Neurologic Infections in Travelers

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


Semin Neurol. 2019;39(3):399-414. 

In This Article


As travel to worldwide destinations has become more accessible, health care providers should be aware of travel-related infections associated with neurological manifestations. Although most travelers who present with neurologic manifestations of infectious diseases will return from Asia, Africa, or Latin America, there are several infections endemic to Europe, North America, Australia, and Oceania that should be kept in mind.[1] It is important that clinicians be able to recognize and formulate differential diagnoses based on clinical manifestations, regions of travel, and potential exposures, as early recognition and management can be lifesaving. Many of these infections are classified as neglected diseases, with hundreds of millions of people at risk of infection. Many prevention measures can reduce transmission rates and have been prioritized by some governmental and nongovernmental organizations. Unfortunately, all of the parasitic diseases are endemic to lower socioeconomic countries, where there are fewer resources for adequate surveillance, diagnosis, or management. With rising levels of emigration and travel, these parasites are increasingly seen and managed in high income countries, and recognition is vital for appropriate management.

Acquisition of the majority of travel-related infections can be largely avoided by taking appropriate precautions before, during, and after travel. The availability of vaccines has markedly decreased the global burden of tetanus, meningitis, and encephalitis. Overall, better quality epidemiological research regarding risk factors, incidence, prevalence, and outcomes in various countries is needed to better guide prevention and management for the majority of these infectious diseases.[74]