Polyarthritis in two travellers returning from Australia

Ross River virus disease in two Dutch travellers returning from Australia, February to April 2015

We report two cases of Ross River virus (RRV) infection in Dutch travellers who visited Australia during February to April 2015. These cases coincided with the largest recorded outbreak of RRV disease in Australia since 1996. This report serves to create awareness among physicians to consider travel-related RRV disease in differential diagnosis of patients with fever, arthralgia and/or rash returning from the South Pacific area, and to promote awareness among professionals advising travellers to this region.

Ross River virus infection in a Thuringian traveller returning from south-east Australia

Ross River virus (RRV) is an arbovirus transmitted by Aedes and Culex mosquitos. It is endemic in Australia, New Zealand and south-east Asia. Clinical manifestation rates in adults range about 20-40%. Symptoms involve arthralgia, myalgia, lymphadenopathy, fever and rash. Here we report a case of RRV in a Thuringian traveller who visited the urban South-East of Australia.

Viruses acquired abroad: what does the primary care physician need to know?

BACKGROUND

Viral infections are imported by travelers and immigrants from tropical or subtropical regions. The primary care physician should be able to include these diseases in the differential diagnosis of various clinical conditions.

METHODS

This review is based on pertinent articles retrieved by a selective search of the literature, including guidelines from Germany and abroad.

RESULTS

The available data on imported viral infections in Germany constitute low-level evidence, because most such infections are not reportable in this country. Useful data have, however, been collected by international surveillance networks. Imported viral infections usually present with fever, often also with a rash and elevated transaminases. An average of 230 cases occur in Germany each year; the most common diagnosis among them is dengue fever. An imported viral infection should also be included in the differential diagnosis of fever with arthralgia, as chikungunya virus causes an average of 38 such cases per year. On the other hand, in the past two years, there have been only five cases of imported viral infections causing encephalitis (West Nile virus and Japanese encephalitis virus).

CONCLUSION

The primary care physician should take a thorough history so that specifically targeted laboratory tests can be ordered as soon as possible. If the suspicion of an imported viral infection is confirmed, the patient should be transferred to a specialized treatment center.