Fever in the returned traveller

The most common causes of fever in a returned traveller include upper respiratory traction infections, lower respiratory tract infections and gastroenteritis. However, unusual and emerging infections may be responsible for the fever instead. Also, potentially fatal conditions such as malaria should not be missed. 

The cause of the fever is dependent on the exposure involved. It is essential to verify where the traveller has visited and lived. Details of activities such as swimming in fresh water areas, insect bites, hiking during the travel may provide clues to the possible diagnoses. 

If pre-travel medical consultation was sought and vaccinations are up to date, infections with hepatitis A and typhoid are less likely. 

Evaluating fever in the returned traveller may sometimes be a clinical challenge for the physician. The fever could be due to unusual and emerging infections, and the amount of information available for the physician to make the diagnosis may be limited. The physician in charge needs to be knowledgeable with global information on outbreaks and offer a practical approach to emerging infections.