Post-travel Investigations and Care

Unlike most travel clinics, we offer a post-travel consultation and investigation service at TrExMed. All clients requesting this service are seen by Dr Bond.

Appointments may be made outwith normal clinic times at mutually convenient times. Please call the Clinic in the first instance and arrangements will be made for Dr Bond to call you back.

Malaria is a medical emergency! If you suspect that you might have malaria, and/or are acutely unwell, you should contact your GP, out-of-hours service or local A&E Dept. as soon as possible. Remember to mention that you have been travelling.

For other, less urgent problems, Dr Bond is usually able to see and examine clients at The Edinburgh Clinic within a day or two, and to request further investigations as indicated, e.g. blood tests, stool or urine samples, X-rays etc. Depending on the clinical picture, he may offer to treat you himself, or refer you on to the most appropriate specialist in that field (either privately, or in the NHS).

Schistosomiasis (bilharzia) screening

Bilharzia (schistosomiasis) is a real risk in the waters of Lake Malawi/Lago Niassa/Lake Nyassa

Schistosomiasis is a disease caught by contact with fresh water in parts of the tropics, e.g. through bathing, wading or swimming. An estimated 200 million people worldwide are infected, mainly in Africa. Schistosomiasis is a leading cause of chronic debility and poor childhood development.

Early recognition is also important in order to prevent rarer, but potentially more serious long-term complications such as bladder cancer, transverse myelitis or epileptic fits.

Often, the infection can go unnoticed in travellers. Even if you have no symptoms, but there is a possibility that you may have picked up schistosomiasis, you should still get checked out. We offer a sensitive and specific blood test for this. If the test is positive, we can offer a single-dose treatment to eradicate the blood flukes from your body. The test should ideally be done 12 weeks after your last exposure to fresh water in an at-risk country. Naturally, if you develop symptoms, Dr Bond would see you earlier.

For a simple Schistosomiasis screening (with no other problems), a 'single item' appointment fee of £35 is charged, plus the cost of the test (£37.50). For those who test positive, a simple, one-dose treatment is available.

TrExMed does not charge for this treatment. Instead, we ask for donation of £25 to support the excellent work of the Schistosomiasis Control Initiative, which aims to eradicate schistosomiasis in some of the poorest parts of the world with population level treatment programmes.

Zika virus testing

TrExMed is one of the few travel clinics in Edinburgh currently able to offer specialist advice and testing for zika infection, both for men and women.

Zika is a monkey virus, which has been widespread in humans in parts of Africa and Asia for many decades. It is typically spread by mosquito bites, but can also be spread by unprotected sex and from mother-to-baby. Since 2007, there have been several, large-scale outbreaks of a new, 'Asian lineage, and there are now up to 60 countries worldwide with evidence of active, local transmission, mainly in Latin America, the Caribbean, SE Asia, Western Pacific islands and Cape Verde.

80% of people infected with zika experience no symptoms whatsoever. The symptoms in the remainder are relatively short-lived and mild, including transient rash, fever, back and joint pain, conjunctivitis and pain behind the eyes.

The main clinical concern with the new, 'Asian lineage of zika is an association with birth defects (including brain damage) in some children born to infected mothers. Zika virus has also been found in the sperm of infected men at least two months after infection, and is now known to be transmissible onwards from men who have had no symptoms. The primary aim of testing is therefore to provide reassurance to couples on whether it is safe to either stop using barrier methods of contraception after travel to affected countries and/or to try to get pregnant.

The two specific tests we offer are the zika antibody test and the zika antigen (PCR) test. The choice of test depends on the travel history and dates, and dates of onset of any symptoms (if applicable). We therefore recommend that if you are considering a zika test, that you contact Dr Bond by email email to explain your situation in the first instance. He would then advise how best to proceed.

If you are worried about future travel when pregnant, or if planning a family thereafter, we would also be able to advise you in a pre-travel appointment.

Responsible / ethical travel medicine

Travelling is an interactive experience, which should ideally be empowering and mutually beneficial to both travellers and local host communities alike. We at TrExMed are very much committed to promoting responsible travel and ethical travel medicine.

Nicky Armstrong and Jim Bond

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