Table 3.

Common causes of fever associated with specific risk activities

Risk activities	Common	Occasional	Rare but important
Bites
Tick	Lyme disease, tick typhus	Q fever	Other borreliosis (tick bite fever, relapsing fever), CCHF (tick bite, crushed tick), ehrlichiosis, tick-borne encephalitis, tularaemia
Tsetse fly		Trypanosomiasis
Animal	Cellulitis	Q fever, tularaemia	Anthrax, rabies, rat bite fever
Environmental exposure
Dust exposure (e.g. caves, mines, deserts)	Coccidioidomycosis, histoplasmosis		Rabies, Ebola/Marburg (caves)
Cruise ships/resorts	Legionella, norovirus
Hospital admission	Multidrug-resistant bacteria (colonization, infection)		MERS-CoV
Freshwater exposure	Katayama fever (acute schistosomiasis), leptospirosis		Acanthamoeba
Game parks	Tick typhus		Anthrax, trypanosomiasis
Farms or animal slaughter exposure	Brucella, Q fever		CCHF
Contact with camels			MERS-CoV
Contact with or ingestion of antelope, primates or bats			Marburg/Ebola
Ingestion
Faecally contaminated water	Amoebiasis, enteric fever, gastroenteritis (bacterial or viral), hepatitis A/E		Poliomyelitis
Unpasteurized milk	Listeria, Salmonella, Shigella	Brucella
Undercooked/raw food	Bacterial gastroenteritis, amoebiasis		Trichinosis
Sexual exposure	HIV, hepatitis A/B/C, syphilis, gonorrhoea, reactive arthritis, pelvic inflammatory disease
Host factors
Immunocompromised	Amoebiasis, non-typhoid Salmonella, tuberculosis	Visceral leishmaniasis, STI (e.g. syphilis)	Blastomyces dermatitidis, coccidioidomycosis, histoplasmosis, penicilliosis

CCHF, Crimean–Congo haemorrhagic fever; MERS-CoV, Middle East respiratory syndrome coronavirus; STI, sexually transmitted infection.