Neurologic Infections in Travelers

Malveeka Sharma, MD, MPH; Joseph R. Zunt, MD, MPH

Disclosures

Semin Neurol. 2019;39(3):399-414. 

In This Article

Abstract and Introduction

Abstract

This review will provide an outline of the neurological complications of specific parasitic, bacterial, and viral infectious diseases that can affect the international traveler. We will discuss the epidemiology, life cycle, ecology, clinical manifestation, diagnosis, treatment, and prevention.

Introduction

Movement of humans around the world has been a key factor affecting the dissemination of infectious diseases throughout recorded history and will continue to shape the emergence, re-emergence, and spread of infections across geographic areas and populations. Globalization has been accompanied by increased tourism, as well as new forms of tourism, including ecotourism, agritourism, medical tourism, and rural and geotourism, resulting in increased exposure of naïve populations to infectious diseases endemic to other countries. There is also a broader cultural shift to exploring new places, with popular hashtags such as "fernweh" a German word used internationally to describe an "ache for distant places; crave for travel," which has garnered over 100 million posts on social media. According to the GeoSentinel survey, approximately 75% of travelers returned home ill.[1] The most common travel-related illnesses were gastrointestinal, febrile, dermatological, and respiratory diseases. Although the proportion of neurological diseases in travelers is relatively low in this group (1.7%), they are often devastating and associated with high morbidity and mortality.

Changes in the environment, climate, technology, land use, human behavior, and demographics have also converged to support emergence of new and re-emergent infectious diseases affecting humans and animals. Table 1 provides an overview of the geographic distribution of infectious diseases with neurological sequelae.[2] This review article provides an overview of infectious diseases with neurological sequelae in the international traveler. We will discuss the epidemiology, life cycle, ecology, clinical manifestation, diagnosis, treatment, and prevention of selected parasitic (Table 2), bacterial (Table 3), and viral infections (Table 4).

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