Eckerle, Isabella, Briciu, Violeta, Ergonul, Onder, Lupse, Mihaela, Papa, Anna, Radulescu, Amanda, Tsiodras, Sotirios, Tsitou, Christine, Drosten, Christian, Nussenblatt, Véronique, Reusken, Chantal, Sigfrid, Louise and Beeching, Nicholas ORCID: https://orcid.org/0000-0002-7019-8791 (2018) 'Emerging souvenirs - clinical presentation of the returning traveller with imported arbovirus infections in Europe.'. Clinical Microbiology and Infection, Vol 24, Issue 3, pp. 240-245.
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Abstract
Arboviruses are an emerging group of viruses that are causing increasing health concerns globally, including in Europe. Clinical presentation usually consists of a non-specific febrile illness that may be accompanied by rash, arthralgia and arthritis and/or with neurological or haemorrhagic syndromes. The range of differential diagnoses of other infectious and non-infectious aetiologies is broad, presenting a challenge for physicians. While knowledge of the geographic distribution of pathogens and the current epidemiological situation, incubation periods, exposure risk factors and vaccination history can help guide the diagnostic approach, the non-specific and variable clinical presentation can delay final diagnosis. This narrative review aims to summarize the main clinical and laboratory-based findings of the three most common imported arboviruses in Europe. Evidence is extracted from published literature and clinical expertise of European arbovirus experts. We present three cases that highlight similarities and differences between some of the most common travel-related arboviruses imported to Europe. These include a patient with chikungunya virus infection presenting in Greece, a case of dengue fever in Turkey, and a travel-related case of Zika virus infection in Romania. Early diagnosis of travel-imported cases is important to reduce the risk of localized outbreaks of tropical arboviruses such as dengue and chikungunya and the risk of local transmission from body fluids or vertical transmission. Given the global relevance of arboviruses and the continuous risk of (re-)emerging arbovirus events, clinicians should be aware of the clinical syndromes of arbovirus fevers and the potential pitfalls in diagnosis. [Abstract copyright: Copyright © 2018. Published by Elsevier Ltd.]
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