I’ve just returned from Montenegro, which is a beautiful country and still relatively undiscovered in terms of European tourist destinations. The beautiful beaches, Venetian towns and stunning scenery make a trip really worthwhile.

One of the great pleasures of travelling is to be able to enjoy local cuisine and gastronomic specialities of the region. It can help you discover the culture of a place and connect with local people in an authentic way.

However, the last thing you want is for travellers diarrhoea to ruin a trip. The majority of tummy trouble abroad happens in the first week of travel and is caused by bacterial infections (such as salmonella) which can’t be prevented by vaccination. They are found in unclean water and ill-prepared food, and the only defence against them is to be careful with food and water whilst away.

How to help avoid dodgy tummies while away:

• Ensure food is cooked and served hot immediately.
• Don’t eat unwashed or unpeeled raw fruit and vegetables.
• Don’t drink tap water – bottled water is easily available and those hiking or camping in remote areas will need to be prepared to purify water themselves
• Wash hands before each meal and after going to the toilet. Alcohol hand gel can be used when hand washing facilities are not available
• Avoid easting unpasteurised dairy produce.

You can buy a Worldwide Gastro Kit online to

Other items for considering when in Montenegro:

• Tick-borne encephalitis can be an issue in Montenegro for those travellers heading off into the mountainous regions during the summer months. Although primarily spread via the infected bite of a tick, the illness can also be contracted via unpasteurised dairy products, so best to avoid the traditional Montenegrin cheese that is offered in these areas. There is a vaccination against the illness that is highly effective.
• Consider a vaccination against Hepatitis A which can occur in areas of Montenegro where travellers cannot guarantee they have safe access to water. Those who are camping or hiking in remote areas should ensure that they have a way to secure a safe water supply, either by boiling water, using a filter or chlorine dioxide tablets. Hepatitis A is a virus that affects the liver and is vaccine preventable.

The Fleet Street Clinic stocks medication for travellers diarrhoea, medical travel kits and our experienced travel clinic nurses can help advise. If you’ve been on holiday and suffering from a lingering tummy bug, you can get a same-day diagnosis and medication using our PCR machine, you can email or call us to find out more.

Do I need vaccinations for Croatia?

The answer is, yes.

Croatia sits on the Dalmatian coast of Europe and is only a short flight from the UK. With abundant sunshine, long coastlines and fascinating history and architecture, Croatia is an enchanting country with so much to discover beyond Dubrovnik.

There is a common misconception that only far flung exotic destinations require travel vaccinations. This simply isn’t true. Whilst certain diseases such as malaria are found within the tropics, travellers to Europe should still seek out pre-travel advice to ensure that they are protected for their trip.

What vaccinations do I really need?

• You should be up to date with the diphtheria, tetanus and polio vaccinations, which can be given every 10 years.
• Europe has seen large outbreaks of measles in recent years, so travellers should ensure that they have received 2 doses of the measles, mumps and rubella vaccination (known as the MMR).

What about other vaccinations?

Depending on the activities you have planned for Croatia, you can consider additional vaccinations.

• If you can’t guarantee access to safe food and water, you should consider Hepatitis A vaccinations.
• If you plan to enjoy the countryside and activities such as hiking, camping, cycling, you may wish to consider vaccinations against Rabies and Tick-borne Encephalitis.

The Fleet Street Clinic stocks travel sickness medication, travel vaccines and medical travel kits. Our experienced travel clinic nurses can help advise with any queries or more information on Croatia.

Fleet Street Travel Clinic

How to avoid getting ill on flights – The Telegraph

How many times have you come down with an illness after taking a flight? Are you concerned about germs when flying? If so, you may (or may not!) want to read the findings of a study showing how infections spread on planes.

The Telegraph reported the study with advice from Fleet Street Clinic’s medical director, Dr Richard Dawood.

Essentially, where you sit in relation to sick passengers and cabin crew will determine your chances of catching an infection.

The study shows:

• Passengers sitting nearest the aisle are most likely to catch an infection from an ill cabin crew member.
• For the best chance of protecting yourself from cabin crew bugs, sit in the window seat.
• Sick passengers pose less risk, although if you are sitting very close to an infected passenger then watch out, as you are at high risk of catching their illness.

It’s not all bad for passengers though, as cabin crew were reported more likely to infect one another than passengers. To avoid catching anything, make sure you wash their hands and avoid touching your face throughout the flight. If you feel ill yourself, make sure you keep your hands clean, avert your face when you cough and turn on the air to reduce the spread of bugs.

You can read the full article here.

For travel advice, you can book a travel consultation appointment here. Or you can learn more about our travel clinic.

Holidaying in the Greek Islands this year? 

Island hopping in Greece is an enchanting way to explore the country’s vast collection of 6,000 islands. With whitewashed houses, tavernas and beautiful beaches at every stop, it’s a trip everyone should take once in their life. 

There are many ferry routes between the mainland and islands. Some people can manage travelling by boat, whereas others may suffer from sea sickness. Days or weeks on a boat can be miserable for those who are prone to sea sickness, yet there are effective treatments and tips for those who are vulnerable to reduce the risk.

What is Sea Sickness?

Sea sickness is similar to motion sickness, caused by repetitive movements when travelling, like floating up and down on a current. The inner ear sends signals to your brain as well as signals from your vision, with the two signals contradicting each other it confuses the brain. These confusing messages cause you to feel unwell and can cause dizziness, vomiting and nausea. 

Despite being common, those prone to travel sickness may wish to take sea-sickness medication with them if they intend to do any island hopping. There are some tips that you can take on board and put your body and mind at ease:

Prevention 

• Sit in the centre of the boat where the motion will be less aggressive
• Close your eyes or focus on a point on the horizon, this can help your inner ear balance.
• Avoid alcohol and large heavy meals, instead keep hydrated on water and eat smaller lighter meals
• Sucking on a mint or ginger sweet can help with nausea
• Seas Sickness medication tablets
• Patches that can be used to prevent sea-sickness

The Fleet Street Clinic stocks travel sickness medication, medical travel kits and our experienced travel clinic nurses can help advise. 

Book your travel appointment today

By Anna Chapman |  Travel Nurse | June 2018

The World Cup is about to kick off. If you’re planning to visit Russia and watch some games in person, here’s some travel advice from one of our expert travel nurses at Fleet Street Clinic, Anna Chapman.

Travellers to Russia should be up to date with measles, mumps and rubella (usually given in childhood), Hepatitis A and Diphtheria, Tetanus and Polio.

Russia also has a risk of:-

• Rabies, a virus spread through the bite or scratch of an animal (mainly dogs, cats and bats). It requires 3 vaccinations ideally before departure which can be given over a rapid schedule of 3 weeks.
• Hepatitis B, a virus spread through blood and bodily fluids. It requires 3 vaccinations ideally before departure which can be given over a rapid schedule of 3 weeks.
• Tick-borne encephalitis – a bacteria which is spread via tick bites or eating unpasteurised dairy products, primarily in the summer months. It does appear that the stadiums are in cities, but if there are any additions to travel remotely where people will be spending lots of time outdoors, this could be considered.

As always, make sure you take precautions with food and water and pack basic medications and first aid supplies. We have several medical kits available to purchase online.

FLEET STREET TRAVEL CLINIC

Book your travel appointment today

By Anna Chapman |  Travel Nurse | June 2018

Simple Steps to Summer-Ready Feet

It’s officially the start of summer! Good news for feet – it’s time to swap shoes for lighter footwear and sandals. But before you reveal your toes, give your feet some attention so look and feel their best.

Let’s start with your toenails

• Keep your nails short and well-shaped – use a good-quality file to smooth the edge after cutting them
• Use a little oil (almond oil works wonders!) on dry nails – rub into the surface and the cuticles to improve their texture
• Don’t cut cuticles though, this can lead to infection
• Did you know that nail polish can cause your nails to dry out? From time-to-time, leave off the colour and use oil to recondition them
• If you’ve had an injury or infection, then nail can sometimes thicken or become misshapen, making them difficult or painful to cut. These are best dealt with professionally and Podiatrists have the expertise help you.

Time to think about your skin

Healthy skin should be smooth and supple. Rough, thickened or callous skin, often occurs on areas of the feet which have to work particularly hard and this can be unsightly and uncomfortable. Additionally, your skin can become very dry which causes it to harden and crack, especially around the heels. In the summer, when open shoes or sandals are worn, dryness can become even worse.

Painful callouses can be pared away by a podiatrist who can advise you on how best to care for your skin. There are excellent creams and lotions available to improve your skin’s texture and comfort which, when used regularly, can make a lasting difference.

Some people suffer from skin that sweats excessively, a problem that tends to be made worse in warm weather or after activity and sports. This makes your skin more prone to chafing, blisters and fungal infections (athlete’s foot) and verrucas (plantar warts). Using a good antiperspirant can help with this (eg Dri-clor), as can dusting powders and a better choice of sports socks.

Having lots of small, itchy blisters on your skin, splits between your toes or flaky patches usually means a fungal infection, while verrucas are caused by a viral infection and both need specialist products to treat them. Podiatrists are experts in advising on and treating skin infections.

You can help protect yourself against infections by wearing flip-flops when walking in areas used by many people, by drying your feet thoroughly and by airing sports footwear well after use (fungi love soggy trainers!)

Finally, don’t forget your feet can get sunburned. If you are walking in sandals on a sunny day, remember to apply suncream regularly to the top of your feet.

Don’t forget the right footwear

As with all types of footwear, summer shoes and sandals need to be well-fitting and appropriate for the activities you are doing. Feet get bigger throughout the day, especially in hot weather, so sandals need to be adjustable to allow for this.

Pavement pounding

Flip-flops are beach shoes and are not suitable for day-long wearing on pavements. Your muscles have to work hard to keep these on your feet, so they will be tired and sore by the end of the day. Instead, choose sandals with a thicker, shaped sole, sometimes known as Fit-flops, which are held in place by a strap and give much greater support and cushioning to your foot. This is especially important if you are planning a day’s walking and sight-seeing.

Trekking footwear

Serious trekking requires a well-designed walking shoe – don’t skimp on cheap shoes or socks! You can find these in specialist retailers for outdoor activities.

Now get out there and enjoy the longer days…

Walking is an excellent activity to improve your fitness. It gives benefits to all your bodily systems, strengthens muscles and bones, improves mood and concentration and can help you to lose weight too. Aim to walk at least thirty minutes a day and keep up a brisk pace. If you are visiting the coast, walking barefoot on a sandy beach gives your foot muscles a good workout and helps to keep your feet strong and supple.

Fleet Street Podiatry Clinic

For further advice and information on treatment and how to look after your feet, see our podiatry page. Or you can book an appointment online.

Dr Richard Dawood, Medical Director of Fleet Street Clinic, was featured in an article published in The Telegraph:  ‘Is there a doctor on board? What really happens during a medical emergency at 35,000 feet’.

The article discusses the issue of a medical emergency in the air, and Dr Dawood recounts some of his experiences where his medical expertise has been required during a flight.

Dr Dawood shares how he is happy to volunteer if a doctor is required, and details his experience of caring for a cabin crew member after she was taken ill during an 11 hour flight to Toyko.  As an eminent Travel Medicine specialist, Dr Dawood is accustomed to helping with all kinds of travel-related health issues both pre and post travel, and as the article demonstrates, sometimes during travel as well!

As founder of Fleet Street Clinic, Dr Dawood has developed a multidisciplinary medical practice with a strong focus on Travel Medicine. If you require a travel appointment, you can book online.

Exposure to high temperatures increases sweating and results in loss of fluid and electrolytes causing rapid dehydration. This can result in heat exhaustion or heatstroke which can be life threatening if not dealt with promptly.

Any traveller can be at risk of sun and heat related injuries but the highest risk is in the elderly, babies, children and those with pre-existing medical conditions.

Travellers who perform strenuous physical activity will increase the risk of illness related to the heat.

It can take the body up to 10 days to acclimatize to the heat, so it is important that travellers are prepared to prevent heat related illness.

What can travellers do?

*Seek shelter and shade during the middle of the day (11am -3pm) when temperatures are at their hottest

*If you are outside, ensure you protect your skin against the sun with a high factor sun cream

*Wear lose fitting light weight and light colour clothing

*Keep hydrated by drinking plenty of fluids and eating food with a high water content (such as fruit)

*Ensure you are taking in sufficient salt in your diet (sweating leads to electrolyte and salt depletion).

*Avoid caffeine and alcohol, which can worsen heat related illness

Heat stroke can be a life-threatening emergency and medical help should be sought.

For more travel health advice, you can book a travel consultation appointment with one of our nurses.

Anna Chapman, one of our experienced Travel Nurses, gives her top 5 reasons why having a travel consultation is so important … food for thought if you’re planning a trip abroad.

1 – Reputable advice from a trusted source

Clinics that specialise in travel have practitioners who have completed extra qualifications in travel medicine, such as a Diploma in Travel Medicine, Diploma in Tropical Medicine and Certificate of Travel Health.  These qualifications ensure the practitioner gets specialist knowledge that is kept up-to-date by attending conferences and participating in research in the field.  Many practitioners who work in travel medicine have experienced health care abroad, through extensive personal travel or through working or volunteering.  This means the travel advice that a patient receives is always current and accurate.

Our travel nurses at the Fleet Street Clinic have a Diploma in Tropical Nursing and a Certificate in Travel Health and both GPs have a Diploma in Travel Medicine and a Certificate in Travel Health.  All the practitioners in our Travel Clinic have travelled extensively and practiced their profession in developing countries.  This means they are more aware of the risks that travellers face and have a greater understanding of how to deal with health issues on the road.

2 – Personalised travel consultation

No two people are the same and no two travel itineraries are the same.  Travel consultations take this into account and give detailed and bespoke travel advice, not only for the itinerary but also for the individual.  Seeing a practitioner face-to-face means that personal risks can be evaluated to ensure all travel health needs are met, rather taking a “one size fits all” approach.

3 – Travel health is NOT just about travel vaccinations

Whilst vaccinations are important, there are many aspects to staying healthy while abroad.  In addition to vaccinations, there are considerations such as avoiding insect bites, use of medical kits, coping with jet lag, use of stand-by medications and coping with altitude sickness – all things that can be discussed when you have a travel consultation

4 – On-going care

Just because you have had your vaccinations before your trip, it doesn’t mean that your care ends when you leave the clinic. Specialist clinics can provide on-going care for subsequent trips and/or post-travel health concerns

5 – Time to talk

When a clinic has a specialist travel service, ample time is allocated to each appointment.  Having a team of dedicated staff committed to travel medicine means that appointments can be completely flexible and can accommodate individuals, groups or families, both at the clinic or off-site, as well as offering appointments for last minute travellers.

You can book a travel health consultation online.  Or see here, or more information about our travel health services.