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;




Awkward Ailments

It must be twenty years since a group of us sat in a tutorial at medical school, being encouraged by our Sexual Health tutor to tell the group of all the euphemisms for ‘genitals’ that we had ever heard of.

The group moved from embarrassment (willy/ winkie), to giggle fits (woo-woo/ tuppence), to deep concentration (John Thomas?)  as we all took up the challenge. The tutorial was a success, and the colourful discussion helped us to take embarrassment out of the equation when dealing with other people’s awkward or disconcerting health complaints.

Here at Student Health we see lots of things that you might feel are embarrassing to mention, but you can be fairly sure we will have seen most of them before. And if we haven’t, well, we like a medical challenge.

The message for this blog is to reassure you that it is better to seek advice for the things that are worrying you, such as bumps on your private bits, as very occasionally they can prove to be a bit more serious, and the sooner we check them out the better. Scrotal or testicular lumps are a classic, with men of all ages being reluctant to seek a medical opinion, but it is vital that you do. If further tests are needed then a non invasive ultrasound scan will be arranged, and that really doesn’t hurt a bit, but can be life saving.

For the ladies, we are used to dealing with issues varying from the after effects of intimate waxing/ hair removal (rashes, infections, folliculitis), to ‘lost’ tampons (our nurses will retrieve them if you can’t), and itchy/ sore vulvas. One of the most effective ways to avoid the latter is to wash only with water, or possibly aqueous cream as a soap substitute, but never to use soaps/ shower gels/ bath oils/ wet wipes etc as they cause havoc with delicate skin.

Piercings are another notorious source of infections in nipples/ genitals, and need careful looking after, or removal, if not settling, as much deeper infection could follow. See us if you are concerned.

And a blog about embarrassing problems wouldn’t be complete without mentioning wee and poo, so if you noticed blood, or pain, or other significant changes when evacuating either of these, then please make an appointment with a nurse or doctor to discuss it. They usually turn out to be caused by minor ailments, but can occasionally be a sign of something more worrying.

So don’t let embarrassment damage your health! The doctors and nurses at Students Health service are here to help, and reassure you. We’ve seen it all before, and if we haven’t, then well done on making our day more interesting!