Infections in the returning traveller, such as dengue fever, malaria, and parasitic infections
Description
- Fever in a returned traveller is malaria until excluded - the only common imported infection that kills within days
- Most imported fever falls into four buckets:
- Malaria (~20-30%), dengue and other arboviruses, enteric fever (typhoid/paratyphoid), traveller's diarrhoea / gastroenteritis
- Plus the ordinary: respiratory infection, UTI, influenza, COVID - most returned travellers have a cosmopolitan infection**
Incubation period narrows the differential more than geography does
| Incubation | Consider |
|---|---|
| <10 days | Dengue, chikungunya, Zika, enteric bacterial diarrhoea, respiratory viruses, rickettsia, leptospirosis, viral haemorrhagic fever, meningococcaemia |
| 10-21 days | Malaria, enteric fever, leptospirosis, rickettsia, brucellosis, Q fever, acute HIV, viral haemorrhagic fever |
| >21 days | *Malaria (especially P. vivax/ovale)*, TB, viral hepatitis, amoebic liver abscess, visceral leishmaniasis, schistosomiasis, HIV, filariasis |
- *Dengue does not incubate longer than 14 days - fever starting >2 weeks after return is not dengue*
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