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Aetiology and epidemiology of fever in children presenting to the emergency department of a French paediatric tertiary care centre after international travel
  1. Jérôme Naudin1,2,
  2. Renaud Blondé2,3,
  3. Corinne Alberti2,4,
  4. François Angoulvant5,
  5. Agathe De Lauzanne3,
  6. Priscilla Armoogum2,4,
  7. Lauren Pull2,5,
  8. Mathie Lorrot2,3,
  9. Patrick Imbert6,
  10. Stéphane Dauger1,2,
  11. Jean-Christophe Mercier2,5,
  12. Albert Faye2,3
  1. 1Assistance Publique des Hôpitaux de Paris, Service de Réanimation Pédiatrique, Hôpital Robert Debré, Paris, France
  2. 2Université Paris Diderot, Sorbonne Paris Cité, UFR de Médecine, Paris, France
  3. 3Assistance Publique des Hôpitaux de Paris, Service de Pédiatrie Générale, Hôpital Robert Debré, Paris, France
  4. 4Assistance Publique des Hôpitaux de Paris, Unité d’Epidémiologie Clinique, CIC-EC INSERM CIE 5, Hôpital Robert Debré, Paris, France
  5. 5Assistance Publique des Hôpitaux de Paris, Service d’Accueil des Urgences, Hôpital Robert Debré, Paris, France
  6. 6Service des Maladies Infectieuses et Tropicales, Hôpital d’Instruction des Armées Bégin, Saint Mandé, France
  1. Correspondence to Professor Albert Faye, Hôpital Robert Debré, Service de Pédiatrie Générale, 48 boulevard Sérurier, 75019, Paris, France; albert.faye{at}


Objective As few data are available on the causes of fever in children returning from international travel, the authors studied children presenting to a French tertiary care centre with fever.

Methods Children presenting to the emergency department of the Robert Debré Paediatric Hospital, Paris, France between July and December 2007 with fever that occurred within 3 months of a stay abroad were included in this retrospective study.

Results The children (n=538) had most commonly visited North Africa (NA) (n=214), sub-Saharan Africa (SSA) (n=185) and Europe (n=67). Their median age was 2.8 years (IQR 1.4–5.8). The median time between their return to France and the onset of fever was 5 days (IQR 0–18). Cosmopolitan infections represented 85% of the established diagnoses (97.8% and 63.9% in the children returning from NA and SSA, respectively). Fever of unknown origin accounted for 19.3% of cases. Malaria was the leading tropical infection. Excluding malaria, diarrhoeal diseases were more frequent in the children returning from NA (38.5%) than in those returning from SSA (24.5%). Malaria was associated with stays in endemic countries that exceeded 30 days (OR 3.13, 95% CI 1.02 to 9.59).

Conclusion Cosmopolitan infections are the leading cause of fever in French children returning from tropical and subtropical areas. However, all febrile children who have returned from an endemic area should be tested for malaria.

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  • JN and RB contributed equally to this work.

  • Competing interests None.

  • Ethics approval The Comité d’Evaluation de l’Ethique des Projet de Recherche Biomédicale (CEERB) from GHU Nord (institutional review board no. IRB0006477) approved this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.