Hemorrhagic Fevers Overview and Transmission Hemorrhagic fevers are caused by infection with single-stranded, small RNA viruses in the Arenaviridae, Filoviridae, Bunyaviridae, or Flaviviridae families ( Table 28.1 ). The clinical picture is usually one of hemodynamic instability and coagulation abnormalities…
Human African trypanosomiasis (HAT), or African sleeping sickness, is a parasitic infection caused by the flagellated protozoa of the Trypanosoma brucei complex, which is spread by the tsetse fly. Sleeping sickness occurs in more than 30 countries in Africa, putting…
Chagas disease, first described in , is endemic throughout Central and South America. An estimated 8 million people are infected with Trypanosoma cruzi , the etiologic agent of this disease. T. cruzi , a protozoan of the order Kinetoplastida, has…
Approximately 2 billion people, one-third of the world's population, are infected with Mycobacterium tuberculosis , and the majority of burden is in developing countries. The World Health Organization (WHO) estimates that the annual incidence of active tuberculosis (TB) cases was…
In 1977, Steere and co-workers reported on an epidemic of arthritis in the region of Old Lyme, Connecticut. This breakthrough work catalyzed a flurry of studies that soon described Ixodes ticks as the vector, identified the spirochete Borrelia burgdorferi as…
Leptospirosis is the commonest zoonosis worldwide. It occurs in all areas except polar regions and is particularly common in the tropics and subtropics. Typical cases present abruptly with high fever and chills, intense headache, severe myalgias, and conjunctival suffusion. Many…
The various forms of viral hepatitis are a ubiquitous concern for travelers, immigrants, and the healthcare providers responsible for their care ( Table 22.1 ). This chapter will cover the five hepatitis viruses that are associated with the majority of…
General Considerations Malaria is preventable by taking chemoprophylaxis and using mosquito avoidance measures ( Chapter 6 ). However, healthcare providers should be knowledgeable about the work-up of malaria, as it is not uncommon for a returned traveler to present with…
The evaluation of fever in travelers poses a diagnostic challenge to clinicians for many reasons. First, there are many possible etiologies, some of which are geographically localized and are, thus, unfamiliar ( Table 20.1 ). Diagnosis may be delayed owing…
In an increasingly globalized world, migration and population mobility are important factors in the demographic makeup of national populations. In the United States, for example, recent estimates indicate that the foreign-born cohort comprises some 40 million people, or 13% of…