Respiratory infection in a returned traveller

Etiologies

Incubation Period	Infections
Less than 10 days	Viral: influenza, SARS, MERS, Nipah virus Bacterial: common organisms causing pneumonia (Streptococcus pneumoniae, Haemophilus influenzae), melioidosis, legionellosis, plague, pertussis, diphtheria Fungal: histoplasmosis
10 to 21 days	Viral: MERS, Nipah virus, hantavirus Bacterial: pertussis, melioidosis Fungal: histoplasmosis, coccidioidomycosis Parasitic: ascariasis, hookworm, strongyloidiasis, toxocariasis
Greater than 21 days	Bacterial: Q fever, TB Parasitic: schistosomiasis, echinococcosis, dirofilariasis, paragonomiasis, Wuchereia bancrofti, Brugia malayi

Risk Factor	Common	Occasional
Mosquitoes	tropical pulmonary eosinophilia	dirofilariasis
Ticks		Q fever
Animals	avian influenza, Nipah virus, hantavirus, MERS	Q fever, tularemia, plague
Caves or deserts	coccidiomycosis, histoplasmosis
Cruise ships or resorts	legionellosis
Farms	Q fever
Soil	strongyloidiasis, hookworm, ascariasis	melioidosis
Undercooked or raw food		paragonimiasis, toxocariasis, echinococcosis
Sexual activity	HIV
Immunocompromised patient	tuberculosis

Geographical Area	Common	Occasional	Rare but Important
Sub-Saharan Africa	HIV-associated pulmonary infections, TB	Katayama syndrome, tropical pulmonary eosinophilia (Wuchereria bancrofti), Loeffler syndrome (hookworm, strongyloidiasis), echinococcosis	Histoplasmosis, pneumonic plague, paragonomiasis
North Africa, Middle East and Mediterranean		Q fever, tropical pulmonary eosinophilia (Wuchereria bancrofti), Loeffler syndrome (hookworm, ascariasis, strongyloidiasis), echinococcosis, toxocariasis	MERS
Eastern Europe and Scandinavia	legionellosis	pertussis, toxocariasis	hantavirus, tularemia
South and Central Asia	diphtheria, TB, avian flu	melioidosis, Loeffler syndrome (hookworm, ascariasis, strongyloidiasis), echinococcus	Nipah virus
Southeast Asia	avian flu	melioidosis, tropical pulmonary eosinophilia (Brugia malayi), Loeffler syndrome (strongyloidiasis, hookworm), leptospirosis, diphtheria	SARS, hantavirus, Nipah virus, dirofilariasis, Katayama syndrome, paragonomiasis
Northern Australia		Q fever	melioidosis, dirofilarisis, pertussis
Latin America and Caribbean		coccidioidomycosis, histoplasmosis, leptospirosis, diphtheria, tropical pulmonary eosinophilia (Wuchereria bancrofti), Loeffler syndrome (ascariasis, strongyloidiasis), echinococcosis, toxocariasis	hantavirus, dirofilariasis
North America	legionellosis, pertussis, diphtheria	coccidioidomycosis, histoplasmosis, toxocariasis	dirofilariasis, Q fever