Infections After International Travel: Relevant Diagnoses in Children and Adolescents

Families can acquire infections that are rare or nonexistent in Germany by international travel for business or private reasons and by migration between countries. Children and adolescents have special risk profiles, and their course of illness may be nonspecific and/or severe. A structured travel history is essential so that regionally specific infections will not be overlooked.

This narrative review is based on publications of the last 25 years that were retrieved by a PubMed search on infections after international travel, with an emphasis on retrospective and prospective studies and on articles with separate data on minors. Further information from books, guidelines, surveillance studies, reports of the Federal Statistical Office of Germany, meta-analyses, reviews, and position statements was considered as well.

Reported case numbers of infectious diseases imported from abroad fell during the COVID-19 pandemic and have since risen again. Among diseases that are usually or exclusively acquired abroad, those most commonly affecting children and adolescents were giardiasis, tuberculosis, hepatitis A and malaria, with 695, 372, 344, and 128 cases in 2024. Less common ones included dengue fever (81 cases) and typhoid fever/paratyphoid fever (45 cases).

Regionally specific infections should be considered in the differential diagnosis of fever, gastrointestinal disturbances, and skin conditions in children and adolescents after international travel. It is critical that relevant diseases including malaria and typhoid fever/paratyphoid fever must be promptly diagnosed or ruled out. Because resistance patterns differ across regions of the globe, targeted determination of the pathogenic organism including a resistogram is important. The possibility of chronic infection should be considered in particular after long stays abroad.