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

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

What is Dengue Fever?

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

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

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

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

What are the symptoms of Dengue Fever?

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

Common symptoms include;

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

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

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

Dengue Fever Vaccination

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

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

Who should get vaccinated?

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

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

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

Related services available at Fleet Street Clinic 

Dengue Fever Vaccination

Specialist Travel Clinic 

Travellers’ Diarrhoea Online Consultation

Antimalarials

For further reading

UK MHRA approves Takeda’s dengue vaccine Qdenga

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

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

Measles Outbreak – What You Need to Know

The WHO has issued a warning about recent outbreaks of measles in Europe and the USA. Cases of measles have risen rapidly in recent months in Italy, Romania and most recently in US.

Measles is a highly contagious virus with potential for serious complications.

Initial symptoms can include:

• Runny nose
• High Temperature
• Spots in the mouth
• Aches and pains
• Sore eyes and swollen eyelids

A rash appears after 2-4 days which can present as blotchy spots, often starting at the head and progressing down.

Medical Advice for Measles

If you think you may be suffering from measles, or are concerned about risk of infection when travelling, please see your doctor straight away.

Travelling to areas with a risk of measles

Make sure you are up-to-date with your vaccinations before you travel, including the measles, mumps and rubella (MMR) vaccine. If your child will be travelling, the MMR can be given from 6 months of age.  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.

Call Fleet Street Clinic for medical assistance, advice on vaccinations and travel precautions on  0207 353 5678  email info@fleetstreetclinic.com or book online now. 

ADVICE ON TICK-BORNE DISEASE IN EUROPE

Tick-borne Encephalitis (TBE) is a viral disease that is spread by the bite of an infected Ixodes tick. It is estimated that the disease infects at least 13,000 people every year.

Symptoms can occur from 4-28 days post-bite and include fever, fatigue and muscle aches.

The virus can also go on to affect the brain and spinal cord, causing meningitis, with up to 20% of cases resulting in death. Unfortunately, there is no specific treatment for TBE.

TBE occurs in 3 main geographical locations:

European TBE – Western Europe

Siberian TBE – Urals, Siberia, Far-Eastern Russia and Finland

Far Eastern TBE – far Eastern Russia, China and Japan

Transmission of TBE occurs mainly during the summer months, mainly via wild vertebrate animals such as rodents. It can be transmitted either by ingestion of unpasteurised milk, or milk products from infected animals or by the bite of an infected tick.

If you’re travelling to affected countries during the transmission period, you are most at risk if you are doing outdoor activities such as hiking, camping and walking in forested areas where ticks are abundant.

Take the following precautions to avoid infection:

Wear long trousers and sleeves. Impregnating clothing with permethrin and using insect repellents such as DEET are also good ways of preventing tick bites.

Get vaccinated. Ticovac (and Ticovac Junior for children) is advised for travellers who may be at risk. It requires two vaccinations prior to travel, and the third dose after a year can provide up to 5 years protection.

Check your body for ticks -especially in the armpits, groin and behind the knees.

Remove ticks promptly and correctly and clean the bite site with antiseptic.

Fast Facts

Tick Removal Tips

If you find a tick embedded on your skin you need to remove it, asap:

To remove a tick follow these steps :

• Use a pair of fine tweezers or a tick-remover
• Grasp the tick head as close the skin as possible
• Pull upwards at right-angles to the skin

Top tip: Avoid putting pressure on the body to avoid incomplete removal which may cause infection.

TICK-BORNE ENCEPHALITIS VACCINATION

There is a vaccination against tick-borne encephalitis (Ticovac and Ticovac Junior) which is highly effective against TBE. The primary schedule requires two vaccinations to be given 14 days apart, and a third dose to be given one year later. A booster vaccination is recommended after 3 years. The vaccination is suitable for adults and children over the age of one-year-old.

You can book a travel consultation appointment online to find out if you beed a tick-borne encephalitis vaccine for your next trip.

Christmas is coming and who doesn’t enjoy a Christmas market (or two!) A popular Christmas city break destination is Germany and visiting the fantastic Christmas markets is top of most travellers to-do list.

Read our advice on how to stay healthy during a winter city break in Germany:

Coughs, sneezes and Christmas wheezes

Christmas markets can be crowded places. A combination of cold damp weather and crowded areas means that it is easy to pick up a viral infection. Preventing the common cold can be helped by observing good hand hygiene to avoid that transfer on infection. If you do start with the sniffles, ensure you use a tissue to ‘catch it, kill it, bin it’ to stop the spread to others.

Festive Flu

Don’t let the flu spoil your festive fun. In the Northern Hemisphere, seasonal influenza occurs during the winter months, with peak season around Christmas. Flu is spread from one person to another via coughing and sneezing and it very contagious in populated areas. It can, however, be easily prevented with a single flu vaccine, which ideally should be given several weeks before the ‘flu season’ begins to provide optimal protection.

Have a Merry measle-free Market

In recent years, many countries in Europe have seen dramatic surges in the cases of measles. Measles is an acute viral infection that has the potential for severe complications. Merry market goers should ensure that they have received 2 doses of the measles-containing vaccination, commonly known as the MMR, to ensure they have adequate protection against the disease.

If you would like more travel advice we’d recommend an appointment with one of our travel nurses.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | November 2018

A weekend in Dublin

The unique mixture of hedonism and heritage makes Dublin the perfect city break.
Be ready to eat and drink your way around the city, indulge and celebrate, both these things are encouraged wherever you go. The Irish definitely know how to live life to the full.

Here is our flu coordinator Laura’s guide to ensure you have a memorable weekend in Dublin.

Plan Ahead

Dublin requires a certain amount of pre-planning especially if you’re wanting a budget city break. Prices tend to steadily increase the closer you book to the date of travel. So, expect to pay more if you’re more of the spontaneous adventurer.
Depending on if you’re taking the whole family or travelling alone, we’d always book flights in advance. Especially expect to pay more on St Patrick’s weekend!
Book your accommodation early! There is a big rental shortage in Dublin and popular times throughout the year can result in overpriced accommodation at hostels, hotels and even Airbnb’s.

Clothing

The Irish weather has a reputation for having four seasons in one day and for that reason pack clothes for all types of weathers. Layering is key, that way you can add and remove layers depending on the weather. An absolute essential is a lightweight raincoat for those unexpected downpours.

Footwear

If you are an adventurous traveller, you will find your normal running trainers might not be enough for the unexpected weather and puddles! We’d recommend investing in some hiking boots, these will come in handy for those out of city days and will make sure your feet stay nice and dry.

Guinness

No trip to Dublin is complete without a trip to the Guinness Brewery. This is a must do!
Believe it when people say the Guinness tastes different in Ireland, it definitely does. Just a tip – Save yourself from the huge queues and book your ticket online. Be ready to drink – your tour comes with a free taster at the end!

Natural Beauty

The city can be all-encompassing but make time to visit the landscapes and explore the natural beauty of the beautiful Irish cliffs. One of the natural wonders to visit would be the Giant’s Causeway. Breathtaking scenery!
You might find it easier to do this by renting a car, remember to bring a credit card and your passport. It can be very cheap, and lets you see all the best stops in your own time.

Locals know best

It is always handy if you know a local, they have all the insider knowledge and are able to steer you away from all the overpriced tourist traps and find something truly authentic. If like me, you don’t know a local, my advice is to ask around, you’re sure to find a friendly local who’ll share the history of Ireland with you in exchange for a pint of Guinness (or two!)

A bit of history

There are no shortages of bars and pubs in Dublin. A couple to definitely make sure you visit would be The Brazen Head and The Temple Bar.
The Brazen Head is Ireland’s oldest pub, the present building was built in 1754 as a coaching inn. However, it appears in documents as far back as 1653.

The temple bar is very loud and very busy, so not to everyone’s liking but if that is your scene then you won’t be disappointed. Many famous Irish legends have taken to their stage and entertain large crowds with their iconic songs and ballads throughout the years. Definitely sink an Irish whisky here!

Book your travel appointment today

By Laura Berry |  Flu Project Coordinator | September 2018

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”.