TABLE 56.1.
Summary Data From Major Studies of Fever in Returned Travelers
| Study | Patient Population (Location) | Most Common Specific Infections | Most Frequently Visited Regions |
|---|---|---|---|
| Wilson et al. 20075 | 24,920 ill returned travelers, 6957 of whom had fever (Multicenter, Global) | Malaria (21%) Acute TD (15%) RTI (14%) Dengue (6%) Dermatologic illness (4%) Enteric fever (2%) Rickettsioses (2%) Acute UTI (2%) Acute hepatitis (1%) |
Sub-Saharan Africa (37%) Southeast Asia (18%) Latin America/Caribbean (15%) South Central Asia (13%) North Africa (3%) |
| Bottieau et al. 20069 | 1743 outpatients presenting with fever after tropical travel (Belgium) | Malaria (27.7%) RTI (10.5%) Bacterial enteritis (6.2%) Mononucleosis-like syndrome (3.9%) Skin/soft tissue infection (3.6%) GU infection/STD (3.4%) Rickettsioses (3.3%) Dengue (3%) |
Sub-Saharan Africa (68%) Southeast Asia (12%) Latin America (7%) Indian subcontinent (6%) North Africa (4%) |
| Doherty et al. 199510 | 195 inpatients presenting with fever after tropical travel (United Kingdom) | Malaria (42%) Nonspecific viral syndrome (25%) Dengue (6%) Bacterial dysentery (5%) RTI (4%) Hepatitis A (3%) UTI (2%) Typhoid (1.5%) |
Sub-Saharan Africa (60%) Indian subcontinent (13%) Far East (8%) South America (3%) Europe (0.5%) |
| O'Brien et al. 200111 | 232 inpatients admitted for management of fever after overseas travel (Australia) | Malaria (27%) RTI (24%) Gastroenteritis (14%) Dengue (8%) Typhoid (3%) Hepatitis A (3%) Rickettsioses (2%) Tropical ulcer (2%) |
Asia (61%) The Pacific (20%) Africa (15%) Latin America (2%) |
| Antinori et al. 200412 | 147 inpatients admitted for fever after tropical travel (Italy) | Malaria (48%) Presumptive viral illness (12%) Viral hepatitis (9%) Gastroenteritis (5%) Schistosomiasis (5%) Typhoid (4%) Dengue (3%) RTI (3%) UTI (1%) |
Africa (61%) Asia (22%) Central and South America (13%) Oceania (2%) Middle East (2%) |
| Parola et al. 200613 | 613 inpatients admitted for fever after tropical travel (France) | Malaria (75%) RTI (4%) Foodborne/waterborne infection (4%) Dengue (2%) Viral hepatitis (1%) |
Indian Ocean (55%) West Africa (22%) Central Africa (9%) Southeast Asia (4%) Indian subcontinent (3%) North Africa (2%) Central America/Caribbean (0.5%) |
| West and Riordan 20038 | 162 pediatric inpatients admitted with fever following travel to tropics and subtropics (United Kingdom) | Viral illness (34%) Diarrheal illness (27%) Malaria (14%) Pneumonia (8.5%) Hepatitis A (5%) UTI (4%) Enteric fever (3%) |
Indian subcontinent (82%) Middle East (6%) Africa (4%) Southeast Asia (2%) |
| Siikamaki et al. 20117 | 462 febrile adults returned from malaria-endemic area; emergency room of tertiary hospital; 54% hospitalized (Finland) | Diarrheal disease (27%) Systemic febrile illness (21%) (sepsis 3%; enteric fever and other bacteria 3.7%; dengue 3%; other viral including EBV and HIV 5%; rickettsiosis 1.3%) RTI (15%) UTI (4%) Other GI (3%) |
Sub-Saharan Africa (42%) Southeast Asia (28%) Central Asia and Indian subcontinent (20%) South and Central America and Caribbean (6%) Other (6%) Unknown (1%) |
| Steinlauf et al. 20056 | 211 inpatient adults after tropical travel, of whom 163 were febrile (Israel) | Malaria (33%) Dengue (17%) RTI (6%) Diarrhea (6%) Enteric fever (3%) Hepatitis (2%) |
East Asia (48%) Sub-Saharan Africa (34%) Latin America (16%) |
| Jensenius et al. 201315 | 82,825 ill returned travelers, 3655 of whom had acute and potentially life-threatening tropical diseases and 91% had fever (Multicenter, Global) | Falciparum malaria (77%) Typhoid fever (12%) Paratyphoid fever (6%) Leptospirosis (2%) Rickettsiosis (2%) Dengue hemmorrhagic fever and dengue shock syndrome (1%) |
Sub-Saharan Africa (74%) South Central Asia (14%) Southeast Asia (5%) Latin America/Caribbean (4%) North Africa (1%) |
EBV, Epstein–Barr virus; GI, gastrointestinal; GU, genitourinary; HIV, human immunodeficiency virus; RTI, respiratory tract infection; STD, sexually transmitted disease; TD, travelers' diarrhea; UTI, urinary tract infection.
Adapted from Wilson M, Boggild A. Fever and systemic symptoms. In: Guerrant R, Walker D, Weller P, editors: Tropical infectious diseases: principles, pathogens and practice. 3rd ed. Edinburgh: Saunders Elsevier; 2011. Pp. 925–38.