Traveler’s Fever – Infectious Causes of Travel-Related Fevers

The presence of a fever after having traveled abroad or to remote areas should always be investigated for possible infections which may have been contracted during the trip. Some of these infections may be rare within a person’s town/city of residence and can often be missed by a doctor if a patient does not divulge their prior travel details.

The fever may have started during the trip and persisted since that time or it may only develop after returning home. Due to the various incubation periods, it is not uncommon for a fever to start up between 2 to 6 weeks after contracting the infection. Some diseases may only cause a fever up to 6 weeks after contracting the infection. Since most trips are of short duration (2 to 4 weeks), patients may not associate the current fever with an infection contracted abroad.

A fever may be present on its own with no other signs and symptoms (non-specific fever) or other features may be present including :

  • Skin rash
  • Breathing problems or cough
  • Abnormal bleeding/clotting
  • Neurological symptoms like confusion, disorientation, seizures, paralysis, paresthesia, or coma
  • Gastrointestinal symptoms like nausea, vomiting, diarrhea, abdominal pain

Causes of Travel Fever

The infectious causes listed below are usually responsible for non-specific fevers. However, it is not uncommon for other signs and symptoms to arise over time. In order to assist your doctor with a differential diagnosis in a case of a non-specific fever possibly associated with a travel-related infection, refer to the article on Travel Disease (Infections) Diagnosis – Traveler’s Medical History for a guide on information that would be relevant for your doctor. The list below is not a complete list and other travel infections may also have to be considered.

Malaria

  • Transmission : Mosquitoes (mosquito bites)
  • Risk Areas : Sub-saharan Africa, Asia, Middle East, South America

Viral Hepatitis

  • Most common : In travelers, hepatitis C although hepatitis A, B, D and E may also be responsible.
  • Transmission :
    • Hepatitis A and E – contaminated food, drinks including water, objects
    • Hepatitis B and D – sexual contact, contaminated needles/syringes
    • Hepatitis C – sharing needles/syringes, less frequently through sexual contact
  • Risk Areas : Globally but especially in developing regions with poor sanitary practices and a lack of safe drinking water.

Dengue Fever

  • Transmission : Mosquitoes (mosquito bites)
  • Risk Areas : Globally (tropical and subtropical areas) particularly Asia, South America, Caribbean

Typhoid Fever

  • Transmission : Contaminated food and water, or less frequently through close contact with an infected person.
  • Risk Areas : Most developing countries but especially in South and South-east Asia, Africa and South America.

Shigellosis

  • Transmission : Contaminated food, water and objects
  • Risk Areas : Globally but especially in child care centers, nursing homes, backpacker hostels

Salmonellosis

  • Transmission : Foods especially raw meat including poultry and seafood, raw eggs, uncooked fruit and vegetables
  • Risk Areas : Globally but especially in developing countries

Chikungunya

  • Transmission : Mosquitoes (mosquito bites)
  • Risk Areas : Africa, Asia and less frequently in Europe and the Americas

Relapsing Fever

  • Transmission : Louse (plural ~ lice) or ticks
  • Risk areas :
    • Tick -borne – Africa, Middle East, Asia, North America
    • Louse-borne – Africa, Asia, South America

Leptospirosis

  • Transmission : Contaminated food, water and soil
  • Risk Areas : Globally but especially in tropical areas

Scrub Typhus

  • Transmission : Mites
  • Risk Areas : Southern and eastern Asia, north Australia

Influenza (Seasonal and ‘Swine’ H1N1 Flu)

  • Transmission : Droplet spread – coughing, sneezing and contact with a person (touch) or infective objects (fomites)
  • Risk Areas : Globally and more commonly seen during colder seasons

Campylobacteriosis

  • Transmission : Raw or undercooked meat including poultry and seafood and contaminated milk
  • Risk Areas : Global

HIV (Human Immunodeficiency Virus)

  • Transmission :  Sexual contact, sharing needles/syringes
  • Risk Areas : Globally but especially in Africa and Asia

African Trypanosomiasis (sleeping sickness)

  • Transmission : Tsetse fly
  • Risk Areas :
    • East African trypanosomiasis – eastern and southeastern Africa : Malawi, Tanzania, Uganda, Zambia
    • West African trypanosomiasis – central Africa : Angola, Congo, Democratic Republic of Congo (DRC), Sudan

Yellow Fever

  • Transmission : Mosquitoes (mosquito bites)
  • Risk Areas : sub-Saharan Africa, South America

Related Articles

  1. Travel Disease (Infections) Diagnosis – Traveler’s Medical History
  2. Fever After Bites, Stings and Animal, Insect Contact

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