You came home from a long visit with family, and now something feels off: a fever that keeps returning, a stomach that will not settle or a cough that lingers. If you are sick after traveling abroad, timing matters. Some travel infections pass on their own, but others, especially with fever, turn serious fast. At Palm Urgent Care on S Magnolia Ave in El Cajon, walk-in patients can see a provider, talk through their trip and get diagnostics and lab testing when needed.
Many East County families travel to Iraq and nearby countries to see parents and relatives. Here is why an illness after visiting family overseas can differ, and what to do.
Why Visiting Family Overseas Carries Extra Health Risk
Travel medicine calls these VFR trips (visiting friends and relatives). The CDC Yellow Book reports higher rates of several travel infections in VFR travelers, including malaria, tuberculosis (TB) and typhoid fever. Common reasons include less pre-travel care, longer stays, food and water exposures in family homes, and trouble keeping up insect-bite prevention. In U.S. surveillance data cited by CDC, about half of typhoid cases (48%) occurred in VFR travelers.
Growing up in a country does not guarantee protection: CDC notes immunity to malaria begins to wane soon after leaving a malaria area, and children born in the U.S. lack exposures their parents may have had.
For Iraq, CDC's travel health page recommends the typhoid vaccine for most travelers and hepatitis A vaccine for unvaccinated travelers age 1 and older, and it reports increased cases of Crimean-Congo hemorrhagic fever (CCHF). Check CDC's page for every country you visit.
Sick After Traveling Abroad? Symptoms That Need Prompt Care
These symptoms after a trip deserve same-day or next-day care:
- Any fever, even a mild one, or chills that come and go (after a malaria area, see the ER list below).
- Diarrhea with fever or blood, or that will not quit. The Yellow Book notes untreated bacterial diarrhea usually lasts 3 to 7 days, while parasite-related diarrhea can persist for weeks to months.
- A cough lasting 3 weeks or longer, chest pain or coughing up blood, which CDC lists as possible signs of TB disease.
- Yellow skin or eyes, dark urine or clay-colored stools, possible signs of hepatitis A, which can appear 2 to 7 weeks after exposure.
- Signs of dehydration, such as a dry mouth or dark urine, per MedlinePlus.
When to Go to the ER or Call 911
Go to the nearest emergency department or call 911 for these and other emergency warning signs:
- Any fever within a year of being in a country with malaria, even a mild one. The Yellow Book calls for malaria results within a few hours, so go the same day to a facility that can deliver them, usually an emergency department.
- Confusion, a change in alertness, a seizure or passing out
- Severe shortness of breath, or severe chest pain or pressure
- Fever or shivering with a racing heart or weak pulse, clammy skin or extreme pain, possible signs of sepsis, a life-threatening emergency
- Severe dehydration, such as no urine, sunken eyes or a rapid heartbeat
Fever After Travel: Never Wait It Out
The CDC Yellow Book advises early evaluation for fever after travel because it can signal a rapidly progressing infection, most importantly malaria. Since malaria is not present everywhere, list every country and layover.
MedlinePlus notes malaria symptoms usually begin 7 to 30 days after an infected mosquito bite, but can take up to a year. Per the Yellow Book, typhoid usually appears 7 to 18 days after exposure, sometimes later, while TB can surface weeks to years later. If you are sick after traveling abroad with a fever, get checked instead of masking it with fever reducers.
What to Tell Your Provider About Your Trip
As the Yellow Book notes, a detailed history helps pinpoint the cause. Come ready to share:
- Every place you visited, including cities, villages and layovers.
- Dates of travel and when symptoms started.
- Where you stayed, such as a family home or a farm.
- What you ate and drank, including tap water, ice, raw vegetables or unpasteurized dairy.
- Bites and animal contact. The World Health Organization notes CCHF spreads through tick bites or contact with infected animal blood or tissue during and right after slaughter.
- Medical care abroad, such as injections, IV fluids or dental work.
- Vaccines and medicines taken before or during the trip, including malaria pills.
Lab Tests Your Provider May Order
Post-travel lab tests depend on your symptoms, itinerary and exam. Some are run by an outside lab or in a hospital setting. Common options include:
- Complete blood count (CBC). A high white cell count may be a sign of infection, according to MedlinePlus.
- Malaria tests. A blood smear or rapid test, usually repeated every 12 to 24 hours for 3 sets if negative, per MedlinePlus. Since CDC calls for results within hours, suspected malaria may need an emergency department.
- Blood cultures, which look for bacterial or fungal infections in the blood, especially when a fever has no clear source.
- Liver function tests when there is jaundice, dark urine or a possible hepatitis exposure.
- Stool tests for a stomach bug after a trip overseas. A stool culture checks for bacteria, and an ova and parasite test looks for parasites and their eggs, often on several samples over a few days.
- TB screening with a skin or blood test after exposure to someone with active TB, or for frequent travel to countries where TB is common.
Learn more in our guide to lab testing at urgent care.
A Pre-Trip Checklist for Your Next Visit Home
- See your doctor at least a month ahead to ask about vaccines such as typhoid and hepatitis A, as CDC advises for Iraq. Leaving sooner? Go anyway: some vaccines have accelerated schedules.
- Check measles protection. CDC advises 2 MMR doses at least 2 weeks before departure for anyone without evidence of immunity, and an early dose for babies 6 through 11 months old.
- Plan food and drinks. CDC's food and drink guidance favors factory-sealed drinks over tap water, skipping ice where water may be unsafe, peeling fruit yourself and washing hands before eating. With hosts, choose hot, fresh dishes.
- Pack insect repellent. CDC recommends EPA-registered repellent and protective clothing against sand fly bites, which spread leishmaniasis in Iraq.
Browse all Palm Urgent Care services, including physical exams and lab testing.
Frequently Asked Questions
How long after traveling abroad can you get sick?
Some travel infections start within days, others much later. Hepatitis A can appear 2 to 7 weeks after exposure, malaria usually 7 to 30 days after a bite (sometimes up to a year), and TB weeks to years later. Mention recent travel at any visit.
Should I go to urgent care or the ER for a fever after travel?
If you were in a country with malaria in the past year, go the same day, even for a mild fever, usually to an ER, since the CDC Yellow Book calls for malaria results within a few hours. After travel only to areas without malaria, urgent care is a good same-day starting point if you are alert, breathing comfortably and keeping fluids down. For confusion, severe breathing trouble, chest pain, a seizure or signs of sepsis, call 911.
What tests are done for a stomach bug after a trip overseas?
A provider may order a stool culture for bacteria and an ova and parasite test, sometimes on several samples over a few days. Blood tests can check for dehydration and infection.
Can I walk in at Palm Urgent Care in El Cajon after a trip?
Yes. Palm Urgent Care, El Cajon (Magnolia), welcomes walk-in patients for urgent care, diagnostics and lab testing. Check the location page for current hours. With fever after a malaria area, go to an ER instead.
If you or a family member is sick after traveling abroad, do not wait it out. For urgent care after travel in El Cajon, stop by Palm Urgent Care at 436 S Magnolia Ave, Suite 101. Visit the El Cajon (Magnolia) location page for hours, directions and coverage details.
This article is for general information and is not a substitute for medical advice from a licensed clinician.