Health Advice for the Returning Traveller; When to see the GP?

It’s the time of year again when all our backpacking students return from the four corners of the world. Some will be arriving for the first time in Bristol, as international students of course, and many of you will have been traipsing through the jungles/ beaches and villages of the world’s most remote places, possibly even to Coca-cola free zones!

Unfortunately, even if you did everything right, had every last jab, and took all your malaria pills, you may still be at risk of post-travelling illness, so here is a quick summary of what to watch for and what to act on;

  • Tell the nurse/ doctor exactly where you have been, and dates
  • Tell them if you worked in ‘at risk’ environments, eg in a hospital/ clinic
  • Most illnesses will be common conditions like pneumonia/ fungal skin rashes
  • Be honest about malaria tablet history and compliance
  • Report any treatment tried or taken overseas
  • Fever is a common symptom requiring medical attention in returning travellers, especially if it is accompanied by; rash/ jaundice/ breathing difficulties/ bruising/ persistent vomiting/ altered conscious level or paralysis (the latter are extremely rare with only 0.3% of unwell travellers ever requiring hospital admission).
  • Malaria commonly presents with fever, chills, sweats, headaches, muscle pains, nausea and vomiting.
  • Jaundice (yellowing of the skin, and whites of the eyes) can indicate Hepatitis, most commonly type A, from infected food and water.
  • Arbovirus infections (Dengue, West Nile and Chikungunya fevers) are the main cause of viral fevers in returning travellers, and tend to have short incubation periods, typically less than two weeks .ie you will show symptoms within 2 weeks of being infected.
  • Diarrhoea is extremely common in travellers, and those who develop three or more loose stools in an eight-hour period, especially if associated with nausea, vomiting, abdominal cramps, fever, or blood in stools, may benefit from antibiotics.
  • Prolonged, severe diarrhoea with blood should be reviewed by a GP.
  • Skin rashes are very common, and should be reviewed by your GP if not settling, or if associated with fever.
  • The vast majority of travellers’ infections have a short incubation period, meaning that symptoms will start within 10 days or less from infection. The notable exceptions are schistosomiasis (bilharzia)/ malaria/ TB/yellow fever, and Q fever.



Therefore, if you continue to feel unwell despite being home, and eating and drinking normally for you, then please come and see one of the GPs. You may also find it useful to look at the following;




Taking Risks

“I’m lying here with a drip in my arm on a hospital bed, gazing out of the window, watching a couple of local children playing with a tin can, wishing I was out there in the sun… Thank goodness I had taken out good travel insurance as I was advised; otherwise this ‘cheap’ backpacking trip would have cost me and my family a fortune in hospital costs…

Being admitted to hospital in India was not on our travel plans.

I feel so sorry for my friends who have cut their holiday short to stay and look after me and update my worried parents on my progress…

 How did I end up here you may ask? Well now, that’s a good question…

Between the many visits to the bathroom to either vomit or have profuse diarrhoea- been probed, prodded or injected with goodness knows what-  I have been lying here asking myself that very question over the last few hours…

 I remember what the nurse told me in the travel clinic about water and food precautions- but how many times did I take risks??

 Was it those delicious tomatoes that I bought from a street seller but which I didn’t bother to wash… that local ice cream that was sooo refreshing… those prawns that looked so fresh… that salad… that meat that was not cooked quite so thoroughly… the buffet we treated ourselves to- how long had it been kept warm for… those ice cubes in my drink… or indeed running out of bottled water and brushing my teeth with tap water?

I have also been eating with my hands a lot and not washed them as much as I should have, and it didn’t help that I’d forgotten to pack some alcohol gel…

I wish I’d been more vigilant with precautions as I was advised,and not taken any risks…”


Any one of these risks could result in severe travellers diarrhoea due to transmission of a bacteria/parasites/virus/cysts.

For advice on prevention please read from the list of sources below.


Remember that Traveller’s Diarrhoea is the most common illness you will be exposed to and the main danger is dehydration, which, if very severe, can be fatal if untreated.

Treatment is therefore rehydration– ensuring you drink plenty of clean water, particularly salty soups and fruit juices with bland bulky foods- bread, pasta, rice and potatoes. You will also need to replace some of the lost salts by taking an oral rehydration sachet e.g. Dioralyte. Anti diarrhoea tablets should be used sparingly and only when truly necessary e.g. a long distance bus/train journey.

Contact medical help if the person has:

♦ A temperature

♦ Vomiting and unable to keep fluids down

♦ Blood or mucus in the diarrhoea

♦Persistent diarrhoea

♦ Become confused

♦Any pre existing medical conditions e.g. diabetes



Students’ Health Service ‘Travel Guidelines’ patient information leaflet- available at the practice