We believe that in our case the timely association between exposure to different pyrethroids and onset of symptoms of inflammation on multiple occasions strongly suggests that what happened on that plane was a severe multi-system allergic reaction, or anaphylactic reaction Selleck ICG-001 to pyrethroids.

Whereas measures to prevent the dissemination of vector-borne illnesses around the globe are necessary, this case introduces a possible downside to this public health approach: flight cabin pyrethroid spraying can provoke life-threatening allergic reactions, at least in one individual, maybe unrecognized in others. Mechanical alternatives to insecticide spraying like “air curtains” should be implemented if proven effective. In the meantime passengers and crew should be notified in advance if, how, and when they might get exposed to insecticides during their flight. Telling people that these insecticides can provoke allergic reactions will allow them to choose to protect themselves. It should be possible

to avoid most of the pyrethroid exposure through inhalation after in-flight spraying (like the blocks-away method) since a 2004 study by Berger-Preiss and colleagues determined that more than 90% of the total amount inhaled insecticides was within the first 5 to 10 minutes following spraying.10 One of the airlines we contacted already tells their passengers prior to spraying that they can cover their eyes and nose if they wish to. Based on the findings from Berger-Preiss and colleagues, we will

also advise our patient to use a face mask during the first 15 minutes following the Autophagy inhibitor spraying. Finally, we believe it might be useful if cabin crew received a formal training in how to recognize and manage allergic reactions to insecticides. Asthma can be countered with bronchodilatating agents like albutarol and for life-threatening allergic reactions epinephrine auto-injectors should be made available. The authors state they have no conflicts of interest to declare. PDK4 “
“We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia. Trichinellosis is a zoonosis caused by nematodes of the genus Trichinella which show a cosmopolitan distribution. It is one of the most serious helminthiasis which still occur in humans in Europe.1 Infection in humans is caused by the ingestion of Trichinella spp. larvae encysted in muscle tissues of raw or undercooked meat or meat products (especially processed meat) of infected animals such as domestic and wild swine, horses, and bears.2 A 42-year-old male of Bosnian origin, who visited our Division of Infectious Diseases in January 20, 2009, complained of severe muscle pain and nonitchy rash.