• Michael Marks, Margaret Armstrong, Christopher J M Whitty, and Justin F Doherty.
• Hospital for Tropical Diseases, London, UK Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK michael.marks@lshtm.ac.uk.
• Trans. R. Soc. Trop. Med. Hyg. 2016 Aug 1; 110 (8): 456-63.

BackgroundUnderstanding geographic and temporal trends in imported infections is key to the management of unwell travellers. Many tropical infections can be managed as outpatients, with admission reserved for severe cases.MethodsWe prospectively recorded the diagnosis and travel history of patients admitted between 2000 and 2015. We describe the common tropical and non-tropical infectious diseases and how these varied based on region, reason for travel and over time.ResultsA total of 4362 admissions followed an episode of travel. Falciparum malaria was the most common diagnosis (n=1089). Among individuals who travelled to Africa 1206/1724 (70.0%) had a tropical diagnosis. The risk of a tropical infection was higher among travellers visiting friends and relatives than holidaymakers (OR 2.8, p<0.001). Among travellers to Asia non-tropical infections were more common than tropical infections (349/782, 44.6%), but enteric fever (117, 33.5%) of the tropical infections and dengue (70, 20.1%) remained important. The number of patients admitted with falciparum malaria declined over the study but those of enteric fever and dengue did not.ConclusionsMost of those arriving from sub-Saharan Africa with an illness requiring admission have a classical tropical infection, and malaria still predominates. In contrast, fewer patients who travelled to Asia have a tropical diagnosis but enteric fever and dengue remain relatively common. Those visiting friends and relatives are most likely to have a tropical infection.© The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

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