There has been an explosion in international travel during the past two decades. Travel in the past was the domain of the rich, but due to the availability of cheap air travel and ‘package holidays’ it has come within the grasp of most people in the developed world. People are travelling far, and to parts of the world that were previously inaccessible to them. The desire to visit far-flung ‘exotic’ locations is insatiable. With this travel comes the danger of being exposed to infections outside one's routine experience. There is also a tendency to throw caution to the wind, not to take the usual precautions and to expose one's self to risks. One of the aims of a holiday, after all, is to relax and try new experiences; it is not surprising therefore that many travellers become ill with infections while on holiday or bring them back. Below are some common (and some not so common) clinical illnesses due to infections that are seen in returning travellers in the UK (See Table 45.1). The reader should consult the individual virus chapters for details of individual infections.

Gastroenteritis

Diarrhoea is by far the most common complaint in travellers. Most of the infections are due to bacteria. Noroviruses are important viral pathogens, especially in those who indulge in eating raw shellfish such as oysters and prawns.