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?
There is no vaccine against dengue licensed in the UK, though several candidate vaccines are in development.
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 taking appropriate measures to protect against mosquito bites, travellers can reduce their own individual risk of contracting dengue as well as other insect-borne infections.
Suitable Medical Kits available to buy online
Related services available at Fleet Street Clinic
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.
By Anna Chapman | Travel Nurse | March 2019
Boating in the Bahamas
The best way to see the Bahamas is by boat. As an archipelago of over 700 islands and cays all strung together like pearls over a turquoise sea, the majority of visitors choose to cruise to see the many delights that this country has to offer. Whether you only visit the Bahamas or take an all-encompassing Caribbean cruise, it is important to remember those travel vaccinations and travel health advice are essential if you are to enjoy a happy healthy holiday.
Here are our top travel tips for staying healthy in the Bahamas…
All travellers should be in date with diphtheria, tetanus polio and Hepatitis A. There is no risk of the Yellow Fever virus in the Bahamas, however, if your cruise takes you to an area that does have a risk of the virus (such as South America), you will need to provide evidence of vaccination in the form of a valid Yellow Fever certificate. Cruise ships are confined spaces with a high volume of passengers which makes you more susceptible to infections. If you plan on travelling during the winter months, it is sensible to consider a flu vaccination as respiratory viruses can spread easily.
The Bahamas lie in the tropical Caribbean seas making the sun, sea and sand the major attraction. Remember to be sun safe. Wear a high factor sun cream throughout your holiday. The sun’s rays are particularly strong between 11am-3pm so it’s best to avoid direct exposure during this time. Slap on a hat, slip on a shirt and slop on some sunscreen.
The Bahamas have a risk of dengue fever, chikungunya and the Zika virus. These illness are spread via the bite of an infected Aedes mosquito. Whilst causing mild illness in many, they can cause more serious complications and are best avoided. Zika virus is associated with a serious complication during pregnancy and those who are pregnant or plan to become pregnant soon after the trip are advised against travel to the area. There are no specific vaccinations against these mosquito-borne viruses so bite prevention is the only defence. Cover up exposed skin and wear an insect repellent containing at least 50% DEET.
See our Ultimate Bug Kit.
The majority of Bahamian cuisine comes straight out of the sea. Whilst seafood and fish are delicious, ensure that any food consumed is cooked thoroughly and served fresh to you. The Bahamas has an abundance of fresh tropical fruit but it is wise to adhere to the ‘cook it, boil it, peel it or forget it’ saying to avoid the dreaded traveller’s diarrhoea. We advise travellers to take a gastro kit with them which can help prevent and treat the commonest gastrointestinal symptoms that occur when travelling.
If you do plan to see the Bahamas by boat, ensure you follow some sensible precautions to avoid getting sick from fellow passengers. Wash your hands regularly, make use of the alcohol-based sanitizers stations on board, carry a small alcohol-based hand sanitiser to keep your hands clean when off the ship. Ensure you stay hydrated, but make sure you drink water from a safe source (bottled, boiled or purified).
By Anna Chapman | Travel Nurse | March 2019
Stay healthy at Holi
Holi is a famous spring Hindu festival that is celebrated in every part of India. It is known as the festival of colours and is mostly celebrated in March in Rajasthan.
The celebration signifies the beginning of spring beginning and the end of winter. It is sometimes known as the “festival of colours” or the “festival of love”. During the festival, it is encouraged to throw powdered paint (gulal) into the air. This symbolises the abundance of colours of spring and the celebration of a new season.
Here are top travel tips to stay healthy at Holi.
Don’t forget your travel vaccinations
Travellers going to India should ensure they are up-to-date with their travel vaccinations. These include Hepatitis A, Typhoid and Diphtheria, Tetanus and Polio. Rabies, Hepatitis B and Japanese Encephalitis are sometimes suggested and are dependent on where you’re travelling to and the activities you plan to do there. A consultation with a travel nurse will provide you with all the information needed to make an informed decision either way.
Eat, drink and be merry…
India is food heaven but don’t let travellers diarrhoea turn it into a Holi holiday hell. Avoid tap water or ice from an unknown source. Ensure bottled water has an intact seal if buying from a vendor. Alternatively, invest in a water-to-go bottle which has a built-in filter making unsafe water safe to drink. You can pick one up during a travel appointment at the clinic whilst getting your vaccines.
Eat well-cooked food served piping hot, and avoid fruits and salad items that might have been washed in the local water. It is worth investing in a gastro medical kit which contains all the necessary medicines should you get sick at any point during your travels.
Holi festival is synonymous with the throwing of coloured powder. Contact lens wearers should stick to their glasses during the festival so to avoid getting dye in their eyes. Any dye that makes its way into your eye could cause a chemical injury and lasting damage. If any powder does get in your eye, wash it well with clean running water.
Don’t let the dye stop the DEET.
Dengue fever, chikungunya, Zika, Japanese Encephalitis and even malaria can occur in parts of India. Therefore, banish the bugs bites by covering up as much as possible, wearing a good insect repellent with at least 50% DEET. See our Ultimate Bug Kit.
If you are trying to conceive, travelling to ‘at-risk countries’ is not advised.
For more information on the Zika virus and advise, you can speak to one our travel nurses during a travel consultation.
We’d always recommend for travellers to book a 30-minute travel consultation with a travel nurse prior to travelling to ensure all necessary vaccinations are given and any risks are discussed.
By Anna Chapman | Travel Nurse | February 2019
Senegal is one of West Africa’s most visited countries; it is considered one of the most stable democracies in Africa, which is probably why it is more popular than it’s neighbouring countries. Senegal offers the hustle and bustle of Dakar, the sand dunes of the Lompul Desert, the clear waters of the Casamance and tropical backwaters of the Sine-Saloum Delta. Unfortunately, a tropical environment comes with tropical diseases, especially ones that fly!
Don’t wing it with your health, follow our top travel tips to stay healthy and have a bug-free break …
Sleeping sickness, also known as “human African trypanosomiasis”, is caused by the tsetse fly, which is native to the African continent and generally active during the day. If an infected tsetse fly, which is carrying the parasite, bites you, it can cause acute trypanosomiasis. Sleeping sickness infects the brain causing confusion, disturbed sleep (hence the name) and can be fatal if not treated.
Malaria is prevalent throughout the whole of West Africa, including Senegal. It is spread by the bite of an infected Anopheles mosquito. Generally, these mosquitos bite most often during dusk til dawn. All travellers to Senegal should take anti-malarial medication and take preventative measures against mosquitoes.
Yellow Fever is a virus spread by the Aedes mosquito, that is most active from dawn till dusk. Catching Yellow Fever can be fatal but can be prevented by vaccination. The vaccination gives a lifetime of protection, however, it is not suitable for everyone and a comprehensive risk assessment should be sought from a travel clinic. Additionally, there is a requirement to be in possession of a valid Yellow Fever certificate when entering Senegal from another infected country, especially those who plan onwards travel to Gambia or Guinea-Bissau.
Zika Virus is spread by the Aedes mosquito which commonly bites during the day in urban settings, such as Dakar and St Louis. The majority of people who are infected with Zika virus have no symptoms, but if contracted during pregnancy or close to conception it can cause Congenital Zika Syndrome. Currently, there is no vaccination nor cure for Zika virus infection and strict precautions against mosquitoes should be taken.
Best prevention to banish those bugs?
- Wear long loose clothing and cover-up. If the insects can’t bite you, they can’t transmit their diseases to you.
- Use a minimum of 50% DEET spray on any exposed areas of skin and reapply regularly
- Sleep under a mosquito net
- Treat clothes with permethrin
- Ensure you receive a travel consultation prior to departure to receive the appropriate pre-travel vaccinations and medications against malaria and Yellow Fever
- You can purchase one of our Ultimate Bug Kits to help protect yourself
By Anna Chapman | Travel Nurse | February 2019
Panama sits on both the Pacific and Atlantic coasts. With its cloud forests, coffee farms, magical islands, world-class diving and a canal that connects two oceans, many people choose to make Panama their holiday destination.
If you plan to go, follow our travel tips to have a safe and healthy holiday.
Vaccinations for vacation
It is advised that all travellers be up-to-date with Diphtheria, Hepatitis A, Tetanus and Polio. Higher risk travellers may want to consider vaccinations against Typhoid, Rabies and Hepatitis B. It is best to speak with a travel expert to see what they advise for you.
Prevent mosquito bites
It is no longer necessary to take anti-malarial medication if visiting Panama. However, precautions against mosquito bites should be taken as viruses such as dengue fever, Zika virus and chikungunya can be transmitted in the region. Pack some insect repellent with at least 50% DEET, and take a mosquito net if you plan to stay in traditional accommodation that may not provide one. You can help protect yourself from mosquitos with our Ultimate Bug Kit.
Find out if you need a Yellow Fever Vaccination
Yellow Fever exists east of the Panama canal. If you plan to visit this area the vaccination is recommended. Also, those who plan to enter Panama from a country that has a risk of Yellow Fever (such as Colombia) will need to be in possession of a valid Yellow Fever Vaccination certificate.
Pack a first aid kit
A first aid kit with necessary medication and first aid items is a good idea. Accessing medical care and medical supplies in parts of the region can be difficult, especially for those who plan to visit the San Blas Islands, cloud forests or coffee farms. Those who plan on diving in the Bocas del Toro may wish to take out items such as ear drops for an infection, and antiseptic cream for any coral cuts.
Don’t get travel sick
A huge attraction in Panama is the coastline and archipelago, including the San Blas and the Pearl Islands. Accessing parts of Panama often involves long bumpy journeys by road and boat trips to the islands can often be choppy. If you suffer from travel sickness, ensure you pack medication to prevent this, and take it before you set out on the journey to prevent feeling queasy.
By Anna Chapman | Travel Nurse | January 2019