Fever in the Returned Traveller - Management at Urgent Care Brisbane
Jack’s Story:
After his journey, Jack was feeling lethargic and developed a fever. Recognizing that the symptoms may relate to a “fever in the returned traveller” (FRT), Jack chose to visit us at Urgent Care Brisbane, a facility staffed with highly trained emergency doctors and nurses, who know that timely medical care can make a world of difference.
Risk Factors for Infections
Several factors can increase the risk of developing a fever post-travel. Jack had been visiting friends and family, which puts him at a higher risk of getting an infection. Activities during travel, destination and duration of the stay also play a key role in this.
Types of Infections
Infections can range from sexually transmitted diseases to vector-borne illnesses. Let’s explore some of them in detail:
Malaria
Risk Factors: Travel to malaria-endemic regions, lack of prophylaxis.
Incubation Period: P. falciparum: 7 days – 12 weeks. Other malarial species: weeks to several years.
Symptoms and Signs: Fever, malaise, headache, nausea, vomiting, hepatosplenomegaly, and anaemia.
Investigations: Microscopic examination of a blood smear and rapid diagnostic tests.
Management: Antimalarial medications, supportive care, and prophylactic measures for future prevention.
Typhoid (Salmonella)
Risk Factors: Consumption of contaminated food or water, travel to endemic areas.
Incubation Period: 3 days – 3 months (usually 8-14 days).
Symptoms and Signs: Fever, headache, abdominal pain, altered bowel habit, rose spots rare in children.
Investigations: Blood culture, Widal test.
Management: Antibiotics, hydration, and preventative measures for future protection.
Rickettsial Infection
Risk Factors: Exposure to ticks, fleas, lice, and mites, travel to endemic areas.
Incubation Period: 3-21 days (depending on type).
Symptoms and Signs: Fever, myalgia, primary inoculation lesion (eschar) ± generalised rash (petechial or macular papular).
Investigations: Serological tests, skin biopsy.
Management: Antibiotics, supportive treatment.
Dengue
Risk Factors: Exposure to Aedes mosquito, travel to endemic regions.
Incubation Period: 3-14 days (usually 5 days).
Symptoms and Signs: Fever + 2 of: myalgia, retro-orbital pain, arthralgia, headache, leucopenia, haemorrhagic manifestations.
Investigations: Blood tests to detect virus or antibodies.
Management: Supportive care (rehydration, pain relievers), medical monitoring.
Chikungunya
Risk Factors: Travel to endemic regions, exposure to Aedes mosquito.
Incubation Period: 1-12 days (usually 3-7 days).
Symptoms and Signs: Arthralgia, myalgia, headache, nausea, rash.
Investigations: Blood tests to detect virus or antibodies.
Management: Supportive care, rest, hydration, pain relievers.
The rest of the conditions in the same format follow:
Influenza
Risk Factors: Exposure to infected individuals, lack of vaccination, travel during flu season.
Incubation Period: 1-5 days (usually 2 days).
Symptoms and Signs: Fever, upper respiratory tract infection/lower respiratory tract infection, myalgia.
Investigations: Rapid influenza diagnostic tests (RIDTs), rapid molecular assays.
Management: Antiviral drugs, rest, hydration.
Campylobacter
Risk Factors: Consumption of undercooked poultry, unpasteurized milk, or untreated water.
Incubation Period: 1-10 days (usually 3 days).
Symptoms and Signs: Fever, diarrhoea, vomiting abdominal pain, bloody stools.
Investigations: Stool culture.
Management: Antibiotics, rehydration, symptom relief.
Shigella
Risk Factors: Poor sanitation, crowded living conditions, contaminated food and water.
Incubation Period: 12 hours – 7 days (usually 2 days).
Symptoms and Signs: Fever, diarrhoea, vomiting, abdominal pain, bloody stools.
Investigations: Stool culture.
Management: Antibiotics, rehydration therapy.
Measles
Risk Factors: Exposure to infected individuals, and lack of vaccination.
Incubation Period: 7-18 days (usually 10 days).
Symptoms and Signs: Cough, coryza, conjunctivitis, rash.
Investigations: A blood test to confirm measles antibodies, throat swab.
Management: Supportive care, isolation, vitamin A supplementation.
Viral Hemorrhagic Fever (Ebola)
Risk Factors: Contact with infected animals or humans, travel to endemic areas.
Incubation Period: 2-21 days (usually 8 days).
Symptoms and Signs: Fever, fatigue, headache, gastrointestinal signs, rash, petechiae, mucosal bleeding.
Investigations: Isolation and testing of blood and tissues.
Management: Supportive care, including rehydration and treatment of specific symptoms.
Leptospirosis
Risk Factors: Contact with urine of infected animals or contaminated water and soil.
Incubation Period: 2-26 days (usually 10 days).
Symptoms and Signs: Headache, myalgia, vomiting, rash, abdominal pain, conjunctival suffusion.
Investigations: Serological testing, PCR.
Management: Antibiotics, supportive care.
Hepatitis A
Risk Factors: Consumption of contaminated food or water, close contact with an infected person.
Incubation Period: 2-7 weeks (usually 30 days).
Symptoms and Signs: Vomiting, abdominal pain, jaundice.
Investigations: Blood tests for Hepatitis A antibodies.
Management: Supportive care, ensuring good nutrition and rest.
Rabies
Risk Factors: Bites or scratches from infected animals, exposure to bats.
Incubation Period: 3-8 weeks (sometimes years).
Symptoms and Signs: Animal bite: tingling at the site, fever, myalgia, headache, neurological symptoms.
Investigations: Skin biopsy at the nape of the neck, saliva, serum, spinal fluid tests.
Management: Post-exposure prophylaxis including wound care, Rabies immunoglobulin, and Rabies vaccine.
Remember, Urgent Care Brisbane is here to provide exceptional medical care for patients who have recently travelled and are presenting with a fever. The dedicated staff of experienced emergency doctors and nurses are available to provide comprehensive assessments and appropriate management for a wide range of infections, ensuring you receive the best care possible.
Clinical Presentation
Our team at Urgent Care Brisbane evaluated Jack for his symptoms which included fever, lethargy, and slight jaundice. Clinical presentation is an essential factor in diagnosing the cause of FRT.
Diagnosis
Post-assessment, our team suspected Viral Hepatitis based on Jack’s symptoms. Further investigations were made using laboratory tests such as blood tests and imaging to confirm this. If you are a returned traveller with fever, rest assured that our team is skilled at dealing with such complex diagnostic puzzles. Read more about the diagnosis process here.
Management at Urgent Care Brisbane
Upon confirming Jack’s diagnosis, he was immediately put on antiviral medications and supportive care. At Urgent Care Brisbane, we believe in not just providing immediate care but also in ensuring our patients are informed and understand their condition well. As such, Jack was given a detailed explanation of viral hepatitis, the cause of his fever, and the steps to manage his condition.
Monitoring and Follow-Up
Post-diagnosis, the journey doesn’t end there. Effective management of a “fever in returned traveller” involves careful monitoring of the patient’s condition and appropriate follow-ups. For Jack, we scheduled routine liver function tests and regular doctor visits to assess his response to treatment. Our expert healthcare team always ensures our patients receive the best public health services possible.
Supportive Care
Supportive care plays a crucial role in managing any disease. With Jack, we ensured he was comfortable, his symptoms were managed, and he received necessary nutrition and hydration.
Preventive Measures
Prevention is better than cure. This phrase cannot be truer than in the context of infectious diseases. At Urgent Care Brisbane, we ensure our patients are educated about the necessary preventive measures. Jack was guided on the importance of vaccines, proper food, and water intake while traveling, and protective measures against sexually transmitted and vector-borne diseases for his future travels.
Next Steps
As a traveller, if you experience any symptoms of fever or illness upon returning home, it’s important to seek immediate medical care. You don’t have to rush to the hospital’s emergency room, instead, Urgent Care Brisbane is here to help.
- Reach Out: The first step is to get in touch with us. You can walk in, call, or schedule an appointment online.
- Assessment: Our team of emergency doctors and nurses will assess your condition, understand your travel history and potential exposure risks.
- Investigation: If necessary, we’ll conduct further investigations like blood tests, imaging to pinpoint the cause of your symptoms.
- Treatment: Once we’ve identified the issue, our team will provide you with a comprehensive treatment plan tailored to your needs.
- Follow-Up: We’ll schedule follow-up appointments to monitor your condition and adjust treatment as needed.
Wrapping Up
Fever in returned travellers can be life-threatening, but with proper and timely medical care, it can be managed effectively. As Jack’s case illustrates, Urgent Care Brisbane offers comprehensive care for returned travellers experiencing a fever. Our skilled team of doctors and nurses are dedicated to ensuring you get back on your feet quickly and enjoy your post-travel life healthily and comfortably.
Travel safe, stay healthy, and remember, Urgent Care Brisbane is here for you when you need us! Remember to bookmark this page as a useful resource when planning your next international travel.