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About 40 million people travel from abroad to the United States per annum; many international travelers arrive in urban centers, and those who are ill will seek care there. Clinicians working in urban hospitals or near points of international arrival must be familiar with diseases commonly acquired abroad as well as uncommon but potentially serious conditions such as emerging and re-emerging infectious diseases. The assessment of the ill international traveler begins with a thorough history including the patient’s itinerary, activities, and risk factors. A familiarity with conditions endemic to the region of travel, timing of exposure, and knowledge of incubation period will allow the clinician to form a focused differential diagnosis. Knowledge of the specific diseases for which the patient is at risk, their potential complications, and the patient’s clinical status will determine need for diagnostic testing, empiric treatment, and ultimate disposition.
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