Infectious Diseases: Traveller with a Fever

Question 1

What are the key elements of the history that you would ask a traveller with a fever?

Answer 1

Time of onset, nature of signs and symptoms

Any other symptoms?

Exactly where did they travel, and how long for?

Type of accommodation?

Any prophylaxis taken?

Any immunisation prior?

Disease exposure?

Healthcare exposure?

Symptoms of fellow travellers

Types of activity?

Food/water consumed?

Sexual Hx?

Question 2

What infectious diseases are associated with patients travelling from abroad?

Answer 2

TB

Lyme disease

Malaria

Typhus

Cholera

Salmonella

Hepatitis A

Shigella

Question 3

What investigations would you request?

Answer 3

Bloods = FBC, U+Es, LFTs

Imaging = CXR, US

Blood culture x2, stool culture

Blood film = malaria parasites

Urinalysis +/- culture

HIV, Hep B/C, syphilis serology

Question 4

What are the principles of Infection Control, whether a diagnosis is made or not, for patients who have recently travelled from abroad?

Answer 4

Isolation = stop further spread

Contact tracing = others to get treatment

Report notifiable diseases

Question 5

Outline which time-frames link to which infections?

Answer 5

0-10 days = dengue, rickettsia, infectious mononucleosis, gastrointestinal

10-21 days = malaria, typhoid, HIV

> 21 days = malaria, Brucella, endocarditis, bone/joint infections, TB, parasitic infections