Module 3 – Fever in the Returned Child Traveller
What’s in this module?
This module aims to introduce residents to concepts that all paediatricians should be aware of when caring for children with fever who have recently travelled. The module starts with an OSCE-style clinical case where the residents split into groups of ≥3: one “physician” (examinee), one “mother” (standardized patient) and one “examiner.” The clinical case answers are reviewed through the subsequent two sections. First, the importance and individual elements of a travel history are discussed. Following this, three important diseases, not usually taught elsewhere in residency curricula, are reviewed in brief (malaria, enteric fever and dengue).
Children bear a disproportionately high burden of travel-related infections. New Canadians (recent immigrants or refugees) with fever have the same differential diagnosis as returned travellers, but we must also consider some chronic diseases that are not reviewed in this module, including HIV and tuberculosis. Although pre-immigration screening is done, results are often not available to the patients. Health care workers always need to consider HIV in children with unusual or very severe infections.
- Realize the importance of a travel history.
- Take a relevant, concise travel history and physical exam.
- Develop a differential diagnosis and workup plan for fever in the returned child traveler.
- List the host factors which contribute to different degrees of risk of contracting an infectious disease while travelling.
- Understand the basics (history, diagnosis, treatment principles, etc.) about important febrile illnesses that present in travelers.
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