1462. A comparison of clinical characteristics and laboratory findings of common fevers acquired by returning travelers: An 8-year report from a large travel clinic in Japan
Session: Poster Abstract Session: Global Health
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • 3 diseases ID week poster for upload.pdf (7.1 MB)
  • Background: It is a challenge to diagnose a febrile illness in returning travelers without specific symptoms. Dengue fever (DF), malaria, and enteric fever (EF) are common fevers in returning travelers and the timely initiation of an appropriate treatment is important. However, it is difficult to differentiate between these fevers without specific diagnostic tests.

    Methods: A retrospective study was conducted in the National Centre for Global Health and Medicine from April 2005 to March 2013. Travelers returning from overseas who were diagnosed with either DF, malaria, or EF were included in the study. Clinical characteristics and laboratory findings were compared between each fever.

    Results: During the study period, 86 malaria, 85 DF, and 31 EF cases were identified. The mean age of the study cohort was 33.1 12 and 134 (66.3%) of the patients were men. Asia was the most frequently visited area (with 89%, 18.6%, and 100% of the DF, malaria, and EF cases respectively), followed by Africa (with 1.2% and 70.9% of the DF and malaria cases respectively). Clinical characteristics and laboratory findings were significantly different among each group diagnosed (Table).

    Conclusion: The specific region traveled, clinical manifestations, and simple laboratory test results, could be helpful for distinguishing between DF, malaria, and EF in febrile returning travelers without specific symptoms.

    Table. Clinical characteristics and laboratory findings of dengue, malaria, and typhoid fever in returning travelers

    DF

    Malaria

    Enteric Fever

    (DF vs Malaria)

    (DF vs Enteric Fever)

    (Malaria vs Enteric Fever)

    Clinical characteristics, number (%)

    Odds ratio (95% Confidence interval)

    Rash

    25 (29.4)

    1 (1.2)

    1 (3.2)

    35.4 (4.7–268.6)

    12.5 (1.6–96.7)

    0.4 (0.0–5.8)

    Arthralgia

    51 (60.7)

    23 (28.0)

    8 (25.8)

    4.0 (2.1–7.6)

    4.4 (1.8–11.1)

    1.1 (0.4–2.9)

    Headache

    65 (77.3)

    54 (65.1)

    14 (45.2)

    1.8 (0.9–3.6)

    4.2 (1.7–9.9)

    2.3 (1.0–5.2)

    Laboratory findings, median (IQR)

    P-value

    WBC

    2780

    (2020–3610)

    4920

    (3800–6280)

    5220

    (3870–6810)

    <0.001

    <0.001

    0.576

    Plt

    11.9

    (8.35–16.1)

    7.8

    (4.8–12.4)

    17.5

    (13.0–24.0)

    <0.001

    <0.001

    <0.001

    T-bil

    0.6

    (0.5–0.7)

    1.8

    (0.8–2.5)

    0.6

    (0.5–0.8)

    <0.001

    0.446

    <0.001

    CRP

    0.5

    (0.3–0.9)

    8.1

    (4.0–13.1)

    5.9

    (3.6–10.8)

    <0.001

    <0.001

    0.148

    Satoshi Kutsuna, M.D., PhD, Kayoko Hayakawa, M.D., PhD, Yasuyuki Kato, MD, MPH, Yoshihiro Fujiya, Momoko Mawatari, Nozomi Takeshita, Shuzo Kanagawa, MD and Norio Ohmagari, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan

    Disclosures:

    S. Kutsuna, None

    K. Hayakawa, None

    Y. Kato, None

    Y. Fujiya, None

    M. Mawatari, None

    N. Takeshita, None

    S. Kanagawa, None

    N. Ohmagari, None

    See more of: Global Health
    See more of: Poster Abstract Session

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.