Case management of ill travelers with infectious diseases.

Recent increase of international travelers raises awareness of travel-related infections. Travelers' diarrhea is the most common and caused by diarrheagenic E. coli and other patho- gens. Undifferentiated fever challenges physicians to correctly diagnose and includes ma- laria, dengue, and enteric fever. The pre-test probability for a disease which causes undiffer- entiated fever largely depends on the travel destination. Malaria is most common in travelers returning from sub-Saharan Africa while dengue is most common those returning from Southeast Asia and Latin America. Screening for asymptomatic travelers is not generally rec- ommended, but for long-term travelers and immigrants. Following outbreaks of highly infectious diseases in the past decades, hospital prepared- ness for travel-related infections focuses on infection prevention and control. Emerging viral pneumonias such as Middle East respiratory syndrome (MERS) and avian influenza H7N9 are major concerns. As seen in the largest outbreak of Ebola virus disease in West Africa, imported viral hemorrhagic fever such as Lassa fever is another concern. Since multidrug resistant bacteria silently spread globally by infected travelers, it would be of help to install appropriate isolation precaution for travelers with history of hospital admission abroad.