After Travel: Guidance for Health Professionals
International Travel & Infectious Disease

Certain travel associated conditions can be life-threatening and constitute a medical emergency/urgency and others can represent a health threat to hospital staff and the public. Travel history is always an important consideration in evaluating ill patients. Patients may not volunteer a history of international travel for various reasons; therefore, it is essential that health staff ask about travel with all ill patients, particularly those with a fever. Initial screening questions should be systematically instituted and are encouraged during patient check-in in case there are communicable disease concerns.

Screening information 

1. Have you traveled internationally within the past 3 weeks (21 days)?
2. If yes, have you experienced symptoms such as fever, rash, bleeding, cough, diarrhea, or other typical infectious disease symptoms? 

Triage and next steps 

Patients who answer “yes” to both questions  should be placed in a private room until they can be evaluated by a health professional. Follow infection prevention precautions based on their symptoms and per usual protocols.

In addition to the clinical history of disease onset, symptoms, signs, severity of disease (vital signs, respiratory status), infectious disease specialists will need a:

• Detailed travel itinerary (including where within countries the patient has visited, dates)
• Underlying illnesses
• If the patient received pre-travel advice, vaccines, or medications (including antimalarials)
• If the patient is taking/took any of their travel medications (e.g., antimalarials, antidiarrheals)
• Known insect bites (e.g., mosquitoes, ticks), animal bites, or close contact
• Intake of risky food items (salad/lettuce/raw vegetables, drinking of tap water, unpasteurized dairy products, raw foods (e.g., raw meats, seafood)
• Contact with persons with known infectious diseases (e.g., TB, measles) or ill individuals