Fevers in Returning International Travelers

Abstract

Infectious Diseases| October 01 2007 Fevers in Returning International Travelers AAP Grand Rounds (2007) 18 (4): 42–43. https://doi.org/10.1542/gr.18-4-42-a Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Fevers in Returning International Travelers. AAP Grand Rounds October 2007; 18 (4): 42–43. https://doi.org/10.1542/gr.18-4-42-a Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: fever, traveler Source: Wilson ME, Weld LH, Boggild A, et al. Fever in returning travelers: results from the GeoSentinal Surveillance Network. Clin Infect Dis. 2007;44:1560–1568; doi:10.1086/518173 The GeoSentinel Surveillance Network consists of clinical sites staffed by providers who are experienced in travel and tropical medicine. Practitioners from these sites contribute anonymous reports of clinical encounters with ill travelers to a large database. For this study, investigators from the GeoSentinel Network reviewed reports from 31 clinics in six continents over a 10-year period (1997–2006) to determine the frequency and causes of fever in returned travelers. To be included patients must have traveled internationally within 10 years and be seeking medical care for a presumed travel-related illness. Information collected in the database included: demographic information; reason for travel (tourism, business, research or education, visiting friends or relatives, volunteer or missionary); travel history; pre-travel clinic visit; clinical findings (including laboratory test results); and travel duration. Countries were divided into 10 regional classifications. The chief reason for seeking medical care and the presence or absence of fever (documented or by history) were recorded. Returning travelers with and without fever were compared. Of the 54,834 clinical encounters included in the database, 24,920 met inclusion criteria. Fever was the main reason for seeking medical care for 6,957 patients (28%); 429 of these were children under 20 years of age. Febrile and afebrile travelers did not differ in age. Febrile travelers were more likely to be male. For patients traveling to sub-Saharan Africa and south-central Asia, those who visited a travel clinic prior to travel were less likely to present with fever than those who did not have a pre-travel visit. Patients who were visiting friends and family in sub-Saharan Africa, south-central Asia, and Central America were more likely to present with fever compared to those traveling for other reasons. The longer the interval between return and presentation, the less likely ill patients were to present with fever. Of all returned travelers with fever, 35% had a systemic febrile illness, 15% had a diarrheal disease, and 14% had a respiratory illness. Malaria was the most common cause of fever (59%) in patients with a systemic febrile illness (n=2451). Plasmodium falciparum, which causes the most severe malaria, was identified in 66% of patients with malaria and in 14% of all patients presenting with fever. More than half of all patients with malaria required hospitalization. Vaccine-preventable infections were identified in 3% of ill returned travelers who presented with fever. Typhoid fever was the most common vaccine-preventable cause of fever. Exposures in south-central and Southeast Asia accounted for >70% of cases of typhoid fever. Travelers visiting family and friends were more likely than other travelers to be diagnosed with a vaccine-preventable disease and less likely to have sought pre-travel advice. The interval between return from travel and medical evaluation varied with type of infection. The majority (66%) of the travelers with Dengue fever were seen within one week. For travelers with malaria, 65% of those with... You do not currently have access to this content.