Travel Tips Thursday - Bosnia

19.08.2019 Category: Travel Health Author: Anna Chapman

Bosnia is where East meets West.

It is a country on the Balkan Peninsula in southeastern Europe and has become somewhat a destination for adventurous travellers.

Beautiful Ottoman architecture, rugged mountains, captivating castles, raft-able rivers, and humble hiking trails are all reasons why travellers are choosing Bosnia as their next travel destination. The unveiling of the Via Dinarica mega hiking trail means the number of tourists to the Balkan country of Bosnia Hercegovina is expected to rise steeply. The 1930km trail provides a corridor linking traditional cultures between the former Yugoslavian nations. So whether you plan to mill about the city of Mostar, stroll the streets of Sarajevo, or take a hike in the hillside, ensure you follow our top travel tips to stay healthy.

Vaccinations

All travellers are advised to be in date with their routine immunisations, including diphtheria, tetanus and polio (DTP) and measles, mumps and rubella (MMR). Europe has seen huge outbreaks of measles this year alone, so all travellers should make sure they have received at least two doses of the measles-containing vaccination. A simple blood test can be done for all those who are unsure about their immunity. Some travellers may wish to consider vaccinations for Hepatitis A and Hepatitis B, rabies and tick-borne encephalitis. The activities you plan to do whilst travelling will determine which vaccines would be required. If you have any doubts or concerns, we also suggest booking a pre-travel consultation with a specialist travel nurse to discuss your options.

Find out more about our travel and wellness vaccinations.

Trekking and Ticks

Bosnia offers a wealth of outdoor activities. Those who plan to take advantage of the great outdoors should strongly consider vaccination against tick-borne encephalitis (TBE). TBE is a bacterial infection. Usually, it is spread through an infected tick bite. However, during Spring to Autumn, the consumption of unpasteurised dairy produce also carries a risk. Contracting the illness causes a fever with neurological complications.  It is vaccine-preventable. Protection requires  2 doses of the vaccination, given at least 2-weeks apart.  A third dose is given 5-12 months later to give longterm protection. You should also avoid ticks by wearing long trousers and socks. Using DEET insect repellant should also repel them.

If you spot a tick on you, it needs to be removed promptly. Use some flat tweezers or a tick remover and clean the bite with alcohol to reduce the risk of infection.

See our Ultimate Bug Kit.

Rabies

Rabies is a fatal virus that can be found in the saliva of an infected mammal. Most commonly a wild dog. Exposure can happen through a bite, scratch or a lick to an open area of the skin. You cannot catch rabies from another person and it cannot spread through unbroken skin. You should, where possible avoid contact with animals when travelling, especially wild or stay animals.

Rabies is almost always fatal once symptoms appear, but treatment before this is very effective. Pre-travel rabies vaccination offers great protection. And means that in the unlikely event you come into contact with the rabies virus, fast and effective treatment can be given easily and in the country of the incident.

Pre-travel rabies protection requires a series of 3 vaccinations given as injections into your upper arm. Your vaccines will be given over a 3-week period, or over 1 week if an accelerated course is needed, prior to travel. Travellers at greater risk are those who plan to do outdoor activities such as hiking, trekking, cycling or caving. You should consider a rabies vaccine if you plan to do any of these activities whilst visiting Bosnia.

First Aid Kit

For those trekking in the hills, packing good basic first aid kit is essential. When travelling in rural areas, access to healthcare can be limited. Travelling with a medical kit will give you access to basic provisions needed to treat minor injuries and pains.

Basic provisions include pain relief, plasters and medication to treat an upset stomach, such as loperamide and oral rehydration salts. If access to safe water may be limited, consider packing chlorine dioxide tablets. Cuts, scapes blisters and even a twisted ankle can occur, so take blister pads, some waterproof dressings and a bandage to deal with any minor injuries whilst you are there. If you take regular prescription medication, ensure you pack enough for the duration of your trip and carry the prescription with you.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | August 2019

Travel Tips Thursday - Tanzania

19.08.2019 Category: Travel Health Author: Anna Chapman

Tanzania is the perfect haven for adventurous travellers. Not only does it boast three of Africa’s Seven Natural Wonders, but it is home to the ancient nomadic stewards, the iconic, Maasai people. It is also the perfect place for an African safari adventure, with it’s 16 national parks accounting for more than 30% of the country.  

Tanzania is blessed with the highest peak in Africa. Mount Kilimanjaro beckons visitors from all over the world. It is the world’s highest free-standing volcano and gets an estimated 30,000 travellers attempting to summit the peak each year. Climbers by the thousands venture here to challenge themselves on its muddy slopes, rocky trails and slippery scree.

It’s crowning jewel is the island, Zanzibar. The island is famous for its mix of exotic white sand beaches, dense palm trees and coral seas. A true paradise. It hosts famous spice plantations and is rich with diverse culture. Unguja (the main island in Zanzibar) is also home to many endangered species including the red colobus monkey and green turtle.

Whether you are visiting for an action-packed safari, challenging yourself to reach the peak of Mt. Kilimanjaro or relaxing on the island of Zanzibar, ensure you follow our top travel tips to stay healthy in Tanzania.

Vaccines

All travellers should ensure they are in date with all their routine immunisations, including diphtheria, tetanus and polio (DTP), and measles, mumps and rubella (MMR). 

You should consider specialist travel vaccinations prior to travel. Hepatitis A and Typhoid are highly recommended. Furthermore, some travellers may also wish to be vaccinated against Rabies, Hepatitis B and Cholera for extra precautions. Especially if travelling to more rural areas.

For more information on our vaccines, please visit our travel and wellness vaccination pages.

Yellow Fever

In Tanzania, there is no risk of yellow fever. If you are only travelling directly from the UK and back, it generally isn’t advised to have yellow fever vaccine. There is, however, a requirement for travellers to have a certificate of vaccination if they enter Tanzania from another country that has Yellow Fever. Bordering countries such as Kenya, Uganda, Rwanda, Burundi & DRC would all require a certificate. In this instance, a vaccination or a waiver certificate may be advised. It is best to speak with a specialist travel nurse, who will look at your route and access what vaccinations and certificates you would require.

Prevent Malaria

Whether you plan to visit Zanzibar or the mainland,  all areas of Tanzania have a risk of malaria. Therefore, you should take anti-malarial medication. Malaria is spread by mosquitoes that are most active between dusk and dawn. A common question is whether or not you need to take them if you plan to trek Mount Kilimanjaro. Even though the risk of malaria is low in areas above 2,500m, the start and finish of the trek take you well below this altitude. In short, you should take medication to prevent it. You should take precautions to reduce the risk of being bitten in the first place.

Precautions include:

  • Wear long, loose clothing
  • Wear plenty of mosquito repellent with a minimum of 50% DEET
  • Use clothes spray containing permethrin – you can spray before you travel for short-duration trips
  • Sleep under a mosquito net

See our Ultimate Bug Kit for everything you need to keep the mosquitos at bay.

Climbing Kilimanjaro

If you are trekking Kilimanjaro, make sure your pre-travel plans take this into account. Trekking is physically demanding and exposes you to the risk of altitude sickness. The summit of the peak is 5,895m and treks can take anything from 5-9 days. Altitude sickness is unpleasant. Not only this but it can develop into something more serious and become life-threatening. Take time to acclimatise. This will reduce your risk of developing altitude sickness. Ideally, choose a longer trek. A slower ascent over more days will reduce your risk considerably. Alternatively, you can get a prescription of acetazolamide (Diamox) to aid the process. Speak to a specialist travel nurse about this at your pre-travel consultation. Don’t let altitude sickness ruin your trip.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | August 2019

Travel Tips Thursday - Greenland

19.07.2019 Category: Travel Health Author: Anna Chapman

Greenland is home to truly magnificent mountainscapes and glaciers.

Jakobshavn Glacier, the world’s fastest-moving glacier in the Northern Hemisphere can be found here.

In the Winter, tourist travel to this wonderland to potentially see the wondrous the Northern Lights. Things are quite different in the Summer.

Chasing the Midnight Sun

Summer in Greenland is an image not often associated with the country. Summertime offers eternal light in the land of ‘The Midnight Sun’ whereby the day has neither a beginning nor an end. Those wanting to experience this time-shifting experience must travel north or the Arctic Circle. The low-lying sun makes the surrounding scenery appear almost dreamlike; icebergs and hilltops are bathed in a surreal palette of pink, purple, yellow and red. Travellers to Greenland have options of hiking the land or sailing the fjords between icebergs.

If you plan to travel to Greenland this summer follow our top travel tips to ensure you stay healthy.

Vaccinations

Even though Greenland resides in the Arctic Circle, travellers should still ensure they receive appropriate pre-travel vaccinations. This includes being up-to-date with Measles, diphtheria-tetanus and polio. Greenland has a high risk of Rabies, a virus spread through the infected bite of a mammal. Travellers who plan to trek inland may wish to consider this vaccination before they travel to reduce the risk.

Suncare

Despite Greenland having long, dark winters, the summer months provide almost constant light. Bright sun, combined with the effects of lights reflection from snow and water can increase the risk of sun damage from UV light. Despite temperatures remaining cold, travellers still need to be sun smart. Ensure you wear a high factor SPF, and use lip balm to prevent cracking. Polarised sunglasses that wrap around will prevent the UV rays causing damage to your eyes.

Sea Sickness

Many activities in Greenland involve taking to the water and visiting the infamous Disko Bay in search of Icebergs. Sometimes the seas can be rough which can make for a miserable time if you are prone to travel sickness.

Sea Sickness can be reduced by:

  • 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

Trekking

Parts of Greenland can be remote so taking a good First aid kit with you is essential. Basic provisions include pain relief, plasters and medication to treat an upset stomach, such as loperamide and oral rehydration salts. If you take prescription medication to ensure you pack enough and carry the prescription with you. If you plan on trekking the hinterland, pack additional items such as blister dressings and plasters.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | July 2019

Inca Trail

19.07.2019 Category: Travel Health Author: Anna Chapman

June to September is the best months to trek to Machu Picchu, although you can visit all year round. The weather is at its driest and coolest with gloriously sunny days. Trekking to the roof of the Andes is a rewarding experience that many travellers to Peru sign up for. Travellers who are trail-blazing their way on the Inca road to catch a glimpse of the forgotten city should follow our top travel tips to ensure they stay healthy on the road.

Vaccinations

All travellers to Peru should ensure that they are up-to-date with measles, diphtheria, tetanus and polio (DTP), and have received vaccinations against Hepatitis A and Typhoid. There is a risk of Rabies and Hepatitis B in Peru, and all travellers attempting the Inca Trail should consider vaccinations against these.

There is no risk of Yellow Fever on the Inca Trail or Cusco. However, the vaccination may be recommended to travellers who are doing further travel in Peru, such as the Amazon rainforest. Those planning to extend their trip to South America may require the Yellow Fever vaccination for personal protection. Additionally, you may require a valid yellow fever certificate to enter some other countries. It is best to book in a travel consultation with our specialist travel nurses to discuss your route.

Altitude Sickness

The highest altitude of the Inca trail is 4,215m, a whopping 1,800m higher than Machu Picchu itself! Most people start the hike from Cusco which lies at 3,400m, meaning trekking this wonder of the world poses a real risk of altitude sickness. Altitude sickness is unpleasant and can develop into something serious and become life-threatening. It is best avoided by taking time to acclimatise. Ideally, if you are arriving from sea level, spend a few days in Cusco before your trek begins to adjust to the different altitude. Choose a longer trek, a slower ascent over more days will reduce your risk considerably. Alternatively, you can get a prescription of acetazolamide (Diamox) to aid the process. Speak to a specialist travel nurse about this at your pre-travel consultation. Don’t let altitude sickness ruin your trip.

Stay Hydrated

Treks on the Inca trail usually last around 5 days, meaning that an average trekker will probably consume at least 15 litres of water over the course of their trek. Unclean and unsafe drinking water can lead to sickness and diarrhoea so it is important that travellers have access to safe water. Carrying 15 litres of water on the trail is a near impossibility so travellers should ensure that they have a way to make water safe to drink. Carrying water purification tablets, or a bottle with a filter can ensure you have access to safe drinking water throughout.

Travellers Diarrhoea

Travellers diarrhoea and other common gastrointestinal infections can put a dampener on any adventure but especially when hiking. Access to toilets is likely to be limited throughout your journey so it is important to stay healthy. Ensure all food you eat is thoroughly cooked. Pack an alcohol hand gel so you can keep your hand clean before you eat and after using the toilet. It is wise to carry medication with you, so, if you do become unwell you have doctor-approved medication available to take. We recommend packing one of our Worldwide Gastro Kits. Inside there is medicine to prevent and treat travellers diarrhoea, dehydration, mild infections, nausea and vomiting. Hopefully, you won’t have to use this kit, however, for peace of mind, it is better to be safe than sorry.

Foot Health

The Inca trail typically consists of between 6-9 hours of walking a day, with shared tent accommodation. Hiking the Inca Trail through the Sacred Valley to Machu Picchu is both arduous and awe-inspiring. Make sure you have good walking boots that are broken in before you start. Book an appointment with a podiatrist and osteopath if you have any niggles or pain before setting off. Take care of your feet throughout your adventure – keep them clean and dry to avoid problems. Any blisters should be cleaned and covered with a dressing to prevent pain and infection. Pack your own first aid kit with some basic medications for pain, allergies and upset stomachs in case you do become unwell. Access to medical supplies will not be until Aguas Calientes at the end of the trek. You can buy a Fleet Street Clinic Essential First Aid Kit online to save you the hassle of assembling yourself. We would recommend considering a medical pedicure upon your return. Treat our feet a little bit of TLC for taking you on an adventure of a lifetime.

We would encourage all those taking on the Inca trail adventure to consider booking a travel consultation with either myself or another of our specialist travel nurses. We all have extensive knowledge on what vaccines and health precautions you should take on an individual basis to remain healthy throughout your adventure. Chances are at least one of us has done a similar adventure so we can give you some first-hand experience on what to expect too!

Book your travel appointment today

By Anna Chapman |  Travel Nurse | July 2019

Travel Tips Thursday - Namibia Safari

19.06.2019 Category: Travel Health Author: Anna Chapman

A safari in Namibia is a unique experience in Africa. It has the highest sand dunes on the continent, the world’s oldest and uninhabited deserts, the Skeleton Coast and a lush jungle to the north. Whatever you have planned on your trip, ensure you follow our top travel tips to stay healthy.

Vaccines

All travellers need to ensure they are up-to-date with Hepatitis A, Typhoid and Diphtheria, Tetanus and Polio (DTP). These are your basic traveller vaccine requirements. You may wish to consider further vaccinations against Rabies and Hepatitis B.

There is no risk of Yellow Fever in Namibia, however, travellers who will arrive in Namibia having transited from a country with a risk of Yellow Fever will be required to be in possession of a valid Yellow Fever Certificate.
Countries this would apply to include Kenya, Nigeria, Zambia, Ethiopia, Brazil, Peru and Bolivia. For the full list of countries with risk of yellow fever transmission as per the World Health Organisation.

For more information on our vaccines, please visit our travel and wellness vaccination pages.

Malaria

There is a risk of malaria in the northern areas of Namibia of the Kunene River, Caprivi and Kavango regions and Etosha National Park. Windhoek, Swakopmund and the Skeleton coast have a low risk of malaria. If you intend to visit malarial regions, ensure that you take the antimalarial medication with you. Mosquitoes that are responsible for the spread of malaria are most active between dusk and dawn, and therefore you need to be extra cautious during this time against mosquito bites.

Insects

Ticks, flies and mosquitoes all have the ability to transmit unpleasant disease in Namibia. The best prevention against these diseases is to avoid mosquito bites. Cover up as much as possible and apply a minimum concentration of 50% DEET to any areas of exposed skin. Clothes can be treated with permethrin before setting off to provide an extra level of protection. Sleep under a mosquito net especially if you plan to stay anywhere remote or rural.

See our Ultimate Bug Kit.

Food and water

Travellers should exercise caution with food and water when travelling to Namibia to avoid tummy troubles. Do not drink tap water in Namibia, stick to bottled water or water that has been boiled. If you are undertaking a self-drive trip and plan camping in remote areas it is a good idea to take either a water bottle with a filter or some chlorine dioxide tablets to make water safe to drink should you not be able to find a shop with bottled water. The Namib Desert is one of the aridest in the world so always ensure you pack extra water.

See our Worldwide Gastro Kit to help with any travellers tummy troubles.

Book your travel appointment online today.

By Anna Chapman |  Travel Nurse | June 2019

Travel Tips Thursday - Uzbekistan

19.04.2019 Category: Travel Health Author: Anna Chapman

Uzbekistan is home to spellbinding architecture and ancient cities. In terms of sights alone, Uzbekistan is Central Asia’s biggest draw and most impressive showstopper. Fabulous mosques, medressas and mausoleums are just some of the pulls for tourists when visiting Uzbekistan while more eccentric views can be seen at the fast disappearing Aral Sea and Nuratau Mountains.

Travel Nurse, Anna, shares her top tips on how to stay healthy during your trip to Uzbekistan.

Vaccinations

Ensure you are up-to-date with your travel vaccinations. The minimum advised for a trip to Uzbekistan is diphtheria tetanus and polio, and Hepatitis A. Typhoid, Hepatitis B and Rabies can be considered by some travellers. It is advisable to attend for a pre-travel assessment with a travel nurse 6-weeks before your trip as some vaccinations requires several injections to complete the course.

Food and water

Precautions against the dreaded traveller’s diarrhoea should be taken to prevent an upset stomach ruining your trip. Do not drink tap water in Uzbekistan, stick to bottled water or water that has been boiled. If you are trekking or visiting remote areas it’s a good idea to take either a water bottle with a filter or some chlorine dioxide tablets to make water safe to drink, should you not be able to find a shop with bottled water.

Sour milk dishes dominate the Uzbek cuisine. Cue caution if you want to try ‘kurt’, the famous fermented cheese balls. There is a risk of a bacterial disease called brucellosis that can be spread through unpasteurised dairy products such as cheese and milk.

Travelling further afield

Uzbekistan forms one of the countries on the old silk route. If you plan on a tour of the ‘Stans’ or attempting the whole Beijing to Istanbul route, you may need to consider other travel health precautions. Depending on your route, and also the time of year you intend to travel, you may wish to consider vaccinations against Tick-Borne Encephalitis and Japanese Encephalitis.

Altitude

Khazret Sultan, Uzbekistan’s highest peak stands at 4643m. Many popular walking and hiking routes such as Big Chimgan exceed over 3000m, making altitude related illnesses a hazard. Tips for reducing altitude sickness include a slow ascent route, keeping hydrated, ensuring that your sleeping altitude doesn’t exceed 500m per day. Diamox (acetazolamide) is a prescription medication that can reduce the symptoms of altitude related illness.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | April 2019

Damian King: Indian Adventure for CALM

22.03.2019 Category: Clinic News Author: Lisa-Marie Ryan

As a specialist travel clinic, we are passionate about travel and get inspired by stories from our patients every day.

We meet interesting people day in, day out, both at the clinic and when we’re doing trade shows.

Following a chance meeting at the Adventure Travel Show in January, we felt inspired to support Damian King as he embarks on an extreme adventure across India.

Damian explained his plans to walk from North India to South India – starting at Kashmir and ending in Kanyakumari. This is a total of 2,547km aiming for 30miles per day – which is no easy feat!

Not only is Damian’s mission a personal extreme adventure to tick off the bucket list but a way to raise awareness and fundraise for CALM, Campaign Against Living Miserably (CALM). If you are unfamiliar with this charity, they are leaders in the movement against male suicide. Which, unfortunately, is still the single biggest killer of men under 45 in the UK.

It is a sad fact that on average 84 men take their lives every week in the UK. As a society, we need to remove the stigma of mental health as a whole but specifically around gender expectations, gender norms and toxic masculinity which has embedded itself with our culture. As healthcare professionals, we strongly believe in promoting a healthy lifestyle, advocate for disease prevention and highlighting the importance of self-care and wellbeing. This is why we so passionately decided to support Damian. To be in some way a small (but essential) part of his adventure and assist in raising awareness for male suicide felt thrilling and essential. Part of our company ethos is to support the adventurous traveller so we said yes to becoming his medical partner, offering support for vaccinations, travel advice, medical kits, podiatry advice and also nutritional advice.

“The decision to work with the guys at Fleet Street Clinic was quite simple. I required a varied number of services which they offered. They are centrally located in between the West End and City, and more importantly, it doesn’t have the clinical feel of a doctors surgery like many do.”

              – Damian King

As a specialist travel clinic, we advocate the importance of good health whilst travelling and assist travellers to view health as one of the most important aspects of their adventure holiday. We have assisted with Damian in his preparation for his adventure from top to toe. Important parts of his pre-travel preparation were travel vaccinations alongside travel advice; highlighting risks from the weather, insects, animals, food and water. Other important health checks included a visit to the podiatrist to ensure his feet remained healthy during training and whilst walking, the nutritionist to speak about the impact of his diet whilst travelling and what he should and shouldn’t be eating in preparation for such a drastic amount of exercise and an in-body scan to document his training efforts which looks at weight distribution, muscle mass and body fat percentage.

We are proud to be a part of Damian’s journey and we wish him a fantastic and safe adventure. If you would like to follow Damian King’s adventure, you can find out more on his blog or on his Instagram.

If you are thinking of embarking on your own travel adventure and need a travel consultation appointment, you can book online.