Hepatitis Claiming More Lives than HIV

19.05.2019 Category: News Author: Dr Richard Dawood

Ask the average person what viral disease they think claims the most lives, and HIV might be the likely response. However, this is not so, according to research in the Lancet. The research suggests that viral hepatitis caused 1.45m deaths in 2013 compared to 1.2m lives claimed by AIDS in 2014. What is Hepatitis?

Hepatitis is best defined as an inflammation of the liver caused by the hepatitis virus. There are 5 types of hepatitis virus called; A,B,C,D and E. Contaminated food is usually the cause of virus types A and E. Types B, C and D are spread via infected bodily fluid contact. Virus types B and C lead to the most deaths.


Hepatitis A and B are vaccine preventable. Many countries offer these vaccines routinely on the childhood schedule but this is not the case in the UK.

Hepatitis Vaccination at the Fleet Street Clinic

Vaccinations are needed to give protection against hepatitis A and B and they currently are not part of the childhood vaccination schedule in the UK. At the Fleet Street Clinic, we make it a priority to have a good supply of hepatitis A and B vaccines for children all year round. The hepatitis vaccinations can be given individually, or as a combined injection. For long lasting protection, several doses are required. Our vaccination team are highly trained, well-qualified and have dozens of years’ experience between them. Our vaccination service takes place in a clean, comfortable and safe environment.

You can learn more about our vaccinations  here.

While hepatitis is causing millions of fatalities across the globe, you can take steps towards protection against the virus by booking an appointment for hepatitis vaccinations at Fleet Street Clinic today.

Travelling abroad this summer?

10.05.2019 Category: Travel Health Author: Anna Chapman

With summer just around the corner, many are busy shopping for essentials. Sun cream, swimwear and toiletries are more likely on the list rather than travel vaccines. Many forget to check if they are up-to-date on the recommended travel vaccines.  To make sure you get full enjoyment out of your holidays it’s important to stay safe during and after your break.

Below we have highlighted some health concerns you need to know if you are travelling this Summer:


Throughout this year we have seen an increased rise in measles cases all over the world. The disease can be easily prevented with two doses of the safe and efficient MMR vaccine.  A review of your childhood vaccine records will indicate if you have had the MMR course or if in need of a booster or the full course. Those struggling to confirm their immunity can have a simple immunity blood test which will either confirm if they are immune or not. 


When visiting areas with poor sanitation, which can affect the water and food consumed, travellers, should consider the Hepatitis A vaccination. A safe and effective vaccination which prevents the viral infection and stop travellers falling ill whilst away. In addition to the vaccination, travellers also should take caution and ensure all food is cooked thoroughly and served hot, stick to bottled water which is sealed and avoid ice (usually tap water).

Hepatitis B is a viral infection spread by contaminated blood and bodily fluids. Examples in which travellers can be at risk are contaminated medical equipment which may be used in an emergency for example needles and syringes. Hepatitis B can also be prevented with a vaccine course before travelling.


Every year there are more than 200 million new cases of malaria, another preventable and treatable disease. The World Health Organizations lists 91 countries and territories at risk of malaria transmission. Preventative medication can be taken to reduce the risk of catching Malaria as there is currently no vaccination.

Infectious diarrhoea:

In about 20% of travellers with diarrhoea, more than one bug turns out to be responsible for the illness. Bugs can be caught from drinking tap water and eating uncooked food or salads washed in tap water. It can put a dampener on holiday plans and make you feel under the weather. Antibiotics can be prescribed prior to travel, in case of a severe infection. Our gastro kit is designed to help travellers who may need medication to help cases of infectious diarrhoea whilst travelling.

“There may be avoidable risks to your health depending on your overall health, destination and planned travel activities. We can assess the risks and provide you with the best travel health advice to ensure you have an enjoyable trip and return healthy.”

Richard Dawood, Medical Director of the Fleet Street Clinic. 

If you wish to discuss how to stay safe on holiday or would like more advice on what vaccinations you may need, our travel nurses can help. Book a travel consultation to discuss your needs.

Travel Tips Thursday - Marrakesh

19.04.2019 Category: Travel Health Author: Anna Chapman

Marrakesh is a former Imperial City and the heart of Morocco. Whether you plan on visiting the medinas of Marrakesh or branch out to the sands of the Sahara or the heights of the Atlas mountains, ensure you follow our top travel tips to stay healthy.


All travellers should ensure they have received vaccinations against Hepaitis A and diphtheria-tetanus and polio. Vaccinations against typhoid should be considered for those who cannot guarantee safe food and water during their trip, Hepatitis B and Rabies vaccinations can be considered for some travellers, especially those travelling to more remote locations.


Travellers should be careful when dining in Morocco. This will help to prevent food and water-borne illnesses. You should avoid drinking tap water, and stick to boiled water, or bottled sealed water. Those who are trekking may wish to take a water bottle with a filter or a supply of chlorine dioxide tablets to make water safe when in remote locations.

Food Safety

Stick to the mantra of cooking it, peel it, boil it, forget it. If you cannot cook, peel or boil what you plan to eat or drink, it is probably safest to avoid consuming. Food contaminated with local water, such as salads are considered high risk and best to be avoided. Ensure all food is cooked thoroughly and served straight away. Avoid buffet items which may have been sat for long periods of time and could be contaminated. You can also purchase our worldwide gastro kit.

First Aid

The availability of health care and first aid supplies are limited in Morocco. Whether you are visiting the median of Marrakesh or ambling around the Atlas, taking a good first aid kit with you is essential – click here to buy online now.
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.


The peak of Mount Toubkal exceeds 4,000m and can be summited in 5-7 hours. High altitude and fast ascent rates can put travellers at risk of altitude sickness and acute mountain sickness. The risk can be reduced by ensuring you stay hydrated, plan a slow ascent and factor in some acclimatisation days. Acetazolamide (Diamox) can be used to help aid the process, speak to a travel nurse about this at your pre-travel assessment.

It is always best to seek travel advice before any holiday. A pre-travel assessment is quick and easy, vaccinations and prescriptions can be given within a single appointment and any follow-up treatments to complete courses arranged for a convenient time straight away.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | April 2019

Travel Tips Thursday - Jordan

19.03.2019 Category: Travel Health Author: Anna Chapman

An Arab nation on the east bank of the Jordan River, Jordan is one of the safest countries to visit in the Middle East. Awash with biblical heritage, ancient sites and large swathes of desert; it is a natural wonder with historical sights to tempt any traveller.

The daytime temperature rarely drops below the high teens, and flight time is less than 5 hours from the UK. Whether you are ambling in Amman, wandering the Wadi’s,  dipping in the Dead sea or plodding around Petra, be sure to follow our top travel tips to stay healthy.


All travellers should ensure they are up to date with their routine vaccinations. Vaccinations include diphtheria, tetanus, polio and hepatitis A. Hepatitis B and rabies can be considered for those at risk (speak to a travel nurse prior to departing).


Rabies is a fatal virus spread through the bite, scratch or lick from an infected animal, most commonly a cat, a dog or a bat. The risk is greatest when the animal pierces the skin and/ or makes contact with an open wound. There are many ‘high risk’ countries, in Jordan, dogs, cats and bats are the biggest culprits and the risk of these animals carrying the disease is high. Once the rabies virus enters the nervous system there is no treatment and it is fatal. Travellers can reduce the risk of rabies by receiving pre-travel vaccinations against the disease. This doesn’t exempt the traveller from treatment if they have been exposed, but simplifies the process and provides the best outcome. Rabies treatment is scarce and can be very difficult to source in some countries, so having pre-travel immunisations puts you in the best possible position should something happen. Those who are trekking, camping or going off the grid to places like Wadi Rum are at highest risk of the disease.

Food and Water

Jordanian cuisine is delicious, but ensure you avoid the dreaded traveller’s diarrhoea by following some sensible precautions. Ensure you are up-to-date with Hepatitis A vaccination as this viral illness are spread through contaminated food and water. Wash your hands regularly, especially after using the toilet and before eating. Ensure water is either boiled or bottled with a good, unbroken seal. Do not drink tap water or brushing your teeth with it and avoid ice. Ensure all food you eat is served piping hot and straight to you.

All that bites

Take precautions against sand fly bites that are ubiquitous in Jordan. Aside from producing a painful bite, they can also carry a parasite responsible for Leishmaniasis. Sand flies tend to feed at night and fly close to the ground. Prevent them from feeding on you by covering up, especially between dusk and dawn. Wear long trousers and socks to prevent bites around your ankles as they are flow flyers. Wear good insect repellant with a minimum of 50% DEET. Sleep under a mosquito net, especially if you are camping or hiking in the more rural areas of Jordan.

See our Ultimate Bug Kit.

From red to dead…

From the riches of the coral in the red sea to the abyss of the dead sea, take sensible precautions when taking the plunge. The dead sea lies 413m below sea level and is actually rather tricky to swim in. Tourist usually come to float on its surface as the high salt content makes it hard to submerge. Be careful. Cover any cuts you have with waterproof plasters to avoid a sharp sting. Do not splash when in the water, as it may cause injury or irritation to your eye if it enters. If you wear contact lenses, it’s best to swap to your glasses.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | March 2019

Mexico... Dia de  Los Muertos

19.10.2018 Category: Travel Health Author: Anna Chapman

November is an optimum time of year to travel to Mexico. Uncrowded beaches with cheaper hotels and air travel are all perks for those who want an affordable and relaxing trip.
Summer in Mexico can be too hot for some, with highs of 32 degrees. Whereas, Winter temperatures are much more comfortable, with highs of 24 degrees instead. Hurricane season has also finished, the rain has let up and the crowds that appear later in December are yet to arrive.
Many prefer a winter visit.
Dia de Los Muertos is Mexico’s most colourful and festive holiday; celebrated from October 31 to November 2. ‘Day of the Dead’ is an incredible expression of Mexico’s religious syncretism and a tradition that dates back centuries. It celebrates and honours friends and relatives who have died. Festivities take place in Central and Southern Mexico with elaborately decorated home altars, parades, parties and nighttime visits to the gravestones of loved ones. Expect many candles, flamboyantly decorated skull-shaped masks and music.

Be warned of mad dogs, wild cats and blood-sucking bats…

Mexico has a high risk of rabies which is a fatal disease if left untreated. The rabies infection is spread through a bite, scratch or lick of an infected animal. You should avoid contact with feral animals or wildlife at all costs. Try to anticipate an animal’s actions and always be careful not to make sudden movements or surprise them.
Travellers can minimise the risk by receiving a rabies vaccination prior to travel. As rabies is a fairly common traveller’s risk, we try to make this particular vaccine affordable for all travellers. You can 
proactively minimise your risk of contracting rabies, putting your mind a ease for your holiday.
If you suspect you’ve been bitten by an animal with rabies, even after having the rabies vaccine, you should seek medical care immediately.

Banish the bugs

Apart from causing an itchy and painful bite, Mexican mosquitoes can spread viruses such as dengue fever, chikungunya and Zika virus. It is advised to use an insect repellent containing 50% DEET, wear long loose clothing, and take a plug-in vaporiser. We have an Ultimate Bug Kit available to order online. All of these will ensure your room stays mosquito free and you, bite free!
The Zika virus is of particular concern to those who are pregnant or planning to become pregnant. Specialist advice should be sought before travel. Our Central London clinic offers Zika Virus testing. Our expert team will give you clear, practical advice on the right test for your individual circumstance. Following the test, we can help you interpret the results and assist in planning your next step towards starting a family.

Don’t get the day of the dead diarrhoea
While Mexican food is delicious, travellers should apply some necessary precautions to prevent picking up stomach bugs which could ruin your holidays. We recommend that travellers avoid tap water and ice in their drinks. It’s advisable to stick to bottled water only as this reduces your risk. Also, do ensure your food is cooked through and served hot. To help get prepared, we recommend purchasing one of our Worldwide Gastro Kits.

Hepatitis A

Hepatitis A is a viral infection which is spread via contaminated food and water. Washing your hands regularly, especially after using the toilet can stop the spread of Hepatitis A. A sensible tip would be to take some alcohol hand gel with you to clean your hands before eating. Make sure you have received a vaccination against Hepatitis A before departure.

There are many celebrations throughout the year in Mexico, such as ‘Revolution Day’ on November 20th. Large crowds will gather to celebrate the 1910 revolution anniversary. This is a unique celebration for a tourist to experience but unfortunately, large crowds increase your risk of catching and spreading germs.
Factors that can increase the risk of getting sick at a mass gathering include the number of people in attendance, the type of venue, the type of infections people carry into it and also how people interact with each other.
The Flu can spread rapidly as the bacteria and viruses can easily be passed from one person to the other by a simple cough or sneeze. The best way to prevent flu is to get your flu jab before departure.

Don’t let your health ruin your holiday to Mexico.
You should take what are reasonable, practical, prevention steps to stay well and enjoy your trip to Mexico.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | October 2018


02.08.2018 Category: Travel Health Author: Anna Chapman

What is Hepatitis?

Hepatitis is a series of viral infections that all cause an inflammation of the liver if not treated, and is responsible for two out of every three liver cancer deaths. The theme of World Hepatitis Day 2018 was ‘Find the Missing Millions’, since 300 million people globally are living with viral hepatitis and are completely unaware of it.

Consequently, the Fleet Street Travel Clinic recommend that you ‘GET ADVICE. GET TESTED. GET VACCINATED’. This is especially the case if you are travelling to high risk areas, namely the Indian subcontinent, Africa, Central and South America, the Far East and Eastern Europe.

Get Advice

Hepatitis A is spread through food and water contaminated with the virus. Travellers should exercise caution by:

  • Ensuring all food is cooked thoroughly and served hot
  • Sticking to bottled water with a seal, or boiled water
  • Avoiding ice as well as tap water
  • Only consuming fruit that can be peeled or sliced without contamination (such as bananas)
  • Avoiding high-risk food such as shellfish, raw or rare meat, salad, buffet food and reheated food

Hepatitis B and C are contracted through contact with infected blood and bodily fluids. This can include:

  • Mother to baby transmission at the time of birth
  • Unprotected sex
  • Contaminated medical equipment such as needles and syringes
  • Contaminated tattoo or body piercing equipment

Get Tested

9 out of 10 people living with viral hepatitis are unaware they have it. Significantly, Hepatitis C is the most common type in the UK and often causes no noticeable symptoms. Fleet Street Clinic offers a range of blood tests and health screenings, and testing is quick, easy, and painless.

Get Vaccinated

Hepatitis A and B are easily preventable through vaccination, and we recommend the vaccine especially for the following people:

  • Those who are at occupational risk (such as health care or aid workers)
  • Travellers who visit high-risk areas, or those who travel frequently or for longer periods
  • Travellers who have pre-existing conditions which may make it more likely for them to need medical attention
  • Those who participate in lifestyle behaviours that may increase the risk (such as unprotected sex and injecting drug use)

Although there is no vaccine for Hepatitis C, it can be treated with effective antiviral medications.

Fleet Street Travel Clinic

Book your appointment today.

4 Illnesses To Watch For in Europe

19.05.2018 Category: Travel Health Author: Anna Chapman

Health Risks of European Travel

How many of us know that European travel can pose a threat to our health?  Health risks aren’t normally associated with European travel – we think of quick flights and familiar cultures so assume we’ll be relatively safe on short-haul holidays. However, there are actually several diseases to watch out for, especially if you are not vaccinated.

Stay aware of these key diseases so that you can prepare properly to have a safe and happy holiday.

Four illnesses to be aware of when holidaying in Europe:

1. Measles

  • Measles continues to spread within and throughout Europe this year. Large outbreaks of the disease have occurred, and it is thought that the drop in vaccination coverage within populations is responsible. Countries that are currently reporting outbreaks of measles include: AUSTRIA, BELGIUM, BULGARIA, CZECH REPUBLIC, FRANCE, GERMANY, HUNGARY, ICELAND, ITALY, PORTUGAL, ROMANIA SPAIN, SWEDEN.
  • Measles is a highly contagious virus which can have life-threatening complications.
  • International travel has played a large factor in the international spread of measles.

2. Tick-Borne Encephalitis (TBE)

  • TBE season has begun in Europe this summer. TBE is a viral infection spread through the infected bite of a tick.
  • TBE effects areas of northern and Eastern Europe, Russia and even China.
  • Those at highest risk of the diseases are those that intend to spend time in rural forested areas during spring summer and autumn where ticks are present. Activities such as camping and hiking and cycling increase the risk.
  • Those who are travelling to areas of transmission can minimise the risk of the disease by taking strict precautions against tick bites.

3. Hepatitis A

  • Europe has seen an increase in Hepatitis A cases this year. The virus is spread through contaminated food and water.
  • The highest risk countries are those in Eastern Europe, the Baltics, the Balkans and Turkey, but in recent months Germany and Portugal have seen an increase in cases.

4. Rabies

  • Rabies is virus-spread through the bite of an infected mammal. The virus is almost always fatal if left untreated. Animals that can spread this disease include dogs, cats, bats, foxes and wolves.
  • Eastern Europe poses the highest risk of rabies in Europe.
  • Travellers at highest risk include those who plan on travelling to remote areas.

Vaccines can prevent travel-related illnesses

The good news is that all these diseases are vaccine preventable and can be avoided by organising vaccines before you travel.

Measles – All travellers should ensure that they have had at least 2 doses of vaccinations against measles. This is usually given as a routine vaccination in childhood (MMR vaccine) at 1 year of age, and then again as a pre-school booster

Tick-Borne Encephalitisvaccination against the disease is available for individuals aged 1 year and above. It requires 2 vaccination 2 weeks apart.

Hepatitis A – A highly effective vaccination is available against Hepatitis A and can be given to children from 1 year of age. Once the schedule of 2 Hepatitis A vaccinations has been given, immunity lasts for 25 years.

Rabies – a vaccine-preventable disease which requires three doses of vaccination to be given prior to departure. Those who have not received the vaccination with potential exposure to rabies require more extensive treatment which is not always accessible.

Travel Vaccinations at Fleet Street Clinic

Fleet Street Clinic is a leading vaccination centre and offers all travel vaccinations at our clinic in the heart of London.

Book your appointment online today.

By Anna Chapman, Travel Nurse at Fleet Street Clinic

Hepatitis A and Hepatitis B Vaccine Shortage

19.05.2018 Category: News Author: Dr Richard Dawood


Although Hepatitis A and Hepatitis B vaccinations are currently in short supply in the UK and globally, Fleet Street Clinic is committed to maintaining the stock of all vaccines and currently has a good supply of both.

Hepatitis A

Hepatitis A is a viral infection that is spread through food and water contaminated with the virus. It occurs world wide including Central and South America, Africa, Eastern Europe, Middle-East, Asia, and the Indian Subcontinent.

Hepatitis A affects the liver causing jaundice, and whilst most people make a full recovery, it can result in chronic liver disease and be fatal.


Hepatitis A is easily preventable through vaccination, and there are several types of vaccination available in the UK that offer protection. The vaccination is available to adults and children over the age of 1 year. It can be given alone (Avaxim, Vaqta) or in combination with typhoid (Viatim), whereby a single injection provides protection for 12 months. A second injection given 6 months later will provide 25 years of protection against Hepatitis A.

The vaccination is available to adults and children over the age of 1 year. It can be given alone (Avaxim, Vaqta) or in combination with typhoid (Viatim), whereby a single injection provides protection for 12 months. A second injection given 6 months later will afford 25 years of protection against Hepatitis A.

It is also possible to receive Hepatitis A in combination with Hepatitis B (TwinRix or Ambirix) whereby 2 or 3 doses of the vaccination can be given between 3 weeks or 6 months.

In addition to the vaccination, travellers should exercise caution with food and water by:-

  • Ensuring all food is cooked thoroughly and served hot
  • Sticking to bottled water only with a seal or boiled water– no tap water
  • Avoiding ice
  • Only consuming fruit that can be peeled or sliced without contamination (such as bananas)
  • Avoiding high-risk food such as shellfish, raw or rare meat, salad, buffet food, reheated food


  • Hepatitis B is a viral infection spread by contaminated blood and bodily fluids.
  • 350 million people worldwide are carriers of the Hepatitis B virus.
  • The highest risk countries for Hepatitis B infection are central, western and southern Africa and south-east Asia.
  • Chronic infection with Hepatitis B can cause liver disease and liver cancer.

Hepatitis B is contracted through contact with infected blood or bodily fluids. These can include:

  • Mother to baby transmission at the time of birth
  • Unprotected sexual intercourse
  • Through contaminated blood products (such as unscreened blood transfusion)
  • Contaminated medical equipment (such as needles and syringes)
  • Contaminated tattoo or body piercing equipment
  • Through contaminated needles and syringes from injecting drug use


  • Those who are at occupational risk (such as health care workers, aid workers where their job puts them at risk of injury)
  • Travellers who visit high-risk areas, or those who travel frequently or for longer periods
  • Travellers who have pre-existing conditions whereby their condition may make it more likely for them to need medical attention
  • Travellers who carry out activities associated with risk (adventure sports, body piercing, tattoos)
  • Those who participate in lifestyle behaviours that may increase the risk (such as, unprotected sex and injecting drug use)

A Hepatitis B vaccine is available and can be given from birth. It requires a primary course of 3 vaccinations to be given over a 6 month period (0, 1 months, 6 months) with a booster dose given 5 years later. Those who require the vaccinations to be given more quickly, such as last-minute travellers, can receive the primary course over a shortened 3 week period. Hepatitis B can also be given in combination with Hepatitis A when protection against both diseases is required. TwinRix is available for both adults and children and adheres to the vaccination schedule outlined above. Ambirix is licenced for children under the age of 15 years and requires 2 doses 6 months apart.

All vaccination appointments can be booked online.