Travel Medicine and Infectious Disease

Article	Citations
Misleading eosinophil counts in migration-associated malaria: do not miss hidden helminthic co-infections	224
Lepromatous leprosy presenting with erythema nodosum leprosum mimicking Bechet's disease	206
Comment on “Clinical manifestation of Rickettsia rickettsii in a familiar outbreak in Panama”	166
The arrival of Mpox in Venezuela: Why so few cases?	131
Authors' response comments on “Diagnosis of monkeypox virus – An overview”	101
Murine typhus in returned travelers to Toronto, Canada	99
The Honduran diaspora and infectious diseases: An urgent need for action	80
Immunogenicity of 4-dose Essen intramuscular regimen for rabies post-exposure prophylaxis: A multi-center cross-sectional study in China	79
Immune profiling and prognosis implications in severe fever with thrombocytopenia syndrome with and without hemophagocytic lymphohistiocytosis	79
Leptospirosis in the United Kingdom: a decade of experience from a large regional hospital	75
Investigating the influence of probiotics in preventing Traveler's diarrhea: Meta-analysis based systematic review	70
On the potential for discontinuing atovaquone-proguanil (AP) ad-hoc post-exposure and other abbreviated AP-regimens: Pharmacology, pharmacokinetics and perspectives	70
Malaria risk perceptions and barriers for effective prophylaxis among sub-Saharan African 'visiting friends and relatives' travellers in Hamburg, Germany	69
Monkeypox proctitis treated with doxycycline in an HIV MSM returning to Italy from France	59
Rabies post-exposure prophylaxis in the emergency department: A monocentric retrospective observational study	50
For how long can monkeypox reach the Balkan region?	49
First evidence of significant autochthonous transmission of strongyloidiasis in northern Spain: A retrospective study from Asturias, Spain	47
Awareness and perceptions of medical students and doctors regarding Tropical Medicine education and training in Europe: An international, online-based survey	44
Therapeutic strategies for human poxvirus infections: Monkeypox (mpox), smallpox, molluscipox, and orf	43
The unequal malaria burden attributable to child growth failure: a global analysis among children under five from 1990 to 2021	43
Effect of Omicron on the prevalence of COVID-19 in international travelers at the Mexico city international airport. December 16th, 2021 to January 31st, 2022	40
A case of imported Plasmodium malariae infection after treated Plasmodium falciparum malaria: Possible explanations and a review of the literature	40
Leukemoid-like eosinophilia in a splenectomised traveler returning from Brazil	40
Incidence and clinical significance of non-tuberculous mycobacteria among migrants in Denmark: A nationwide register-based cohort study from 1991 through 2021	39
Pretravel preparation and factors associated with willingness to seek pretravel consultation among Taiwanese travelers	39

First imported Clade 1b Mpox case in India: Implications for travel medicine and public health surveillance	39
Irreversible malarial retinopathy in a returning adult traveler to Marseille, France	36
Editorial Board	35
Appropriate vaccinal policies face to asymptomatic monkeypox virus transmission	35
Crimean-Congo haemorrhagic fever virus screening among African individuals in Spain: Lessons to learn	33
From local burden to global threat: Neglected tropical diseases in an era of climate change and human mobility	32
Telemedicine for international travelers through a Smartphone-based monitoring platform (Trip Doctor®)	31
Laboratory diagnostics for monkeypox: An overview of sensitivities from various published tests	31
Assessing dengue seroprevalence among people living with HIV (PLWH) in rome, Italy: Insights from the 2023 Italian autochthonous outbreak	30
Extensive buruli ulcer in a patient returning from Mali and Senegal	29
Types and outcomes of pharmacist-managed travel health services: A systematic review	29
Detection of circulating mosquito-borne arboviruses in Brazil using travellers as sentinels	28
Scabies: An updated review from epidemiology to current controversies and future perspectives	28
Global spread of mpox Clade I: Implications for travel and public health	27
Is Omicron the end of pandemic or start of a new innings?	25
Epidemiology and transmission dynamics of tuberculosis among internal migrants in Hangzhou: A retrospective analysis from 2013 to 2022	25
Comparative effects of pharmacological interventions for the prevention of acute mountain sickness: A systematic review and Bayesian network meta-analysis	25
Modeling approaches to inform travel-related policies for COVID-19 containment: A scoping review and future directions	24
Understanding the journey towards rabies vaccination for travellers: Results of a cross-sectional survey with patients and providers in the US, Germany, Sweden, and Switzerland	23
Infection tracking in travellers using a mobile app (ITIT): The pilot study	23
Mortality from COVID-19 in Amazonian and Andean original indigenous populations of Peru	22
Fever with spontaneous gingival bleeding: A diagnostic challenge	21
Epidemiological characterization of the pediatric population diagnosed for SARS-CoV-2 in the public health laboratory from Tolima, Colombia: A retrospective analysis 2020–2022	21
Atypical presentations of denguevirus 3 in Veracruz, Mexico	21
Assessing scalability factors of a malaria intervention using Malakit and target drug administration among hard-to-reach populations: An original approach focusing on key stakeholders – implementers a	21
Leishmania infantum infection after visiting southern Spain in patients on biological treatment; an observational, longitudinal, cohort study	21
Travellers with prosthetic limbs: A neglected population	20
Review of short-term and long-term adverse effects of covid-19 vaccination during pregnancy	19
Prevalence, anti-malarial chemoprophylaxis and causes of deaths for severe imported malaria: A systematic review and meta-analysis	18
Changes in the epidemiology of Crimean-Congo hemorrhagic fever: Impact of travel and a One Health approach in the European region	17
Rabies in humans: A treatment approach	17
Marburg virus disease in Equatorial Guinea: The need for one health approach	17
Dengue and climate changes: Increase of DENV-1 in São Paulo/Brazil – 2023	17
Locally acquired cutaneous larva migrans in Ontario?	17
Monkeypox virus: A novel sexually transmitted disease? A case report from France	17
Screening for schistosomiasis in a non-endemic setting: Accuracy of a rapid antibody test using finger prick blood	16
Aortic aneurysm lesions in Echinococcus infection. A review of cases in literature	16
Challenging therapeutic management of visceral leishmaniasis (L. Infantum) in a patient with thymoma: Case report with literature review	16
Neutralization of SARS-CoV-2 omicron after BBIBP-CorV and ZF2001 booster vaccination	16
Immune thrombocytopenia occurs in an aplastic anemia patient infected with scrub typhus in China	16
Travel patterns, pretravel preparation, and travel-associated morbidity in travelers with diabetes in Taiwan	16
Climate change and dengue Fever: A 14-year study of mortality trends during 2010–2023 in Indonesia	16
Can COVID-19 vaccines improve cardiovascular outcomes?	16
Infections with long latency in international refugees, immigrants, and migrants seen at GeoSentinel sites, 2016–2018	15
Malaria in hard-to-reach populations: Challenges and solutions	15
Trends in temporal and spatial changes of Japanese encephalitis in Chinese mainland, 2004–2019: A population-based surveillance study	15
Cost-effectiveness analysis of seasonal influenza vaccination during pregnancy: A systematic review	15
Global geotemporal distribution of chikungunya disease, 2011–2022	15
Virological findings in a case of travel-associated Oropouche virus (OROV) infection imported to Italy, June 2024	15
ESBL-producing and colistin-resistant Enterobacterales among Czech international travellers: genomic relatedness to community and environmental isolates	15

Anchovy-like fluid drained from a huge liver abscess: A diagnostic challenge	14
Travel-related potential rabid animal post-exposure consultation at the Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok, Thailand	14
A sheepherder with a severe diarrhea caused by Trichostrongylus colubriformis	14
Detection of the Omicron variant of SARS-CoV-2 in international travelers returning to Venezuela	14
Heart failure after dengue infection– a population-based self-controlled case-series study	14
Application of omadacycline in the treatment of severe Japanese spotted fever	13
Reply to comment on “ticks infected with Crimean-Congo hemorrhagic fever virus (CCHFV): A decision approach systematic review and meta-analysis regarding their role as vectors”	13
Obituary Ana Paulina Celi de la Torre (1958–2023)	13
Rabies post-exposure prophylaxis: A retrospective analysis of timing of initiation and antibody responses in a Belgian cohort	12
Host biomarkers for early identification of severe imported Plasmodium falciparum malaria	12
The global challenges of the long COVID-19 in adults and children	12
How did the 2022 global mpox outbreak happen? A travel-associated case 6 months earlier may provide important clues	12
Association between prehospital medication and fatal outcomes in a cohort of hospitalized patients due to coronavirus disease-2019 in a referral hospital in Peru	12
Unmasking hidden risks: A case of primaquine-induced intravascular hemolysis in G-6-PD deficient malaria patient	12
Dengue incidence, mortality, and case-fatality in Brazil: spatial patterns, socioeconomic contrasts, and serotype impact	12
A severe case of mpox complicated with penile necrosis and keratitis in a patient living with HIV	12
Single visit rabies pre-exposure prophylaxis: A literature review	12
Concern over monkeypox outbreak: What can we learn from the top 100 highly cited articles in monkeypox research?	12
Malarial hepatopathy followed by delayed hemolysis after artemether–lumefantrine therapy for Plasmodium falciparum infection in a Colombian patient	12
IRIS in a person living with HIV due to disseminated Mycobacterium simiae infection possibly acquired after a remote travel history to Thailand	11
Loneliness in long-term Taiwanese expatriates and domestic residents in the COVID-19 era: A cross-sectional study	11
International outbreaks of Monkeypox virus infection with no established travel: A public health concern with significant knowledge gap	11
Monkeypox caused less worry than COVID-19 among the general population during the first month of the WHO Monkeypox alert: Experience from Saudi Arabia	11
Children orphaned by COVID-19: A grim picture and the need of urgent actions	11
Multiple nodules and pustules in a traveler	11
Latino migrants’ healthcare use in the US and perceived immigration laws and consequences: A multivariable analysis	11
Pregnancy outcomes in women with imported malaria in mainland France: A retrospective study from 2004 to 2014	11
Corrigendum to “Epidemiological and clinical profile of adult patients with diarrhoea after international travel attended in an International Health referral center” [Trav Med Infect Dis 45 (2022) 102	11
Acute colonic pseudo-obstruction syndrome in patients with severe COVID-19 in Buenos Aires, Argentina	11
Monkeypox virus neurological manifestations in comparison to other orthopoxviruses	11
The basic reproduction number (R0) of ebola virus disease: A systematic review and meta-analysis	10
Prevalence of Chagas disease and strongyloidiasis among HIV-infected Latin American immigrants in Italy – The CHILI study	10
Diagnosis of monkeypox virus – An overview	10
Ultrasonographical and molecular diagnosis of breast sparganosis due to Spirometra erinaceieuropaei	10
Emerging bacterial infectious diseases/pathogens vectored by human lice	10
The increase in cases and deaths from malaria in the Brazilian Yanomami territory is associated with the spread of illegal gold mining in the region: A 20-year ecological study	10
Knowledge, attitudes, practices and vaccine acceptance towards seasonal influenza vaccination among international travelers: a cross-sectional survey in Thailand	10
Icterus provoked by Echinococcus mimicking a tumor: A diagnostic challenge	10
Renaming the tropical febrile syndrome: A clinical and semantic imperative in global health	10
Dramatic re-emergence of avian influenza in Colombia and Latin America	10
An asylum seeker from Nigeria with a swollen foot with ulcerating lesions	10
Autochthonous dengue outbreak in Northern Italy, September 2024: epidemiological, microbiological, entomological investigation and public health response	10
A case report of travel-associated infection with melioidosis pneumonia and septicemia	10
False positive for hepatitis C virus by rapid test in a patient with Salmonella Typhi infection	10
Shigellosis in Southeast Asia: A systematic review and meta-analysis	10
Incidence of dengue fever in Israeli travelers 2008–2019	10
Cocktail of FIFA 2022 Vis-A-Vis camel beauty pageant championship; potential health threat of MERS among players and fans - A possible global spread	9
First report of a traveller myiasis caused by Cordylobia rodhaini (Diptera, Calliphoridae) in Spain	9
Mpox knowledge, risk perception, attitudes and willingness to vaccinate in Colombia's LGBTIQ+ communities: Online survey (CoSex)	9
Costs of typhoid vaccination for international travelers from the United States	9
Knowledge, attitudes and practices of malaria control and prevention in a high-exposure occupational group: A cross-sectional survey of mining workers in Haut-Katanga Province in the Democratic Republ	9
Increase in COVID-19 underreporting among 3,282,337 Brazilian hospitalized patients due to SARS: A 3-year report and a major concern for health authorities	9
Travel medicine in Basel - 450 years before CISTM18	9
Chronic schistosomiasis imported in France: A retrospective multicentre analysis of 532 patients, calling for international recommendations	9
Vaccinations for Hajj: Enhancing health and global health security	9
Clinical profile and management of a Spanish single-center retrospective cohort of patients with post-chikungunya associated complications	9
Sudanese migrants' pathways to malaria care in Egypt: An in-depth qualitative study	9
Rhino-orbital conidiobolomycosis in non-endemic Settings. A diagnostic and therapeutic challenge	9
Pustular lesions and itching in a couple of young migrants	9
Guidelines to prevent malarial transmission among interprovincial travelers to malaria endemic regions	9
Screening of imported malaria infection in asymptomatic migrants from Sub-Saharan Africa: A retrospective analysis of a 2010–2019 cohort	9
Determinants of insect repellent use to prevent dengue infection among travelers visiting Lipe island, Thailand: A cross-sectional survey	9
Fever in a traveler returning from Kenya	9
Clinical and epidemiological survey of tungiasis in Madagascar	9
mRNA vaccines as an armor to combat the infectious diseases	8
Dynamics of viral DNA shedding and culture viral DNA positivity in different clinical samples collected during the 2022 mpox outbreak in Lombardy, Italy	8
Fungal and bacterial mycetoma in migrants from Haiti: A case series	8
The safety, pharmacokinetics and neutralizing activity of recombinant human anti-rabies monoclonal antibody NM57 injection (rhRIG, Ormutivimab) in combination with rabies vaccination in Chinese health	8
Factors impacting severe disease from chikungunya infection: Prioritizing chikungunya vaccine when available	8
Rapid evolving cutaneous lesions on the hand: A diagnostic challenge	8
Hotel employees' knowledge of monkeypox's source, symptoms, transmission, prevention, and treatment in Egypt	8
Imported infectious diseases in migrants from Latin America: A retrospective study from a referral centre for tropical diseases in Spain, 2017–2022	8
Provision of Travel Health Advice Through Local Tourist Handlers: Perspectives of Safari Tour Operators in Uganda	8
Scalp myiasis presenting as forehead edema in a returning traveller from Belize: A diagnostic challenge	8
Asian lineage Zika virus infection in a traveler returning to Italy from Seychelles, April 2024	8
A case of orf virus infection in the human: Other zoonotic poxvirus infection events should not be ignored during the mpox epidemic	8
Real-world evidence of rabies post-exposure prophylaxis in Serbia: Nation-wide observational study (2017–2019)	8
Impact of epigenetic mechanisms in re-emerging viruses	8
Does adenovirus cause the acute hepatitis of unknown etiology among children? Epstein-Barr virus May give us a hint	8
Risk of monkeypox outbreak in Nepal	7

Monkeypox and human transmission: Are we on the verge of another pandemic?	7
Acceptance towards COVID-19 vaccination in Latin America and the Caribbean: A systematic review and meta-analysis	7
Preliminary screening of ESBL-producing Escherichia coli and Klebsiella pneumoniae carriage among migrant communities in Klang Valley, Malaysia	7
Epidemiology and response to the COVID-19 pandemic in the Dadaab Refugee Camp Complex, Kenya, March 2020–December 2022	7
The first possible case of airport Zika virus infection in the EU/EEA	7
A resistant parasitic flare-up amid children in Italy: Comment on “Diagnosis and management of pediatric scabies: Results from a survey on 317 Italian dermatologists”	7
Clarification of factors associated with post-artesunate delayed hemolysis (PADH): Analysis of 327 patients with severe imported Plasmodium falciparum malaria in France	7
Refractory giardiasis: Exploring the contribution of bacterial community shifts	7
A case of scrub typhus encephalitis in a pediatric patient with different serotypes detected in blood and cerebrospinal fluid	7
Molecular epidemiology and surveillance of imported dengue in travellers returning to Spain, 2022-2024	7
Atypical hand foot and mouth disease related Coxsackievirus-A10 infection in an adult patient	7
Water-borne oculoglandular tularemia: Two complicated cases and a review of the literature	7
Rabies post-exposure treatment in metropolitan Sydney residents, 2013–2023: A retrospective case-series analysis	7
Emergence of cutaneous anthrax in a case with non-stock farming professional woman: The need for heightened surveillance and public health readiness	7
Leishmaniasis in the United Kingdom: Experience of a national multidisciplinary team meeting in a non-endemic setting	7
Artemether-lumefantrine, mefloquine and atovaquone-proguanil in the treatment of uncomplicated Plasmodium falciparum malaria in travellers: A retrospective comparative study of efficacy and treatment	7
Dengue serotypes and epidemic dynamics in Brazil: a spatiotemporal perspective	7
Infectious diseases on passenger ships: Port preparedness and response - A narrative systematic review	7
Prognosis and mortality risk in elderly patients with dengue virus infection: Excess fatality and the urgent need for revising current WHO criteria for elderly patients	7
Might procalcitonin help predict imported falciparum malaria in children?	7
Viral shedding in saliva, axillary, rectal and vaginal swabs of an imported case of Dengue - Oropouche virus Co-infection	7
Blood smear examination matters: an incidental case of tick-borne relapsing fever in a traveller returning from Senegal	7
Visualization of scientific collaboration and themes for arbovirus disease in the caribbean: A forty-year trend analysis with focus on dengue, Zika and Chikungunya	7
A comprehensive review of highly pathogenic avian influenza (HPAI) H5N1: An imminent threat at doorstep	7
Mapping the global risk of chikungunya virus endemicity and autochthonous transmission following importation	7
Emerging threats: Is highly pathogenic avian influenza A(H5N1) in dairy herds a prelude to a new pandemic?	7
The 2026 FIFA World Cup: Communicable disease risks and advice for visitors to Canada, the United States, and Mexico	6
Monkeypox clinical disease: Literature review and a tool proposal for the monitoring of cases and contacts	6
The secondary outcome of public health measures amidst the COVID-19 pandemic in the spread of other respiratory infectious diseases in Thailand	6
Table of Contents	6
Yellow fever in older populations: Marked age– and sex–based disparities in case-fatality rates in Colombia, Brazil, and Peru	6
Evaluating the effectiveness of dengue surveillance in the tropical and sub-tropical Asian nations through dengue case data from travelers returning to the five Western Pacific countries and territori	6
Comments on “Shigellosis in Southeast Asia: A systematic review and meta-analysis”	6
Screening for Chagas disease in Latin-American pregnant women and their newborns: A prospective observational, multicenter study in Milan, Italy	6
The first imported case of monkeypox in Singapore during the 2022 outbreak – Reflections and lessons	6
Imported malaria from land bordering countries in China: A challenge in preventing the reestablishment of malaria transmission	6
Editorial Board	6
Turkish airline cabin crew members’ attitudes towards protection from infectious diseases in the context of their health responsibilities and health perceptions	6
ChatGPT in travel medicine: A friend or foe?	6
Neuromelioidosis causing rapidly progressing neurological syndromes mimicking stroke and demyelination: Insights from a case series	6
Leishmaniasis in Syria – A call for action of the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) Study Groups for Infections in Travellers and Migrants (ESGITM) and for Cl	6
Zero by 2030 and OneHealth: The multidisciplinary challenges of rabies control and elimination	6
Cycle threshold values are not associated with mortality: Risk factor analysis in older patients with the SARS-CoV-2 Omicron variant	6
Clinical presentation and diagnosis of imported strongyloidiasis at a tertiary hospital, Stockholm, Sweden	6
COVID-19 influences both physical and mental health: Lessons from bibliometric analysis	6
Evaluation of fatigue and sleep problems in cabin crews during the early COVID-19 pandemic period	6
Title page	6
Community acceptability of dengue fever surveillance using unmanned aerial vehicles: A cross-sectional study in Malaysia, Mexico, and Turkey	6
Monkeypox virus declared as a global health emergency: What next for Africa's preparedness?	6
Imported fascioliasis in non-endemic countries: a case series and review of the literature	6
Prevalence of health problems related to marine tourism among travelers in the Andaman Coast provinces of Southern Thailand	6
Infectious diseases in migrant pregnant women from an area of the Colombian Caribbean	6
Cerebral cystic echinococcosis: A retrospective series of 7 cases	5
Unusual coinfection of Malaria and Hantavirus in the Colombian Caribbean Region	5
Modelling international travel as risk of acquiring Dientamoeba fragilis: Comparison to Giardia duodenalis data	5
Investigating seroprevalence of IgG antibodies against Monkeypox Virus (MPXV) in a cohort of people living with HIV (PLWH) in Rome, during the 2022 outbreak: Moving beyond traditional at-risk populati	5
Arboviral vaccines for use in pregnant travelers	5
Please get me out of here: The difficult decision making in fit-to-fly assessments for international fixed-wing air ambulance operations	5
HKU5-CoV-2: A silent threat looming in bats	5
Dual infection: What diptera has (have) bit her	5
Clinical features and outcomes of dengue and scrub typhus in hospitalized adults in the Maldives	5
Association between positive serology for COVID-19 and chagas cardiomyopathy progression: The SaMi-Trop project	5
Marburg virus disease outbreak in Tanzania, 2023–2025	5
Spontaneous regression of cutaneous lesions caused by Leishmania panamensis in a traveller returning from Costa Rica	5
Improving the mental health of lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA+) community through counseling and rehabilitation measures during monkey pox disease outbreak	5
Clinical, therapeutic, and stigma-related challenges in leprosy and the emerging role of apremilast in managing leprosy reactions	5
Recrudescence of Plasmodium falciparum malaria imported from Sub-Saharan Africa: a report of two cases and the first detection of artemisinin resistance in Italy	5
Clinical and epidemiological characteristics of mpox: A descriptive cases series in Colombia	5
What concerns the general public the most about monkeypox virus? – A text analytics study based on Natural Language Processing (NLP)	5
Role of village health worker in control activities for malaria elimination efforts: A systematic review	5
Preclinical evaluation of the RBD-Trimeric vaccine: A novel approach to strengthening biotechnological sovereignty in developing countries against SARS-CoV-2 variants	5
Seroprevalence of Mayaro virus infection in Veracruz, Mexico	5
World tuberculosis day 2023 – Reflections on the spread of drug-resistant tuberculosis by travellers and reducing risk in forcibly displaced populations	5
An African West Nile virus risk map for travellers and clinicians	5
Travel Healthy, a mobile app for participatory surveillance among U.S. international travelers	5
Rickettsia amblyommatis-infected Amblyomma coelebs parasitizing a human traveler in Rio Grande do Sul, southern Brazil, after returning from the Amazon	5
Hypersensitivity eosinophilic myocarditis possibly triggered by meglumine antimoniate	5
Travel- and migration-associated epidermal parasitic skin diseases. A review	4
Fever with rashes in a traveller: A diagnostic challenge	4
Zika virus infection in a German traveller to the Maldives, August 2025	4
Avian Influenza – The next travel-associated pandemic? Proactive One Health surveillance is required to reduce the risk of the spread	4
Associated factors for mortality in a COVID-19 colombian cohort: is the third wave relevant when Mu variant was predominant epidemiologically?	4
Screening and early detection of communicable diseases on board cruise ships: An assessment of passengers’ preferences on technical solutions	4
Metagenomic next-generation sequencing enhances the diagnosis of Q fever: A retrospective observational study	4
The cascade of care in tuberculosis infection screening and management in newly arrived refugees in Aarhus, Denmark	4
A preliminary analysis of hand disinfection use by travellers and their colonisation-risk with multi-resistant bacteria: A proof-of-concept study	4
Emerging cases of Naegleria fowleri infection in India: A brief report (2018–2025)	4
Prevalence of crimean Congo hemorrhagic fever in Khyber Pakhtunkhwa, Pakistan	4
COVID-19 isolation strategies: What have we learned	4
Mosquito-borne ross river virus: A raising concern in Queensland	4
Knowledge, attitudes, and practices about malaria in travelers to risk areas in Peru	4
Prevalence of orthohantavirus in rodents: A systematic review and meta-analysis	4
The next arbovirus epidemic in Latin America and beyond: A question of when, not if – Mayaro, Oropouche, Usutu or Disease X?	4
Polymerase chain reaction positivity and cycle threshold values in biological samples from patients with monkeypox: A meta-analysis	4
Multiple intracranial space-occupying lesions caused by Talaromyces marneffei infection in an AIDS patient returning from Cambodia	4