Travellers and viral haemorrhagic fevers: what are the risks?

Nick J. Beeching (1, 2) , Tom E. Fletcher (1) , David R. Hill (3, 4) , Gail L. Thomson (1, 5)

1 Royal Liverpool University Hospital
2 LSTM - Liverpool School of Tropical Medicine
3 UCLH NHS Foundation Trust
4 LSHTM - London School of Hygiene and Tropical Medicine
5 Centre for Emergency Preparedness and Response

Viral haemorrhagic fevers (VHF) are caused by zoonotic viral infections transmitted to humans directly or by ticks or mosquitoes. The overall risk to travellers is conservatively estimated at <1 in 1 million travel episodes to African countries where infection is present, and febrile patients returning from these countries are at least 1000 times more likely to have malaria than Lassa fever or another VHF. No cases have been reported in fellow travellers exposed to a travelling case and only one asymptomatic seroconversion (to Lassa) has been reported in over 2000 contacts following care of VHF cases in modern Western hospital settings. However, healthcare-associated transmission of infection has been a major problem in some endemic settings. The potential for healthcare-associated infection and the threats posed by unrecognized or new agents necessitate a high index of suspicion and a standardized risk assessment approach to febrile travellers. Travel-related hantavirus infections are increasingly being reported from Europe and the Americas. This article summarizes the epidemiology and reports of travel-related VHF cases in the past 40 years, together with strategies for their recognition, management and prevention.

Mots clés: Travel; Viral haemorrhagic fever; Epidemiology; Risk prevention; Vaccine; Zoonosis

Nick J. Beeching, Tom E. Fletcher, David R. Hill, Gail L. Thomson. Travellers and viral haemorrhagic fevers: what are the risks?. International Journal of Antimicrobial Agents, 2010, 36, ⟨10.1016/j.ijantimicag.2010.06.017⟩. ⟨hal-00632726⟩