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Travel Clinic

 

Going abroad and need to know which vaccinations you require or need advice on precautions?

Our Pharmacies provide a range of travel vaccinations, occupational health vaccines and malaria tablets. Our specialist travel pharmacists administer all vaccines to both children (9 months plus) and adults.

All our Pharmacy travel clinics are NaTHNaC approved Yellow Fever Centres.

  • Expert Travel Consultation
  • Hajj and Umrah
  • Full range of vaccines in stock including ACWY
  • Anti-malarials dispensed on site
  • Walk In or Book Over the phone
  • We offer a wide range of services at competitive prices
  • Our friendly team comprises of trained pharmacists

Walk in for a free travel health consultation in our designated private consultation rooms today. We look forward to welcoming you and helping you with all your travel healthcare needs.

We provide a walk-in service at all of our travel clinics within a professional environment, which are both easily accessible and convenient.

For further information or to make an appointment, book online or email the branch.

Services provided:

  • Same day appointments available
  • Children’s vaccinations
  • Travel vaccinations including Yellow Fever
  • Anti-malaria medication (without prescription)
  • Up to date travel health advice for you itinerary
  • Travel health medications, vitamins and accessories

For further information or to make an appointment, book online or email the branch.

Are you going away? Book an appointment now

This is an infection caused by a bacteria spread through contaminated food, water and faeces. The disease is most common in places with poor sanitation for example where sewage comes into contact with drinking water, crowding and famine. The disease is found throughout the world particularly in countries where sanitation is poor, such as parts of Africa, India and South East Asia.

The symptoms are diarrhoea, nausea, vomiting, stomach cramps, sunken eyes and cold skin.

If not treated, it can lead to dehydration, electrolyte imbalance and shock.

When to get vaccinated:

You need to finish the course at least one week before travel. This means, that you need to get your first dose at least two weeks before travel.  Avoid eating, drinking, and if possible taking medication for one hour before your appointment.

The course for adults consists of two doses given seven days apart. The cholera vaccine is given as a drink. The vaccine is suitable for children over the age of two.

You may experience temporary side effects such as fever, digestive problems or headache.

Additional Precautions

In addition to getting vaccinated you need to practise food, hand and water hygiene while in a risk area.

Dengue, also known as dengue fever, is an infection spread by mosquitoes. It's not usually serious and often gets better on its own. Some people get a more severe type of dengue, but this is rare.

You can get dengue if you're bitten by an infected mosquito. The mosquitoes that carry the dengue virus bite during the day.

There's also a risk of getting dengue at certain times of the year (spring to November) in parts of southern Europe. Dengue is not found in the UK and you cannot catch it from another person.

Symptoms of dengue include a high temperature, severe headache, pain behind your eyes, muscle and joint pain and feeling or being sick. Dengue does not always cause symptoms.

Some people get a more severe type of dengue a few days after they first started feeling ill, but this is rare.

You may start to feel better with your temperature returning to normal, but about 24 to 48 hours later you may get more serious symptoms. Symptoms of severe dengue include: severe tummy pain, repeatedly being sick, fast breathing, bleeding gums or nose, extreme tiredness (fatigue), blood in your vomit or poo.

Severe dengue can be very serious if it's not treated quickly in hospital.

Go to a hospital as soon as possible if you get severe dengue symptoms while you're travelling.

Treatments for dengue

Most people with dengue feel better in a few days.

There is no treatment for dengue, but you can help ease your symptoms by:

  • resting
  • drinking plenty of fluids
  • taking paracetamol to help bring down your temperature and ease any pain

Do not take anti-inflammatory painkillers like ibuprofen or aspirin. These can cause bleeding problems if you have dengue.

If you’re in a country where dengue is found, the best way to prevent infection is to avoid being bitten by mosquitoes.

Do

  • wear long-sleeved clothing and trousers to cover your arms and legs, particularly during early morning and early evening
  • use insect repellent on your skin (ideally one that contains the ingredient DEET)
  • close windows and doors whenever possible, or use blinds or screens
  • sleep under a mosquito net treated with insecticide, including during the day

The vaccine for Dengue Fever is in the form of a live attenuated (weakened) virus, and may not be suitable for everyone. Our pharmacist will carry out an assessment to establish your suitability.

The vaccine schedule is 2 doses, given 3 months apart.

Diphtheria is a highly infectious disease affecting the throat and upper airways, caused by the diphtheria bacterium.

The disease is found worldwide and high vaccination uptake is required to keep the rates of infection low. It is still prevalent in many countries due to low immunisation levels, especially the Indian Subcontinent, Central and South East Asia, Africa and South America.

Tetanus is a life threatening infection caused by a bacteria that is found in the environment worldwide.

The bacteria enters the body through skin wounds or cuts, especially soil contaminated wounds. Symptoms are due to muscles spasms and rigidity and include lock jaw and paralysis of the respiratory muscles. Death rates vary from 10% (if good intensive medical care is available) to 90%. Children and older adults are especially vulnerable.

Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children. Since the launch of the Global Eradication Programme led by WHO, the incidence of Polio has fell by 99% since 1988. The disease is now endemic in 2 countries-Pakistan and Afghanistan. However, sporadic outbreaks still occur due to imported disease or as result of the oral polio vaccine virus reverting to infectious type.

The virus is transmitted through the personal contact and contaminated food and water. The virus spreads from the gut to the nervous system causing paralysis. Irreversible paralysis occurs in 1 in 200 cases of polio and the death rate is 5-10% due to respiratory failure.

 

When to get vaccinated

You should get your polio, diphtheria and tetanus booster two weeks before travel.

 If you have had the vaccine before, you will need one dose as a booster. If it’s your first jab, you may need several doses. You will need a booster to remain protected after 10 years.

Hepatitis A is a viral infection, which affects the human liver. This virus occurs through ingestion of contaminated food or water and is widespread to countries with an insufficient sanitation system and poor personal hygiene.

The hepatitis A virus can persist in the environment and can withstand food production processes.

The symptoms of infection are fever, digestive problems and jaundice. The severity of the symptoms can vary in different people and can lead to complications such as cholestasis and liver failure.

The vaccination course consists of one dose. The vaccine protects you for one year. If you have another booster after 6 -12 months, you won’t need any further boosters for 25 years thereafter.

Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. It puts people at high risk of death from cirrhosis and liver cancer.

Hepatitis B is spread through contaminated blood via sexual intercourse, needle sharing, blood transfusions and medical interventions. The virus can also be passed from mother to baby. Tattooing, body piercing and acupuncture are other ways in which the virus may be spread. The virus can survive outside the body for 7 days.

Hepatitis B occurs worldwide. Areas where there is a higher risk of exposure to hepatitis B include Eastern Europe, Russia, India, China, South and Central America, Africa, South East Asia and many south pacific islands.

The incubation period for hepatitis B infection is long varying between 60-90 days. Most people do not develop symptoms of hepatitis B infection. If symptoms occur in the acute stage of infection, they consist of fever, nausea/vomiting, diarrhoea and abdominal pain. Jaundice may also occur. A small subset can develop fatal acute liver failure in the acute stage.

The acute illness lasts for about six months and the virus is cleared from the body in the majority of adults. However, 5% of adults and 30-50% of children aged 6 years and below develop chronic disease, where the virus persists. Chronic infection with hepatitis B is associated with progressive liver disease (cirrhosis) and liver cancer.

The course consists of three doses. The second injection is given four weeks after the first, and the third injection should be given five months later (completing the course in six months).

Meningococcal meningitis is an acute bacterial disease that can cause systemic infection.

There are many different serogroups of meningitis of which groups B and C are the most common in the United Kingdom and group A and W135 predominantly in the African belt from Senegal to Ethiopia. These serotypes have also been responsible for outbreaks in Saudi Arabia during the Hajj pilgrimages. It is transmitted through close contact by coughing, sneezing, kissing, and sharing food and drinking utensils.

Meningococcal infection can cause meningitis (inflammation of the lining of the brain and spinal cord), septicaemia (blood poisoning) or both. Symptoms can develop within hours and can be non-specific. Symptoms include a sudden onset of a high fever, a severe headache, dislike of bright lights (photophobia) and vomiting.

The course consists of one dose. Boosters aren’t currently recommended. However, you can get a booster five years after your last jab if you need it for a meningitis ACWY certificate.

Meningitis is a serious infection. It occurs when the lining around the brain and spinal cord becomes inflamed. The group B strand accounts for over 80% off all cases. The infection can lead to brain damage, epilepsy, blindness, deafness, blood poisoning (septicaemia) and even death.

The most common symptoms are a stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting.

The MenB vaccine is offered as part of the NHS vaccination schedule. It’s given to babies at: 8 weeks, 16 weeks and 1 year

Rabies is a dangerous viral infection endemic to many countries. The Rabies virus kills over 55,000 people every year. Children are especially vulnerable to rabies and 40% of bites occur in children under the age of 15 years.  95% of deaths from rabies occur in the Indian Subcontinent, Africa and South East Asia.

Rabies is transmitted by animals (domestic and wild carnivores and bats) to humans via close contact with saliva from infected animals. This can be through bites, scratches, and licks on broken skin. The majority of cases are contracted from dogs. This is especially true in the Indian Subcontinent and South East Asia. In other countries, rabies can be spread by bats, monkeys, and cats.

Once symptoms have developed rabies is 100% fatal.

Rabies infection starts within non-specific early symptoms of fever, headache, muscle ache and loss of appetite. This is followed by either:

  • Furious rabies-the common form characterised by fear of water (hydrophobia), confusion, hyperactivity and death after a few days.
  • Paralytic rabies-slow paralysis of the muscles starting from the site of the bite followed eventually by death.

If someone who is unvaccinated against Rabies is infected, Human Rabies Immunoglobulin (HRIG) could be a lifesaver. However, HRIG is often unavailable or unreliable in many countries. Without HRIG, the results of a rabies infection is often fatal, and so a rabies vaccination before you travel is the best way to protect yourself. This is particularly important if their travel activities are likely to increase the risk of exposure, such as trekking or travel in rural areas. It should also be considered if travelling to countries or areas where post exposure medical care may not be accessible within 24 hours.

The rabies vaccine should be considered for all children traveling to high risk areas to the increased chances of them being exposed and developing symptoms very quickly. The rabies vaccine can be given safely from birth onwards.

It is particularly important to keep children away from animals and ensure that older children understand that they must report a bite as soon as possible for post exposure prevention to be carried out.

The course consists of three vaccines. The second dose is given seven days after the first dose. The third dose should be given three weeks after the second dose.

 If you’re travelling at short notice, you may be able to have the third dose two weeks after the second.

The rabies vaccine protects you for 10 years. If you are working with animals or are otherwise at a higher risk, more frequent boosters may be recommended.

Japanese encephalitis is a viral disease which, like malaria, is transmitted by mosquitoes. The virus affects the human brain and can lead to inflammation and swelling of the brain.  In many patients, Japanese encephalitis symptoms remain mild and the infection may even go unnoticed. Typical encephalitis symptoms include nausea and vomiting, seizures, headaches and confusion.

The course consists of two doses. The second dose needs to be given ideally 28 days after the first. You are protected from seven days after the second dose.

In special cases you can get a faster course where the first dose should be at least 2 weeks before you travel.

The vaccine protects you for at least 12 months, so you need a booster 12-24 months later to remain protected after one year.

These conditions are highly infectious and can be very serious, even fatal. They can also lead to complications like meningitis, encephalitis (inflammation and swelling of your brain) and deafness.

The viruses are transmitted by sneezing, coughing, or direct contact via respiratory secretions. There is a risk to all travellers since they are present globally and when visiting for lengthy periods or living/working closely with the local population. The symptoms are a rash, fever, headache, muscle aches, swollen glands in the neck or behind the ears, sore red eyes that may be sensitive to light, cold-like symptoms.

There is a single injection that is safe and effective in protecting against the three separate illnesses, MMR. You will need two doses of the vaccine, with at least four weeks in between each dose.

Typhoid fever is caused by a bacterium called Salmonella Typhi. It is a highly contagious and potentially deadly disease. Typhoid can be found throughout the world but it is more common in countries where food or water is contaminated. This is particularly common in regions with poor sanitation such as in Africa, the Indian Sub-continent, South East Asia and South America.

The disease is transmitted from human to human via ingesting contaminated food or drinking water or through poor personal hygiene, such as lack of hand washing. The bacteria is found in the faeces of infected individuals and 2-5% of those infected become long term carriers and excrete the bacteria in their faeces.

Common symptoms of typhoid fever include a high temperature, headaches, nausea, muscle pain, loss of appetite, digestion problems such as constipation or diarrhoea, tiredness and confusion.

There are two different typhoid vaccines. One is an injection, the other consists of a course of tablets. Which vaccine is suitable for you depends on your age and medical history.

You will be administered one dose if you receive the typhoid injection. The oral vaccine consists of three capsules taken over a course of five days. The typhoid vaccine protects you for three years. After that, you will need a booster if you travel to a risk area.

Yellow Fever is an acute haemorrhagic viral infection transmitted by the bite of an infected mosquito. The mosquitoes feed during day light hours and are found in both urban and rural areas. It affects several body systems such as the liver and kidneys. The symptoms include high fever and headache to extreme light sensitivity and vomiting but can also progress to jaundice. At its most severe, yellow fever is fatal. Yellow fever cannot be transmitted directly from human to human contact.

The mosquito that carries yellow fever virus is found in many countries of the world and thus, these countries have a potential to develop the disease in their mosquito population leading to outbreaks of this potentially deadly infection. Therefore, several countries, which do not have the disease may have a requirement for proof of vaccination against yellow fever before entry is allowed.

The yellow fever vaccine lasts a lifetime. Most people won’t need any boosters for future travel.

 In addition to getting vaccinated you need to practise mosquito bite avoidance.

 Some countries require a yellow fever certificate. Your certificate becomes valid 10 days after you have had the jab.

Tick borne encephalitis is a viral infection involving the central nervous system affecting the brain and spinal cord. It is found in Central, Northern and Eastern Europe, Russia, Northern China, and Mongolia.

The infection is transmitted to human via a bite from an infected tick found in woodland habitats.

Symptoms are similar to that of meningitis, which includes a sudden fever, nausea and vomiting, a stiff neck and headaches.

There is a safe and effective vaccine against Tick-borne encephalitis. Additional measures include wearing covered footwear and long trousers and checking regularly for ticks after carrying out any outdoor activities in forested areas, such as hiking, camping or fishing.

The course consists of three doses. The second dose is given 1 – 3 months after the first. The third dose is given 5 – 12 months after the second dose.

 If you are travelling at short notice, you may be able to have the first two doses 14 days apart instead. You need to start this course at least two weeks before travel to be fully protected by the time you go.

 

 

Malaria is a serious infection spread by mosquitoes. If it's not diagnosed and treated quickly, you can die from it.

Malaria is caused by being bitten by an infected mosquito. It can take just 1 bite to get it. The infection is very common in certain parts of the world. It's found in tropical regions, including:

  • large areas of Africa and Asia
  • Central and South America
  • Dominican Republic and Haiti
  • parts of the Middle East
  • some Pacific islands

Malaria is not found in the UK and you cannot catch it from another person.

How to avoid malaria

Do

  • take any antimalarial medicine you're prescribed – you usually need to start taking it a few days or weeks before you go, until a few weeks after you get back
  • use insect repellent on your skin – make sure it's 50% DEET-based
  • sleep under mosquito nets treated with insecticide
  • wear long-sleeved clothing and trousers to cover your arms and legs in the evening, when mosquitos are most active

Symptoms

Malaria can be hard to spot, but symptoms include:

  • a high temperature, sweats and chills
  • headaches and feeling confused
  • feeling very tired and sleepy (especially in children)
  • feeling and being sick, tummy pain and diarrhoea
  • loss of appetite
  • muscle pains
  • yellow skin or whites of the eyes
  • a sore throat, cough and difficulty breathing

These symptoms usually appear between 7 and 18 days after you've been bitten by an infected mosquito. But sometimes you may not have symptoms for months after travel, and rarely years.

Our travel pharmacists will help you choose your right anti-malarial medication for you trip, whether you’re going away for only a few days to a few months.

The following anti-malarials are available:

  • Malarone
  • Malarone – Generic
  • Lariam
  • Docycycline

 

Altitude sickness can happen when you're at a high altitude. It usually gets better in a few days with rest, but it can sometimes be life-threatening and need treatment. You can get altitude sickness if you're in a place that is at a high altitude (usually more than 2,500 metres above sea level).

You're more likely to get it if you travel or climb to a high altitude quickly.

 Symptoms of altitude sickness

 Symptoms of altitude sickness usually start 6 to 10 hours after being at a high altitude.

The main symptoms include:

  • a headache
  • loss of appetite
  • feeling or being sick
  • feeling tired or exhausted
  • dizziness
  • difficulty sleeping

Sometimes, the symptoms can develop into more serious symptoms that can be life-threatening.

What to do if you get altitude sickness

 If you're at a high altitude and have symptoms of altitude sickness or feel unwell:

  • tell someone who you're travelling with that you do not feel well
  • rest at the same altitude until you feel better – do not travel or climb to a higher altitude
  • you can take anti-sickness medicine or painkillers such as ibuprofen or paracetamol to ease symptoms

Symptoms of altitude sickness usually get better in 1 to 3 days.

If your symptoms have gone and you feel better, you can travel or climb to a higher altitude.

Important: If your symptoms do not get better

 If your symptoms get worse or do not improve after 1 day, go to a lower altitude if you can. Try to go around 300 to 1,000 metres lower.

Urgent advice: Get medical help immediately if:

 You are at a high altitude and you or someone else:

  • have symptoms of altitude sickness and feel very unwell
  • are confused
  • have problems with balance or coordination
  • are seeing or hearing things that are not real (hallucinations)
  • feel short of breath, even when resting
  • have a cough or are coughing up frothy or bloody spit
  • have blue or grey skin, lips, tongue or nails (on brown or black skin this may be easier to see on the palms of the hands or the soles of the feet)
  • are very sleepy or difficult to wake

Go to a lower altitude straight away (around 300 to 1,000 metres lower) if you can.

How to reduce your risk of altitude sickness

 There are some things you can do to help reduce your risk of getting altitude sickness.

Do

  • travel or climb to a high altitude slowly to give your body time to get used to lower oxygen levels
  • spend a few days at an altitude below 2,500 metres before going any higher
  • have a rest day at the same altitude every 3 to 4 days (if you're at an altitude of 3,000 metres or more)
  • drink enough water so you do not get dehydrated
  • speak to our travel pharmacist if you've had altitude sickness before or if you're travelling to a high altitude quickly – they may prescribe medicine to help prevent altitude sickness

Don’t

  • try not to travel from an altitude that's less than 1,200 metres to an altitude that's more than 3,500 metres in 1 day
  • try not to fly directly to a place with a high altitude – if this is not possible, rest for 1 day before going any higher
  • try not to sleep more than 500 metres higher than you slept the night before (if you're at an altitude of 3,000 metres or more)
  • do not drink alcohol while travelling or climbing

Medication to prevent AMS

Acetazolamide (Diamox) is a medicine that is sometimes taken to prevent AMS.  It works by speeding up the processes your body goes through to acclimatise to high altitude.  It might be recommended if you have had AMS before or if a gradual ascent is not possible.

Acetazolamide does not replace the need to acclimatise through a gradual assent.

Jet lag is when your normal sleep pattern is disturbed after a long flight. It usually improves within a few days as your body adjusts to the new time zone.

Jet lag cannot be prevented, but there are things you can do to reduce its effects.

Get plenty of rest before you travel. You could start going to bed and getting up earlier or later than usual (more like the time zone of the place you're travelling to).

During your flight

  • drink plenty of water
  • keep active by stretching and regularly walking around the cabin
  • try to sleep if it's night time at your destination
  • use an eye mask and earplugs if they help you sleep
  • do not drink too much caffeine or alcohol – they can make jet lag worse

After you arrive

  • change your sleep schedule to the new time zone as quickly as possible
  • set an alarm to avoid oversleeping in the morning
  • go outside during the day – natural light will help your body clock adjust
  • do not sleep during the day – only sleep at night time

 Medicines are not usually needed for jet lag. Jet lag often improves after a few days as your body clock adjusts to the new time zone.

Sleeping tablets may be helpful if you're having problems sleeping (insomnia). But they can be addictive so should only be used for a short time and if symptoms are severe.

Melatonin is a natural hormone released by the body in the evening to let your brain know it's time to sleep.

The main symptoms of jet lag are:

  • difficulty sleeping at bedtime and waking up in the morning
  • tiredness and exhaustion
  • difficulty staying awake during the day
  • poor sleep quality
  • concentration and memory problems

Jet lag can also sometimes cause indigestionfeeling sick (nausea)constipation, changes in appetite and mild anxiety.

Norethisterone tablets contains the progestogen called norethisterone as the active ingredient. Progestogens are similar to the natural female hormone progesterone.

Norethisterone has many uses. You can take Norethisterone tablets to treat or manage:

  • Heavy periods
  • Painful periods
  • Irregular periods or periods that are more frequent than normal
  • Premenstrual tension (PMT)
  • Endometriosis (where tissue from your womb is found outside your womb)
  • Breast cancer.

Norethisterone can also be taken if you want to delay your next period.

Our period delay service allows women to postpone and control when their period starts for times when a period would be inconvenient, such as when they are going on holiday.

The usual dose to delay your periods is one tablet three times a day. You need to start taking the tablets 3 days before your period is due to start. Your period will usually start within 3 days of finishing the tablets.

This service is not suitable for women currently using hormonal methods of contraception (such as the pill, patch, implant). It is also not suitable for women at higher risk of blood clots. Our pharmacist will be able to assess you during the consultation.

Xifaxanta 200mg tablets are indicated for the treatment of travellers diarrhoea in adults (18 and over) that is NOT associated with any of following:

  • Fever
  • Bloody Diarrhoea
  • Or 8 or more unformed stools in the previous 24 hours.

If symptoms recur shortly after the end of the treatment, you should not take another course but should seek medical advice.

The normal dosage is one tablet every eight hours for three days. You should continue to take Xidaxanta tablets for 3 days, even if your symptoms have improved.

Animal Bites

  • Avoid contact with animals especially dogs, monkeys and cats.
  • If bitten wash wound thoroughly with soapy water for 10 minutes
  • Do not suture or close the  wound
  • Seek urgent medical advice
  • Open water, soil and sand can harbour infection therefore
    • avoid swimming in fresh water (risk schistosomiasis)
    • avoid walking barefoot on sand/soil, which may be contaminated with faeces (hookworm infection)

Insect Bite Avoidance

  • This is extremely important even if you are vaccinated or taking antimalarials
  • Plan activities so that you can avoid insect/tick/mite infested areas, and maximise preventive measures during peak hours to reduce exposure where possible
  • Day biting mosquitoes spread infections such as dengue and yellow fever
  • Night biting mosquitoes spread diseases such as malaria and Japanese Encephalitis
  • Sandflies-cause leishmaniasis and are active from dusk until dawn
  • Tsetse fly bite during the day, and cause sleeping sickness. They are found within vegetation and grasslands of Sub Saharan Africa
  • Ticks/mites-cause Lyme’s disease and tick borne encephalitis, and are found in meadows, woodlands, grasslands and forests
  • Wear long sleeved shirts and pants, and tuck in shirts. Wear closed shoes. Adding permethrin to clothes gives extra protection
  • Check skin regularly for ticks/mites during and following outdoor activities
  • Apply insect repellents regularly to exposed areas of skin

DEET

Repellent containing DEET, at 50 percent concentration, is recommended for all travellers over 2 months provided it can be tolerated.

The interval between re-application of repellent will depend on the DEET formulation and concentration used. In practice, travellers apply around half of the amount at which a product has been tested, therefore more frequent application will be required. Repellents may also need to be reapplied more regularly, for example after swimming and in hot, humid conditions when they may be removed by perspiration.

DEET and sunscreen

Several studies have shown that DEET decreases the protection of SPF 15 sunscreen. When both are required, DEET should be applied after the sunscreen, and 30 to 50 SPF sunscreen should be used to compensate for the reduction in SPF induced by DEET.

Alternatives to DEET

If DEET is not tolerated (or unavailable), and travellers are visiting areas where malaria or other vector-borne diseases are present, a repellent containing one of the following three active ingredients repellents should be used as an alternative, at the highest strength available.

  • Icaridin (Picaridin) - Icaridin has repellent properties similar to DEET with a comparable duration of protection when both are used at 20 percent.
  • Eucalyptus citriodora oil, hydrated, cyclized - This active ingredient provides effective protection for several hours. However, the duration of protection is shorter than DEET so more frequent application is required.
  • 3-ethlyaminopropionate (IR3535) - 3-ethlyaminopropionate (IR3535) has a shorter duration of protection against Anopheles mosquitoes than DEET, and so more frequent application is required, but it is still an effective repellent.

How to use insect repellents safely:

  • Use on exposed skin only, not under clothing.
  • Do not use over cuts, irritated or inflamed skin.
  • Do not apply directly to the face - apply repellent to hands, then to the face to avoid contact with lips and eyes. Wash hands after application.
  • Do not apply to children's hands.
  • Apply and re-apply repellents according to manufacturers' instructions.
  • Remove with soap and water when repellent is no longer needed.
  • Ensure repellents are not ingested or inhaled.
  • DEET can be used in concentrations of up to 50 percent in pregnant and breastfeeding women, and in infants and children older than 2 months (unless allergic).
  • When sunscreen and DEET are needed, DEET should be applied after sunscreen (use 30 - 50 SPF sunscreen to compensate for reduction in SPF induced by DEET).
  • DEET may damage plastics and artificial fibres so care is needed to avoid contact. DEET does not damage natural fibres such as wool, linen or cotton.
  • Picardin, eucalyptus citriodora oil or ethlyaminopropionate based repellents are available for those who prefer not to use DEET-based products. Picardin should be used in concentrations of at least 20 percent.

Mosquito nets

All travellers to malaria-endemic areas should sleep under a mosquito net to avoid being bitten, unless the room is well screened or with working air-conditioning where mosquitoes cannot enter. Most nets now available are long-lasting impregnated nets, which have an expected useful life of at least 3 years.

Room protection (including air conditioning and screening)

Doors and windows to sleeping accommodation should be screened with fine mesh.

Air conditioning reduces night-time temperature and increases air flow in a building and therefore reduces the likelihood of mosquito bites. Ceiling fans reduce the nuisance from mosquitoes,

There is evidence that insecticide vaporisers inhibit mosquito bites and cause mosquito repellence and knockdown.

General hand hygiene:

Food Hygiene

Preparation and storage

Cooking is the best way to make your food safe. If you can you should:

  • choose food that is served fresh and whilst still steaming hot
  • avoid pre-prepared foods which are not kept hot, kept refrigerated or kept cool on ice from buffets, street vendors, markets or restaurants
  • avoid reheating leftovers

Meat and seafood

You should avoid:

  • seafood which is raw
  • meat that is still red or pink or has red or pink juices

Dairy

  • Only drink or eat pasteurised milk or dairy products:
  • Avoid dishes that contain raw or undercooked eggs, such as mayonnaise, some sauces or desserts (eg. mousse).

Fruit and vegetables

  • Avoid salads and fresh herbs (including garnishes in drinks e.g. mint leaves in mojitos) where drinking water may be unsafe
  • Peel all fruits and vegetables, including tomatoes if they are to be eaten raw - avoid types that cannot be peeled
  • Avoid berries, in particular raspberries - they are difficult to wash and may be a source of cyclospora
  • Choose fruit juice from sealed cartons - freshly squeezed fruit juice may have been made with unwashed fruit

Water Hygiene

Tap and bottled water may not be safe if it has not been produced under proper conditions, even if water appears clear and colourless.

  • You should only use water for drinking, making ice cubes or cleaning teeth if it has been:
    • bottled or canned by a known manufacturer and the seal is intact
    • boiled and cooled and stored in a clean container
    • chemically disinfected or passed through a reliable water filter and stored in a clean container
  • Ask for no ice or remove it from your drink - ice cubes may be made using unsafe water

Safe drinks include:

  • hot tea and coffee if boiled water has been used
  • beer, wine and other alcoholic drinks
  • fizzy drinks from sealed cans and bottles
  • pasteurised juices

Water Purification

If you are concerned about the safety of your water, you can treat it to make it safe to drink.

 

Accidents

Major leading causes of death in travellers abroad are due to accidents, predominantly road traffic accidents and swimming/water accidents. You can help prevent them by following sensible precautions.

Precautionary Guidelines

  • Avoid alcohol and food before swimming
  • Never dive into water where the depth is uncertain
  • Only swim in safe water, check currents, sharks, jellyfish etc.
  • Avoid alcohol when driving, especially at night
  • Avoid hiring motorcycles and mopeds
  • If hiring a car, rent a large one if possible, ensure the tyres, brakes and seat belts are in good condition
  • Use reliable taxi firms, know where emergency facilities are.

Personal Safety and Security

The Foreign and Commonwealth Office (FCO) provide excellent information about this.  They have information for many different types of travel and also advise on travel to specific destinations in times of political unrest and natural disasters.  Please go to their website for more information at https://www.gov.uk/government/organisations/foreign-commonwealth-office.

Insurance Cover

  • Take out adequate insurance cover for your trip. This should possibly include medical repatriation as without it, this service is extremely expensive if needed.
  • If you have any pre existing medical conditions, make sure you inform the insurance company of these details and check the small print of the policy thoroughly.
  • If you travel to a European Union country, make sure you have obtained an GHIC card before you travel which takes some time to obtain.

Air Travel

It is sensible on any long haul flight to be comfortable in your seat.  Exercise your legs, feet and toes while sitting every half an hour or so and take short walks whenever feasible.  Upper body and breathing exercises can further improve circulation.  Drink plenty of water and be sensible about alcohol intake which in excess leads to dehydration.

 

Travellers should:

  • Avoid exposure when the sun is at its highest in the sky (11am - 3pm).
  • Avoid “once a day” sunscreens.
  • Use broad spectrum, high protection factor sunscreens (30 SPF plus with UVA rating of 4/5 stars to blocks UVA/UVB rays) even on cloudy days.
  • The British Association of Dermatologists recommends at least six full teaspoons of sun lotion per application for an average adult.
  • Apply sunscreen liberally at least 30 minutes before sun exposure, reapply at least two hourly, after swimming, exercise and towel drying.
  • Reapplying sunscreen is important for even coverage and to avoid missing patches of skin.
  • Protect lips with sun block.
  • Wear a wide-brimmed hat and cover up as much as possible with sun protective clothes, especially if peak time exposure is unavoidable.
  • Wear sunglasses, with a CE mark or goggles for skiing and climbing to protect the eyes from sun damage and glare. Avoid staring directly at the sun.
  • Children are particularly vulnerable to sun damage. Babies under six months of age should never be placed in direct sunlight and young children should always be protected with high SPF sun cream.

To treat mild sunburn:

  • Have a cool bath/shower or sponge affected areas with cold water.
  • Drink plenty of fluids to prevent dehydration.
  • Take painkillers like paracetamol or ibuprofen if needed. Aspirin should not be given to children under 16 years.
  • When comfortable, apply moisturising cream.
  • Cover up and stay out of the sun until skin has fully healed.
  • Get prompt medical attention for swollen or blistered skin, chills, a high temperature, dizziness, headaches and feeling sick.
Travel Vaccination NameValidityPrice Per DoseOther Info
Cholera2 years£302 doses needed
Dengue Fever£1002 doses needed
Diphtheria Tetanus Polio10 years£37
Hepatitis A1 Year/Long Term£602 doses for long term
Hepatitis A Paediatric£602 doses for long term
Hepatitis A&B10-20 years£78
Hepatitis B10 years£5016 Years of age or over only - 3 or 4 doses may be required
Hepatitis B Junior£45
Meningitis ACWY3 years£55
Meningitis BLong Term£1202 doses needed
MMR£502 doses needed
Japanese Encephalitis (Ixiaro)1 year£1052 doses needed
Rabies10 years£723 doses needed
Tick Borne encephalitis1-3 years£653 doses needed
Typhoid(injection)3 years£35
Typhoid(Oral)1 year£45*Price for full course
Yellow Fever Certificate£25replacement/exemption
Yellow FeverLong Term£65includes certificate
Other Travel Preparations
Pack SizePrice Per PackPrice Per Tablet
Altitude Sickness5£15
Jet Lag10£15
Period Delaymin £1550p
Traveller's Diarrhoea9£23