Barrhaven Travel Medicine Clinic
3201 Greenbank Road K2J 4H9 Ottawa, ON, Canada

Cutaneous larva migrans is in the news from time to time particularly as people travel south. This is a skin condition contracted mainly on beaches. If a dog or cat infected with hookworm uses the sand as a litter box, the eggs may subsequently hatch there. The barefoot vacationer may become the next host as the larva makes its way into the skin. Unlike dogs and cats however, humans are not a suitable habitat for this micro-organism and no internal infection occurs. Still, as the larva moves slowly and aimlessly toward oblivion it causes a very itchy rash.

A traveller is bitten by a dog and wonders what needs to be done. The wound, even if trivial, should be washed for 10-15 minutes. The aim is to wash away the saliva and any rabies virus which might be present. Then injections are needed and this should be looked after right away. We have details on the rabies page of our Riverside clinic website at www.travelclinic.org. But are these injections always necessary? There are rabies-free countries and areas within countries. These are listed by the Centers for Disease Control and by Public Health England. The latter can be found at https://www.gov.uk//rabies-risks-in-terrestrial-animals-by# It is a good idea to contact the local public health office, asking what their usual recommendation is for their locality.

The Riverside Travel Medicine Clinic has a position open for an office assistant, 3 or 4 days per week (applicant's choice), one year term. This could become permanent at either the Riverside or Barrhaven location. We ask applicants to let us know if they are bilingual, have experience working in a medical office, and how they rate their knowledge of world geography. More details including pay rate will be posted shortly on the Job Bank web site. CVs can be sent to [email protected]

Friday November 3 is Zambia's day at Lansdowne, part of "Ottawa Welcomes the World". We'll be there with a display and answers to travel health questions about Zambia and anywhere else.

Our clinic opened its doors Wednesday evening. Our first clients - a family of four - were presented with a gift basket of travel items. At closing time we treated ourselves to a fruit platter and champagne but in the excitement didn't take pictures. The backdrop of this one though might look good in February.

IAMAT Our clinic received a rather distressed email from an ill traveller last week who had seen us prior to leaving for Indonesia. Her symptoms were such that I thought she should be seen by a doctor there. I told her about IAMAT and provided her with the names of some recommended doctors in the city she was in. She wrote back to tell me that within an hour of calling, a doctor (who spoke excellent English) and a nurse had come to see her, diagnosed her condition and had be...gun treatment. The doctor asked her to call back if she was not improving. The cost was $53. IAMAT is the International Association for Medical Assistance to Travellers, a non-profit Canadian organization well-known to travel medicine providers. A donation provides a membership with access to a world-wide list of hospitals, clinics and doctors along with many other travel health resources. Find IAMAT at www.iamat.org

What's special about yellow fever vaccine? A number of countries may refuse entry to a traveller who does not have the certificate of yellow fever vaccination. In most cases this applies only if arriving from a country which itself is in the yellow fever zone. However there are some such as Ghana which require proof even when arriving from Canada or Europe. Yellow fever vaccine is live and can rarely cause serious illness or even death in people who are immunocompromised or ...elderly. This is one reason why travel clinics ask their clients targeted questions during the consultation. For some individuals it is deemed too risky to recommend the vaccine in which case other options are discussed. The World Health Organization lists all countries and their requirements at http://www.who.int/ith/2017-ith-country-list.pdf?ua=1 Pictured: Aedes aegypti, the yellow fever mosquito

A quiz for readers. There are two countries with high altitude destinations currently popular with travellers. We see at least one person a day going to the more visited of these. Travellers to the other must be aware of the most severe forms of altitude sickness. This photo from another such country provides a hint only by reducing the possible answers by one.

We saw a relief worker at our Riverside clinic today leaving for the Caribbean. The aftermath of a hurricane brings its own set of disease risks. One of the lesser-known illnesses is leptospirosis, a sometimes severe bacterial infection that affects both animals and humans. Urine from infected animals, particularly rodents, gets into the flood water. The microbe is then able to gain access to humans through skin abrasions or through mucous membranes. The worker was offered a prescription for doxycycline. A once-weekly dose of this antibiotic is thought to offer protection. The microbe belongs to the genus Leptospira (lepto- = slender, narrow; -spira = spiral).

CATMAT is the Committee to Advise on Tropical Medicine and Travel, an advisory panel of the Public Health Agency of Canada. Two of the staff of our clinics are past members and one is a current member. This committee makes recommendations for travel clinics in Canada, particularly regarding malaria prevention and the appropriate use of vaccines. When CATMAT recommendations for immunization are observed, fewer vaccines tend to be given to travellers. You can find the list of CATMAT publications by googling "About CATMAT".

The Riverside Travel Medicine Clinic is pleased to announce the October 4 opening of its second location in Barrhaven. The Barrhaven Travel Medicine Clinic will be situated at 3201 Greenbank Road, second floor of the Marketplace Loblaws. You will find the same attention itinerary detail and conservative approach to vaccine recommendations as we have been practicing at Riverside since 1990. Visit www.barrhaventravelclinic.ca for a list of our posted prices. We are offering evening and weekend appointments; parking is free.