Table 3. Top diagnoses and source countries for specific etiologies within syndromic chief complaints among 2004 ill returned travellers with definitive travel-related diagnoses.
| Diagnosis | No. (%) of patients* | Total no. in database (travel-related) | Top three₤ source countries for diagnosis | |
|---|---|---|---|---|
| Chief complaint fever (n = 287) | ||||
| Malaria | 47 | 92.2 | 51 | India, Nigeria, Sierra Leone |
| Plasmodium falciparum | 28 | 93.3 | 30 | Nigeria, Haiti |
| Severe cerebral | 1 | 100.0 | 1 | |
| Plasmodium vivax | 11 | 91.7 | 12 | India, Pakistan, Afghanistan |
| Plasmodium species unknown | 6 | 100.0 | 6 | |
| Plasmodium ovale | 1 | 50.0 | 2 | Nigeria, South Sudan |
| Dengue fever | 14 | 77.8 | 18 | Vietnam, Thailand, Guyana |
| Active tuberculosis | 17 | 29.8 | 57 | India, Philippines, China, Vietnam |
| Pulmonary | 7 | 20.6 | 34 | |
| Extrapulmonary | 10 | 43.5 | 23 | |
| Enteric fever | 14 | 82.4 | 17 | India, Pakistan |
| Salmonella enterica serotype Typhi | 7 | 77.8 | 9 | |
| Salmonella enterica serotype Paratyphi | 4 | 100.0 | 4 | |
| Typhoid fever, unspecified | 3 | 75.0 | 4 | |
| Influenza / Influenza-like illness | 15 | 71.4 | 21 | Peru, India, Dominican Republic |
| Upper respiratory tract infection | 9 | 45.0 | 20 | India, Dominican Republic |
| Pneumonia | 9 | 56.3 | 16 | China, Thailand |
| Lobar | 7 | 53.8 | 13 | |
| Atypical | 2 | 66.7 | 3 | |
| Acute urinary tract infection | 5 | 50.0 | 10 | India |
| Rickettsioses, spotted fever† | 7 | 87.5 | 8 | South Africa, India, Malawi, Namibia |
| Chikungunya fever | 2 | 50.0 | 4 | India, Pakistan, Cambodia, Kenya |
| Brucellosis | 1 | 33.3 | 3 | Dominican Republic, Iraq, Peru |
| Chief complaint gastrointestinal (n=804) | ||||
| Acute diarrhea‡ | 128 | 96.2 | 133 | Mexico, India, Dominican Republic |
| Post-infectious irritable bowel syndrome | 133 | 100.0 | 133 | India, Cuba, Mexico |
| Chronic diarrhea | 122 | 99.2 | 123 | Cuba, India, Mexico |
| Giardiasis | 42 | 87.5 | 48 | India, Cambodia, Ghana |
| Dientamoebiasis | 27 | 90.0 | 30 | Mexico, Dominican Republic |
| Campylobacteriosis | 16 | 100.0 | 16 | Peru, Indonesia, India, Cambodia |
| Cryptosporidiosis, cyclosporiasis | 8 | 80.0 | 10 | United States, Costa Rica |
| Amoebiasis due to Entamoeba histolytica§ | 4 | 100.0 | 4 | Dominican Republic, India, Turkey |
| Chief complaint dermatologic (n=440) | ||||
| Skin and soft tissue infection** | 60 | 72.3 | 83 | Cuba, India, United States |
| Arthropod bite | 77 | 97.5 | 79 | United States, Dominican Republic, India |
| Insect | 60 | 96.8 | 62 | |
| Tick/Spider | 17 | 100.0 | 17 | |
| Rash | 70 | 95.9 | 73 | Cuba, Mexico, Dominican Republic |
| Atopic dermatitis | 19 | 100.0 | 19 | |
| Contact dermatitis | 12 | 100.0 | 12 | |
| Drug reaction | 2 | 66.7 | 3 | |
| Photosensitivity reaction | 7 | 100.0 | 7 | |
| Unknown rash | 23 | 100.0 | 23 | |
| Urticarial | 8 | 80.0 | 10 | |
| Cutaneous larva migrans | 43 | 100.0 | 43 | Jamaica, Thailand, Mexico |
| Animal bite†† | 22 | 78.6 | 28 | Thailand, Indonesia, Mexico, Costa Rica, Chile |
| Cutaneous leishmaniasis | 16 | 100.0 | 16 | Costa Rica, Mexico, Afghanistan |
| Marine envenomation | 11 | 84.6 | 13 | United States, Mexico |
*Percentages are calculated by total number in the database. An ill returned traveller could present with more than one chief complaint. †Includes infection with Rickettsia africae, R. conorii, and R. rickettsii. ‡Includes acute bacterial, parasitic, and viral diarrhea, as well as acute diarrhea of unspecified cause. §Includes both intestinal and extraintestinal amoebiasis. ¶Includes lice, fleas, true bugs, mosquitoes, flies, and midges. **Includes erysipelas, cellulitis, furunculosis, carbuncles, skin abscess, pyoderma, ecthyma, impetigo, and superficial fungal skin infections. ††Includes bites by cats, dogs, monkeys, and other animals. ₤ Where only one or two countries are listed, this indicates >3-way tie for second or third place.