Hajj and Umrah: Travel Health

10.05.2023 Category: Travel Health Author: Dr Richard Dawood

Hajj and Umrah are religious pilgrimages to Mecca, Saudi Arabia. Hajj is a mandatory Pilgrimage for every Muslim to take once in their lifetime, given that the individual is physically and financially able.

It takes place in the last month of the Islamic calendar and is taken annually by 2.5 million Muslims worldwide pre-pandemic. Whereas, Umrah is a shorter pilgrimage to Mecca taken any time of the year. 

Muslims from all over the world gather annually in Mecca in a display of unity, faith and solidarity. Due to the large number of participants performing the pilgrimage there are some health risks you should be aware of.

There are also health requirements set by the Health Ministry of Saudi Arabia that you could affect your VISA. It is good to be aware of those requirements before travelling. 

COVID-19 Requirements:

Ministry of Health KSA states that in order to perform Hajj pilgrims, one must have the proof for the following: 

  • A full course of COVID-19 vaccinations (second dose of a two dose vaccine or received a single dose vaccine) approved by the Saudi Ministry of Health. The approved vaccines’ list can be found here – Ministry of Health Approved Vaccines. 
  • There is no longer a requirement for PCR testing to perform Hajj or to enter KSA. 

Vaccine Requirements:

A pre-travel consultation should be scheduled at least 4 weeks before your trip.
Any mandatory or advised vaccinations will be discussed with a nurse and can be given in the appointment. Follow up doses can also be arranged in the appointment.

Before travelling to Hajj or Umrah, it is recommended that pilgrims be up-to-date with all of their wellness vaccinations.

– Meningitis

All British citizens travellers performing Umrah or Hajj are required to submit a valid Meningitis ACWY vaccination certificate in order to obtain a visa.  The MenACWY vaccine protects against meningitis (strains A, C, W & Y) and sepsis. Adults and children over the age of 2 are required to have the vaccine and provide evidence of immunisation no less than 10 days before you plan to arrive in Saudi Arabia. This requirement also applies to seasonal workers in Hajj areas.
You may also want to consider Meningitis B vaccine – this is not a mandatory VISA requirement.

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

– Covid-19

All travellers must be vaccinated against Covid-19 to perform Hajj Pilgrim. The vaccines that are approved by the Ministry of Health KSA can be found here – Ministry of Health Approved Vaccines 

Polio

Travellers from countries reporting positive environmental sources samples of circulating vaccine derived polio virus 2 (cVDPV2), including the UK, are recommended to be vaccinated with at least one dose of IPV within the previous 12 months and at least four weeks prior to arrival, however there is no polio vaccination certificate requirement. 

A polio certificate requirement will only apply to UK pilgrims if they are travelling to KSA via a country reporting WPV1, cVDPV1 or cases of cVDPV2 or Acute Flaccid Paralysis, and not if they are travelling directly to KSA from the UK. 

If you require a vaccination, you can choose from our available appointments online – click to book your appointment. 

Flu Vaccine

Since both Hajj and Umrah both pose crowded conditions and close contact, seasonal flu vaccination is advised, especially for those who are more vulnerable to severe influenza diseases. This precautionary measure will help reduce the potential spread of the flu.

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

Hepatitis B

Hep B is spread by contaminated blood and bodily fluid. Pilgrims who intend to shave their heads as one of the rites of Hajj should consider taking the vaccination. Although licensed barbers performing head shaving are obliged to use a new blade for each pilgrim, unlicensed barbers may not adhere to this practice. Vaccinations require 3 injections to be given over a 3 week period and can be given from birth. 

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

Rabies

Rabies is  spread through the bite of an infected animal such as cats, dogs, monkeys and bats. Saudi Arabia is classified as a high-risk country for rabies. Full protection is achieved with 3 doses – 3 vaccinations usually given over a 3 week period, however, we do offer a rapid course which can achieve full protection in 7-days.  The rabies vaccine can be given from birth.

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

TRAVELLERS’ DIARRHOEA

Travellers’ diarrhoea can occur in up to 60% of travellers. Although most cases are mild, taking sensible precautions with food and water can reduce the risk. Carrying medicines for self-treatments is useful such as antibiotics – take our Online Travellers’ Diarrhoea Consultation to see if it is suitable for us to prescribe you standby Travellers’ Diarrhoea treatment.

The best protection are preventative measures such as  drinking bottled or purified water, washing your hands thoroughly and frequently and eating well-cooked, hot food.

Fore more information on Travellers’ Diarrhoea.

CLIMATE HEALTH

Saudi Arabia has had some of the hottest temperatures on record this year. Exposure to such high temperatures increases sweating, and results in loss of fluid and electrolytes which can cause rapid dehydration. This can result in heat exhaustion or heat stroke which can be life threatening if not dealt with promptly. 

Heat related illness can be avoided by the following:

  • Seek shelter and shade during the middle of the day (11am-3pm) when temperatures are the hottest
  • If you are outside, ensure you protect your skin against the sun with high factor sun cream
  • Wear loose fitting, lightweight and light colour clothing 
  • Keep hydrated by drinking plenty of fluids
  • Ensure you are taking sufficient salt in your diet (sweating leads to electrolyte and salt depletion)
  • Avoid caffeine and alcohol, which can worsen heat related illnesses

GENERAL HEALTH:

Both Hajj and Umrah pilgrimages require strenuous effort, it is worth considering having a full body medical check up before you travel to ensure you are in good health. To prepare for the miles of walking, try increasing your physical activities to improve mobility and movement. In case of unforeseen circumstances, remember to pack a first aid kit and extra supplies of any prescribed medication you are currently taking. We have an onsite pharmacy if you’d like to purchase any of these items during your appointment, speak with your GP or nurse whilst at the clinic.

DENGUE AND MALARIA:

Dengue is spread by day-biting mosquitoes and Malaria by mosquitoes that are active at night. You can reduce your risk of insect bites by using effective insect repellents and protective clothing. You can also sleep under a mosquito net that is impregnated with insecticide to have a peaceful sleep. 

If you require complete protection from bugs and mosquitoes, you can check out our ultimate bug kit here.

Delaying your period:

If you decide you would like to delay your period for pilgrimage, you can do so by taking hormonal medication. In advance of your trip, book an appointment with a GP to discuss your options as soon as possible.

When you get home:

If you return home unwell it is important to book an appointment with a GP to determine the cause. If your symptoms worsen or becoming life-threatening do not wait to see a doctor, go straight to A&E for urgent medical care.

If you return with a stomach bug or persistent travellers’ diarrhoea, you may want to consider booking a Gastrointestinal (GI) Panel PCR test – it looks for any microbes (bacteria, viruses & parasites) that may be causing your symptoms and can quickly identify the exact cause. Results can be provided in as little as 1-hour, so that accurate and effective treatment can begin straight away. Firstly, you need to book a GP appointment, express your interest in a GI PCR test and they will advise whether you are suitable or not.

 

Dengue Fever in Europe: Temperature Risk

10.03.2023 Category: Travel Health Author: Dr Richard Dawood

Dengue Fever has been in the news following two cases linked to travel to the Spanish island of Ibiza. This has sparked concerns about the spread of mosquito-borne illnesses in Europe, which is especially unusual for this time of year.

Dengue fever is a viral infection transmitted by the Aedes mosquito, which is found in tropical and subtropical regions worldwide. With rising temperatures and changing climates, there is a risk of mosquitoes and other disease vectors spreading to new areas, potentially causing outbreaks of diseases such as dengue fever.

The two cases of dengue fever in Ibiza were reported by the Spanish Ministry of Health and were both in residents of Germany who had visited the island before becoming ill. Each case was accompanied by two family members who were also suspected to have had dengue fever.

The risk of dengue fever in Spain is highest between the months of May and November, when mosquitoes are most active so to have cases at this time of year is uncommon.

So, why are we seeing cases outside of the usual infection months?
The reason is multi-facetted.

Our medical director and travel health specialist, Dr Richard Dawood explains:

“Firstly, there is the introduction or spread of mosquitoes to “pastures new” – places that might have been previously inhospitable, perhaps through temperature; or alternatively, that offer an environment with plenty of suitable breeding sites that they are suddenly able to take advantage of. These mosquitoes can bring disease with them, or can spread it around if there is a reservoir in the local population.

Secondly, there is the possibility of introducing disease to a vector population that is already established, ready and waiting. This is exactly the (long-standing) concern with yellow fever. There are mosquito species in Asia, for example, that are easily capable of spreading yellow fever were it to be introduced by an infected traveller – which is why Asian countries are so careful to insist on proof of yellow fever vaccination from travellers arriving from the endemic zones of Africa and South America. Asia is yellow fever-free, and wants to remain so. However, this type of introduction has already recently happened in Australia, where Japanese encephalitis (a virus infection that can cause rare but serious complications in humans) has recently established a reservoir of infection in farm animals, that may be impossible to reverse. It is also happening with Lyme disease spreading gradually into parts of Europe (and the UK) with a susceptible tick population.

Similar concerns apply to Zika – there is very large potentially susceptible mosquito population that could spread the virus in many tropical countries, if introduced; dengue fever; and also potentially malaria, in parts of the world that have been the target of successful elimination campaigns, but where mosquito populations could still spread it, were it to be reintroduced, if control measures are neglected or ceased.

With changing climates, a valid concern about global warming is that it could create conditions in which populations of mosquitoes and other vectors thrive and spread – hence the crucial importance of vigilance, surveillance, and early action if needed.”

How can you protect yourself from Dengue Fever?

QDENGA, Dengue Fever Vaccination

Relatively new to the UK, QDenga is a new travel vaccine that can prevent dengue fever.

The course consists of two doses, given three months apart, and provides long lasting protection.

Learn more about QDENGA, Dengue Fever Vaccination

Book a travel consultation for your Qdenga vaccination.

 

Avoid Mosquito Bites

In addition to vaccination, the best way to protect yourself against dengue fever is to take measures to avoid mosquito bites. This includes wearing protective clothing, using mosquito repellent, and staying in places with air conditioning or screens on windows and doors.

If you develop a high fever during or after travelling to an affected area, seek medical advice as soon as possible and provide details of your recent travel history. Dengue is often also accompanied by a rash and joint or muscle pain.

 

In conclusion, rising temperatures and changing climates have the potential to create conditions in which populations of mosquitoes and other disease vectors thrive and spread. It is crucial for public health authorities to remain vigilant and take early action if needed to prevent the spread of diseases such as dengue fever.

By receiving the Qdenga vaccine and implementing effective measures to prevent mosquito bites, travellers can lower their personal risk of contracting Dengue Fever, along with other insect-borne diseases.

If you’re considering Qdenga before your next trip, book a travel consultation with one of our specialist travel nurses.

 

Related services available at Fleet Street Clinic

QDENGA, Dengue Fever Vaccination

All Travel Vaccinations

Antimalarials

 

Suitable Medical Kits available to buy online

Buy: Ultimate Bug Kit

Buy: Essential First Aid Kit

 

Related Online Consultations

Female Travel Health Kit: Start Consultation

Travellers’ Diarrhoea Kit: Start Consultation

Altitude Medication: Start Consultation

NICE recommends wider use of statins for prevention of cardiovascular disease (CVD)

19.01.2023 Category: General Health Author: Dr Richard Dawood

Statins are a widely prescribed class of drugs used to lower cholesterol levels and prevent cardiovascular events such as heart disease and strokes. The National Institute for Health and Care Excellence (NICE) has recently released updated guidelines on the use of statins, which now recommend that they can be considered for people at a lower risk threshold.  

This decision was made after the independent committee updating the NICE guideline on cardiovascular disease (CVD) risk assessment and reduction considered new evidence on the safety and side effects of statins, meaning more people could be given them. 

The draft guideline recommends that doctors should consider statins for people who haven’t had a CVD event (called ‘primary prevention’) with a 10-year CVD risk score of less than 10%. The committee agreed that if more people took statins there would be a greater reduction in the incidence of heart disease and strokes. 

In addition to being prescribed by National Health Service GP’s, statins can also be prescribed by private healthcare providers, such as us, Fleet Street Clinic. In fact, private GP’s can play an important role in the management of cardiovascular disease risk by offering statins as part of a comprehensive treatment plan for patients at high risk. 

People can be at risk from CVD because of factors they cannot change including their age, sex, ethnicity and family history but it’s important to note that certain lifestyle changes can reduce the risk. These include stopping smoking, reducing alcohol consumption, introducing or increasing exercise and eating a healthy diet.  

Therefore, the decision to take a statin should be made in consultation with a healthcare professional and should take into account the individual’s values and priorities as well as the potential risks and benefits of treatment. 

With the British Heart Foundation noting that “there are around 7.6 million people living with heart and circulatory diseases in the UK” and that they “estimate that in the UK more than half of us will get a heart or circulatory condition in our lifetime” this is likely to be an impactful change in the landscape of CVD and statins. 

To conclude, Paul Chrisp, director of the Centre for Guidelines at NICE, said:  

“What we’re saying is that, for people with a less than 10% risk over 10 years of a first heart attack or stroke, the decision to take a statin should be left to individual patients after an informed discussion of benefits and risks.  

“The evidence is clear, in our view, that for people with a risk of 10% or less over 10 years, statins are an appropriate choice to reduce that risk.  

“We are not advocating that statins are used alone. The draft guideline continues to say that it is only if lifestyle changes on their own are not sufficient, and that other risk factors such as hypertension are also managed, that people who are still at risk can be offered the opportunity to use a statin, if they want to. They don’t have to, and their decision should be informed by an understanding of the risks and tailored to their values and priorities.” 

Reference Source: https://www.nice.org.uk/guidance/indevelopment/gid-ng10178/documents 

 

Related services available at Fleet Street Clinic:

Strong link found between sleep and cardiovascular health

19.01.2023 Category: General Health Author: Dr Richard Dawood

Sleep plays a crucial role in maintaining overall health and well-being, and recent research has revealed a strong link between sleep and cardiovascular health. A study conducted by the University of Warwick in the UK found that individuals who get 7-9 hours of sleep per night have a lower risk of cardiovascular disease (CVD) and mortality compared to those who sleep less or more than the recommended range. 

The study, published in the Journal of the American College of Cardiology, analysed data from over 116,000 participants in the UK Biobank study and found that those who slept less than 6 hours or more than 9 hours had a higher risk of CVD and mortality. These findings add to the growing body of evidence that suggests a link between sleep duration and cardiovascular health. 

The exact mechanisms by which sleep affects cardiovascular health are not fully understood, but researchers suggest that it may be related to the impact of sleep on cardiovascular regulation, inflammation, and metabolic function. 

It is important to prioritize sleep and aim for the recommended range of 7-9 hours to maintain cardiovascular health.  

It’s worth noting that these findings are observational, and more research is needed to fully understand the relationship between sleep and cardiovascular health, but it’s a good indication that sleep plays a vital role in maintaining a healthy cardiovascular system. 

To read the full study, continue reading here:
medscape.co.uk – Does sleep duration influence cvd and mortality risk?

 

Related services available at Fleet Street Clinic: 

NICE recommends wider use of statins for prevention of cardiovascular disease (CVD)

Read more

Travel is good for your health

17.01.2023 Category: Travel Health Author: Dr Richard Dawood

Travelling can have a significant positive impact on one’s physical and mental health, according to a study published in the Journal of Travel & Health. The study surveyed over 1,000 adults who had recently returned from a trip and found that the majority of them reported improvements in overall well-being, including increased energy and reduced stress levels. 

One of the key reasons for these self-rated health benefits is that travelling allows individuals to step out of their daily routine and experience new environments and cultures. This can lead to increased physical activity, as travellers may be more likely to walk or bike instead of drive which may also expose them to different types of food, leading to a healthier diet. 

Additionally, travelling can have a positive impact on mental health as well. The study found that the majority of participants reported feeling more relaxed and less stressed after their trip. This is likely because travelling can provide a sense of excitement and adventure, as well as a break from the demands and responsibilities of everyday life. 

Another benefit of travelling is that it allows individuals to build new social connections, which can be important for mental health. Meeting new people and forming new friendships can provide a sense of belonging and can also help to reduce feelings of loneliness and isolation. 

In conclusion, the study suggests that travelling can be good for one’s physical and mental health. It can help to increase energy levels, reduce stress and improve overall well-being. So, next time you are planning a trip, remember it’s not only good for your soul but also for your body. 

To read the full study, continue reading here: https://www.sciencedirect.com/science/article/pii/S2214140522002079?via%3Dihub 

 

Related services available at Fleet Street Clinic: 

 

Flu Update: an early start to the 2022/23 flu season

01.12.2022 Category: Flu Jabs Author: Dr Richard Dawood

Flu cases in the UK have increased earlier this winter than usual, perhaps by over a month.

Other unpleasant respiratory infections such as RSV are also on the rise.

Information from around the world can help us predict what might type of flu season might be heading our way.

  • Australia has just come to the end of a bad flu season, with a dramatic increase in flu cases and hospitalisations relative to the mild season it experienced last year, in a pattern likely to be replicated in the UK.
  • In the USA, by the end of November 2022 there had already been more than 6.2 million flu cases, with 53,000 hospitalisations, and 2,900 deaths from flu.
  • Across Europe as a whole, the flu season has commenced earlier than in the 4 previous seasons, and the proportion of positive tests from sentinel locations has exceeded the technical threshold for consideration as an epidemic.

Meanwhile, UK vaccination rates have so far been low: by the end of November, when the flu vaccination campaign should be largely complete, fewer than 40% of “at risk” adults under 65 had been vaccinated, fewer than 25% of healthy adults aged 50 to 64, and fewer than 30% of pregnant women.

So this winter’s flu season is likely to be more severe, and not enough people will be protected.

What can you do to keep well this winter?
Get Vaccinated . Get Tested . Get Treatment

Get Vaccinated

The good news is that circulating flu strains have so far been a good match with this year’s flu vaccines. It is not too late to be vaccinated. Vaccines are still available. At this point in the season, our preferred vaccine for adults is our premium recombinant vaccine, Supemtek, which is known to be highly immunogenic.

Flu cases in children are rising but the nasal spray vaccine has so far been in restricted supply. If your child has not yet been able to obtain the flu spray, injected flu vaccines are at least as effective and should be given without further delay.

You can easily book your flu jabs online.
For family or groups bookings, it may be more convenient for you to book by phone or email.

Get Tested

At the Fleet Street Clinic, we can test quickly and accurately for a full panel of respiratory viruses in our own laboratory. It is helpful to know whether you are suffering from flu, covid, or another circulating virus such as RSV or metapneumovirus. We can tailor treatment to the result, help you know how long symptoms will last, and can help you prevent spreading it to others – especially important over the Christmas period when socialising in high at work and amongst family and friends.

Get Treatment

Flu is treatable with anti-viral drugs, which reduce symptoms and speed recovery. Preventive treatment for close contacts and other members of your family is also something we can help with, available from our GPs. Knowing for certain that you have a viral infection can also help avoid unnecessary antibiotic treatment.

 

___________________________

For more information on Flu Jabs available at Fleet Street Clinic.
Other recommended winter vaccinations are the shingles vaccine & the pneumonia vaccine.

We can also provide onsite Workplace Flu Vaccinations for companies in the UK – for more information.
Complete the below form for a quote:

    How many employees need this service?*

     

    Diabetes

    15.06.2022 Category: General Health Author: Dr Richard Dawood

    WHAT IS DIABETES?

    Diabetes is a lifelong condition that occurs when the body is unable to properly regulate the amount of glucose (sugar) in your blood. Poor control of diabetes can lead to high blood sugar levels and cause long term damage to your overall health and organs. 

    WHAT HEALTH PROBLEMS DOES IT CAUSE?

    High blood sugar levels can cause a lot of damage to your body and if not managed correctly, may lead to many diabetic complications. This will cause long term health problems, especially if they go untreated. 

    HOW DOES DIABETES AFFECT OTHER PARTS OF YOUR BODY?

    Eyes: Retinopathy is a complication of diabetes caused by high blood sugar levels damaging the retina, often leading to vision impairment. It is the leading cause of blindness among working-age adults in the UK. As a consequence of diabetic retinopathy, swelling can take place, called diabetic macular oedema. People with diabetes are also more prone to develop cataracts and glaucoma at an earlier age, contributing to vision reduction.

    Feet: Foot health is often a neglected area anyway but high blood glucose levels can lead to insensitivity in the foot and lower limbs, which means you lose the ability to feel pain and distinguish hot or cold.  It can also lead to less blood supply to your feet leading to poor circulation. 

    Loss of sensitivity means that you may not notice if you have a minor cut, sore or wound and poor circulation means if you do get a cut or sore, it will take longer to heal and open wounds are more likely to become infected. This combination is why there is an increase in risk of amputation for those who are diabetic. Regular podiatry appointments are the best way to look after your foot health.

    Heart: High blood sugar levels can also cause problems to your blood vessels which can sometimes lead to serious problems such as heart attacks and strokes. 

    Kidneys: High blood sugar levels creates more difficulty for the kidneys to clear waste. This may lead to Diabetic Nephropathy, the deterioration of the kidneys.

    HOW CAN DIABETES BE TREATED?

    There is currently no cure for diabetes, therefore, the best way to deal with diabetes is to get it properly managed and controlled. If you are diagnosed with type 1 diabetes, you must either inject or pump insulin into body to treat your diabetes. If you have type 2 diabetes, you may also have to use insulin, however, it can be managed through diet and lifestyle changes. 

    HOW CAN YOU TEST FOR DIABETES?

    An instant HbA1c test can confirm if you’re within the recommended range, or are considered pre-diabetic or confirm that you have diabetes. Using a small blood sample it will measure how well your blood sugar has been controlled over the last 3 months and provide a numerical reading.

    As the HbA1c test provides 3-months insight, it is an important blood test for diagnosed diabetics. It provides a good indication of how well they are managing their diabetes.. 

    Many people are more familiar with the glucose blood test – it measures the concentration of glucose molecules in your blood at a single point in time. The amount of glucose in your blood could also indicate whether you could be diabetic or not. People with diabetes can also use this test to manage their condition on a daily basis alongside regular HbA1C testing.

    You can book an instant HbA1C test online at a cost of £54.50.

    WHAT ARE THE SYMPTOMS?

    When it comes to diabetes the symptoms are not always obvious and can often go unnoticed for long periods of time before being diagnosed. 

    The most common symptoms include:

    • Feeling constantly thirsty or dehydrated 
    • Unintentional loss of weight and increased appetite (type 1)
    • Vision begins to blur
    • Numbness in your hands or feet (type 2)
    • Fatigue 
    • Urinating more frequently 

    WHO IS AT RISK?

    In the UK, type 2 diabetes is the most common type of diabetes, affecting over 90% of sufferers. The symptoms of diabetes are often mild, therefore, it’s important to be aware of the risk factors that could make you more susceptible to diabetes in the future. 

    According to Diabetes UK, type 2 diabetes is twice more likely in people of African descent in comparison to people of European descent and six times more likely in South Asian communities, making them a high risk category in developing diabetes. Additionally, people of African – Caribbean and South Asian descent are also at risk of type 2 diabetes much earlier, usually over the age of 25. On the other hand, for Europeans the risk increases when over the age of 40. Other factors contributing to diabetes include being overweight, high blood pressure and genetics. 

    Other general risk factors include:

    • Having high blood pressure
    • Carrying extra weight around your middle
    • Smoking 
    • Polycystic Ovary Syndrome (PCOS) sufferers
    • Those with a sedentary lifestyle
    • Drinking too much alcohol
    • Those with disturbed sleep – this includes those who do not get enough sleep and those whose sleep too much

     

    If you have symptoms of diabetes or general concerns about your diabetic risk, you can book a GP appointment to discuss in more detail. 

    Alternatively, you can book in for an instant HbA1c test with a nurse

     

    Monkeypox Statement

    30.05.2022 Category: General Health Author: Dr Richard Dawood

    With monkeypox cases being recorded in over 20 countries across the globe, people are becoming increasingly concerned about its spread and transmission.

    Following 2 years of the Covid-19 pandemic, this outbreak has reignited the public’s fear and uncertainty of infectious diseases. 

    Whilst the media coverage of the monkeypox outbreak is alarming, we would like to reassure our patients that as it stands, the risk is still very minimal and vaccination is not advised as a precautionary measure. Whilst vaccines will undoubtedly be a key part of containing the outbreak, for now, only people who may have been exposed are being offered vaccination.

    Our Medical Director & Travel Medicine Specialist, Dr Richard Dawood explains;

    “Lots of people have been getting in touch with us to ask about a monkeypox vaccination, but this is not available privately. It is currently only being offered to anyone identified as a direct, close contact of a confirmed case deemed to be at sufficient risk.

    The current outbreak does, however, highlight the need to think about your vaccine protection more generally, whether for travel or simply to protect your health and well-being, taking advantage of the best vaccines currently available.”

    In a more general sense, it is never too late to catch up on childhood vaccinations, incomplete vaccination courses or any required boosters.

    Your immune system naturally decreases with age and certain diseases are also more prevalent in older adults so there may be new vaccinations which are now suitable for you to consider for preventable diseases. Some health conditions can also weaken the body’s immune response, making you more vulnerable to infectious diseases, complications and hospitalisation. Therefore, it is important to ask your GP which vaccinations would be suitable for keeping you healthy.
     – For more information on wellness vaccinations.

    If you are travelling soon and haven’t had a travel consultation with a travel nurse, perhaps it is time to consider one. Travel nurses are experts in travel health and will advise which travel vaccinations & medications you should consider based on the risk of where you are travelling to and your itinerary once there.
    – For m
    ore information on travel consultations.

    To conclude, we’d like to dismiss a couple of dangerous myths about monkeypox that are unnecessarily scaremongering the public:

    Myth 1: Monkeypox is as contagious as COVID-19 or smallpox

    Fact: Monkeypox is far less contagious compared to smallpox, measles, or COVID-19.

    Myth 2: Monkeypox is a new virus.

    Fact: No, the monkeypox virus is not a novel virus. It’s a known virus and is generally seen in central and western African countries as localised outbreaks.

    In summary, we, like the rest of the medical field, will be keeping a close eye on the progression of the Monkeypox outbreak and should our advice change based on new information, we will update this statement accordingly.

     

    For more information on Monkeypox.

    Spotlight on our new laboratory

    07.06.2021 Category: Clinic News Author: Dr Richard Dawood

    Our new, in-Clinic PCR laboratory is now open: Introducing Fleet Street Laboratory.

    Our historic Grade II listed premises have been adapted to accommodate one of the latest and most technically advanced robotic PCR systems anywhere, enabling us to carry out more tests simultaneously, accurately, and delivering the fastest results. Our lab upgrade means we will also continue to meet the highest quality and safety standards.

    PCR technology is not new, but until recently hasn’t needed the space, complexity and resources of a full-scale clinical laboratory. Our upgrades mean samples can be processed in large batches rather than individually run.

    In 2017, we embraced the challenge of bringing PCR closer to the consulting room: a pioneering colleague in the US had begun to use PCR at “point-of-care”, and I’d seen the benefits to patients first-hand. The Fleet Street Clinic became one of the first practices in the UK to apply this to respiratory infections, and also to gastrointestinal infections in returning travellers at our busy Travel Medicine practice. This enabled us to confirm a diagnosis and start treatment all at the same initial visit.

    PCR stands for “polymerase chain reaction”.

    It is a laboratory technique that exponentially amplifies the tiniest traces of any genetic material – DNA and RNA – that exactly matches the infection or disease under test. Instead of hunting with microscopes, or incubating cultures for days at a time, viruses, bacteria and parasites can be found quickly and reliably.  They can be sought individually, or in “syndromic panels”: a respiratory panel, for example, can screen a sample for an array of 22 different organisms at the same time, each capable of causing respiratory symptoms, detectable from a nasal swab.

    By the time SARS-CoV-2 reached the UK at the beginning of 2020, we were onto our second generation of PCR systems. We had just added two faster and more efficient machines, adding a panel of sexually transmitted infections to the repertoire (and capable of delivering a full sexual health screen in a couple of hours rather than the 2 to 3-day turnaround that our outside lab was offering). Both were quickly “upgraded” to be able to detect coronavirus infection – and when I contracted a mild version at the beginning of March 2020, my sample was our first in-house positive case. Within a couple of weeks, demand for consumables overwhelmed supplies, and we were left with equipment that was impossible to use.

    One year on, we have dramatically expanded our capacity and capabilities. We have four sophisticated PCR systems, each with different strengths and capabilities, to which our newest system will now be added. We have been able to support some of the most challenging requirements: from clinical diagnosis (including support for the NHS) to facilitating international travel; and workplace screening for critical industries and complex projects – including major film production in the UK and abroad. Our focus has been on combining high quality service with the fastest possible turnaround. We have built expertise, developed our team, and are very excited about our new lab.

    Come and see it next time you come to the Fleet Street Clinic!

    Or if you need a PCR test, you can book online.

    Statement on Coronavirus: Service updates

    30.03.2020 Category: Clinic News Author: Dr Richard Dawood

    We are hoping you and your family are keeping safe and healthy.

    We want to reassure you that we are committed to looking after your health during these trying times.

    We have every intention of remaining open so you can access all of our services, however, we have had to make some necessary changes to adapt to the current circumstance.

    Temporary Opening Hours:


    We have made the difficult decision to temporarily adjust our opening hours. Starting Monday 23rd March, for the foreseeable future, the clinic will be open 9:00am – 5:30pm for face-to-face appointments – we may be able to facilitate virtual clinic appointments outside of these hours.

    Virtual Clinic Offerings:


    With many of you now working from home outside of London, it makes sense to adapt our services to meet your new needs.

    You’ll be able to access a lot of our services through our virtual clinic from Monday 23rd March:

    • GP appointments
    • Travel consultation for health advice only
    • Repeat prescriptions

    We are confident that this will not affect the quality of service that we will continue to supply to you.

    Reduced Services:


    We are running a reduce service for optical appointments. We advise you call our front of house team on +44 20 7353 5678 to make any appointments or alterations.

    Booking An Appointment:


    To protect the health and wellness of our patients and our team, we’ve decided to turn off online bookings for the time being. Rest assured you can still book appointments, however, this now needs to be done through our friendly reception team on +44 20 7353 5678 to determine if a face-to-face appointment or virtual consultation is required. Due to reduced availability, a deposit is required for all appointments.

    Getting in touch:


    Due to these unprecedented circumstances, we’re experiencing an increase in phone calls so you may have noticed our call waiting times have been slightly longer than usual. Our reception team are working at full capacity to offer reassurance and to book your appointments, however, please do not hesitate to email us if the phone line is too busy. We will answer all enquiries we receive.

    Prescriptions for Medicines & Contact Lenses:


    Please note, you can place orders for repeat prescriptions and contact lenses in advance via email here.
    Outline your medicine needs and/ or your contact lens prescription and you can either pick your prescription up from the clinic or we can dispense these directly to you via the post.

    Feeling unwell?


    We would kindly like to remind you that you must not come to the clinic if you are suffering from any of the symptoms below:

    • Coughing
    • Sneezing
    • Running nose
    • Sore throat
    • High temperature
    • Shortness of breath

    We are not offering testing for COVID-19 at our clinic but will be sure to keep you informed if this is to change.

    Our commitment to our patient’s health and well-being remains our primary focus and we will continue to work safely and strategically during these unprecedented times. If there are any developments that impact these arrangements, we will notify you at the earliest possible opportunity.

    Thank you for your support in keeping one another safe.


    For more advice on Coronavirus…

    The perils of walking barefoot on a beach

    05.08.2019 Category: News Author: Dr Richard Dawood

    Imagine you’re holidaying in a tropical paradise, walking barefoot on the beach. Would you consider this a health risk? What if this simple, carefree activity could turn your trip into a nightmare?

    Unfortunately, this is what happened to a Canadian couple in the Dominican Republic, who contracted hookworm in Punta Cana after walking on the beach without shoes.

    Fleet Street Clinic’s medical director, Dr Richard Dawood, is Telegraph Travel’s medical expert and shared his medical opinion on the case in a recent article. 

    The article details the story of the couple, who shared their plight on social media to raise awareness of the parasitic worm infection.

    Hookworm can infect humans if soil contaminated with their larva comes into contact with bare skin. Most commonly, hookworm infection can occur in Africa, the Americas, China and south-east Asia, according to the NHS.

    Dr Dawood explained to the Telegraph how you can spot a hookworm infection:

    “Typically there is a linear rash that follows the track of the migrating larva. It can become almost unbearable itchy, much worse than an insect bite, which is an important clue. There’s a local allergic reaction, which can then blister, making the line pattern harder to spot.”

    And how to treat: “There are a number of different anti-parasitic treatments that work, either taken as tablets, or made into a cream and applied locally. The larvae can sometimes also be killed using cryotherapy to freeze them. Blisters or scratching can easily lead to infection, necessitating antibiotic treatment.”

    To avoid hookworm, avoid coming into contact with soil or sand that could be contaminated. If walking on the beach, it’s advisable to wear shoes at all times!

    Dr Richard Dawood at Fleet Street Clinic

    Dr Richard Dawood is founder of Fleet Street Clinic in London and has practiced for over 35 years. He was one of the first doctors in the UK to establish Travel Medicine as a distinct speciality. Richard is the most senior UK travel medicine specialist working exclusively in a private setting.

    You can book a travel consultation appointment online.

    Could your flight be making you ill?

    19.06.2018 Category: Travel Health Author: Dr Richard Dawood

    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.

    Dr Richard Dawood said airlines should not allow anyone to travel who was obviously ill.

    “It’s a contravention of airline regulations for someone who’s showing overt signs of infection to be allowed to travel in the first place,”

    – he said.

    He said the best way travellers could protect themselves was by asking someone to wear a face mask.

    “The ideal thing to do would be to get the person who’s ill to wear a face mask. You could escalate it to captain level and say, here’s a person who’s a danger to other passengers and they should wear a face mask. However, you could end up with a pretty nasty incident if someone digs in their heels,”

    – he said.

    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.

    WHAT REALLY HAPPENS DURING A MEDICAL EMERGENCY AT 35,000FT?

    19.06.2018 Category: Travel Health Author: Dr Richard Dawood

    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 Richard Dawood Fleet Street Clinic The Telegraph
    Dr Richard Dawood

     

    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.

    Yellow Fever Advice - New Video!

    19.05.2018 Category: Travel Health Author: Dr Richard Dawood

    Dr Richard Dawood, our Medical Director and Travel Medicine specialist answers frequently asked questions about Yellow Fever and the Yellow Fever vaccine in our new video.

    You can book a Yellow Fever vaccination appointment online.

    Statement on the current Measles Outbreaks

    28.02.2018 Category: General Health Author: Dr Richard Dawood

    Measles on the rise:

    The World Health Organisation (WHO), has reported that measles cases are on the rise worldwide and in Europe alone, outbreaks have surged to a 20-year high.

    The WHO states that reported measles cases (provided by each country) currently show that about 229,000 cases have already been reported, compared with 170,000 for 2017. Worryingly the 2018 number is likely to rise as the reporting deadline ends April ’19.

    With a 50% increase in measles cases last year, it is important to understand the benefits of vaccinating against measles:

    Dr Richard Dawood, our Medical Director explains;

    “I recently heard about a patient suffering a bad attack of shingles. She didn’t believe in doctors, medicines or vaccines, I was told, and was languishing at home, with a dreadful, crusted rash across her body, and burning with pain. She had stuck to her beliefs and refused to take antiviral medication that could have aborted the attack or reduced the probability of ending up with long term nerve damage and lingering pain. Shingles can strike more than once, but since she doesn’t believe in vaccines (there is a good one that is 95% effective) she will have to take her chances of a recurrence in future. I disagree with her opinions, but her latest actions will harm nobody but herself.

    But measles is different: when it comes to vaccination, personal choices and opinions have a direct impact on the health and wellbeing of others – individually as well as for entire communities. Measles vaccination is a major public health issue. Memories of the past outbreaks, epidemics, tragic disability and loss of life that drove research and ground-breaking vaccine development now belong to a previous generation. In these days of “fake news”, “influencers” and social networks, it has become too easy to undermine confidence in matters of public health. In the case of measles, concerns about vaccine safety are down to the “fake research” of Andrew Wakefield, who was struck off the medical register for concocting a spurious link with autism in the 1990s. But the damage was long-lasting.

    The complications of measles are most severe in babies who are not yet old enough to be vaccinated, and children with reduced immunity. When the rate of vaccination in the general population falls below 95%, outbreaks occur and can easily spread, with the highest impact on those most vulnerable populations, undermining years of hard work around the world to bring measles under control.

    That is what is happening now”.

    Written by: Richard Dawood, Medical Director and specialist in travel medicine

    VACCINATION AGAINST MEASLES

    ‘The highly contagious disease can cause severe diarrhoea, pneumonia and vision loss. It can be fatal in some cases and remains an important cause of death among young children”, according to the WHO.

    The disease can be easily prevented with two doses of a safe and efficient vaccine that has been in use since the 1960s’.

    Make sure you are up-to-date with your vaccinations including the measles, mumps and rubella (MMR) vaccine. Although the NHS immunisation schedule offers the vaccine to children from 12 months of age, the MMR can be given from 6 months. If you have not had measles or if you have not had two doses of MMR, you may be at risk.  Measles is easily passed from person to person and can be a serious illness in adults as well as children. It is never too late to have the vaccine.

    New study highlights countries at greatest risk of Zika Virus

    19.05.2016 Category: News Author: Dr Richard Dawood

    A new medical paper in Lancet Infectious Diseases has highlighted some of the countries at the highest risk for a major Zika virus outbreak. The study looked at air traffic between countries in the Americas, where Zika is already established, and places in Africa and Asia where the Aedes mosquitoes, the mosquitoes that can spread Zika, are most prevalent. The study also took other factors into account such as seasonality of transmission, population density, and economics to come up with a “hit list” of countries where Zika could potentially have the biggest impact.

    Countries with larger volumes of travellers arriving from Zika virus-affected areas of the Americas and large populations at risk include:

    • India (67,422 travellers arriving per year; 1.2 billion residents in potential Zika transmission areas)
    • China (23,8415 travellers arriving per year; 242 million residents in potential Zika transmission areas)
    • Indonesia (13,865 travellers arriving per year; 197 million residents in potential Zika transmission areas)
    • The Philippines (35,635 travellers arriving per year; 70 million residents in potential Zika transmission areas)
    • Thailand (29,241 travellers arriving per year; 59 million residents in potential Zika transmission areas).

    Of the countries with the largest at risk populations, the authors suggested that India, the Philippines, Indonesia, Nigeria, Vietnam, Pakistan, and Bangladesh might be most vulnerable to impact because of their limited per capita health resources.

    Dr Richard Dawood, Medical Director and co-founder of the Fleet Street Clinic, discussed the paper with one of its authors, as well as the current situation faced by travellers, on the Victoria Derbyshire programme on BBC2 on 2nd September.

    “We have always known Zika could spread everywhere Aedes mosquitoes abound,” Dr Dawood told the programme. “This study tells us about the seasonality of risk of spread, and when/where it might take root, but does not model travel/risk of spread within Africa or Asia – so more studies are still needed.”

    The study’s publication coincided with the arrival of Zika in Singapore – a major hub for Asian travel and Malaysia, with clear implications for further spread. With this news came the new evidence that Aedes aegypti mosquitoes are capable of passing the infection on to their offspring.

    There is currently no vaccination available for the Zika Virus. If you have any questions and would like some more information and advice, please contact the Fleet Street Clinic on 020 7353 5678 or you can book a travel consultation appointment.