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Fever in returned travellers presenting in the United Kingdom: recommendations for investigation and initial

Victoria Johnston1, Jane M Stockley, David Dockrell

  • 1Hospital for Tropical Diseases, Mortimer Market Centre, Capper Street, London, UK. victoria.johnston@lshtm.ac.uk

The Journal of Infection
|July 15, 2009
PubMed

Insights

Physicians should suspect tropical infections in returned travelers with fever, as many travel-related illnesses originate in tropical regions. Prompt diagnosis and treatment are crucial for recovery from potentially fatal travel-associated diseases.

Area of Science:

  • Global Health
  • Infectious Diseases
  • Travel Medicine

Background:

  • International travel is increasing, leading to a rise in returned travelers presenting with fever.
  • A significant proportion of travel-related infections are acquired in tropical regions.
  • Physicians and general practitioners must be prepared to diagnose and manage febrile illnesses in this population.

Purpose of the Study:

  • To provide a pragmatic approach to the initial diagnosis and management of fever in returned travelers.
  • To highlight common and rare geographically concentrated infections associated with international travel.
  • To guide empirical treatment decisions when diagnostic results are pending.

Main Methods:

  • Review of common and rare infectious diseases associated with travel to specific geographical regions.
  • Consideration of differential diagnoses including malaria, HIV, rickettsial diseases, enteric fever, arboviral infections, brucellosis, and visceral leishmaniasis.
  • Emphasis on evidence-based recommendations and expert consensus for management strategies.

Main Results:

  • Malaria and HIV must be excluded in travelers returning from the tropics.
  • Specific non-malarial fevers are prevalent in different regions (e.g., rickettsial diseases in Africa, enteric fever in Asia).
  • Early diagnosis and treatment are associated with rapid and full recovery for most potentially fatal travel-related infections.

Conclusions:

  • Fever in returned travelers necessitates a high index of suspicion for travel-related infections.
  • Management should be guided by epidemiological probability and regional disease patterns.
  • Timely intervention significantly improves patient outcomes, even for severe infections.

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