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Fever in returned travelers: results from the GeoSentinel Surveillance Network.
Clin Infect Dis. 2007 Jun 15; 44(12):1560-8.CI

Abstract

BACKGROUND

Fever is a marker of potentially serious illness in returned travelers. Information about causes of fever, organized by geographic area and traveler characteristics, can facilitate timely, appropriate treatment and preventive measures.

METHODS

Using a large, multicenter database, we assessed how frequently fever is cited as a chief reason for seeking medical care among ill returned travelers. We defined the causes of fever by place of exposure and traveler characteristics.

RESULTS

Of 24,920 returned travelers seen at a GeoSentinel clinic from March 1997 through March 2006, 6957 (28%) cited fever as a chief reason for seeking care. Of patients with fever, 26% were hospitalized (compared with 3% who did not have fever); 35% had a febrile systemic illness, 15% had a febrile diarrheal disease, and 14% had fever and a respiratory illness. Malaria was the most common specific etiologic diagnosis, found in 21% of ill returned travelers with fever. Causes of fever varied by region visited and by time of presentation after travel. Ill travelers who returned from sub-Saharan Africa, south-central Asia, and Latin America whose reason for travel was visiting friends and relatives were more likely to experience fever than any other group. More than 17% of travelers with fever had a vaccine-preventable infection or falciparum malaria, which is preventable with chemoprophylaxis. Malaria accounted for 33% of the 12 deaths among febrile travelers.

CONCLUSIONS

Fever is common in ill returned travelers and often results in hospitalization. The time of presentation after travel provides important clues toward establishing a diagnosis. Preventing and promptly treating malaria, providing appropriate vaccines, and identifying ways to reach travelers whose purpose for travel is visiting friends and relatives in advance of travel can reduce the burden of travel-related illness.

Authors+Show Affiliations

Mount Auburn Hospital, Cambridge, MA, USA. mary_wilson@harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

17516399

Citation

Wilson, Mary E., et al. "Fever in Returned Travelers: Results From the GeoSentinel Surveillance Network." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 44, no. 12, 2007, pp. 1560-8.
Wilson ME, Weld LH, Boggild A, et al. Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clin Infect Dis. 2007;44(12):1560-8.
Wilson, M. E., Weld, L. H., Boggild, A., Keystone, J. S., Kain, K. C., von Sonnenburg, F., & Schwartz, E. (2007). Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 44(12), 1560-8.
Wilson ME, et al. Fever in Returned Travelers: Results From the GeoSentinel Surveillance Network. Clin Infect Dis. 2007 Jun 15;44(12):1560-8. PubMed PMID: 17516399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fever in returned travelers: results from the GeoSentinel Surveillance Network. AU - Wilson,Mary E, AU - Weld,Leisa H, AU - Boggild,Andrea, AU - Keystone,Jay S, AU - Kain,Kevin C, AU - von Sonnenburg,Frank, AU - Schwartz,Eli, AU - ,, Y1 - 2007/05/07/ PY - 2006/11/18/received PY - 2007/02/21/accepted PY - 2007/5/23/pubmed PY - 2007/6/22/medline PY - 2007/5/23/entrez SP - 1560 EP - 8 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 44 IS - 12 N2 - BACKGROUND: Fever is a marker of potentially serious illness in returned travelers. Information about causes of fever, organized by geographic area and traveler characteristics, can facilitate timely, appropriate treatment and preventive measures. METHODS: Using a large, multicenter database, we assessed how frequently fever is cited as a chief reason for seeking medical care among ill returned travelers. We defined the causes of fever by place of exposure and traveler characteristics. RESULTS: Of 24,920 returned travelers seen at a GeoSentinel clinic from March 1997 through March 2006, 6957 (28%) cited fever as a chief reason for seeking care. Of patients with fever, 26% were hospitalized (compared with 3% who did not have fever); 35% had a febrile systemic illness, 15% had a febrile diarrheal disease, and 14% had fever and a respiratory illness. Malaria was the most common specific etiologic diagnosis, found in 21% of ill returned travelers with fever. Causes of fever varied by region visited and by time of presentation after travel. Ill travelers who returned from sub-Saharan Africa, south-central Asia, and Latin America whose reason for travel was visiting friends and relatives were more likely to experience fever than any other group. More than 17% of travelers with fever had a vaccine-preventable infection or falciparum malaria, which is preventable with chemoprophylaxis. Malaria accounted for 33% of the 12 deaths among febrile travelers. CONCLUSIONS: Fever is common in ill returned travelers and often results in hospitalization. The time of presentation after travel provides important clues toward establishing a diagnosis. Preventing and promptly treating malaria, providing appropriate vaccines, and identifying ways to reach travelers whose purpose for travel is visiting friends and relatives in advance of travel can reduce the burden of travel-related illness. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/17516399/Fever_in_returned_travelers:_results_from_the_GeoSentinel_Surveillance_Network_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/518173 DB - PRIME DP - Unbound Medicine ER -