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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."


Why are vaccines less effective in the developing world?

Posted on June 7, 2018 at 10:55 AM

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 structures which are important centres for developing immunity after a vaccine.

At a deeper level the study evaluated the 2 groups to find that every Ugandan patient showed a difference such as fibrosis and anatomy changes of their secondary lymph nodes compared to USA patients.

Following a trail with yellow fever vaccine, antibodies were measured after 60 days to determine that lymphoid abnormalities were associated with immune dysfunction. The study suggests that common infections in the developing world maybe a limiting factor for in the development of immune response of other vaccines.

If this study is true the implications for new vaccines against malaria, HIV, dengue, etc would need to be designed to either avoid the secondary sites or be unaffected by any damaged tissue.


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