Fever in the Returned Traveler — Evaluate Travel Risk — Clinical Pathway: Emergency Department

Fever In the Returned Traveler — Emergency Department

Evaluate Travel Risk in the Returned Traveler

Fever Definition:

≥ 38 °C in a traveler within 30 days of return to the U.S.

Evaluate Traveler Risk
  • Specific location of travel (including lay-overs): Information about endemic disease:
  • Complete List of Destinations   and recent disease outbreaks: Travel Health Notices  
    • Geographic Area Common Tropical Diseases Causing Fever Other Infections Causing Outbreaks/Clusters in Travelers
    Caribbean Chikungunya, dengue, malaria (Hispaniola), Zika Acute histoplasmosis, leptospirosis
    Central America Chikungunya, dengue, malaria (primarily P vivax), Zika, enteric fever (incl. typhoid) Leptospirosis, histoplasmosis, coccidiomycosis, leishmaniasis
    South America Chikungunya, dengue, malaria (primarily P vivax), Zika Bartonellosis, leptospirosis, enteric fever (incl. typhoid), histoplasmosis
    South-central Asia Dengue, enteric fever (incl. typhoid), malaria (primarily non-falciparum) Chikungunya, scrub typhus
    Southeast Asia Dengue, malaria (primarily non-falciparum) Chikungunya, leptospirosis
    Middle East Enteric fever (incl. typhoid), hepatitis (some areas with malaria, dengue) MERS, Meningococcal Meningitis (Hajj/Umrah Pilgrimage); CDC Refugee Health Guidance  
    Sub-Saharan Africa Malaria (esp. falciparum), tickborne rickettsiae, acute schistosomiasis, dengue, African trypanosomiasis, chikungunya, enteric fever (incl. typhoid), filariasis, Ebola
    CDC Yellow Book 2020: Health Information for International Travel  
  • Patient preventative measures (and compliance to them), including vaccinations, medications, bed nets.
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  • Unusual exposures during travel
  • e.g. food/water source (including raw dairy), insect bites, animal contact (including rodents), swimming in fresh water, high risk sexual activity, unusual activities, tattoos/injections

Additional Guidance Documents from Infection Prevention and Control:

  • Alphabetical Index of Infectious Diseases & Precautions
  • Guidance for Ebola Isolation and PPE Procedures:
  • Guidance for Measles Isolation Procedures
  • Guidance for MERS Isolation Procedures (CDC Page)  
  • Guidance for Tuberculosis Isolation Procedures

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