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[Fever in children returning from travel]
F Sorge1, N Velayudhan-Deschamps2, A Faye3
1Service de pédiatrie générale, hôpital Necker, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France; Service de pédiatrie générale, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France; Groupe de pédiatrie tropicale de la Société française de pédiatrie, 75019 Paris, France.
Insights
Assessing febrile child travelers returning from abroad requires prompt evaluation for tropical diseases like malaria. Early diagnosis and treatment are crucial for life-threatening infections and public health.
Area of Science:
- Pediatrics
- Infectious Diseases
- Travel Medicine
Background:
- Child travelers face risks of infectious and noninfectious diseases, often outside practitioners' experience.
- Assessing febrile returning child travelers is increasingly common and complex.
- Identifying travel history is paramount for diagnosing potentially life-threatening tropical diseases, such as malaria.
Purpose of the Study:
- To provide guidance on the first-line evaluation and management of febrile child travelers.
- To highlight the importance of travel history in diagnosing tropical infections.
- To outline public health considerations for contagious diseases in returning children.
Main Methods:
- Detailed review of immunization, medical, and travel history, incorporating geographic, seasonal, environmental, sociocultural, and epidemiological data.
- Clinical examination and elementary first-line investigations.
- Guidance on using history to direct second-line diagnostic exams.
Main Results:
- Travel history is essential for identifying potential tropical diseases in febrile children.
- Approximately 75% of cases can be diagnosed and treated effectively by guiding second-line exams.
- Most children present with common infections, but malaria requires urgent, specific treatment.
Conclusions:
- Prompt and thorough evaluation of febrile child travelers is critical.
- Travel history is a key component in diagnosing and managing pediatric febrile illnesses post-travel.
- Effective management strategies are essential for both individual patient outcomes and public health protection.
Abstract:
Child travelers are numerous, exposed to the risk of diseases, both infectious and noninfectious, for which practitioners often lack experience. The assessment of febrile returning child travelers is becoming more frequent and challenging. The question of previous travel should be foremost in the checklist of the interview of any febrile child traveler, because this implies a possible tropical disease such as malaria that may be life-threatening. These need to be investigated and treated effectively and rapidly. There are highly contagious infections that could pose public health risks requiring implementation of hygienic and public health measures. A detailed immunization, medical, and travel history for exposure to infectious risks using geographic, seasonal, environmental, sociocultural, and epidemiological data are needed. Along with clinical examination and elementary first-line investigations, the history should guide second-line exams, which will provide the etiology and optimal treatment in approximately 75 % of cases. The majority of children will have a cosmopolitan infection that resolves spontaneously or is simple to treat. Malaria will need urgent and specific treatment. This article describes guidance on first-line evaluation and management of febrile child travelers as recommended in France.
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