International travel carries a risk of colonization by antimicrobial-resistant intestinal flora. The use of a quinolone, but not a macrolide, during travel further increases the risk of acquisition of extended-spectrum beta-lactamase-producing Enterobacteriaceae.
Infectious illness is common in travelers from other countries visiting the United States. Skin and soft tissue infections, respiratory infections, and gastrointestinal illness are most likely, but specific geographic illnesses such as Lyme disease also occur.
This observational cohort study was conducted among 1.25 million adults from 4 private US healthcare organizations (HCO): Geisinger Health System, Danville, Pennsylvania; Henry Ford Health System, Detroit, Michigan; Kaiser Permanente-Northwest, Portland, Oregon; Kaiser Permanente, Honolulu, Hawaii.
Two men (one age 57 with no prior significant illnesses and one age 67 with type 2 diabetes) from northwestern Missouri presented separately to a hospital with illnesses characterized by fever, fatigue, diarrhea, thrombocytopenia and leukopenia.