Illness in Children Presenting to the Emergency Department After International Travel: A 10‐Year Retrospective Analysis From the University Hospital of Helsinki, Finland

AIM: We characterized infections after international travel and identified predictors of severe infection to refine management. METHODS: We conducted a retrospective cross-sectional analysis of children aged 0-18 years presenting to Helsinki University Hospital Emergency Department within 90 days of international travel between January 1, 2015, and January 26, 2025. RESULTS: Among 921 patients (median age 5.1 years), 59.6% were travellers visiting friends and relatives (VFR), 31.7% outbound tourists, 7.3% migrants and 1.4% visitors to Finland. Sub-Saharan Africa was the most common travel destination (46.3%). The leading diagnoses were diarrhoea (36.0%), viral (22.6%) and respiratory infections (21.3%); 8.2% of infections were tropical and 15.3% potentially severe. Independent predictors of severe infection were migrant status, fever, travel from South-Central Asia, presentation > 5 days after return, and male sex. Malaria was diagnosed in 3.3% of patients, and only 22.4% of eligible travellers received adequate prophylaxis. Extended-spectrum β-lactamase producing organisms were frequent in Salmonella typhi infections and Escherichia coli pyelonephritis. CONCLUSION: The main reason for paediatric travel was visiting friends and relatives. Migrants presented more frequently with potentially life-threatening infections. Only 22% of eligible travellers received adequate malaria chemoprophylaxis. Antimicrobial resistance represents a significant concern among paediatric travellers.