When You Return Home Sick

All right, so you managed to survive your international expedition without getting sick. In fact, perhaps you didn't follow all the pre-travel advice you were given and think you got away with it. But international travel is so rapid these days that the trip home may be shorter than the incubation period for many illnesses. So then, after you've been home for a few days or weeks you find yourself coming down with a new and strange illness. What are you to do?

The most common ailment for which returned travelers consult a physician is a rash. And there are a host of rashes that can result from foreign travel. Everything from prickly heat and sun sensitivity to serpentine rashes due to worms crawling under your skin. Most of these rashes are self-limiting and can easily be diagnosed and treated by your family physician. Persistent ones, however, may need the help of a dermatologist or infectious disease specialist, preferably one who is also trained in tropical/travel medicine.

The traveler's diarrhea, which you avoided en route, may also crop up after your return home. A few days of cramps and runny stools may be easily treated at home the same way it would have been overseas--with a liquid diet and Imodium. But if diarrhea doesn't respond to symptomatic treatment, lasts more than a week or is accompanied by blood in the stools, you should see a doctor. A simple stool exam will often suffice for diagnosis and treatment, but sometimes more extensive endoscopic examinations or blood tests are required.

Returning from abroad with a fever (100 degrees or more) should always be considered important. Most often it turns out to be something simple like bronchitis or the flu, but the possibilities of what it COULD be are horrendous. It is a rule in travel medicine that fever after returning from a malarious area is malaria until proven otherwise. If you can't see an infectious disease or travel medicine specialist right away, then make sure your family doctor or emergency department promptly has a lab test done for malaria by someone who knows how to make the diagnosis. And keep repeating the test every 24 hours until a diagnosis is made or you are cured, whichever comes first. It is NOT advisable, however, to be treated for malaria without the diagnosis actually having been made.

Sometimes the symptoms one acquires are not so clear cut. "Chronic fatigue syndrome", for instance, can be caused by a number of unusual organisms. In fact, most of the illnesses a person acquires after foreign travel are not travel related at all. It is important, though, that the treating physician KNOW that you traveled overseas so those things can be included in his or her thinking. And if symptoms persist, it is important to seek the advice of an appropriate specialist who understands travel medicine.