Israel.
