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Derek Evans

Welcome to Evans Travel Health

Blog     posted on Wednesday 4th August 2021

       How to prepare for Travel Medicine post-Covid

"We are all aware of that the impact of Covid infections has had on travel and continues to do. With the advent of vaccination programs and sophisticated testing and recording systems in place travel is starting to increase.

However the types of travel such as short haul continues to expand according to the determination of national governments whilst long haul remains dormant. The traveller groups have changed and the emphasis on routine vaccinations being sought by first time travellers going to exotic destinations has shifted to business and essential workers.

With this in mind the marketing of any specific travel medicine services will need to understand these changes. Following lockdowns and extended restrictions many travellers are now attempting to visit families and friends (VFRs) who they have only seen through video links. These VFRs will be a key target group during the revival of travel medicine demands and services.

A key part of the practitioners will be the flexibility to react to short time departures and supply necessary vaccines and medication where required. This parallels with the quick turn around that Covid tests are required for entry into another country before departure from the UK. It seems that a mix of PCR and rapid antigen tests are required within a range of departure times from 24 to 96 hours before departure.

The underlying point here is that this increased cost needs to be allowed for during any travel consultation and also the returning costs of testing and/or isolation. It is unlikely that these costs will be removed in the short term and certainly Covid will become another disease to be routinely covered during a travel medicine risk assessment."


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Why are vaccines less effective in the developing world?

Posted on June 7, 2018 at 10:55 AM Comments comments (1660)

Often a question that is implied but never answered is why there appears to be lower success rates in vaccination programmes in developing countries when compared to developed countries.

A recent piece of research from the University of Minnesota Medical School has compared the response rates between patients in Uganda and the USA. The study concludes that some diseases such as malaria, TB and those caused by parasites may damage the lymph node struct...

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WHO- World Malaria Report 2017

Posted on May 2, 2018 at 10:15 AM Comments comments (202)

WHO- World Malaria Report 2017 .This annual report has previously been the online publication of a single document of many pages available through the WHO web site and not easily accessed.

This year the WHO have produced the report in an app version which can be downloaded on Apple and Android platforms. This far easier to use app includes headings of

Quick Stats- estimated annual cases 216 million, 90% of which occurred in the WHO African region. Along...

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Sourcing non-microbiologically contaminated water when travelling.

Posted on January 31, 2018 at 9:15 AM Comments comments (3)

Some unpublished research following a survey of travellers indicated that their intention when travelling was to rely on the purchase of bottled water to rehydrate. The survey indicated that the largest group intending to rely on this were in the 20-29 age group, and travelling on holiday or for business for a period of less than 2 weeks. This defined a rough profile of a group wanting to use bottled water in place of that from the tap or local source. The destinations...

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UK MALARIA CHANGES- impact for travel health professionals with differing online advice

Posted on November 1, 2017 at 9:30 AM Comments comments (17)

The new Advisory Committee on Malaria Prevention (ACMP) have released the 2017 guidelines based on the results of 2016. Interestingly enough in its summary, the focus is upon the realisation from WHO that nearly 90% of global cases have originated from Africa and this contingent remains the focus for both residents and returning travellers. The report goes on to indicate that ACMP have evidence to suggest that there is a real reduction in other areas such as SE Asia and South America; and the...

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HepA and HepB shortage - an opportunity?

Posted on July 31, 2017 at 10:20 AM Comments comments (0)

Like many of us in travel health I am concerned about the the shortage of these vaccinations, especially when HepA is considered high risk in so many places. Upon reflection and following national guidance (UK) does this present a golden opportunity for travel health professionals to demonstrate the kind of assessment and rationalising that we have trained for? In a perfect world many will routinely follow the guidance issued by the respective agencies, but how many of us stop to ...

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New guidelines for the prevention and treatment of Travellers Diarrhoea(TD)

Posted on July 7, 2017 at 12:25 AM Comments comments (205)

At the recent CISTM meeting in Barcelona an expert panel reported back on a major review of TD. They concluded that prevention and treatment of TD requires action at the provider, traveller, and researchers. There is now strong evidence to suggest the effectiveness of Antimicrobial therapy in most cases of moderate to severe TD.

So what is classified as moderate TD- diarrhoea that is distressing or interferes with with planned activities. Severe TD is further classified as ...

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Posted on May 6, 2017 at 12:15 AM Comments comments (1044)


With this season's climbing season well on the way and expectations of summits in the next few days, is it not amazing to read that in between the serious climbers and outdoor specialists there are now breakfast trips to Everest Base Camp (EBC), as reported in a national newspaper.


The new breakfast club is a helicopter journey up to base camp for a 15 minute breakfast (tourists not sufficiently acclimatised at altitude cannot stay any l...

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Reasons for not having Vaccines

Posted on February 6, 2017 at 11:00 AM Comments comments (126)


This is an age old problem in travel health, in that the traveller gives reasons for not having vaccines and many opinions have been postulated why. It is a story that continues and recently in the Journal of Travel Medicine and Infectious Diseases(1), a report of a 10 member French family returning from Algeria where they had all been in contact with a rabid dog and received poor post exposure care.


A article published in the Journal of Travel Medi...

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Mosquito vectored diseases- what have we learnt this year for 2017?

Posted on December 21, 2016 at 4:40 AM Comments comments (198)


This year we have seen the rise and lately the fall of the incidence of zika reported infections; the rise in the frequency of reported dengue and chikungunya along with lesser known diseases such as West Nile fever appearing more frequently.


The appearance of these diseases is not unknown nor was undetected before. However; with zika appearing in Florida, rising dengue reports from India then the question must be, is this improved reporting or an e...

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DEET 100% - time for a change

Posted on November 24, 2016 at 1:00 PM Comments comments (4784)


For some considerable time the use of DEET in concentrations above 50% has been a concern for healthcare professionals when applied directly to the skin. This has followed some reports indicating that there may be an increased risk of systemic toxicity with dermal absorption.


Despite this evidence, manufacturers have continued to formulate products with claims of up to 100% DEET and indicated in packaging of its superior protection. When reviewing t...

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