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When is COVID-19 not COVID-19? Staying vigilant in travel health

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Mosquito Despite all attention being focussed on COVID, conditions such as malaria are still widespread in countries across Africa and Asia

Imagine this scenario if you will:

A third party telephones the practice to report a lady in her 40’s and her son (under 10 years of age) who appear to be both extremely unwell. They are concerned and ask you to review them. The GP on call telephones the patient, but unfortunately English is not her first language, and communication is difficult. What are your thoughts about differential diagnoses?

At this precise moment in time you will be thinking, COVID-19, but what if it wasn’t Spring 2020, but Autumn 2009? You might have been thinking, H1N1 ‘Swine flu’, but what about summer 2014?

This scenario played out in the author’s own practice in August 2014. A third party telephoned the practice to report their neighbour, a 46 year old lady and her 7 year old son, appeared to be very unwell. The GP phoned the patient, who was known to have limited English, and arranged to see her in the practice later that morning during an emergency surgery. Following examination she was sent home with a diagnosis of, ‘viral infection’, but was found moribund, at home later that evening. Both she and her son were admitted to ICU.

What happened?


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