“It started at my cousin’s wedding and it still won’t stop — I need to be back at work on Saturday”

Bloody diarrhoea with fever after travel is dysentery until proved otherwise, not “a bug”. Send stool for culture and ova, cysts and parasites with the travel history; check FBC, U&E and CRP when there is blood (dehydration, and STEC can cause haemolytic uraemic syndrome, usually 5–10 days after onset). Avoid antimotility drugs such as loperamide in bloody diarrhoea or high fever, and do not give antibiotics routinely — many cases are self-limiting and antibiotics may increase HUS risk with STEC; discuss with microbiology if he is systemically unwell or a result needs treatment. Infectious bloody diarrhoea is a notifiable condition: the GP notifies the health protection team on clinical suspicion, without waiting for the laboratory. Food handlers are excluded until 48 hours after symptoms stop, and some organisms (for example STEC, typhoid, some Shigella) need microbiological clearance as directed by the health protection team. Malaria and enteric fever must be considered in any febrile traveller returning from a risk area — here Morocco carries no malaria risk, but ask the itinerary.