There is a new name for the most advanced of the pneumococcal pneumonia vaccines: the previous version, Apexxnar, has now been re-branded as Prevenar 20. Although this may result in some initial confusion for medical stall and patients alike, the composition and effectiveness of the vaccine are unchanged. Under its new name, however, it is now licensed for adults and children alike – in fact for everyone over 6 weeks of age.

If you have been previously vaccinated with Apexxnar, there is no reason to be revaccinated. However, if you have been vaccinated with a previous version of Prevenar (such as Prevenar 13), it makes good sense to update now to Prevenar 20, which covers more strains.

Prevenar 20 provides protection against the 20 most important strains (called serotypes) of pneumococcal bacteria, offering a more comprehensive defence against pneumonia.

Covid vaccine updated

Another respiratory vaccine has also had an important update: privately available Covid vaccines will now cover the currently predominant variant, KP.2. Covid cases rose by ten per cent in February, and vaccination is an important protective measure, reducing the likelihood and severity of infection. (It seems that the NHS spring Covid booster campaign is based on the previous JN.1 vaccine.)

Prevenar 20 and the updated Covid vaccine, together with vaccination against RSV, flu and whooping cough, make up the 5 vaccines now available to prevent respiratory infection.

If you would like to find out more about these vaccines, consider making an appointment with one of our knowledgeable nurses or doctors.

About Pneumonia:

Pneumonia is a lung infection that can cause a range of symptoms, including:

1. Cough: A persistent cough that produces mucus or phlegm is a common symptom of pneumonia. The cough may be dry or productive, and the mucus or phlegm may be green, yellow, or rust-coloured.
2. Fever: Pneumonia often causes a high fever, which may be accompanied by chills and sweats.
3. Shortness of breath: Pneumonia can cause difficulty breathing, especially during physical activity. The shortness of breath may be accompanied by chest pain or tightness.
4. Fatigue: Pneumonia can cause extreme tiredness and weakness, making it difficult to carry out normal daily activities.
5. Muscle aches: Pneumonia can cause muscle aches and joint pain, which may be mistaken for the flu.
6. Chest pain: Pneumonia can cause chest pain, especially when breathing deeply or coughing.
7. Nausea and vomiting: Some people with pneumonia may experience nausea and vomiting, especially if the infection is caused by a type of bacteria known as Legionella.
8. Confusion or disorientation: Pneumonia can cause confusion or disorientation, especially in older adults and people with underlying health conditions.

It’s important to seek medical attention if you experience any of these symptoms, as pneumonia can be a serious and potentially life-threatening condition.

More information on pneumonia.

Who is considered “high-risk”?

Individuals considered to be at high risk for hospitalisation due to pneumonia include the elderly, young children, people with weakened immune systems (including people who have had their spleen removed), and individuals with underlying health conditions such as chronic heart or lung diseases, diabetes, and liver or kidney problems.

At the Fleet St. Clinic, we also regard anyone who has had a previous significant episode of pneumonia as likely to benefit from being vaccinated.

When is the best time for a pneumonia vaccine?

The best time to vaccinate against pneumonia depends on various factors such as the type of vaccine, the individual’s age, and underlying health conditions.

Pneumonia vaccine is not necessarily a winter vaccine, and can be given at any time of year. 

How to book an appointment?

Booking an appointment is easy. You can book online through our online booking system.

If you would like to discuss anything further or would like to book with our reception team, you can call them on +44 207 353 5678 or email us at info@fleetstreetclinic.com

If you’re taking a medication like tirzepatide (Mounjaro) or semaglutide (Ozempic or Wegovy), for weight loss or type 2 diabetes, and you’re also using the combined oral contraceptive pill, it’s important to know that these might not always work well together. Weight loss injections belong to a group called GLP-1 receptor agonists (or dual agonists in the case of tirzepatide), which help lower blood sugar, reduce appetite, and support weight loss. One of the ways they do this is by slowing down how quickly food moves through your stomach—and that can also slow down how your body absorbs other medications, like the pill.

This can be a problem because the pill relies on being absorbed properly to be effective. If your stomach is emptying more slowly, or if you’re feeling nauseous, vomiting, or have diarrhoea (which are common side effects when starting weight loss injections), there’s a chance your body might not absorb enough of the hormones from the pill to prevent pregnancy. Because of this, the Faculty of Sexual and Reproductive Healthcare (FSRH) in the UK has issued guidance saying that there’s a potential risk of reduced effectiveness when taking oral contraception with GLP-1 medications like tirzepatide or semaglutide.

To stay on the safe side, the FSRH recommends using a non-oral form of contraception—such as the contraceptive implant, IUD (coil), injection, patch, or vaginal ring—since these options aren’t affected by the digestive system and are more reliable in this situation. If you prefer to stay on the pill, you might be advised to use extra protection like condoms, especially during the first few weeks of starting the weight loss medication or if you’re unwell.

If you’re currently on something like Mounjaro or Wegovy and using the pill, it’s a good idea to book an appointment to speak to one of our GPs or sexual health nurses. We can help you figure out what contraceptive method works best for you and make sure you’re fully protected. Everyone’s situation is different, so having that conversation can help you make the best choice for your health and peace of mind.

What is health clearance for the National Performers List?

As part of the application process to apply to the National Performers List, candidates are required to submit a Certificate of Health Clearance. This certificate confirms that the worker is medically fit to practice and ensures all relevant vaccinations have been completed. This certificate is an essential document that is required as part of the application process.

How do I apply for the Certificate of Health Clearance?

All individuals need to complete a medical questionnaire to apply for their health clearance certificate. The questionnaire will ask some general questions about your medical history, which countries you have lived in, and about any previous vaccinations or blood tests you may have taken. Once you have submitted your medical questionnaire, an occupational health nurse will review your application. After review, if  any vaccinations or blood tests are required, they will let you know.

How do I know what tests and vaccinations are required?

All candidates need to demonstrate immunity to measles, rubella, hepatitis b, varicella and tuberculosis. In addition, candidates will also need to undertake EPP screening for HIV, hepatitis B and hepatitis C. C

Individuals who have spent 3 months or more in TB prevalent settings, or countries with a high risk of TB will also need to undertake tuberculosis screening.

Once you have submitted your application form, an occupational health nurse will advise you on what tests or vaccination are required as this can vary slightly between individuals.

I don’t live in the UK, will you accept blood test or vaccinations completed abroad?

There are strict requirements in occupational health for compliance. We are unable to accept blood tests and vaccination records from outside the UK. The exception to this is the BCG vaccination where we can accept a record from abroad.  This is because there is no lab test available to confirm immunity for tuberculosis.

What is EPP clearance and what does an ID validated sample mean?

EPP clearance is required for doctors and dentists applying for the National Performers List. Exposure prone procedures  (EPP) are invasive procedures where there is a risk that an injury to the worker may result in the patient being exposed to the blood of the health care worker. These procedures include those where the worker’s gloved hands may be in contact with sharp instruments, needle tips or sharp tissues (such as spicules of bone or teeth) inside a patient’s open body cavity.

EPP clearance requires blood tests to be taken for

• Hepatitis B surface antigen
• Hepatitis C antibody
• HIV

Blood tests for EPP clearance need to be taken from an ID validated sample.

ID validation requires the candidate to show photo ID at the time of the blood test being taken , and for this to be documented on their results.

Where can I get the necessary tests done?

The Fleet Street Clinic is able to offer all the necessary blood tests and vaccinations required.  As a healthcare worker you will be eligible for a discounted rate. Alternately you may use a provider of your choice and send your blood test results or immunisation to us for review.

How long will the process take?

You have 3 months from submitting your application to complete all the necessary tests and vaccinations.  Once you have met all the criteria to be compliant, your certificate of health clearance is issued via email within 48 hours.

It states that the certificate must be issued from a Safe, Effective, Quality Occupational Health Service. What does this mean?

Safe, Effective, Quality Occupational Health Service (SEQOHS) is an accreditation scheme that sets the standards of occupational health services. The Fleet Street Clinic is SEQOHS accredited and can issue compliant certificates for the Performers List.

How can I submit my application?

If you need health clearance to join the National Performers List,  contact the clinic or occupational health team prior to making an appointment.

Fill out the form below and we will send you the forms and information needed to submit your application.

At Fleet Street Clinic, we uphold a steadfast commitment to delivering the highest standards of patient care. We are pleased to announce that we have successfully attained reaccreditation from SEQOHS (Safe Effective Quality Occupational Health Service) in 2025. This notable achievement underscores the dedication and expertise of our professional team, as well as our unwavering commitment to maintaining exemplary standards in the field of occupational health services.

Understanding SEQOHS

SEQOHS is an accreditation programme that establishes a benchmark for quality in occupational health services throughout the United Kingdom. It ensures that healthcare providers adhere to stringent standards in various areas, including patient care, clinical governance, and the overall quality of services rendered. Administered by the Faculty of Occupational Medicine (FOM), the reaccreditation process for SEQOHS involves an exhaustive review of clinical practices, staff qualifications, and patient satisfaction, among other crucial factors.

The Significance of SEQOHS Reaccreditation

The attainment of SEQOHS reaccreditation affirms our clinic’s ongoing dedication to providing safe, effective, and superior quality occupational health services. For our patients, this achievement represents a guarantee that the care and guidance they receive align with national standards. Furthermore, it highlights the expertise and experience of our team in delivering solutions designed to enhance employee well-being and organisational health.

The reaccreditation process is comprehensive, ensuring that our clinic continually evolves to meet the demands of regulatory standards and patient needs. It instills confidence in our partners, clients, and patients that we prioritise quality and are committed to consistently improving our services.

The Advantages of SEQOHS Reaccreditation for Our Patients

Quality Care: Through SEQOHS accreditation, our clinic ensures the delivery of all services in accordance with best practices, thus providing patients with confidence in the quality of care they receive.

Expertise: SEQOHS establishes high standards for staff training and qualifications, ensuring our team remains at the forefront of developments in occupational health.

Consistency: Reaccreditation guarantees that we uphold high standards consistently, allowing patients to depend on us for reliable and quality services over time.

Accountability: The accreditation process necessitates regular reviews and audits, ensuring that we consistently meet or exceed the requisite standards of care.

Moving Forward

The reaccreditation by SEQOHS represents a significant milestone in our continued journey toward delivering the highest level of care. At Fleet Street Clinic, we remain committed to providing outstanding occupational health services tailored to fit the needs of both employees and employers.

If you have any questions or want to find out more about how we can help, get in touch with us today on: occhealthadmin@fleetstreetclinic.com

Among the journalists, television crews, lawyers and other professionals who often have to travel at short notice one of the longest-standing users of the Fleet Street Clinic’s same-day vaccination and travel-health service is the celebrated war photographer Goran Tomasevic. 

Softly spoken, calm and courteous, the 6 ft 4 56-year-old Serbian has been ducking bullets and reporting from the world’s battle zones for almost 35 years.  Carrying the same equipment wherever he goes – three Canon cameras and three spare lenses, so if one gets damaged he can still continue working – he has spent most of that time working for the global news agency Reuters. His Reuters’ assignments have seen him cover conflict in warzones from Afghanistan, Colombia and Iraq to Libya, Somalia and South Sudan. Voted Reuter’s Photographer of the Year a record-breaking four times, in 2016 he achieved the unique feat of having 100 newspapers around the world put his extraordinary photograph of a fireball in an anti-Gaddafi attack in Libya on their front cover. In 2023 one reviewer of the 444-page book of his pictures, published by Edition,  called him ‘ a Caravaggio of photography’.  “I want to show exactly how it was … if there’s enough light, I will stay until the end,” he says. 

Now working for the Canadian newspaper The Globe and Mail, he will only answer with a cryptic “Asia” when asked about his next assignment.  But he is happy to add that wherever precisely that might be – Taiwan, we wonder; perhaps Myanmar? – he will detour via Fleet Street to get any necessary vaccinations and to collect a locale-and-calamity appropriate travel kit. As usual, that will have been made up for him by Fleet Street Clinic’s founder – and now his friend – Dr Richard Dawood.  

Q) How did you come across the Fleet Street Clinic? 

A) I grew up in Belgrade, and I started working with the Politika news agency during the Bosnian war, in 1991.  After all our trouble finished, in 1996 I joined Reuters, and they started sending me to the Middle East and Africa.  Their offices were in Fleet Street (they’re in Canary Wharf now) and as they had a contract with Fleet Street Clinic they sent me to the clinic to get jabs and the medical kit, trauma kit, travel kit.  From the beginning Dr Richard, he say to me: “Call me any time you’re in trouble!”.  

Q) So have you ever had to make that kind of call? 

A) Ha ha, many times! The last time, I get a bad reaction for the dengue fever jab. I was about to cross the border between Dominican Republic and Haiti but they sent me back. I had a fever. I was feeling very bad.  But after calling Dr Richard I knew where I was standing.  He said, don’t worry, it’s not common, but stay in bed and after three days you’ll be ok.  Absolutely brilliant!  And with an iPhone of course I can send a picture of a rash or a wound and say, Dr Richard, what’s your opinion? 

Q)  What’s inside your travel kit? 

A) It depends where I’m going – tropical area, somewhere very remote, whatever.  Not every medication for every possibility, but for a lot of possibilities. In Africa, sometimes you need to walk five to 10 days to find any medical facilities. It’s the nature of the job that often I’m following rebels in a very remote area so you can quickly go through all the kit.  In Central African Republic I got some infection and needed to test if I had malaria again. I was in Bambari with Seleka Islamist rebels and there’s nothing there, really. No medical facilities. So the medical kit’s sterile syringes, tests, antibiotics, everything, it’s very useful. 

Q) You once said ‘the eye of the sniper is everywhere’. Has it ever caught you?  

A) I was shot in my right leg in Egypt. It was a bad experience because the Egyptians told me “It’s just a small pellet, not very deep. It’ll get infected and just jump out.” So I took the antibiotics in the kit but after 10 days I see the infection again and Dr Richard said, “That’s not good, you know.”  I saw another Egyptian doctor; he said the same thing: “It’ll jump out!”  So I went back to Serbia and I found a military doctor who said,  “They’re mad! Look at your leg! If you didn’t come now, you might need amputation.” I always like soldiers, they know what they are doing. He had been in the war in Bosnia.  He told me, “I took a lot of metal out of humans. I’ll fix you, boy.” He took out a 8.2mm pellet, gave me more antibiotics, and I was ok. 

Q) You’ve also said you love to go into a conflict zone – so where have you been recently? 

A) Last year I did Lebanon, spent lots of time in south Lebanon. What else? I can’t remember but I was three times in Port au Prince in Haiti.  That was tough. It’s like an outlaw country.  Eighty per cent controlled by different gangs. Raiding, burning, taking everything. The last time, I was focussed on child soldiers, kid gangsters. Kids nine, ten, 11, with 9mm guns. Shooting without hesitation, quick reactions, handling guns well.  I’ve been in the army but was in total shock, seeing that.  

Q) How do you relax when you’ve finished work for the day? 

A) Cigarettes. In Haiti I found a hotel at the edge of the front line, the Hotel Plaza.

  No one else was staying.  Only me with a fixer and two motorbike drivers to move us around. All night you could hear bang, bang and stuff.  But the staff were really nice. The food was wonderful. The biggest trouble was, I’m sitting on the balcony, it’s really humid, I’m sweating, and I’m looking at the beautiful blue swimming pool and it’s tempting to jump in it. But Dr Richard told me a long time ago, if a pool isn’t treated with chlorine there’s a high possibility of getting giardia.  No guests – hmm, I knew the manager he wouldn’t be spending money on chlorine. My fixer jumped in and he was unwell for two days.    

 Q) Do you often have to just bed down on the ground while working?

A) Often. One picture I took which became quite famous, that was in Afghanistan, a US Marine Sergeant Bee being shot at. It was very early morning; we had been camping and I had just wake up. When Taliban suddenly started shooting I was still in my just boots and underpants. It was so quick, I didn’t even know if I had the picture.  

Q) When did you first pick up a camera? 

A) When I am 14, 15, my parents had a bit of desperation to take me off the streets, playing football, fighting, messing around, so my father gave me a camera. And I loved it! It was amazing.  It’s a beautiful toy.  It was a Russian copy of a German Leica with no light meter. A friend of my sister, Mico Smiljanic, a photographer, helped me a lot. I learned to understand light, what is reflecting light, what is coming in at an angle, how it’s behaving.  Everything in photography is about the situation of the light.    

Q) How you start working as a photographer? 

A) In Belgrade, 1987, when I was 18, I did one year of national service. I was still not behaving well, so my father – he was a chemical technician in a factory – wanted to put me in order.  I loved it.  It was just before the Bosnian war, so my father did me a great favour. Discipline, waking up early, exercising, all good.  Then the Bosnian war started. Serbia was bombed by NATO. I had my camera,  I knew how to look after myself, and that’s how I started.  

Q) What kind of conflict produces the best pictures? 

A) When you’re with soldiers on foot, although now with drones it’s more difficult, drones have  really changed the dynamic.  When governments and armies create restrictions, then you don’t have good pictures. I don’t want to do only what I’m allowed and what the new security advisors show me. But us who have field experience, we understand we have no idea how we’re going to get the picture. You look, and you see opportunities. You need to be very patient.  Sometimes I wait weeks, months. I don’t have any vision of the pictures I want to get. Zero. But when I see an opportunity, I’m going to push for it.   I want to see the fear, I want to see the faces, I want to tell the story properly.   

Q) Are you usually sympathetic to the cause or side you’re photographing?  

A) I’m a journalist: I’m not supporting any side. You have good guys, you have bad guys, and the truth is somewhere in between.  I try to cover untold stories important to people. 

Q) Do you feel traumatised by what you’ve witnessed – the maiming, desperation, death? 

A) You need to be stable in your head, doing this.  A couple of years ago in Canada, Anthony Feinstein, a psychologist, wrote a book, Shooting War, about how war affects journalists, especially photographers. They brought a bunch of us with this kind of experience to talk.  

A lot of my colleagues have PTSD, mental troubles, as a result of what they’ve seen. I don’t think I have PTSD. But crazy people don’t believe they’re crazy, so maybe I have.  

Q) You’ve said you love to go into a conflict zone.  Is that still true? 

A) When I go to say Syria, I know exactly what I’m doing, where I’m going. I’m not going to Nice or Cannes, the red carpet.  I started this work very young, and when you work, if you’re emotional, you are not for this job. You have to work hard, be disciplined.  I always joke when the correspondents start running, I’m starting to work. As a journalist, you can write your story about Syria from London. I need to see everything and I need to come close, close, closer.  

Q)  Your life must be hard on your family  

A)  Ha ha, I am the perfect husband, away all the time!  I’ve been married three times although not now.  My daughter, she’s 29.   I live now in a village outside Belgrade;  when I’m home,  I dig my garden, I use the gym, I use the punchbag under my walnut tree.  When I say to my daughter,  “Do you want to come over, to stay this evening?”, she says, “Dad, I know that just means you want to go to the bar and have me get you home!”  But what else am I going to do, be a bus driver? I’m just a yob from Belgrade!  A peasant! But I work hard. My mother said once, “I’m just glad you’re not in prison!” 

Q) Any regrets? 

A) I’m sorry I missed the Battle of Stalingrad. That was the mother of all battles. But 1942, 1943. I was born too late!

In today’s fast paced world, finding the time to visit a doctor can be challenging. Whether you are juggling a busy work schedule, looking after family, facing mobility issues, or travelling, accessing quality healthcare shouldn’t be difficult. This is where a home visit GP service in London can make all the difference. Fleet Street Clinic offers private GP home visits, ensuring that expert medical care comes directly to you, whenever and wherever you need it. 

Why Home Visits Are Essential in London 

1. Convenience at Your Doorstep 

Navigating London’s traffic and packed public transport can make a short trip to the doctor extremely stressful. A GP home visit removes travel time, allowing you to receive expert medical care in the comfort of your home, office, or hotel. 

2. Same-Day Appointments for Immediate Care 

Waiting for a GP appointment at a busy surgery can take days, if not weeks. Often, NHS appointments require a registration process that can take several days. With same-day GP home visits in London, Fleet Street Clinic ensures you receive prompt medical attention when you need it most. 

3. Personalised and Unhurried Care 

Unlike traditional 15- or 30-minute clinic visits that may feel rushed, a private GP home visit allows for a more in-depth consultation. Your doctor can assess your condition in a familiar environment and provide tailored treatment plans suited to your lifestyle. 

4. Ideal for Families, Elderly Patients, Busy Professionals, and Travellers 

• Parents with young children can avoid exposing them to germs in waiting rooms.
• Elderly patients or those with mobility issues benefit from receiving care without the challenge of travelling. 
• Professionals with demanding schedules can fit a GP consultation into their day without taking time off work. 
• People travelling into London may need urgent medical attention before flights back home; home visits can also take place in hotels, airbnbs, or any other third party location. 

5. Comprehensive Medical Services at Home 

Fleet Street Clinic’s private doctor home visits cover a wide range of medical services, including: 

• Diagnosis and treatment of illnesses. Prescriptions and medication advice.
• Vaccinations, including flu and travel vaccines. Health check-ups and screenings.
• Chronic disease management.
• Medical certificates and sick notes.
• Wide range of services including blood tests, urine samples, swabs, and more.

Book a GP Home Visit in London Today

If you need a home visit GP in London, Fleet Street Clinic is here to help. We provide professional, same-day medical care wherever you are, ensuring your health remains a priority without the hassle of travel. 

Call us now at +44 207 353 5678 to book your appointment or schedule a home visit directly on our website. Take control of your health with the convenience of private GP home visits in London. 

Book now

Step into the realm of Movember, where the Chevron, the Dali, or the Handlebar becomes more than just a style statement – it’s a symbol of men’s health awareness.

Are you ready to join the Mo-gang and make a statement this Movember?

Movember transcends mere facial hair growth; it’s a global movement dedicated to transforming the landscape of men’s health. This renowned charity, a beacon of hope and change, addresses critical issues like prostate cancer, testicular cancer, and mental health and suicide prevention.

In the heart of London, at Fleet St. Clinic, we’re not just embracing the ‘Mo’ spirit; we’re championing the cause of male health. As the statistics reveal, one man succumbs to prostate cancer every 45 minutes in the UK. It’s time to take charge of your well-being and be part of a movement that’s making a difference.

Prostate Cancer –
Our clinic offers a comprehensive Prostate Cancer check, with an experienced doctor committed to your health journey. This thorough examination includes a detailed health discussion covering lifestyle and family history, an internal (rectal) examination of the prostate gland, and a prostate-specific antigen (PSA) blood test. Early detection is the key, and we’re here to guide you every step of the way.

Testicular Cancer –
Testicular cancer, the most common cancer among young men in the UK, demands attention. Knowledge is power, and understanding the symptoms can be a lifesaver. A lump or swelling, a heavy scrotum, or discomfort in the testicle or scrotum are health signals not to be ignored. At Fleet St. Clinic, we emphasise the importance of awareness and early detection.

Mental Health –
Let’s break the silence surrounding mental health. The Movember Foundation has spearheaded programs globally, fostering resilience and mental well-being in men. It’s not just about growing a mustache; it’s about cultivating conversations that matter.

Now, let’s talk about your health journey with Fleet Street Clinic’s essential men’s health screenings and medicals.

Medical Health Check (From £425) – 

Essential    
Review your health with one of our experienced GPs. Benefit from a thorough physical examination and carefully selected health checks and blood tests, including thyroid function.
1 hour appointment with a GP – £425

book online

Executive
Check your health from top to toe, with our more enhanced Executive medical, including an audiometry test to assess your hearing, spirometry tests to assess your lung function, and cancer checks and markers.
1.5 hour appointment with a GP – £675

Executive+
For maximum reassurance and peace of mind, consider our most advanced medical. Benefit from advanced health screenings including a sophisticated cardiac (CaRi-Heart) scan, and a bone density DEXA scan.
3 hour appointment with a GP – £3,950

View our medical health checks in more detail and book online.

Prostate Cancer Check (£175)

Prostate cancer is the most commonly diagnosed cancer in men in the UK. Early diagnosis is crucial.

Our prostate cancer check is carried out by an experienced male GP, who’ll conduct a detailed health discussion, internal (rectal) examination of the prostate gland, and a prostate-specific antigen (PSA) blood test. Swift courier services ensure timely analysis at our nearby pathology laboratory. Our GP will provide you with full support throughout the process and provide aftercare services and referrals if required.

In a world where ‘strong, silent men’ are rewriting their narrative, Movember beckons. Join us at Fleet St. Clinic, where your health is not just a checkup; it’s a commitment to a longer, healthier life.

Book your Appointment now, and let your Mo make a statement for men’s health in London.

According to Prostate Cancer UK, 1 in 8 men will get prostate cancer in their lifetime and it is the most common cancer in men in the UK.

In 2021, around 52,000 men were diagnosed with prostate cancer in the UK alone and the risk of developing it increases with age, as most cases are diagnosed aged 65 and over.

It’s not uncommon for men find out by complete chance, and often it can be too late when the diagnosis is less treatable. For that reason, it’s essential to understand the symptoms, available tests, and the importance of early detection.

What is the Prostate?

The prostate gland is a small, walnut-sized gland located below the bladder and in front of the rectum in males. It plays a key role in the male reproductive system by producing seminal fluid, which nourishes and helps transport sperm during ejaculation.

As men age, the prostate can undergo changes, including enlargement (benign prostatic hyperplasia) or other conditions, such as prostatitis (inflammation) and prostate cancer.

Regular check-ups and awareness of symptoms are important for prostate health.

What is Prostate Cancer?

Prostate cancer occurs when cells in the prostate gland grow uncontrollably.

An enlarged prostate is very common in men over the age of about 50, but having an enlarged prostate is not the same as having prostate cancer.

Having an enlarged prostate doesn’t increase your risk of getting prostate cancer. But it’s possible to have an enlarged prostate and prostate cancer at the same time.

While many men with prostate cancer may not experience symptoms, early detection is vital for effective treatment.

Symptoms of Prostate Cancer

In its early stages, prostate cancer may not cause noticeable symptoms. However, as the disease progresses, some common symptoms include:

• Needing to urinate more often than usual, especially at night
• Difficulty starting or stopping urination
• Weak or interrupted urine flow
• Painful urination or ejaculation
• A feeling that your bladder hasn’t emptied properly

If prostate cancer breaks out of the prostate (locally advanced prostate cancer) or spreads to other parts of the body (advanced prostate cancer), it can cause other symptoms, including:

• Persistent pain in the lower back, hips, or pelvis
• Unexplained weight loss or fatigue
• Blood in urine or semen
• Problems getting or keeping an erection

If you experience any of these symptoms, it’s crucial to consult a healthcare professional for evaluation.

All these symptoms are usually caused by other things that aren’t prostate cancer. But it’s still a good idea to tell your GP about any symptoms so they can find out what is causing them and make sure you get the right treatment, if you need it.

Who Should Consider a Prostate Screening?

1. Men aged 50 and older: if you’re at average risk, starting at 50 is recommended.
2. Men aged 45 and older: if you have a higher risk, such as a family history of prostate cancer.

Tests for Prostate Cancer at Fleet Street Clinic

Several tests can help confirm the presence of prostate cancer:

1. Prostate-Specific Antigen (PSA) Test: This blood test measures the level of PSA, a substance produced by the prostate gland. Elevated PSA levels can indicate prostate cancer, but they can also be elevated due to benign conditions such as an enlarged prostate. A normal PSA indicates that the chance of a prostate cancer is very low.
2. Digital Rectal Exam (DRE): During this exam, a doctor manually examines the prostate for any irregularities or lumps. While this test can help identify abnormalities, it is typically used in conjunction with the PSA test.

Consider booking a GP appointment for either of these Prostate Cancer tests, or for a more comprehensive assessment, opt for our Prostate Cancer Check, which includes both tests.

Factors That Can Cause the PSA to be Falsely Raised

Several factors can cause a false elevation in Prostate-Specific Antigen (PSA) levels, potentially leading to misleading test results. Here are common causes:

1. Recent Ejaculation: Sexual activity, especially ejaculation, can elevate PSA levels temporarily. Avoid sexual activity for 24–48 hours before a PSA test.

1. Prostate Manipulation: Any recent procedures or physical manipulation, such as a digital rectal exam (DRE) or catheter insertion, can elevate PSA levels. Let your doctor know if you’ve had any recent prostate exams or urological procedures.
2. Vigorous Exercise: Activities that put pressure on the prostate, like cycling or horseback riding, can raise PSA levels temporarily. Avoid these activities for a f48 hours before the test.
3. Prostate Infections or Urinary Tract Infections (UTIs): These infections can cause inflammation and increase PSA levels. Treat infections and allow recovery before testing.
4. Benign Prostatic Hyperplasia (BPH): An enlarged prostate from BPH can raise PSA levels even though it’s not cancerous. Make sure your doctor considers this in the interpretation.
5. Certain Medications: Some drugs, like testosterone, can increase PSA levels, while others like finasteride (for hair loss or BPH) can decrease it. Inform your doctor of any medications you’re taking.

Avoiding or managing these factors before a PSA test can help improve the accuracy of the results. Always discuss any concerns with your doctor.

You may need additional tests, as listed below, if your PSA is raised or if there is concern from the examination. We can refer you to specialists who may be available for same-day consultations to provide further evaluation.

1. Imaging Tests: Additional imaging tests, such as an MRI or CT scan, may be conducted to visualise the prostate gland.
2. Biopsy: If initial tests indicate potential cancer, a biopsy is often performed to confirm the diagnosis. During this procedure, a small sample of prostate tissue is removed and examined under a microscope for cancer cells.

Movember, an organisation focused on raising awareness of men’s health issues, including prostate cancer, emphasises the importance of regular check-ups and understanding one’s own health risks. Their campaigns encourage men to talk openly about health issues, promoting early detection and treatment.

Prostate cancer is a serious health concern for men, but awareness and early detection can lead to better outcomes. Regular check-ups and understanding the symptoms are essential steps in addressing this disease.

If you have concerns about prostate cancer or related symptoms, don’t hesitate to seek medical advice by booking a GP appointment. Early action can make a significant difference in your health and well-being.

Related services at Fleet Street Clinic

Prostate Cancer Check

Private GP Appointments

Annual Medical

Blood Tests

Egypt has long been a fascinating destination for travellers with its ancient monuments, rich culture, and vibrant landscapes. Now, there’s even more reason to consider Egypt as a travel destination: the World Health Organization (WHO) has officially declared the country malaria-free.  

Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said “Malaria is as old as Egyptian civilisation itself, but the disease that plagued pharaohs now belongs to its history and not its future.

This is a significant milestone in public health and brings an added layer of safety and assurance to travellers planning to visit.  

Here’s what you need to know about this important achievement and what it means for your health when traveling to Egypt. 

What does it mean to be “Malaria-Free” 

To be certified as malaria-free, a country must demonstrate that it has interrupted local transmission of malaria for at least three consecutive years. Egypt met this requirement, showing consistent results in controlling the disease, improving healthcare infrastructure, and reducing the risk of reintroduction.  

According to the WHO, Malaria in Egypt has been traced as far back as 4000 B.C.E., with genetic evidence of the disease found in Tutankhamun and other ancient Egyptian mummies.

Egypt is one of the latest countries to receive this certification, contributing to a global push toward eradicating malaria worldwide. 

What does it mean for travellers? 

Malaria has long been a concern in various tropical and subtropical regions, causing severe illness, fever, and sometimes even death.  

Travellers often must take preventative steps, such as antimalarial medication and mosquito avoidance measures, when visiting areas where malaria is prevalent.  

Egypt’s certification as malaria-free means travellers now have one less health risk to consider when planning their holiday.

For the tourism and travel health sectors, this achievement reassures visitors that Egypt is safe from malaria transmission, especially in rural areas and near water sources, which are typically high-risk locations for malaria-carrying mosquitoes. 

Are there any precautionary measures still needed? 

While Egypt’s malaria-free status is excellent news, it’s still essential to practice general travel health precautions to stay safe.  

Here are some tips: 

1. Protect Against Other Mosquito-Borne Diseases: While malaria may not be a concern, other mosquito-borne illnesses, such as West Nile Virus and Dengue Fever, can still pose risks. Use insect repellent, wear long sleeves, sleep under a mosquito net and consider vaccinations where possible, like Qdenga for Dengue Fever.
    

1. Stay Up-to-Date on Vaccinations: Egypt does require certain vaccinations for travellers, such as Rabies, Hepatitis A, Hepatitis B, and Typhoid. Make sure you are aware of any health advisories and have up-to-date vaccinations before your trip.
    

1. Practice General Travel Hygiene: Staying hydrated, avoiding untreated water, and being cautious with food preparation are essential for staying healthy on your travels. 

Is a travel consultation still necessary? 

Yes, whilst it is fantastic news that Egypt is now malaria-free, there are other health risks to consider when travelling and it is still important to seek travel health advice from an expert. 

We advise booking a travel consultation at least 4-6 weeks before your departure date to allow enough time for any necessary vaccinations, medications, and preventive advice to take full effect. 

If you’re planning a last-minute trip, don’t worry! Book a consultation as soon as possible; even a brief appointment can provide valuable advice, essential vaccinations, and immediate preventive tips to keep you safe during your travels.

The Future of Malaria Control in the Region

Egypt’s success in eradicating malaria is a hopeful indicator for neighbouring regions where malaria is still a concern. The country’s strategies and investments in healthcare could serve as a model for other nations aiming to reduce or eliminate malaria. 

Planning Your Malaria-Free Trip to Egypt

Whether exploring the pyramids, cruising the Nile, or enjoying the coastal resorts, travellers to Egypt now have added peace of mind regarding malaria. However, consulting with a travel health specialist before your trip remains important to ensure your overall health and safety. By staying informed and prepared, you can focus on enjoying the cultural and natural wonders Egypt has to offer. 

As always, our travel health experts are here to provide personalised advice, vaccination guidance, and preventive health tips to make sure your journey is as safe and enjoyable as possible. 

Book a travel consultation to discuss your upcoming trip to Egypt.

Related services at Fleet Street Clinic

Specialist Travel Clinic 

Travel Vaccinations 

Dengue Fever

Rabies Vaccination

Antimalarials 

According to Menopause Support, approximately 13 million peri, current and post-menopausal people are living in the UK today.

This makes up a whole third of British women.

Despite making up such a large portion of society, a lot of women find themselves feeling ashamed, shunned or invisible due to their symptoms and the lack of discussion surrounding the subject of menopause.

What is menopause?

Menopause simply means no periods for 12 months and usually begins between the ages of 45-55, but it may start earlier. 80% of women are menopausal by the age of 54 years, so an average woman spends one third of her life being menopausal. In the lead up to menopause, women often experience symptoms of ‘perimenopause’. Changes in the menstrual cycle, hormonal fluctuations and ‘hot flashes’ can all occur as the ovaries begin to stop producing eggs. It is important to note that menopause is a natural transitionary period in life and is not a disease or illness.

What are the symptoms of menopause?

80% of women suffer some symptoms.

Meaning 20% of women have no symptoms at all, and of the 80 % who do suffer some symptoms, only 25% want or need treatment.

Some of the physical symptoms of menopause may include, but are not limited to:

• Night sweats
• Hot flushes
• Dizziness
• Fatigue
• Headaches
• Recurring UTIs
• Stiff joints, aches and pains
• Heavy periods
• Insomnia
• Itchy skin
• Osteoporosis
• Weight gain

Menopause is not only characterised by physical health symptoms, but mental health can also be affected by it too.

Some symptoms might include:

• Anxiety
• Memory loss
• Depression
• Reduced concentration
• Brain fog

How can I manage symptoms for menopause?

A healthy diet and regular exercise, alongside simple lifestyle changes, may improve some symptoms and are important parts of the toolkit in dealing with menopause.  Reducing nicotine, alcohol and caffeine intake further assist in reducing symptoms as well.

‘Phytoestrogens’ also help, and these are found in foods like soya protein, beans, yams and nuts.  These non-hormonal treatments should always be tried first before hormonal treatments like HRT, which top up hormone levels.

World Menopause Day

World Menopause Day is recognised every year on October 18^th to attempt to break the stigma around menopause and highlight the support available to women when they’re experiencing symptoms.

This year’s theme is based on HRT and the various pros and cons.

HRT works by replacing the hormones lost in the menopause process and can relieve symptoms of menopause to a manageable degree. Many women see it as a necessity for managing their menopause symptoms.

However, studies have shown that HRT can slightly increase the risk of breast cancer. This may sound concerning but the risk reduces when using oestrogen only HRT, rather than combined. HRT for managing menopause is an ongoing discussion in the medical field, but a lot of women experiencing menopause find the benefits outweigh the risks, and your GP will be able to advise whether HRT is the right solution for you.

How can Fleet Street Clinic help me?

If you think that you are beginning to experience symptoms of perimenopause or are suffering with your current symptoms, it may be time to book a GP appointment to discuss your menopause and see how we can help you.

Menopause can be a scary transition, but we want to do everything we can to make it as easy as possible for you.

Book a GP appointment today and let us support you.

More information:

Women’s Health information

GP Appointment information

Focused Health Checks

October is Breast Cancer Awareness Month

You may notice an increased amount of pink during this month, especially iconic pink ribbons, and it’s for a good reason: October is Breast Cancer Awareness Month.

This annual campaign aims to increase the awareness of the disease and to raise funds for research into its cause, prevention, diagnosis and treatment. With the hope that in the not too distant future, a cure will be found!

Breast Cancer is the most common cancer in the UK. 1 in 8 women in the UK will be diagnosed at some point in their lives.

In the UK, over 55,000 women each year are diagnosed with Breast Cancer which is the most common cancer. Thanks to research, more people are surviving breast cancer than ever before, yet there are still nearly 1,000 women who’ll die of breast cancer each month. Breast cancer is often thought of as something that only affects women, but men can get it in rare cases. It is important for males (especially those over 75 years with a high BMI) to check breast tissue for abnormalities as well.

We will be sharing important information on symptoms, causes and lifestyle alteration you can make to reduce your risk.

We are urging everyone, especially women, to check their breasts regularly and get checked out by a professional if something seems unusual for you.

REMEMBER: The earlier breast cancer is diagnosed, the easier it is to treat and the better the chance of successful treatment.

BREAST CANCER SYMPTOMS TO LOOK OUT FOR:

• a new lump or thickening in your breast, upper chest area or armpit
• a change in size, shape or feel of your breast
• skin changes in the breast such as puckering, dimpling, a rash or redness of the skin
• fluid leaking from the nipple in a woman who isn’t pregnant or breastfeeding
• changes in the position of the nipple
• Unexplained pain in your breast or armpit that’s there all or almost all the time

How to check your breasts

Checking your breasts yourself means you’ll get to know what is “normal” for you. As a society we are probably not that familiar with how our body currently is and so that makes it difficult to know what subtle changes happen. It’s most likely that unless a dramatic change has occurred a subtle change will go unnoticed.

So, how do you check your breasts?
There is no special technique and you don’t need any training to start checking your breasts. It may feel like you’re unsure what you’re doing but get to know your body and any breast check is better than no breast check.

The easiest and most accurate way is to divide the breasts into four quadrants; the upper outer quadrant, outer lower quadrant, inner lower quadrant and inner upper quadrant. Examine each quadrant with the flat of your hand. It is important to do this regularly so that you are familiar with what each breast feels like normally. That way, should you notice any changes, (hopefully not), you will pick them up straight away and changes won’t go unnoticed. It is important to remember to check your armpits as well. It is surprising how many breast lumps are discovered after an “axillary” or armpit lymph node is found and checked.

Breast Cancer Now advises the TLC method – “touch, look and check”.

Touch: Can you feel anything new or unusual?
Look: Does anything look different?
Check: Any changes with your GP

You should check your breasts Regularly

Get to know your “normal” by checking your breasts regularly. Get in the habit of checking your breasts at least every month. It can be easier whilst in the bath or shower. 

Your breasts can change throughout your life for many reasons – like the menopause, pregnancy and breastfeeding, or puberty. So, if you check them regularly, you’ll be able to spot any new or unusual changes that should be checked out by a GP.  

For young and pre-menopausal women it is advised to check mid-cycle (a week after their period finishes) if there are any changes this requires checking with your GP. 

As older women are of a higher risk of breast cancer, due to age, it is advised they check even more frequently. Older women should check on a monthly basis without exception. It is advised for men to check also.

Any lump requires attention and checking with your GP immediately.

In addition to regular self-checks, it is important to never miss a mammogram appointment. They may be painful and momentarily uncomfortable, but a mammogram can save your life. If you have a long wait for a mammogram, are unable to access an appointment or just want an additional check, contact the Fleet Street Clinic and we should be pleased to help.

What are the causes of breast cancer?

There are several factors that contribute to increasing your risk of developing breast cancer. There is no single cause, and has to do with our lifestyle, environment and genetics. There are factors which we simply cannot control such as getting older, family history, inherited genes, dense breast tissue, hormones and age at which period started and stopped. However, there are some lifestyle choices that if altered can reduce your risk of breast cancer.

Lifestyle change that will reduce your risk of breast cancer

1. Your weight

Being overweight or obese has a high risk of breast cancer in both men and women (especially after menopause). You can work out your ideal weight using a BMI (Body Mass Index) calculator, this checks your height and weight to see if you are at a healthy weight. For the majority of adults an ideal BMI ranges from 18.5 to 24.9. A BMI between 25 – 30 means overweight. Obesity means a BMI of 30 and above.

2. How much alcohol you drink

Alcohol consumption increases the risk of breast cancer. The risk is greater with each extra unit per day, the latest UK guidelines state no more than 14 units a week. 

3. How much exercise you do

Being inactive contributes to a small increased risk of breast cancer, this qualifies as doing less than 150min of moderate activity on a weekly basis. This does not necessarily mean sport and exercise, anything that makes you warmer and out of breath counts.

Throughout October we’ll be highlighting the reasons to support this campaign across our social media platforms. We will be sharing inspirational stories from those who have survived the disease and those who are currently battling.  We will also hear from those who have supported a suffering loved one during treatment. Sharing these stories humanises the disease and can provide support/tips for those who may be struggling with a current diagnosis. We will be sharing ways of checking for early warning signs. We’ll also be encouraging all to undertake a Well-Woman or Well-Man health checks. Both of which contain a breast examination.

At Fleet Street Clinic, we specialise in women’s health and have four female GPs on-site to facilitate well-woman health checks. Our Executive Well Woman medical is focused on protecting your well-being and involves a full examination including breast examinations and cervical screen tests. Our comprehensive medical is designed to screen for health problems at the earliest possible stage.

Book Your Well Woman Medical Online. Or if you notice any changes to your breast or have any concerns, you should book a GP appointment as soon as possible.

_______________
To find out more from Breast Cancer Now, visit breastcancernow.org

Here at Fleet Street Clinic, we have had many stool samples come through our laboratory. One recent clinical case using our in-house Full Gastrointestinal PCR Panel, presented unprecedented results.

Patient overview:

• 51-year-old patient
• Travelled to and from Pakistan for a trekking trip
• The patient presented with a history of severe diarrhoea
• Symptoms recorded: erratic bowel movement and weight loss.

Test results:

The PCR result came back quicky as positive for four pathogens:

• Cyclospora cayetanensis,
• Enteroaggregative E. coli (EAEC),
• Enteroinvasive E. coli (EIEC)/Shigella,
• and Enteropathogenic E. coli (EPEC)

This is highly unusual and it is little wonder why our patient was feeling so unwell with severe symptoms.

Our Biomedical Scientist, Jenny Reyes commented; “This is my first time in all of my time as a Biomedical Scientist to encounter such a result with four pathogens presenting all at once.”

Without our GI PCR test, this patient may have undergone many tests to identify the cause and may not have identified that the symptoms were the result of four simultaneous pathogens causing a mixed infection.

The advantage of a panel PCR test is its ability to identify the exact cause, enabling targeted treatment.

In this case, the clinician overseeing this patient’s care was able to tailor treatment to address all four identified pathogens simultaneously with precision.

Without this technology, diagnosing a mixed infection could have taken significantly longer, requiring multiple different tests to pinpoint each cause.

This would have increased the risk that only one pathogen would have been identified, leaving the symptoms caused by the others untreated even after addressing the diagnosed cause.

We encourage all patients with unexplainable gastrointestinal symptoms to consider the GI PCR Panel. It really does offer faster, more targeted care and can identify mixed infection with ease!

More information on our GI Panel:

Our Gastrointestinal Panel Test delivers accurate and reliable results quickly, often within a matter of hours.

It is capable of detecting any of the 23 commonest pathogens that cause diarrhoea – such as E. coli, campylobacter, norovirus salmonella, shigella and giardia, from a single stool sample – all that’s needed is a simple swab.

This supports our rapid diagnostic process, clinical management and educated treatment decisions which improve overall patient outcomes.

Learn more and book today

Dengue has been declared an epidemic in the state of Karnataka in India. 

Dengue fever is an unpleasant viral infection spread by the bites from infected Aedes mosquitoes. Unlike the mosquitoes that transmit malaria and are active at dusk, Aedes mosquitoes are most active during daylight hours, making dengue prevention more challenging. 

As of this week, Karnataka has reported 25,589 cases and 12 deaths so far, with a staggering 15,000 new cases in the last 45 days alone—the highest in a decade.  

Bengaluru, one of the hardest-hit cities, has recorded over 11,500 cases, driven by the rainy season that has created ideal mosquito breeding conditions. 

To combat this, the government is enforcing strict measures, including penalties for property owners who allow mosquito breeding. However, personal protection remains critical, especially for those planning to travel to India. 

At Fleet Street Clinic, we offer Qdenga®, the newest dengue vaccine. As a live vaccine, it’s not suitable for everyone, so we recommend booking a consultation with one of our specialist travel nurses to determine if it’s right for you. 

Safety Tips:

In addition to vaccination, follow these safety tips: 

• Cover up, wear long sleeves and trousers when there are mosquitoes around.
• Use mosquito repellent creams, coils, and sprays. 
• Use a mosquito net at night 
• If you experience symptoms like fever, muscle aches, nausea, or vomiting, seek medical attention. 

If you’re planning to travel, ensuring your vaccinations are up-to-date is essential for your safety. To determine if the Qdenga® vaccine is right for you, we recommend booking an online consultation with one of our expert travel nurses.

The Qdenga® vaccine requires two doses, with each dose priced at £148. Our specialists will provide personalised advice and help you navigate your vaccination needs.

Click to book your appointment.

For more information on:

Dengue Epidemic in Karnataka, India

Karnataka declares Dengue an Epidemic

Dengue Fever

Travel Vaccinations 

Antimalarials

Holidays are a time to relax, unwind and have fun!

However, this excitement can lead to us making decisions we may not usually make when we are at home. If you have unprotected sex whilst abroad whether it is oral, vaginal or anal you are at risk of catching sexually transmitted infections.

You could be at risk of catching these common STIs:  HIV, chlamydia, HPV, herpes, syphilis and gonorrhoea.

What can you do to prevent an STI?

Abstaining from sex is the most reliable way to avoid infection. However, if you wish to be sexually active follow some of the tips below:

• Use a condom from start to finish every time during sex including oral, vaginal and anal.
• Get vaccinated to protect against diseases such as Hepatitis B and HPV.
• Do not assume that your partner is STI-free. Talk openly and discuss your sexual health histories.
• Taking drugs and/or alcohol can lead to bad decisions. Be cautious when having sex whilst inebriated as you are more likely to take risks. These include not wearing a condom or having sex with someone you usually would not.

What are the symptoms of an STI?

Symptoms are different depending on the infection. Some diseases also do not cause any symptoms which makes them very hard to spot. If symptoms do occur, they could be some of the following:

• Pain when you urinate or have sex
• Discharge from the vagina, penis, or anus
• Unexplained rash, sore, or ulcer on your skin, genitals, or throat
• Jaundice (yellow colour of the skin and eyes)
  

What do you do if you think you have an STI?

Having an open and honest conversation, discussing your sexual health with your doctor is a good start to help guide you towards any tests or medication that you may need.

Long-term problems can be prevented by testing for STIs early and also prevent the spreading to other partners.

If you are worried that you may have an STI you should:

• Not have sex with anyone. This will reduce the risk of spreading the disease to anyone else.
• See a doctor or nurse as soon as possible.
• Discuss your sexual history and international travel with the doctor or nurse as some diseases are more common in some countries.
• If you have a positive result notify your recent partners. They may also be infected and unaware.

Fleet Street Clinic offers a discreet and trusted sexual health service including confidential sexual health advice, instant testing, and comprehensive STI screening.

You can book a sexual health appointment online.

On 14^th August 2024, the World Health Organization declared outbreaks of mpox in Africa to be a Public Health Emergency of International Concern.

What is mpox?

Mpox is a viral infection that was previously known as “monkeypox”.

It shares some similarities with smallpox, to the extent that smallpox vaccine may be cross-protective; however, the illness is much less severe. (Waning population immunity to smallpox, since vaccination programmes ended in 1980, is one possible reason for the increased tendency to outbreaks now.)

So far, there have been 14,000 cases reported in Africa, with 524 deaths. Sweden has just reported the first case of clade I mpox outside Africa in the current outbreak (see below).

Previously confined to central Africa, recent outbreaks have ultimately spread globally, which is why the WHO has now decided to urge a concerted global response.

How is it spread?

The infection is spread mainly by close direct / intimate contact with body fluids and secretions, and by sexual exposure.

It can also be spread by contact with animals, or their droppings, or by eating under-cooked contaminated meat – so-called “bush meat”. The animal reservoir of infection is mainly among rodents and non-human primates.

The illness

Infection may be symptomless, but in most cases, symptoms appear 7 to 14 days following exposure.

Mpox is characterised by blistering skin lesions that are often extremely painful (and highly infective to other people), occurring particularly on the skin, genitals and face. They can be sparse, or even single blisters.

Other symptoms include fever, chills, headache, muscle aches, fatigue and swollen lymph glands.

The blisters may appear first on the face, spreading to other parts of the body; or alternatively in the genital area if the infection was acquired by sexual contact. Extensive lesions around the mouth may make eating and drinking painful or impossible, requiring intravenous treatment.

The illness is considerably more serious in people with HIV infection or reduced immunity. Severity of infection is also linked to the degree of exposure.

Mpox strains

There are two strains (called clades – Clade I and Clade II) that differ in severity and ease of spread.

Clade II tends to be more severe (up to 1,000 times more virulent than clade II) and occurs in Central Africa, Clade II occurs mainly in West Africa and may sometimes be more easily transmissible. Mutations into sub-strains is also occurring, which makes testing more complicated, especially in countries where resources are poor.

Where are cases occurring?

It is important to bear in mind that official statistics generally underestimate true numbers of cases, since not everyone with symptoms seeks medical attention, and not all cases undergo full testing.

Laboratory-confirmed cases have been reported in:

• Burundi: over 100 cases (Clade Ib) throughout the country
• Central African Republic: 28 cases (Clade I) throughout the country
• Côte d’Ivoire: 6 cases (Clade II) in Abidjan and Bas-Sassandra districts
• Democratic Republic of the Congo: > 14,000 cases (Clades Ia and Ib) throughout the country, mainly in Équateur, Sankuru, South Kivu, and Sud Ubangi provinces
• Kenya: 1 case (Clade Ib) in Taita-Taveta County
• Republic of the Congo: > 120 cases (Clade I) throughout most of the country, mainly in Cuvette, Kouilou, Likouala, and Point-Noire departments
• Rwanda: 4 cases (Clade Ib); no specified locations
• South Africa: 24 cases (Clade IIb) in Gauteng (12 cases and 2 deaths), KwaZulu-Natal (11 cases and 1 death), and Western Cape (1 case) provinces
• Uganda: 2 cases (Clade Ib) in Kasese District; no secondary transmission has been reported

A previous outbreak in 2022 resulted in spread to over 40 countries – with over 30,000 cases in the USA, for example, mainly in the MSM community.

Are visitors at risk?

Although current news reports of mpox cases are alarming and intended to generate a global public health response, so as to raise awareness and help bring outbreaks under control, most tourists and travellers to Africa are not at risk.

Travel to Africa for the usual tourist activities (e.g. safari, outdoor activities, beach) should be unaffected by the outbreak.

Older travellers who have previously been vaccinated against smallpox may still have some additional cross-protection against mpox.

• Risk arises from close contact (especially sexual contact) with infected people.
• Those at highest risk are men who have sex with men (MSM).
• High-risk behaviour is easily avoided, and safe-sex precautions reduce the risk of infection.
• Risk also arises from close physical contact with infected animals, or by eating under-cooked bush meat – which should be avoided. (Thorough cooking kills the virus.)
• Healthcare workers may be at risk if caring for people who are ill with mpox
• Journalists and news media personnel should avoid physical contact, keep their distance and observe the usual hygiene precautions when reporting on the evolving mpox outbreak situation

Mpox vaccines and treatment

• In the UK, vaccination is available for MSM and healthcare workers via the NHS.
• Current vaccines protect against all strains.
• Vaccination within 14 days of possible exposure also appears to confer protection (post-exposure protection).
• Several antiviral drugs can provide benefit in the most severe cases.

More information:

UK: NaTHNaC 

USA: CDC 

Oropouche Virus Disease: A growing concern in Central and South America.

As of mid-2024, Central and South America are experiencing a significant outbreak of Oropouche virus disease, impacting countries such as Brazil, Bolivia, Colombia, Peru, and Cuba.

The Oropouche virus is primarily transmitted through the bites of infected midges (Culicoides paraensis) and mosquitoes. The virus is mainly spread in tropical and subtropical regions where these vectors are prevalent.

Symptoms of Oropouche virus disease include:

• sudden-onset fever,
• severe headaches,
• muscle and joint pain,
• rash,
• eye pain,
• nausea,
• and dizziness.

While most cases are mild and self-limiting, lasting 3 to 7 days, some individuals may experience more severe symptoms like meningitis and encephalitis.

There is no specific antiviral treatment or vaccine for the disease, so care focuses on symptom relief, such as rest, hydration, and pain management.

How to protect yourself from Oropouche virus

Preventing Oropouche virus disease involves reducing exposure to vector bites. Unlike mosquitoes, the main vector (midges) lacks a proboscis, and so is unable to bite through clothing.

Covering up, and wearing long-sleeved clothing, is therefore a keyway of preventing infective bites.

Other key measures include using plenty of insect repellent, impregnating clothing with Permethrin insecticide, using bed nets, and staying indoors during peak biting times.

Eliminating standing water where vectors breed is an important public health measure.

Prevention is key!

With no vaccine available, prevention remains the best defence against Oropouche virus disease.

Personal protective measures against insect bites also help protect against dengue, yellow fever, Zika, chikungunya, malaria, and a wide range of other tropical insect-borne infections, and should be followed carefully by travellers to tropical countries.

Cases found in Europe

Spain, Italy and Germany reported infections in numerous patients who had recently travelled to Cuba and Brazil.

The European Centre for Disease Prevention and Control (ECDC) warned of a moderate threat to travellers visiting Brazil, Bolivia, Colombia, Peru and Cuba, where Oropouche virus (Orov) is currently spreading.

If you’ve recently travelled to a known outbreak area and are experiencing any of the symptoms mentioned above, it is important to mention this to your doctor. This will help them rule out an Oropouche virus infection.

Worried about your upcoming travel plans?

Schedule a travel consultation with one of our specialist travel nurses.

They will guide you through potential health risks and recommend the necessary preventive measures and vaccinations to ensure your safety while travelling.

For more information on:

Dengue Fever

Yellow Fever

Antimalarials

Travel Vaccinations 

If caught and symptoms develop, rabies is almost invariably fatal.

Rabies is spread through the saliva of an infected animal and is present in over 150 countries worldwide. Up to 100 children die each day from rabies, and more than 55,000 people a year are killed from the disease, mainly in Asia and Africa.

If bitten or scratched by an infected animal you need to act quickly. Your pre-exposure vaccines simplify medical care in case of a potential rabies exposure, reducing the number of post-exposure vaccine doses needed and providing more time to seek medical care because your antibodies will start to respond. This is crucial when traveling to remote areas with limited access to medical facilities.

If you haven’t had pre-travel vaccinations, the treatment is much more complicated; it is also expensive and can be hard to access in lower income countries. If treatment is given correctly and promptly after exposure, it is 100% preventable.

It is extremely important that if you are travelling somewhere with a known risks of rabies it only seems sensible to protect yourself against it. Rabies is a vaccine-preventable disease, so make sure you get vaccinated before you travel.

For more information on rabies and travel health, visit our rabies page here.

The Fleet Street Clinic is passionate about travel. We have provided rabies vaccinations for over 20 years. Our team of expert travel medical professionals provide advice and detailed consultations to ensure you have a healthy trip.

You can book a travel consultation or rabies vaccination appointment online.

ESSENTIAL CHICKENPOX VACCINE FACTS: 

• The chickenpox vaccine is not currently given by the NHS, but is part of the childhood vaccination schedule in other countries
• Chickenpox is a highly contagious infection caused by the varicella zoster virus
• In the UK, it mostly affects children
• It can be itchy and uncomfortable, can leave scars, and can sometimes cause severe disease – adults may suffer more serious symptoms, including pneumonia
• Chickenpox is spread by inhaling droplets coughed up by people infected with the virus
• People with chickenpox become contagious about 2 days before the appearance of the rash, which can make it difficult to avoid infection
• The chickenpox vaccine (varicella vaccine) can be administered from the age of twelve months onwards
• Two doses of vaccine are needed, with a 4 week gap between doses
• If your child is receiving the MMR vaccination or a Yellow Fever vaccine, the varicella vaccination must either be given on the same day, or 4 weeks later

HOW TO BOOK A VACCINATION APPOINTMENT

Fleet Street Clinic is dedicated to maintaining a good supply of the chickenpox vaccine.

Our private chickenpox vaccine service is undertaken by doctors and nurses with long experience of vaccinating children. Our family friendly clinic is sympathetic to parents’ needs and concerns, and we welcome any vaccine-related queries. We operate a Saturday vaccination clinic once a month, the next will be held on Saturday April 8th.

To book your chickenpox vaccination for yourself or your child, you can book online now.

The summer holidays will fly by and be over as quickly as they began, much to your relief, but probably the disappointment of your kids! Unfortunately, alongside the general back to school chaos, September also brings with it the start of the flu season.

Flu season not only means that people have to take time off of work due to being ill themselves, but parents often have to take time off work to look after their children who have the flu, because schools are rife with superspreaders. It seems that the best solution to the frustrating effects of the flu on school and parenting life is to nip it in the bud early enough in the season for immunity to make a significant difference.

This is where the flu vaccine comes in.

The flu vaccine comes in two forms, the traditional syringe-administered jab, and a nasal spray vaccine. While the nasal spray vaccine may be the preferred administration tactic for parents of children who don’t like needles, supply issues have resulted in limited availability, and it may still be worth considering the alternative.

When might the jab be preferable?

The nasal spray vaccine is protective and an excellent choice, but is not suitable for everyone. It is a live vaccine, and so cannot be administered to children who are immunocompromised or who live with anyone who may be immunocompromised. It is also unsuitable for anyone with bad asthma, since it may trigger an attack. The injected vaccine is not a live vaccine and is an obvious solution for a lot of people.

The nasal spray vaccine contains traces of gelatine and egg, and so may be unsuitable for vegetarians, vegans, Muslims or those with a severe egg allergy.  There is a cell-culture based injectable vaccine that is egg-free, which may be a more acceptable alternative.

The nasal spray vaccine can only be given from age two onwards. However, if there is a special reason for needing to vaccinate your child at a younger age than this, the standard injectable vaccine can be given from the age of 6 months. (The best way to protect babies younger than this is by vaccinating mums during pregnancy.)

For the past three winters, the nasal spray vaccine has been in limited supply. It has not been available privately but only through the NHS, and supply issues have resulted in extended delays. By contrast, injected vaccines have been available reliably from September onwards.

A well-timed dose of the injected vaccine, early in the season, may be a better option than the uncertainty of a delayed dose.

At the Fleet Street Clinic, we have been happy to offer the nasal spray vaccine previously but having been unable to obtain reliable supplies for the past three years, we will not be offering it this season.

If you decide to book the injected flu vaccine for your child this winter, you can rely on guaranteed supplies as well as our expertise in vaccinating babies and children of all ages.

__________________________

24/25 Winter Flu Vaccination Pricing:

Cell-Based Quadrivalent Flu Jab – £42 – Suitable from 2 years
Standard Quadrivalent Flu Jab – £15 (while stocks last) – Suitable from 6 months old

Book Your Flu Jab Online Today

Recent media reports have raised awareness of the effects of Meningitis B and the importance of the meningitis vaccine (if your child is aged under 12 months, the vaccine still readily available via your NHS doctor). Less well-known is the fact that there are different strains of Meningitis, with different vaccines protecting against them.

Strains and Meningitis Vaccines:

• Meningitis B: the protective single-strain meningitis B vaccine is Bexsero
• Meningitis A C W Y: the 4-strain vaccines Menquadfi and Nimenrix offer protection.

Meningococcal Meningitis and its Symptoms

Meningococcal meningitis is a bacterial infection that causes inflammation of the protective membranes surrounding the brain and spinal cord. It can affect people of any age, but those most commonly affected are children under 5, and  teenagers and young adults heading off to university.

Initial symptoms may be similar to flu, progressing to:

• A high temperature/fever, with cold hands and feet
• Vomiting
• Refusal to eat
• Drowsiness
• Floppy and unresponsive
• Rapid breathing
• Neck stiffness
• Bright light sensitivity
• Pale, blotchy skin, and a red rash that doesn’t fade when a glass is rolled over it
• Convulsions or seizures

Further information: https://www.meningitisnow.org/meningitis-explained/

The specialists at the Fleet Street Clinic recommend getting your children vaccinated not just against Meningitis B, but against Meningitis A,C,W & Y strains as well (the vaccine is currently available and in stock).

Meningitis B Vaccines Availability

We currently have a good supply of Meningitis B vaccine, available on a first come, first served basis. You can book a Meningitis B vaccination appointment online. 

Respiratory Syncytial Virus (RSV) is a common and highly contagious virus that primarily affects the respiratory tract, causing significant illness, particularly in infants.

It is present year-round but peaks during the winter months, and spreads through droplets from coughs and sneezes or via contact with contaminated surfaces. RSV is a virus, so antibiotics are not an effective treatment.

Each year, RSV poses a substantial health risk to infants and older adults worldwide.

In the UK, RSV accounts for approximately 33,500 hospitalisations annually in children aged 5 and under, resulting in 20 to 30 deaths per year. 75-80% of hospitalisations due to RSV happened during the first 6 months of life.

Is there a suitable RSV vaccine for pregnant woman?

Abrysvo is a recombinant vaccine for the prevention of severe lower respiratory tract disease caused by RSV in infants up to six months old. It is the only maternal RSV immunisation given to the pregnant woman between 28 – 36 weeks of pregnancy to help protect newborns. It can also be used for older adults over the age of 60 years, in preventing RSV that can lead to breathing difficulties and pneumonia.

Maternal vaccination involves administering vaccines to pregnant women to protect their newborns through the transfer of antibodies. This approach has been effectively used for diseases like whooping cough.

Vaccinating pregnant women against RSV provides passive immunity to their babies, safeguarding them against RSV until they can receive their own vaccines. The RSV vaccine should ideally be given at least 2 weeks apart from the whooping cough vaccine.

In the UK, the Joint Committee on Vaccination and Immunisation (JCVI) has assessed the impact of RSV and now recommends vaccination to protect vulnerable groups, including infants and older adults with the aim of reducing the incidence of RSV-related illnesses among infants, ultimately reducing RSV-related morbidity.

At Fleet Street Clinic, we can offer private RSV vaccination to protect you and your baby, ahead of the NHS roll out.

Abrysvo is an inactivated vaccine and only requires a single dose for protection.

Price: £296

Please contact our reception team to book by phone, +44 20 7353 5678 or by emailing info@fleetstreetclinic.com

RELATED SERVICES AVAILABLE AT FLEET ST. CLINIC 

RSV Vaccination

Pneumonia Vaccination

Childhood Vaccinations

Flu Jab for Pregnant Mothers and Babies

Wellness Vaccinations

Every year, Brits take more than 70 million trips abroad. Most notably for holidays, business trips and to visit family and friends. Whilst the majority of people have a safe trip, some people do experience illness or have an accident. In most cases, minor accidents and illnesses don’t require a visit to a medical centre or hospitalisation and can be self-treated with the help of a medical kit.

Where you are travelling to and the activities you plan to do there will dictate what type of medical kit(s) you would need.

Essential First Aid Kit £27

If you are planning to travel outside of a major city, you’re best to travel with an Essential First Aid Kit. It’s very easy to get scratched, twist an ankle or develop a blister. Particularly if you’re sight-seeing, hiking or even just taking a trip to the beach. Having a few essential supplies handy will reduce the need for a trip to the local chemist. Inside this kit, you will find items aimed at treating minor cuts, grazes, blisters, cleaning wounds, minor burns and sprains.

Worldwide Travellers’ Diarrhoea Kit £29.95

When you travel to a developing country, you have a high likelihood of catching a stomach bug. Also known as traveller’s diarrhoea. This is not always brought on by unsafe water and can be due to a change in diet or the high levels of impurities in the local water that you’re not used to. However, if the cause is a microorganism such as bacteria, parasite or virus, your symptoms may be much more severe and lead to complications. Travelling with a Worldwide Gastro Kit covers all eventualities. Including preventative items, plus medications for common symptoms such as nausea, vomiting, dehydration and travellers diarrhoea.

Sterile Needle Kit £9.50

The adventure traveller is likely to travel to remote areas where medical supplies are not sterilised to a safe standard or medical care in a hospital setting is not available at all. In these scenarios, it is safest to travel with a Sterile Needle Kit. This kit is to be provided to a medical professional to be used for medical emergencies such as a blood transfusion, fluid replacement, general vaccinations or blood tests. This kit is to reduce the spread of diseases such as HIV & Hep B.

Female Health Kit £29.95

There are many female-specific health concerns that may occur whilst travelling. Unfortunately, urinary tract infections (UTI’s) and thrush (yeast infections) are common among female travellers. Therefore travelling with a Female Health Kit is highly recommended.

Travelling with a fit-for-purpose medical kit is not glamorous. However, you’ll be glad you have it if you suffer any mishaps. Saving you time, money and stress involved in finding a local chemist, medical centre or hospital quickly when you are abroad. And if you don’t, then at worst you’ve lost out on a tiny amount of suitcase space.

Before International Travel you should consider a pre-travel consultation with a specialist travel nurse to discuss the health risks at your destination. You can book a travel appointment online or email us for more information at info@fleetstreetclinic.com.

SUMMER TREKKING

Do you enjoy the great outdoors and active holidays? If so, you may be contemplating a trekking adventure. Top summer trekking destinations include Cotopaxi, Ecuador, the Atlas Mountain Range in Morocco, The Ladakh Ranges in India and Mont Blanc in the French Alps.

Fleet Street Clinic offers travel tips for trekkers from Anna Chapman, one of our specialist travel nurses, to help prepare for your holiday and make the most of your adventure.

1. Ensure that you are up to date with vaccinations. It comes as a surprise to most people that vaccination should be considered before hiking in northern Europe. Tick borne Encephalitis is a serious viral infection that causes swelling of the brain. As the name suggests, it is spread by the bite of an infected tick, and it is endemic throughout northern Europe, Russia and China. If you’re heading further afield, to South America or Africa, you may need Yellow Fever vaccination for your own protection, or for border control.

2. The most common illness amongst travellers is upset stomachs. Pack hand sanitiser to use when soap and water for hand washing is unavailable. Take water purification tablets if you have not got access to safe water. Medicines such as rehydration salts and anti-motility medicines can be helpful if you do become unwell.

3. Most trekking routes are at high altitudes. Understand the effects of altitude sickness. Take time to acclimatise to altitudes and consider taking medication such as Diamox to reduce the severity of acute altitude sickness.

4. Look after your feet. Invest in good trekking boots, socks and wear them in before you go. Keep your feet dry when trekking by changing your socks and using foot powder. Zinc oxide tape or Compeed dressings can be helpful if you do get blisters.

5. Pack suitable clothing. Trekking in mountain ranges usually involves variable temperatures: Warm days, thin air, strong sunshine and cool nights. Pack breathable clothing, a waterproof jacket and warm base layers. Sun protection is essential, especially in high altitude ranges, so apply the “Slip, Slop, Slap” rule. Slip on a shirt, slop on some sunscreen and slap on a hat.

FLEET STREET TRAVEL CLINIC

Book your travel appointment today

Travelling with children can be an enlightening and wonderful experience for the family – creating memories and opening their minds to other cultures and ways of life. But on the flip side it also can be quite daunting, especially if this is your first time travelling with children. The best way to establish a safe travel experience abroad is to take early precautions.

Before Your Travels

When it comes to travelling with children, careful planning and preparation should be considered. It is highly advised to have a travel consultation well in advance of your travels. The travel nurse will make you aware of any travel risks and take into consideration your child’s current wellbeing. Depending on where you are travelling, your child may require certain vaccinations. 

These preventative measures will safeguard your child from any diseases or illness. 

Your may be advised the following vaccinations: 

• Rabies
• Yellow Fever
  –  Some countries require this as a condition of entry and will ask for proof of vaccination when you arrive into the country.
• Hepatitis A 
• Typhoid 
• Tick-borne Encephalitis 
• Japanese Encephalitis 
• Hepatitis B
• Meningitis ACWY
• Cholera

All vaccinations require a duration of time following vaccination to reach full protection, usually 10 – 14 days, so factor this time in before your travels. In addition, some vaccinations require a multi-course dose before they are considered effective, such as rabies which requires 3 vaccinations to be considered a complete course. Book a travel consultation early to ensure you have enough time before you travel.

In addition to travel vaccinations it is worth discussing any upcoming childhood vaccinations that could be beneficial to have at the same time so your child is protected against any other common diseases that aren’t necessarily associated with just travel.

If you intend to go to countries with a high malaria risk it is important to discuss antimalarial protection  during your travel consultation. Malaria can be fatal and there is a higher risk for children. Antimalarials (malaria tablets) are generally taken for a duration before, during  and after your trip  and need to be purchased in advance of your travels. There are a number of different types and are suitable for different people so it is important to discuss your options with a travel health expert. The tablets work by ensuring the malaria parasite doesn’t reach unmanageable numbers, keeping you healthy whilst you travel. 

Travelling abroad can be exhausting, especially for young children. Jet Lag is known to cause temporary sleep disturbance, which can have an impact on your mental health and other bodily functions. To prepare ahead, The Jet Lag Calculator can tell you how long it will take the body to adjust to your new time zone when you travel – and to adjust back again when you come home.

To undergo a Pre-Travel Consultation, book online or for more information on Travel Health Services.

During Your Travels

Travelling can sometimes result in unexpected situations. For the protection of your child/ren and your family in general, always carry a First Aid Kit. This will reduce your need to seek medical aid for minor accidents or journeys to a chemist, especially if local towns are at a further distance.

When travelling to warmer climates, sun safety is crucial as young children are more vulnerable to sunburn from outdoor activities. To protect the skin apply sunscreen of at least SPF 30, with broad spectrum UVA and UVB protection throughout the day. In addition, hot weather can also pose a risk of dehydration and heat stroke. Ensure you and your child are hydrated throughout the day by drinking  water from a safe source. This can be bottled water, boiled water, or water that has been filtered. 

To further avoid traveller’s diarrhoea:

• Wash your hands regularly, especially before eating
• Carry an alcohol-based sanitiser 
• Keep children from crawling or sitting on the ground
• Avoid swimming in contaminated water
• Don’t swallow any shower or pool water
• Eat raw fruits and vegetables only if washed in clean water or peeled 
• Stick to foods that are well cooked and served hot
• Stick to canned or bottled beverages
• Avoid food that has been sitting on a buffet to avoid contamination

We have launched a new, free online consultation for Travellers’ Diarrhoea – by answering a few simple medical questions about yourself, we can check if antibiotics are recommended for your trip. You can pay online and we’ll dispatch them directly to you if you are suitable. 

Alternatively, you can have a more comprehensive travel consultation in-clinic with one of our experienced travel nurses. 

For more information on the prevention and treatment of Travellers’ Diarrhoea.

The feeling of discomfort from bug bites can truly be a nightmare whilst travelling. Insect bites such as mosquitoes, ticks, biting fleas and kissing bugs can cause pain, irritation and even spread diseases. However, they can be avoided through protective clothing. Our Ultimate Bug Kit  has everything you need from repellents to aftercare. Alternatively, you could purchase individual items and create your own kit.

After Your Travels 

Travelling can expose your child to certain diseases. If your child falls unexpectedly ill – contact your doctor or emergency services right away. A high temperature/ fever could mean an infection. For most people, travellers’ diarrhoea usually clears up within a few days. However, if your stomach bug has been ongoing for weeks after returning home, then you will need to do testing to investigate the root cause. Viruses, bacteria or parasites all cause similar symptoms but require an entirely different treatment approach. Our Gastrointestinal (GI) Panel PCR test looks for any microbes that are causing your symptoms and can quickly identify the exact cause of your Travellers’ Diarrhoea. Results can be provided in as little as 1-hour, so that accurate and effective treatment can begin straight away.

I picked up Covid early in the pandemic and put my newly acquired immunity to good use by joining the Covid medical team at my local hospital for the weeks that followed. There was a side-effect however: a sense of invincibility that has perhaps made me take less care to protect myself from respiratory viruses ever since.

My luck ran out recently while looking after a group of patients with upper respiratory infections. Not all respiratory viruses are equal: we may call them “colds”, but some varieties are considerably more unpleasant than others.

Using PCR, we can now tell the difference between 22 different bugs with pinpoint accuracy, in about an hour. Mine turned out to be parainfluenza type 1 (there are four serotypes, who knew?) – a nasty virus, more common in the USA and among children.

My bout ranked alongside my experience with Covid: the symptoms lasted over three weeks and included a secondary lower respiratory infection requiring antibiotics to clear.

There’s no vaccine as yet against parainfluenza, but there are vaccines against other important respiratory infections – pneumococcal pneumonia, RSV, Covid-19, a newly-recommended adult top-up against whooping cough, and of course flu.

I shall be having all of these vaccines this winter and will take much greater care to protect myself when those around me have “colds”.

Women between the ages of 25 and 64 are invited for regular cervical screenings where a healthcare professional looks at the health of the cervix to detect any cell changes or abnormalities. However, in 2022-2023, the number of women who attended their cervical screen fell. Nearly a third of the women invited to do their cervical screen didn’t attend their appointments, this is around 4.6 million women, a deeply concerning number, as over 3000 women are diagnosed with cervical cancer each year and 99.8% of those cases are preventable. Prevention is better than curing, and the earlier you are aware of any cell changes, the easier it is to treat.

Why do some women not attend their cervical screenings?

One of our general practitioners, Dr Belinda Griffiths, has found that in her experience women don’t attend their cervical screenings for a number of reasons including: difficulties with taking time off work for a GP appointment, fear of embarrassment, and fear of the process being uncomfortable or painful. 

However, to combat these concerns, the NHS has launched at-home HPV kits. Dr Griffiths explains how they work – “The HPV test is highly sensitive so it separates out those who are HPV-positive and HPV-negative. Those who are HPV-negative will be considered ‘low risk’ for cervical cancer and will be asked to do a future test. Those who are HPV-positive will be deemed ‘high risk’ and be asked to attend for follow-up with a clinician whereby they will conduct a cervical screening to check the health of their cervix and investigate if any abnormal cells are present.”

These new tests are the same process as at-home STI tests whereby a simple swab collects the sample from the vagina. Having the option of this sort of test at home removes the fear some women may have surrounding the slightly more intrusive cervical screen.

What is HPV?

HPV (human papillomavirus) is a common virus passed on via skin-to-skin contact, usually through genital contact. There are many types of HPV, most of which are harmless, don’t usually cause any symptoms and the infection will go away on its own. However, others are deemed ‘high risk’ as they can persist and cause cell changes which can lead to cancer. It is thought that these ‘high risk’ HPV strains are responsible for around 80% of cervical cancer cases, making the detection of HPV all the more important.

How can you prevent HPV?

You can be protected from certain HPV strains through vaccination. There are two HPV vaccines currently available in the UK: Gardasil which protects against 4 strains of HPV used in the NHS and the vaccine used here at the Fleet Street Clinic, Gardasil-9, which protects against 9 of the high-risk HPV strains.

When can you be vaccinated against HPV?

The NHS now routinely offers the Gardasil vaccine to girls and boys around age 12/13, before the age people generally become sexually active. However, the vaccination programme only came into full force in 2019, meaning many people are currently unvaccinated. It should be pointed out that adults can get vaccinated at any age and even if you have already been exposed to HPV, the vaccine can still offer protection against other strains to which you have not yet been exposed. 

It is a particularly good idea for people to get vaccinated before they attend university or before they go travelling on a ‘gap year’, as these are typically times where young people are more sexually active and therefore more likely to be exposed to HPV. 

It is important to note that getting the HPV vaccination most certainly doesn’t mean missing or not participating in HPV tests or cervical screenings. A combination of these preventative measures gives you the highest possible chance of preventing cervical cancer. 

Book your Cervical Screen or HPV vaccine online today.

As the threat from the disease grows, here is everything the modern traveller needs to know about malaria.

What is malaria?

Malaria is an infection caused by a tiny, blood-borne parasite, transmitted by the bites of infected female Anopheles mosquitoes. Symptoms can often be delayed until sometime after exposure (a minimum of seven days but often four weeks or much longer), meaning the connection with travel may be forgotten, delaying diagnosis. 

Returning from a tropical holiday should come with a suntan and sense of relaxation – not a tropical disease. However, the number of British travellers catching malaria abroad is rising, and scientists are warning it could get worse. 

The UK Health Security Agency (UKHSA) has just published its latest data on malaria in travellers returning to the UK, and the numbers are troubling. Over 2,000 cases were reported in 2023, the highest total in over two decades. Globally, the number of cases of malaria has risen by 16 million, compared with pre-pandemic levels. 

No less worrying is the potential impact of climate change. Warmer temperatures can extend malaria transmission season, as well as extend the disease’s geographical range to higher altitudes and cooler places where transmission was previously uncommon. Flooding and extreme weather events create perfect conditions for mosquitoes to thrive, resulting in outbreaks of the disease. 

In tropical countries where malaria is widely prevalent, the disease takes a huge toll. In 2022, there were 249 million cases, 94 per cent of which were in Africa. These led to at least 608,000 deaths, mostly in children. 

But research recently presented at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global Congress in Spain suggested that if the world’s carbon emissions and population growth remain on the current trajectory, the populations at risk of malaria and other mosquito-borne diseases could increase by an additional 4.7 billion people by 2100, relative to 1970-1999. 

Diagnosing malaria depends on knowing that a person has been in a destination with a risk of the disease, since early symptoms can be non-specific, and malaria has a remarkable ability to be mistaken for other conditions. 

The most common symptoms of malaria:  

• Fever, usually above 38C and often intermittent 
• Fatigue 
• Aching muscles and joints 
• Headache 
• Chills (often with sweating and shivering) 
• Abdominal pains and diarrhoea 
• Sometimes jaundice (yellowing of the skin and whites of eyes) 

Severe malaria can result in headache, fits and even death. Suspected malaria is therefore a medical emergency, and prompt treatment is effective and lifesaving. 

The bottom line 

If you develop a fever or become unwell on returning home from travelling abroad, seek medical advice promptly and make sure you doctor know that you have been away. 

What areas have risks of malaria?  

Risk areas for malaria include many parts of Africa, Asia, Central and South America, the Caribbean and Oceania – including holiday destinations in parts of Thailand, India and Peru. 

How to prevent malaria on your travels

Medical prevention

Four to six weeks before your holiday begins, book a travel consultation regarding antimalarials – a travel nurse can advise on where and whether they are needed, and the options likely to suit you best.  

Malarone and doxycycline are the two most-commonly prescribed medications, usually tablets or capsules taken once a day. They need to be commenced before travel, taken while you are away and continued on your return home.  

For now, there are no suitable malaria vaccines for travellers. However, promisingly, two important vaccines have recently become available to combat malaria as part of public health campaigns in parts of Africa. 

Avoiding insects

Bite prevention measures dramatically reduce the risk of disease, with insect repellents containing DEET, plug-in insect killers, mosquito bed nets and a wide range of other options. Our expert travel nurses can recommend suitable products during your travel consultation. 

Other mosquito-borne diseases

Malaria is not the only disease on the rise due to climate change. Other mosquito-borne diseases include Dengue Fever (currently causing a large outbreak in South America), Japanese encephalitis, Chikungunya, Yellow Fever and Zika. The Zika outbreak in 2016 demonstrated how quickly mosquito-borne diseases can turn into an international health emergency. Climate change is expanding the range of mosquitoes capable of spreading them, and constant vigilance will be needed to combat them. 

If you’re travelling to areas that are at risk for Malaria, book a travel consultation for a stress-free holiday. 

Find more travel health information at fitfortravel.nhs.uk and travelhealthpro.org.uk. 

Related services at Fleet Street Clinic

Specialist Travel Clinic 

Antimalarials 

Travel Vaccinations 

Dengue Fever
 

Continued Reading about “Why malaria is on the rise – and how to protect yourself on holiday”

Read – Why malaria is on the rise – and how to protect yourself on holiday 

Read – Britons catching Malaria at highest number in over 20 years 

Read – Climate change drives deadly malaria surge as elimination efforts reach ‘crunch point’ 

Read – Vaccines are a glimmer of hope against malaria, but the battle has only just begun 

Trusted London clinic now offers private Covid-19 vaccines.

As a trusted name in healthcare for the past three decades, Fleet St. Clinic are proud to announce the expansion of our services to include private Covid-19 vaccination for individuals and businesses alike. We offer the most up-to-date Pfizer Covid vaccines at a cost of £98 per dose.

Covid Vaccinations for Individuals

Until now, Covid vaccination has only been available through the NHS, which has rightly prioritised access those most likely to suffer complications. However, coronavirus infection remains a hazard for everyone, and many other people also wish to be protected. Protection can be especially important for people keen to avoid illness abroad, for people in key occupations, and for those in close contact with vulnerable friends and relatives.

Covid vaccination will now be available year-round for all those who would like to be protected, including those who have not been eligible for NHS care. Whether you need a booster vaccination or would like to consider having the Covid vaccine for the first time, we can help.

Book your private covid vaccination here.

Covid Vaccinations for Businesses

Fleet St. Clinic has provided large-scale flu vaccination initiatives for businesses across the United Kingdom since 1995. These programmes are now being expanded to include long-awaited vaccination against Covid-19. Many of our clients have been keen to protect those in business-critical roles as well as to protect employee health and wellbeing more generally.

Workplace vaccination programmes are offered as a straightforward and fully-managed service, enabling employees to access vaccinations they might otherwise find challenging to obtain. Introducing vaccination against Covid-19 reflects our longstanding commitment to keeping companies and their employees healthy.

Book your private covid vaccination workplace programme here.

Fleet St. Clinic Medical Director, Dr Richard Dawood commented:

“We are delighted to be one of the first medical practices in the UK to offer Covid-19 vaccinations outside the NHS. Now that Covid has transitioned from being a pandemic to an endemic disease, it is important that vaccination against Covid should become as “normal” and accessible as vaccination against other infectious diseases.

As a private, multi-disciplinary medical practice, the Fleet St. Clinic has specialised in vaccines for three decades, delivering hundreds of thousands of doses. Through the pandemic, most of our doctors and nurses volunteered to deliver Covid-19 vaccines in the NHS. We are especially pleased that being vaccinated against Covid-19 can now be a matter of choice for individuals and businesses alike, no longer restricted to those in the most vulnerable groups.”

Pre-Book Your Covid Vaccine

Covid vaccination will become available in March, but you can pre-book your own Covid vaccine or a Workplace vaccination programme, from today. Fill in our online form and we will be in touch with more information.

Pre-book your private covid vaccination programme here.

RELATED SERVICES AVAILABLE AT FLEET ST. CLINIC 

Covid Vaccines

Wellness Vaccinations

Full Respiratory Panel PCR Test

Private GP Appointments

There has been a huge rise in measles cases already this year inciting a national campaign to ensure that children and adults are adequately vaccinated against measles.

Measles is a highly contagious virus that can cause serious illness. Complications of the disease include pneumonia and meningitis. In some cases, the virus can be fatal.  

The MMR vaccine is a highly safe and effective vaccine that not only offers protection against measles but also against mumps and rubella, as a 3-in-1 vaccine. 

In the UK, the uptake of the MMR vaccination has declined significantly, resulting in an increase in measles infection. It is estimated that 3.4 million children under the age of 16 years remain unprotected against the disease. 

The UK is not alone with rising cases of measles. The World Health Organization has reported a 30-fold increase of measles in Europe. Over 30,000 measles cases were reported by 40 of the Region’s 53 Member States between January and October 2023. Compared to 941 cases reported in all of 2022. 

The MMR vaccination forms part of the national childhood schedule where the vaccinations are given at one year of age and then at 3 years of age.   

Two doses of the vaccination provide over 99% protection against illness. 

ADVICE 

Although measles is a highly contagious illness, it can be easily prevented with vaccination. 

MMR VACCINATION: 

For full protection, ensure your child has received their routine childhood immunisations of 2 doses of the MMR vaccine. 

Children at high risk of measles exposure can receive an accelerated vaccine schedule of MMR if they are high risk for contracting the disease, where two doses are given one month apart. 

Infants at high risk contracting the disease can receive the MMR from as early as 9 months of age. 

In some cases, a catch-up vaccination may be recommended for individuals who have not received the vaccine at the recommended ages.  

Additionally, in certain situations, infants may receive an early dose of MMR, such as during outbreaks or if they will be traveling to areas where there is an increased risk of exposure. 

Travellers who are visiting countries reporting outbreaks of measles should ensure that their routine immunisations against MMR have been completed. A simple blood test can confirm immunity if in doubt. 

HOW MANY VACCINES ARE NEEDED?

Two doses of the MMR vaccine will provide lifetime immunity. 

In the UK, these are normally given to a child around their first birthday. The second is normally given at around the age of three. If there is a risk of an outbreak or an infant is at higher risk to contract the disease, vaccines are sometimes given as early as 9 months of age.  

You can easily book an MMR vaccine appointment online. 

SHOULD I BE WORRIED?

Adults are also encouraged to check their own and their children’s vaccination status. This is especially important for those who are considered vulnerable or those travelling to countries that have reported outbreaks of measles.  

In the first instance, you should call your GP for confirmation of your vaccination history. If you didn’t have the MMR vaccine or your course is incomplete, you can book your MMR catch up vaccinations online. 

Alternatively, if you are unable to find your records, a simple blood test will be able to confirm if you are immune or not. If you were born before 1970, it is assumed you will be immune through natural infection with the disease.

DO YOU HAVE ANY ADVICE FOR PARENTS? 

Yes, we wrote a separate blog for parents who are worried about measles. We cover symptoms of measles, what to do if you suspect your child has measles, what to do if your child has been exposed to measles, amongst other important information. 

The take home message being that the risk to you child dramatically reduces if they have had the full course of the MMR vaccine. If they are part-way through the course or have missing vaccinations, we encourage you to consider catch up vaccinations for full protection and peace of mind. 

Read our full blog on what to do if you think your child has measles and when you should keep them off school. 

CAN ADULTS RECEIVE THE VACCINE? 

Yes, it is perfectly safe to have catch up vaccinations if they are required. 

If you are unsure of your vaccination status, we would recommend a blood test to check your antibody level first. If we discover that you are not immune, you will require two vaccine doses, given a month apart. 

WERE THERE ANY WARNING SIGNS OF AN OUTBREAK?

In July last year, the UK Health Security Agency (UKHSA) issued a warning that, unless vaccination rates improve, London is at risk of a major measles outbreak. Even after that, the vaccination rates did not improve.  

It is predicted that in some areas of the capital, up to forty per cent of children are not protected from measles by the time they start school. Young adults between the ages of nineteen and twenty-five are also particularly vulnerable. Referred to as the ‘Wakefield cohorts’ by UKHSA, this generation were exposed to misinformation published in the early 2000s and as a result, many were left unvaccinated.  

In a bid to mitigate risk, councils wrote to households across the capital explaining the possibility of isolation requirements; Children who are identified as close contacts of a measles case, and who do not have an up-to-date vaccination record, may be required to self-isolate for up to twenty-one days. The NHS are therefore urging parents to check their children’s’ vaccination status. Records of their vaccines should be kept at their GP practice, or in their red book. 

Book your MMR vaccination appointment today. 

RELATED SERVICES AVAILABLE AT FLEET ST. CLINIC 

MMR Vaccination  

Childhood Vaccinations 

Adult Wellness Vaccinations 

CONTINUED READING ABOUT THE UK HEALTH SECURITY AGENCY (UKHSA) “ISOLATION WARNING FOR LONDON CHILDREN WITHOUT MEASLES JAB” 

Read: Isolation warning for London children without measles jab 

CONTINUED READING ABOUT THE LATEST MEASLES STATISTICS AND GUIDELINES (UKHSA) “LATEST MEASLES STATISTICS PUBLISHED” & “NATIONAL MEASLES GUIDELINES” 

Read: Latest Measles Statistics Published 

Read: National Measles Guidelines 

What to do if you think your child has measles and when to keep them off school.

Measles cases are increasing throughout England, particularly among children. This highly contagious infection can lead to severe complications for some individuals. 

Since there is no specific medical treatment for measles, obtaining vaccination is crucial for the best defence against serious illness. The measles, mumps, and rubella (MMR) vaccine is part of routine childhood vaccinations, meaning most children are already immunised against measles.  

If your child has received both doses of the vaccine, it is unlikely that they will contract the virus. 

Here, we’ll provide everything you need to know about measles, from ensuring your child’s vaccination to knowing when to keep them away from school.
 

What are the symptoms of measles? 

Measles usually starts with cold-like symptoms, followed by a rash a few days later. Some people may also get small spots in their mouth.  

Symptoms of measles usually start to appear 7-14 days after you become infected, which include: 

• Runny/blocked nose 
• Sneezing 
• High temperature 
• Sore, red eyes that may be sensitive to light 
• Sore throat 
• White spots inside the mouth
  

What does a measles rash look like?

Measles usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, body, arms, legs, and feet. Small, raised bumps may also appear on top of the flat red spots. The spots may become joined together as they spread from the head to the rest of the body.

What should you do if you think your child has measles?  

If you suspect that you or your child might have measles, it’s important to request an immediate GP appointment or seek assistance from NHS 111. 

Before visiting the GP or any healthcare facility, make sure to call ahead for guidance. 

In the event of a measles diagnosis for your child by a doctor, it is advisable for them to refrain from attending nursery or school for a minimum of 4 days from the onset of the rash. Additionally, they should steer clear of close interactions with infants and individuals who are pregnant or have compromised immune systems.

What is the best way to protect against measles? 

The best protection against measles for children and adults is to get both doses of the MMR vaccine. 

MMR vaccination is available at Fleet Street Clinic for children and adults who would like catch-up on doses. If you or your child haven’t been vaccinated yet, or have an unfinished course of vaccines, either book an appointment online or contact our reception team on +44 20 7353 5678 to book an appointment.  

We can usually accommodate same day appointments. 

Alternatively, children receive the vaccine at no cost on the NHS at 12 months and then a second dose at 3 years and 4 months. You may find the NHS vaccination service has a longer wait time that us. 

If you prefer a version of the MMR vaccine without pork products, please get in touch, explaining your preference and we will do our best to accommodate. It’s important to note that we would be ordering this product specially for you, so there may be a longer wait time for delivery and prepayment will be required. Either call our reception team on +44 20 7353 5678 or email info@fleetstreetclinic.com

Cold-like symptoms can be an early sign of measles. Should you still send your child to school? 

If your child has been vaccinated, it’s very unlikely that they have measles. Check if they have a high temperature or a fever, and if not, we’d advise it’s fine to send your child to school. 

Keep an eye on their symptoms and adapt accordingly if they worsen.

When should you keep your child off school or nursery and how long for? 

If your child has measles, they should stay off nursery or school for at least 4 days from when the rash first appears and avoid close contact with babies and anyone who is pregnant or has a weakened immune system. 

The school will let you know if your child has been in contact with someone who has measles and advise what you need to do. 

They may advise people who are more susceptible to contracting the virus, such as unvaccinated siblings to stay away from school for the incubation period to be on the safe side. 

The incubation period is the length of time it can take to develop the illness after being in contact with someone with measles. For measles, the incubation period can be up to 21 days. 

Anyone, child or adult, who has been vaccinated is unlikely to be considered susceptible. 

If you’re not sure whether your child is due a vaccination or has missed a vaccination, you can check their Red Book or contact your registered GP practice for confirmation. 

If your child has missed their first or second dose of the MMR vaccine, we’d advise you book an appointment for catch up vaccines. You can book an appointment online.

Should you keep your child off school if another pupil has been diagnosed with measles? 

Most children will be protected against measles and there is no need to keep your child off school if they have had both their MMR vaccinations. 

Your school will let you know if your child has been in contact with someone with confirmed measles and will advise what the next steps are.

Can I still get my child vaccinated even if they’re older?  

Yes. The MMR vaccine is suitable for adults and children, therefore, anyone who has not had 2 doses of the MMR vaccine can book an appointment for catch up vaccinations. 

It’s best to have vaccines on time, but you can still catch up on most vaccines if you miss them. Two doses of the vaccine are needed to ensure full protection. 

RELATED SERVICES AVAILABLE AT FLEET ST. CLINIC

MMR Vaccination

Childhood Vaccinations

Related Blogs:

Measles outbreak & isolation warning

UTIs can strike unexpectedly, casting a shadow over an otherwise fantastic holiday.

Whether you’re a seasoned traveller or embarking on your first adventure, the risk of urinary tract infections (UTIs) is real and more likely to occur during travel, especially in hot countries.  

This blog compiles expert advice and practical tips to empower you to minimise the chances of developing a troublesome UTI during your travels. 

1. Stay hydrated

One of the simplest yet most effective ways to prevent UTIs is to stay well-hydrated. Proper hydration helps flush bacteria out of your urinary system, reducing the likelihood of infection.

Aim to drink at least eight glasses of water a day, and avoid excessive consumption of caffeinated and alcoholic beverages, as they can contribute to dehydration.

Bring a reusable water bottle and make a habit of refilling it throughout the day, ensuring you have access to clean and safe drinking water wherever you are. 

2. Don’t delay going to the toilet 

It can be tempting to “hold it in” during long journeys, delayed or remote travel but putting off going to the bathroom can cause UTIs.

Holding your bladder for too long can contribute to the growth of bacteria in your urinary tract. Since urination flushes bad bacteria out of the bladder before they get a chance to multiply to dangerous levels, going to the toilet as soon as you can means less bacteria are left to sit in your bladder for longer than necessary, reducing your risk of a painful infection. 

Remember, maintaining good personal hygiene is crucial in preventing gynaecological infections, particularly UTIs and cystitis. When travelling, it’s essential to prioritise cleanliness. Carry antibacterial wipes to clean your hands before and after using public toilets.   

3. Choose comfortable clothing

Believe it or not, your choice of clothing can impact your risk of developing UTIs. Tight-fitting clothes, especially in the pelvic area, can trap moisture and create an environment conducive to bacterial growth.  

Opt for loose-fitting, breathable fabrics to allow proper air circulation. Additionally, change out of wet bathing suits promptly to prevent the proliferation of bacteria.

By paying attention to your wardrobe choices, you can significantly reduce the risk of developing uncomfortable infections during your travels. 

4. Treat constipation 

Exploring new cuisines can lead to various challenges for travellers. While some may grapple with traveller’s diarrhoea, others might experience constipation due to altered eating patterns, dehydration, increased alcohol consumption, and a more sedentary lifestyle. 

Unfortunately, constipation increases your risk of contracting a UTI. To mitigate this risk, aim to eat a diet rich in fibre, stay active, and drink plenty of water. 

5. Carry a female health kit with you whilst you travel 

If you experience any symptoms of a UTI or gynaecological infection, it’s crucial to have medications on hand so you can continue your holiday or travel unaffected. 

Carrying a female health kit with you whilst you travel means you can detect and treat your UTI symptoms whilst on-the-go. It contains urine test strips which can confirm if you have a urine infection as well as antibiotics and cystitis relief sachets to alleviate symptoms of inflammation. 

Symptoms of a UTI may include frequent and painful urination, lower abdominal discomfort, blood in your urine, a high temperature or lower back pain. 

Take our free online consultation to see if you can buy a female health kit online. 

Remember, in addition to self-treatment, it’s crucial to seek prompt medical attention, especially if symptoms worsen. 

Your travel experience should be memorable for all the right reasons, not marred by the discomfort of a urinary tract infection.

By following these essential tips – from prompt bathroom breaks, to arming yourself with the right travel medicine – you can significantly reduce the risk of encountering a UTI while abroad.  

Our female health kits are designed for travel and contain everything you would need to treat and alleviate symptoms for a urinary or gynaecological infection.  Begin by completing our free online consultation today.  

Whether you’re prone to urinary tract infections, or have never experienced one before, it’s a good idea to buy a female health kit  before any trip or holiday and arm yourself against the discomfort and misery of a UTI while abroad. 

Fleet St. Clinic is here to support your well-being whilst you travel.
Stay healthy, stay informed, and make the most of your travels! 

Related services available at Fleet Street Clinic 

Specialist Travel Clinic

Travel Vaccinations

Travellers’ Diarrhoea Medication Online Consultation

Blue Monday happens every year on the third Monday of January. It is supposedly the most depressing day of the entire year, based on a crude calculation of bad weather, long nights, back to work dread and post-Christmas debt.  

It does sound very plausible perhaps because we so familiar with the term “January Blues” but Blue Monday is in fact, a myth! 

The phrase “Blue Monday” was coined by Sky Travel back in 2005 as a way to encourage people to book their next holiday as something to look forward too. They highlighted all the seasonal negatives to reinforce the benefits of booking a holiday – a clever marketing trick. 

But can we really pinpoint the most depressing day of the year?

There is no actual scientific studies that have ever backed up any claims about Blue Monday being true or that there could even be a “most depressing day of the year”. This does make sense because this would be different for each and every one of us based on personal circumstances and the variables are extensive. It did, however, get use thinking about our mood, mental health and overall wellbeing at this time of year.

January is cold, often wet and everyone is trying to shake off the Christmas comedown and get excited about the new year ahead, but the January blues can creep in.

Remember you are not alone, and many people experience a dip in mood this time of year but it is important to identify when the January blues are actually symptoms of depression.

Depression is more than simply feeling unhappy, fed up or low for a few days. It can be long lasting and the symptoms range from mild to severe. Once accessed by a doctor, they will conclude the severity of your depression.

A simplified description follows:

Mild depression will have some impact on your daily life.
Moderate depression has a significant impact on your life.
Severe depression makes it almost impossible to get through daily life.

Sometimes there’s a trigger for depression. Life-changing events, such as bereavement, losing your job or giving birth, can bring it on. Other times, it can be linked with family history; people with family members who have depression are more likely to experience it themselves. But you can also become depressed for no obvious reason. It is quite complex and each person is unique.

There are many symptoms of depression and the combination is unpredictable.

They can be categorised at physiological, physical and social symptoms.

Some examples of psychological symptoms of depression include:

• continuous low mood or sadness
• feeling hopeless and helpless
• having low self-esteem
• feeling tearful
• feeling irritable and intolerant of others
• having no motivation or interest in things
• finding it difficult to make decisions
• not getting any enjoyment out of life
• feeling anxious or worried
• having suicidal thoughts or thoughts of harming yourself

Some examples of physical symptoms of depression include:

• moving or speaking slower than usual
• changes in appetite or weight (usually decreased, but sometimes increased)
• constipation
• unexplained aches and pains
• lack of energy
• low sex drive
• changes to your menstrual cycle
• disturbed sleep – for example, finding it difficult to fall asleep at night or waking up very early in the morning

Some examples of social symptoms of depression include:

• avoiding contact with friends and taking part in fewer social activities
• neglecting your hobbies and interests
• having difficulties in your home, work or family life

The most common symptoms of depression tend to be a low mood, feelings of hopelessness, low self-esteem, lack of energy, problems with sleep and a loss of interest in things you used to enjoy but it can be any number of symptoms listed above. 

It’s important to seek help from a GP if you think you may be depressed. The sooner you see a doctor, the sooner you can be on the way to recovery. 

For more information on GP services at Fleet Street Clinic, click here.

Click to book a GP appointment

With every change of season comes a host of different medical issues, and winter can be one of the worst. With colder temperatures, shorter days, and seasonal illnesses circulating, it is one of the harder seasons to keep fit and healthy. There are certain conditions which are known to worsen in the colder months and so it is important to be aware of them and how you can best prepare yourself to keep healthy throughout winter. 

These conditions include:

• Asthma
• COPD
• Circulatory disorders, such as claudication, Raynaud’s disease, and chilblains
• Ischaemic heart disease
• Hypothyroidism (if untreated)
• Osteoarthritis and any joint disorder to include rheumatoid arthritis
• Seasonal Affective disorder
• Allergic rhinitis

To reduce the increased risk associated with the above conditions, it is important to have a check up with your GP, ideally in the early Autumn before the Winter months. This will give you the best chance of getting ahead and allowing you to prepare for the coming season. But, if for whatever reason, you were unable to have a check up in Autumn, it is still beneficial to have a check up during the Winter months.

During a check up for asthma and COPD it’s advised to have a peak flow and lung function check. Asthma and COPD are worse in the dry, cold weather, so it is important to make sure you have plenty of your prescribed inhalers. It is best to be prepared rather than be taken unawares by an attack of wheezing. It is extremely important to see a doctor if you develop winter wheezing and are short of breath, especially during the night as this is when asthma and COPD attacks are most dangerous.

Circulatory disorders are worse in the cold weather as lower temperatures constrict blood vessels, increasing the likelihood of pain due to claudication (pain in the calves after walking a certain distance), Reynaud’s (discolouration of the fingertips due to constriction of the blood vessels) and chilblains (small, itchy, red patches on the skin). You can prepare for all of these conditions by obtaining prescriptions for treatment but most importantly, by keeping  warm and preparing for the cold.

Ischaemic heart disease is also worse in the cold weather due to the effect of constricting blood vessels. It is important to have a cardiac check to include blood pressure, and if you suffer from angina, to ensure you have the medication to treat this painful condition which is likely to be much worse in the cold weather. Avoiding the extreme cold and wearing thermal clothing may also mitigate against the likelihood of a heart attack or myocardial infarction if you do suffer from Ischaemic heart disease. 

If you suffer from Hypothyroidism, it is a good idea to have an annual blood test. Left untreated, hypothyroidism can cause increased sensitivity to cold, which can be particularly unpleasant in winter.

For those with arthritis of any kind, the best way to avoid pain and stiffness in the joints is to keep warm and keep the joints moving. Find more information on Arthritis in Winter here.

If your mood tends to be lower in the winter months, each year, you should have a check up with your GP to discuss Seasonal Affective Disorder (SAD). If you are diagnosed with SAD, consider CBT (Cognitive Behavioural Therapy) rather than medication if you can, and invest in a daylight lamp as these do help.

Allergic rhinitis is another ailment that tends to crop up a lot around winter time. This is diagnosed when you have a persistent nasal discharge. This can occur either as a result of pine or autumnal tree leaf mould, or due to house dust or mould which is often exacerbated by central heating. In this instance, nasal sprays and antihistamines are often required.

Finally, the Norovirus peaks in November until April. This is a really unpleasant vomiting virus which is picked up from contaminated surfaces or foods. To help avoid this nasty bug, always wash hands when handling food and make sure food is washed thoroughly before cooking or eating raw.

If you know or suspect that you might suffer from any of these conditions, please do visit your GP to help you keep prepared. Similarly, if anything new arises you should see your GP as soon as you can; the earlier a health condition is addressed, the easier it is to treat. 

In general, an annual medical is a good way to give you a full-body overview of your health, as well as monitor the progression of any existing health conditions. A varied, balanced diet and regular exercise will also be crucial in keeping you generally fit and healthy throughout winter.

For more information on our GP Services. 

Book a GP Appointment or an Annual Medical.

Arthritis is a common condition that causes pain and inflammation in joints. It is not a single disease but an informal way of referring to joint pain or joint disease. There are more than 100 types of arthritis and related conditions. There are thought to be 10 million people with some form of arthritis in the UK. It is the most common cause of disability in the UK and can affect people of all ages but it does occur more frequently as people get older.

Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms can range dramatically from person to person, with some experiencing mild symptoms with occasional flare ups to those who experience constant debilitating pain everyday. The sad truth is that there is no cure for arthritis, so it is all about pain management and how to best reduce flare ups.

The impact of the weather on the symptoms of arthritis has been debated for many years and people tend to report more arthritis flare-ups in the winter, but the reason why is not specifically known.

Quite often sufferers will state that their symptoms get worse when the weather is damp and cold and some state they are able to tell when the weather is about to change based on their arteritis symptoms worsening.

Even if there is currently nothing to support this scientifically, this doesn’t remove the pain felt by sufferers and so rather than comment on where this is true or not, let’s look at ways to reduce flare ups in winter.

Our top 4 tips:

1. Stay warm
When the temperature drops both inside and outside, dress warmly. Make sure all arthritis prone areas are kept warm.

2. Stay hydrated
Drink plenty of water throughout the day. Even mild dehydration might make you more sensitive to pain.

3. Take warm baths
A warm bath or visiting a heated swimming pool will ease joint pain and comfort you. If you visit a heated swimming pool, gentle exercise will also help your mobility.

4. Stay active
It is now clear that active people experience less joint pain than those who are sedentary. If you are experiencing an arthritic flare then reduce your usual activity (but don’t stop altogether) and use simple anti-inflammatory medication such as ibuprofen if it is safe for you to do so.

Enjoy winter while taking the above precautions for Arthritis.
If you are facing extreme discomfort and pain in your joints due to arthritis, book an appointment with a GP to discuss your options.

Click to book a GP appointment

In the months since its release in the UK, we have seen a huge demand for the new Dengue vaccine, Qdenga.

For those with experience of the disease, the news of its licensing has been much anticipated and we are proud to be one of the first clinics in the UK to offer the vaccine.

What is Dengue Fever?

Dengue is a viral infection that is spread through the bite of an infected aedes mosquito, a species easily recognisable by its striped legs. It occurs in over 120 countries worldwide, mainly in the tropics and sub-tropics, and is the second most common cause of fever in the returning traveller.

The most seriously impacted regions are the Americas, South-East Asia, and Western Pacific, with Asia accounting for around 70% of the world’s disease burden.

It is also spreading to new areas, including Europe, where outbreaks have been increasing in recent years. Read more about this in our recent blog, Dengue Fever in Europe: Temperature Risk.

Since it is transmitted from person to person, via the mosquito vector, it is of particular concern in populated, urban areas.

What are the symptoms of Dengue Fever?

Whilst most cases are asymptomatic, some will develop a severe flu like illness that can require hospitalisation. In rare cases, this will be life threatening.

Common symptoms include;

a high fever,
severe headache,
pain behind the eyes,
muscle ache,
joint pains,
nausea,
vomiting and rash.

There are four serotypes of Dengue virus; for those infected by one type, a subsequent infection is more likely to be life threatening. The severe type of Dengue usually starts a few days after the initial symptoms began. After feeling a bit better, symptoms suddenly return and can include severe abdominal pain, persistent vomiting and bleeding.

Approximately 1 in 20 patients with Dengue will progress into the severe form of the disease.

Dengue Fever Vaccination

Historically, the only protection we could provide was advice surrounding mosquito bite avoidance. With the arrival of Qdenga, we now have the option of a vaccination which provides safe and effective protection.

Studies have shown Qdenga to offer 80% protection from the first dose, with long term immunity achieved after the second.

Who should get vaccinated?

Qdenga can be safely given to those who have previously had the disease, and it is especially important for this group. We would also encourage frequent or long stay travellers to consider the vaccine. The vaccine is licensed for the prevention of Dengue in individuals from 4 years of age and requires two doses, to be given three months apart.

It is a live vaccine, so it’s not suitable for everyone. To discuss your suitability with one of our specialist travel nurses, please book a travel consultation online, or call our reception team on +44 20 7353 5678.

We can usually accommodate same day bookings and suitable vaccinations can be given within the same appointment.

Related services available at Fleet Street Clinic 

Dengue Fever Vaccination

Specialist Travel Clinic 

Travellers’ Diarrhoea Online Consultation

Antimalarials

For further reading

UK MHRA approves Takeda’s dengue vaccine Qdenga

WHO: Message by the Director of the Department of Immunization, Vaccines and Biologicals at WHO – September 2023

In September 2021, Public Health England released new rules surrounding the timing of BCG vaccination, increasing the minimum age of vaccination to 28 days. This has been implemented in line with a pilot disease screening programme that tests eligible newborns for Severe Combined Immunodeficiency (SCID), the outcome of which becomes available by the time the baby is 6 weeks old. It is important that we wait for the result of this test before giving the BCG vaccine.

What is SCID screening?
All newborn babies in the UK are currently offered blood spot screening (heel prick test) that looks for 9 rare diseases, including sickle cell and cystic fibrosis. The NHS is considering introducing an additional test for Severe Immunodeficiency (SCID), a name given to a group of rare, inherited disorders that cause major abnormalities in the immune system. Affected infants have an increased risk of life-threatening infections and will normally become severely unwell in the first few months of life. Without treatment they will rarely live past their first birthday. About 14 babies a year are born in England with SCID.

The evaluation of this testing, which began on 6th September 2021, is taking place in 6 areas across England and will cover around 60% of new born babies. It is running alongside the existing blood spot screening and the intention is to roll it out nationally once the 2 year evaluation has been made. 

Why does this affect the BCG vaccination?
Bacillus Calmette-Guérin (BCG) is a live attenuated vaccine that can cause problems if given to an immunocompromised person. Treatment for SCID is more complicated if the child has received the BCG vaccine, so it is important that if your child has been tested. We wait for a negative result before vaccinating. 

What we need from you:
If your child was included in the SCID programme, you will need to provide a letter that confirms the negative result of screening.

If your child was born outside of the programme areas and therefore, not included in the SCID programme, we will need to see a letter confirming this. 

In either case, please bring the letter with you to your appointment, as well as your child’s vaccination book.

Nb. If your child was born before 1st September 2021, before the programme was introduced, no letter will be needed. 

For more information on:

BCG vaccination

Other Childhood Vaccinations