Travelling with children can be an enlightening and wonderful experience for the family – creating memories and opening their minds to other cultures and ways of life. But on the flip side it also can be quite daunting, especially if this is your first time travelling with children. The best way to establish a safe travel experience abroad is to take early precautions.
Before Your Travels
When it comes to travelling with children, careful planning and preparation should be considered. It is highly advised to have a travel consultation well in advance of your travels. The travel nurse will make you aware of any travel risks and take into consideration your child’s current wellbeing. Depending on where you are travelling, your child may require certain vaccinations.
These preventative measures will safeguard your child from any diseases or illness.
Your may be advised the following vaccinations:
- Yellow Fever
– Some countries require this as a condition of entry and will ask for proof of vaccination when you arrive into the country.
- Hepatitis A
- Tick-borne Encephalitis
- Japanese Encephalitis
- Hepatitis B
- Meningitis ACWY
All vaccinations require a duration of time following vaccination to reach full protection, usually 10 – 14 days, so factor this time in before your travels. In addition, some vaccinations require a multi-course dose before they are considered effective, such as rabies which requires 3 vaccinations to be considered a complete course. Book a travel consultation early to ensure you have enough time before you travel.
In addition to travel vaccinations it is worth discussing any upcoming childhood vaccinations that could be beneficial to have at the same time so your child is protected against any other common diseases that aren’t necessarily associated with just travel.
If you intend to go to countries with a high malaria risk it is important to discuss antimalarial protection during your travel consultation. Malaria can be fatal and there is a higher risk for children. Antimalarials (malaria tablets) are generally taken for a duration before, during and after your trip and need to be purchased in advance of your travels. There are a number of different types and are suitable for different people so it is important to discuss your options with a travel health expert. The tablets work by ensuring the malaria parasite doesn’t reach unmanageable numbers, keeping you healthy whilst you travel.
Travelling abroad can be exhausting, especially for young children. Jet Lag is known to cause temporary sleep disturbance, which can have an impact on your mental health and other bodily functions. To prepare ahead, The Jet Lag Calculator can tell you how long it will take the body to adjust to your new time zone when you travel – and to adjust back again when you come home.
During Your Travels
Travelling can sometimes result in unexpected situations. For the protection of your child/ren and your family in general, always carry a First Aid Kit. This will reduce your need to seek medical aid for minor accidents or journeys to a chemist, especially if local towns are at a further distance.
When travelling to warmer climates, sun safety is crucial as young children are more vulnerable to sunburn from outdoor activities. To protect the skin apply sunscreen of at least SPF 30, with broad spectrum UVA and UVB protection throughout the day. In addition, hot weather can also pose a risk of dehydration and heat stroke. Ensure you and your child are hydrated throughout the day by drinking water from a safe source. This can be bottled water, boiled water, or water that has been filtered.
To further avoid traveller’s diarrhoea:
- Wash your hands regularly, especially before eating
- Carry an alcohol-based sanitiser
- Keep children from crawling or sitting on the ground
- Avoid swimming in contaminated water
- Don’t swallow any shower or pool water
- Eat raw fruits and vegetables only if washed in clean water or peeled
- Stick to foods that are well cooked and served hot
- Stick to canned or bottled beverages
- Avoid food that has been sitting on a buffet to avoid contamination
We have launched a new, free online consultation for Travellers’ Diarrhoea – by answering a few simple medical questions about yourself, we can check if antibiotics are recommended for your trip. You can pay online and we’ll dispatch them directly to you if you are suitable.
Alternatively, you can have a more comprehensive travel consultation in-clinic with one of our experienced travel nurses.
For more information on the prevention and treatment of Travellers’ Diarrhoea.
The feeling of discomfort from bug bites can truly be a nightmare whilst travelling. Insect bites such as mosquitoes, ticks, biting fleas and kissing bugs can cause pain, irritation and even spread diseases. However, they can be avoided through protective clothing. Our Ultimate Bug Kit has everything you need from repellents to aftercare. Alternatively, you could purchase individual items and create your own kit.
After Your Travels
Travelling can expose your child to certain diseases. If your child falls unexpectedly ill – contact your doctor or emergency services right away. A high temperature/ fever could mean an infection. For most people, travellers’ diarrhoea usually clears up within a few days. However, if your stomach bug has been ongoing for weeks after returning home, then you will need to do testing to investigate the root cause. Viruses, bacteria or parasites all cause similar symptoms but require an entirely different treatment approach. Our Gastrointestinal (GI) Panel PCR test looks for any microbes that are causing your symptoms and can quickly identify the exact cause of your Travellers’ Diarrhoea. Results can be provided in as little as 1-hour, so that accurate and effective treatment can begin straight away.
From Sunday, June 12, 2022 at 12:01AM ET all COVID-19 testing entry requirements for international travellers to the United Stated were rescinded.
Arrivals no longer need to show proof of a negative Covid-19 test or documentation of recovery prior to boarding a flight to the U.S nor upon arrival.
The Centre For Disease Control (CDC) has reached the decision based on the high vaccine uptake and widespread population immunity.
In the statement they released, they explain; “The COVID-19 pandemic has now shifted to a new phase, due to the widespread uptake of highly effective COVID-19 vaccines, the availability of effective therapeutics, and the accrual of high rates of vaccine- and infection-induced immunity at the population level in the United States. Each of these measures has contributed to lower risk of severe disease and death across the United States. As a result, this requirement which was needed at an earlier stage in the pandemic may be withdrawn.”
Most countries, including the UK, have already abandoned testing requirements in a bid to return international travel to pre-Covid levels and it seems the CQC have decided it is now time for the U.S to do the same.
Does this mean that the COVID-19 pandemic has ended?
No, but it does signify a shift in the pandemic. As we see a worldwide reduction in covid cases and death rates, the CDC statement clarifies that whilst testing may not be necessary right now, they will continue to monitor the data and adapt accordingly.
They state; “CDC continues to evaluate the latest science and state of the pandemic and will reassess the need for a testing requirement if the situation changes”.
What about covid vaccinations…
Do I need to be vaccinated to travel to the U.S?
Yes, foreign travellers from outside of the U.S are required to be double vaccinated from COVID-19 to enter the country. But for people under the age of 18, U.S citizens/ nationals or lawful permanent residents will be exempt from vaccination requirements. Currently, the Covid Booster vaccination is not a requirement and there is no set expiry date on the first dose of vaccination.
Overall, the easing of the US Covid restrictions is welcome news to the travel and tourism industry and demonstrates the possibility of international travel returning back to its pre-covid levels.
However, the absence of masks, vaccines, or travel mandates does not mean that the risk of catching Covid-19 has gone away.
We strongly recommend:
- Having comprehensive travel health insurance for all travel to the USA – hospital care should you require treatment for Covid is very costly.
- Wearing a high filtration (N95 or FFP3) mask during your journey
- Practising all the usual hygiene recommendations during your journey (e.g. hand sanitisers, distancing where possible
- Having an early test and avoiding travel if you have even minor symptoms.
For more information on the covid testing services available at Fleet Street Clinic.
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.
It’s been announced that the Saudi Ministry will allow up to 1 million Muslims to participate in Hajj 1443H/2022. British citizens wishing to perform Umrah or Hajj are required to be:
- Under the age of 65 and received COVID-19 vaccinations which has been approved by the Saudi Ministry of Health
- Travellers from outside of Saudi Arabia must submit a negative COVID-19 PCR test 72 hours before their departure to Saudi Arabia.
Whilst Covid-19 vaccinations are not available privately, Covid-19 PCR travel tests are. We believe in access to rapid PCR testing to remove the worry of waiting for your results. We guarantee all our turnaround times – with our fastest being 90 minutes. For more information and pricing: Covid PCR travel tests at Fleet Street Clinic.
A pre-travel consultation should be scheduled at least 6 to 8 weeks before your trip.
Any mandatory or advised vaccinations will be discussed with a nurse. Initial doses can be given during this initial appointment and you can pre-book any required follow up doses in the lead up to Hajj or Umrah pilgrimage.
Before travelling to Hajj or Umrah, it is highly recommended that pilgrims be up-to-date in all their wellness vaccinations.
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.
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.
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 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 – 2 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.
Travellers’ diarrhoea can occur in up to 60% of travellers. Eating contaminated food or water are the usual culprits. 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.
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 sin against the sun with high factor sun cream
- Wear loose fitting, lightweight and light colour clothing
- Keep hydrated by drinking plenty of fluids and eating food with high water content (such as fruit)
- 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
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 too 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.
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.
Fear of flying, otherwise known as aerophobia, is an excessive worry about air travel. It is one of the most common forms of phobia and according to YouGov, around 24% of Brits have some form of anxiety about getting on a plane.
People suffering from fear of flying experience extremely anxious thoughts which are often so powerful they become physical symptoms. These can include shallow breathing, experiencing chest tightening, sweaty palms, feeling nauseated or lightheaded and sometimes these even develop into a panic attack, meaning many opt to avoid air travel altogether.
For some, it will have been a lifelong problem that has meant never flying at all. For others, who have flown many miles in their lifetime, it is a problem that slowly creeps up on them over time. In both circumstances, the fear can be debilitating and symptoms often trickle into other areas of life.
Like all phobias, there is little logic to support the anxiety that it causes – travel is in fact the safest form of transport and you are much more likely to die from a car accident than in a plane crash. Knowing that fact does little to ease the flying-related anxiety of an aerophobic sufferer.
So, what can be done to overcome our fear of flying?
Understand the reason why you’re a nervous flyer
Fear of flying is usually caused by a combination of factors. Understanding the root cause of your own phobia is perhaps the first step in overcoming it. Is it a fear of heights? Claustrophobia? Was it that film you watched as a child? Or has a particular world event sparked the fear? Many people suddenly developed a fear of flying after 9/11 for example. Figuring this out will then allow you to tackle it in the right way and using the appropriate techniques.
Fight fear with knowledge
Some experts suggest the first strategy for everyone suffering from a fear of flying is learning about the aeroplane and the science behind flight. Our anxiety is fed by ‘what if?’ catastrophic thoughts. Once you become knowledgeable, your ‘what if’ thoughts will be limited by the facts. There are professionally designed courses that will explain aspects like air traffic control, anti-terrorism measures, and what happens during turbulence. Some courses use Virtual Reality (VR) to simulate a flight, explaining everything along the way with the aim of injecting logic into an illogical fear.
Seek medical help for anxiety, fear and panic
From here, a form of therapy may help to identify and break anxiety cycles. There are many different types of therapy and choosing the right one for you will depend on your own needs and goals. Hypnotherapy and cognitive behavioural (CBT) are some of the most commonly used, but there are countless more to choose from. Deciding which is the most appropriate form of therapy can be daunting, so it may be helpful to seek advice from your GP or a travel nurse.
For those who manage to make it onto the plane, there are quite a few, simple personal techniques that can be used to calm your nerves.
Deep breathing techniques
Making a conscious effort to breathe slowly and deeply can interrupt panic. Deep breathing is known to trigger a comfort response and will help prevent hyperventilation.
Reading a book or listening to a good podcast can refocus your mind and attention.Distracting yourself from the fact that you are flying can be a great way to keep calm if you’re a nervous flyer.. Time tends to pass much more quickly when adequately distracted.
Tell the flight attendants
Alerting the flight attendants of a nervous flyer could also help – with their training and expertise, they are ideally placed to provide reassurance and will regularly check in on you during the flight.
Avoid coffee and wine
Nervous flyers in general should avoid drinking coffee and wine before and whilst flying. Both can leave you more dehydrated than normal. The extra caffeine in coffee can aggravate anxiety issues and the Dutch courage wine offers will pass leaving you more susceptible to jet lag. Stick with water where possible.
Tea really does help
It’s very British to recommend tea to make everything better, but there are many different herbal teas available which can help with relaxation, reducing stress and calming anxiety. Peppermint, camomile, lemon balm and lavender teas are the most commonly used.
We advise nervous flyers and people with aerophobia to seek further information and guidance from their GP who will be able to make a formal diagnosis and treatment options.
For more advice and information you can book a travel consultation appointment.
Chinese New Year is a festival celebrated annually by Chinese communities across the world to bring good luck and prosperity into the New Year. Every year corresponds with one of the 12 animals in the Chinese Zodiac, with 2022 being the Year of the Tiger. Celebrations for Chinese New Year kick off on the 1st Feb, continuing until the 15th February where the festivities culminate with the Chinese Lantern Festival. Every year, thousands of people travel to China to enjoy the celebrations. So, if you are one of those people who are planning to travel to China to join in with the festivities, please ensure you follow these tips to stay healthy whilst abroad.
Firstly, you may want to check the entry requirements for China in terms of required covid-19 testing. Recently the Chinese Embassy in the UK announced a temporary suspension of entry into China by non-Chinese nationals in the UK holding Chinese visas or residence permits valid at the time of the announcement. If you are unaffected by these restrictions and still travelling to China you can view what covid-19 testing entry rules are currently in place here: GOV.UK WEBSITE. You can find more information on our rt-PCR Testing service here and our Lateral Flow Testing here.
Covid aside, check your vaccination history. All travellers need to ensure they are up-to-date with their childhood vaccines, most importantly, Hepatitis A, Measles, Mumps and Rubella (MMR), and Diphtheria, Tetanus and Polio (DTP).
More information on our wellness vaccinations can be found here.
It is worth noting that it is still influenza season in the northern hemisphere and transmission can occur well into spring. Those travellers who haven’t received their annual flu vaccination to protect them against the most common strains for 2021-22, should ensure they receive it before travelling to China. You can still book your annual flu vaccine, here.
Travellers who are planning extended stays, and more remote and rural travel may also wish to consider vaccinations against Typhoid, Rabies and Hepatitis B.
More information on our travel vaccinations can be found here.
Those who are heading further south to rural areas where the weather is warmer may wish to consider vaccination against Japanese Encephalitis (JE), which is spread via the culex mosquito. You can also purchase our ‘Ultimate Bug Kit’ which will help protect you from mosquito bites.
There have been recent cases of Avian Influenza (bird flu) in both the UK and China. Bird flu is a very unpleasant illness which can cause people to fall quite unwell. It is passed on via contact with infected birds. Travellers can minimise risk by avoiding contact with any birds (dead or alive): avoid touching dead or dying birds, and steer well clear of ‘wet markets’ (marketplaces that sell meat, fish, and often live animals including birds).
Chinese New Year is heavily focused on food, with items such as fish, fruit and dumplings symbolising luck, wealth and prosperity. Travellers should ensure that they maintain good food and water practises to avoid tummy trouble whilst away. You should avoid tap water and ice made from tap water, instead stick to bottled water. Ensure you wash your hands thoroughly before eating and after using the toilet. Ensure all food that you eat is cooked thoroughly and served straight to you. And lastly, consider taking medicines for self-treatments with you, such as antibiotics – take our Online Travellers’ Diarrhoea Consultation to see if it is suitable for us to prescribe you standby Travellers’ Diarrhoea treatment.
By following these guidelines and ensuring you are generally sensible and hygienic, you will be able to relax and enjoy the sheer joys of travel and seeing the world.
Happy Chinese New Year!
Covid-19 testing is available at Fleet Street Clinic, including PCR testing for active infection, antibody testing for confirmation of past infection and PCR testing for travel purposes including travel certificate.
Samples can be collected in-clinic, during a home from the nurse or using a self-sample home testing kit.
For more information:
Alternatively, please call our reception team on 020 7353 5678 to see which option is most appropriate for your current circumstance.
Virtual GP Appointments:
If you have symptoms of coronavirus (a high temperature or a new, continuous cough), please do not leave your home. That includes coming into the clinic, any other GP surgery, a pharmacy or a hospital.
We’d suggest you can book a virtual GP appointment with one of our doctors. You can discuss your health concerns and symptoms by telephone or video call.
Alternatively, you can use the NHS 111 online coronavirus service. If you are experiencing life-threatening symptoms, always call 999 for an ambulance.
If you have symptoms you should self-isolate for 7 days. If you live with someone who has symptoms, you’ll need to self-isolate for 14 days from the day their symptoms started. This is because it can take 14 days for symptoms to appear. More details about self-isolation can be found here.
How to stop the spread of Coronavirus:
- Wash your hands with soap and water often – do this for at least 20 seconds
- Use hand sanitiser gel if soap and water are not available
- Wash your hands as soon as you get back home
- Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- Put used tissues in the bin immediately and wash your hands afterwards
- Do not touch your eyes, nose or mouth if your hands are not clean
Recommended information sources:
Gov.uk: For the latest guidance about coronavirus (COVID-19) for health professionals, businesses, schools and other organisations.
Public Health England: For the latest information about the situation in the UK, along with guidance for what to do if you think you’re at risk. You can sign up for email alerts from PHE concerning coronavirus updates here.
NaTHNaC: For travel health advice for travellers to countries/areas affected by COVID-19
Our Medical Director and Travel Specialist Dr Richard Dawood, has been at the forefront of the conversation, sharing insight and opinions as the pandemic unfolds:
Please note: All information stated is correct at time of posting.
The Philippines is a fascinating archipelago, made up of thousands of islands where you can explore stunning beaches and enjoy superb surfing and diving.
Ensure you follow our top travel tips to stay healthy.
7,641 islands, of these islands, only 2,000 are inhabited.
The Philippine archipelago is divided into three island groups: Luzon, Visayas, and Mindanao.
If you are heading to the Philippines you should ensure that you are up to date with your routine immunisations. There have been outbreaks of measles and polio this year in the country so all travellers should ensure they have received 2 doses of the MMR vaccination and a full course of diphtheria, tetanus and polio (DTP) vaccinations.
In addition, it is advised that vaccinations against hepatitis and typhoid are given. Other vaccinations that can be considered are hepatitis b, rabies and Japanese encephalitis. Find out more about our wellness and travel vaccinations.
Rabies is an especially high risk in the Philippines. It is a virus found in the saliva and bodily fluids of mammals. It is transmitted to humans by the bite, scratch or lick to open skin. Once the virus enters the body and the nervous system, it is fatal. There is a large number of stray animals in the Philippines so extra care should be taken to avoid contact with animals. Pre-travel rabies vaccinations are strongly recommended for travellers to the Philippines. There have been reports of falsified rabies vaccinations and immunoglobulin circulating in the country meaning anyone exposed to the virus seeking medical treatment in-country may not receive the proper treatment.
The majority of the Philippines is low to no risk of malaria. Palawan, Tawi Tawi, Zambales and Zamboanga del Norte present a higher risk of malaria. Most travellers will not require anti-malarial medication providing they are careful not to get bitten by mosquitoes. The malaria mosquitoes are most active during the evening, so if you plan to visit a high-risk area, ensure you are cautious between the hours of dusk and dawn and aim to sleep under a mosquito net to prevent bites whilst you sleep.
The Philippines has a risk of several non-vaccine preventable viruses that can be spread by mosquitoes. Dengue fever, chikungunya and zika virus are the main culprits. These viruses are spread by mosquitoes that predominantly bite in the day. As there is no vaccination nor medication that will prevent this illness, strict precautions must be taken to prevent their bites. Wear long loose clothing and cover up as much as possible, particularly between dawn and dusk. Wear a good insect repellent with a minimum of 50% DEET in it, and treat clothes with the insecticide permethrin for added protection.
See our ultimate bug kit.
The Philippines is made up of over 7000 islands and the main way of reaching them is by boat. If you are prone to travel sickness you may want to ensure you pack some medication to prevent this so not to interrupt your experience. There is an abundance of pristine coral reefs throughout the archipelago making the country perfect for water sports. Whether you are snorkelling, surfing or scuba diving, if you plan to take the plunge you need to be careful to avoid coral cuts and abrasions. Extra care needs to be taken with coral cuts to prevent them from becoming infected. Packing a small first aid kit with tweezers, waterproof dressings and antiseptic is a sensible idea.
The availability of medical care varies across the Philippines, and may not meet the standards of care in the UK. Although adequate in major cities, medical care is limited in more remote areas.
By Anna Chapman | Travel Nurse | November 2019
Myanmar is becoming an increasingly popular destination to visit in South-East Asia.
The golden pagodas of Yangon and the stupors of Bagan are top on most travellers itineraries, alongside a trip down the Irrawaddy river to Inle Lake.
The more adventurous may head to the islands on the Myiek archipelago or hike the hill station of Kalaw. Whatever the itinerary, it is essential to ensure you have sought pre-travel advice to ensure you stay healthy whilst abroad.
Travellers should ensure they are up-to-date with their routine immunisations. All travellers should ensure that they have received a vaccination against diphtheria, tetanus and polio (DTP) in the last 10 years. Other vaccinations that all travellers should ensure they are up-to-date with are Hepatitis A and Typhoid. Some travellers may wish to consider vaccination against hepatitis b, rabies, cholera and Japanese encephalitis. It is best to book a travel consultation with a travel nurse to discuss your route and your plans to ensure you are protected for all circumstances.
The cities of Yangon and Mandalay have no risk of malaria. The majority of areas that travellers visit such as Bago, Inle Lake, Kyaikto Padoga and Bagan have a low risk of malaria and anti-malarial medication is not usually advised. The states of Chin, Kachin, Kayah, Rakhine and Sagaing have a high risk of malaria. Travellers visiting these areas are advised to take anti-malarial for this part of their trip. The malaria mosquitoes are most active during the evening. So, if you plan to visit a high-risk area, ensure you are cautious between the hours of dusk and dawn. Aim to sleep under a mosquito net to prevent bites whilst you sleep.
Myanmar has a risk of several non-vaccine preventable viruses that can be spread by mosquitoes. Dengue fever, chikungunya and Zika virus are the main culprits. These viruses are spread by mosquitoes that predominantly bite in the day. As there is no vaccination or medication that will prevent these illnesses, strict precautions must be taken to prevent being bitten. Wear long loose clothing and cover up as much as possible. Particularly between dawn and dusk. Wear a good insect relevant with a minimum of 50% DEET in it. Treat clothes with the insecticide permethrin for added protection. For short adventures, this can be done before your trip.
See our Ultimate Bug Kit.
Fancy a dip in Lake Inle?
Think again. Temperatures in Myanmar can reach 40 degrees and a quick dip in the lake may sound like a good way to cool off. However, there have been recent outbreaks of schistosomiasis infection in Myanmar. Schistosomiasis is a parasitic blood fluke. The fluke lives in freshwater snails and enters through the skin when an unsuspecting person takes a dip. The fluke causes infection of the liver, bladder and bowels and can lead to long term damage. The best way to avoid this is to avoid swimming or bathing in freshwater. The detection of schistosomiasis can take up to 8-weeks. You should visit a GP for a health assessment 2 months after your suspected exposure date, even if you haven’t yet returned to the UK.
Some areas of Myanmar are remote. The further in-country you travel, the harder it will be to access medication and first aid supplies. In some areas, access will be non-existent. Packing a good basic first aid kit is essential to help treat minor injuries and illnesses. Include items such as dressings, plasters and antiseptic cream. They can help with minor cuts, scrapes and blisters. It is useful to pack items that can alleviate pain and treat upset stomachs, as these are common traveller’s health problems. Another medical kit you may want to consider is a worldwide gastro kit. Other items you may want to consider are anti-histamines for any mild allergic reactions.
If you take prescription medication to ensure you pack sufficient for your trip and carry a record of the medication with you.
By Anna Chapman | Travel Nurse | November 2019
Botswana is one of the greatest safari destinations.
The Okavango Delta offers exceptional opportunities to view wild creatures and birdlife. Elephants roam freely and herds of buffalo crowd around the winding waterways the river. The stark and desolate landscape of the Kalahari desert can be found in the south with the longest unbroken stretch of sand there is. Whatever your itinerary, ensure you follow our top travel tips.
All travellers should ensure they are up-to-date with their routine vaccinations including measles, hepatitis A, typhoid, diphtheria-tetanus and polio (DTP). You may want to consider getting vaccinations for rabies and hepatitis B as well. Both these diseases are classed as high-risk in Botswana. We would advise you to speak with a travel nurse ideally 4-6 weeks before travel. At this appointment, you can discuss where you’re going and what you plan to do. They can then advise you of all the recommended vaccinations you should consider.
There is a high risk of malaria throughout the year in the northern areas of Botswana including the Okavango Delta, Chobe and Moremi. There is a low risk of malaria in the rest of the country including the central Kalahari, Gaborone and Gemsbok. Individuals travelling to hight risk regions are advised to take anti-malarial medications to prevent the disease. As well as taking precautions against mosquito bites. The mosquitoes that spread malaria predominantly bite at night. For that reason, it is essential you sleep under a mosquito net.
All travellers need to take extra precautions against insect bites. Mosquitoes, ticks, mites and lice are able to spread diseases such as African tick bite fever, dengue fever, filariasis and myiasis. Travellers should wear good insect repellent with at least 50% DEET and try to cover up with long loose clothes. You can add extra protection to your clothes by treating them with an insecticide. We would recommend using a permethrin spray.
See our Ultimate Bug Kit.
What about Yellow Fever?
The is no risk of Yellow Fever in Botswana. It is therefore not recommended that travellers get vaccinated. Travellers may require a valid Yellow Fever Certificate if they are entering Botswana from a country that has yellow fever, or who have transited through a country with a risk of yellow fever.
First Aid Supplies
Areas of Botswana can be remote, and access to medication and first aid supplies can be limited. Packing a good basic first aid kit is a good idea to help treat minor injuries and illnesses. Basic items such as anti-histamines, pain relief and medicines to treat upset stomachs are useful. Likewise, pack small dressings, plasters and antiseptic cream to treat minor scrapes and scratches. If you take prescription medication to ensure you pack sufficient for your trip and carry a record of the medication with you.
By Anna Chapman | Travel Nurse | October 2019
Bosnia is where East meets West.
It is a country on the Balkan Peninsula in southeastern Europe and has become somewhat a destination for adventurous travellers.
Beautiful Ottoman architecture, rugged mountains, captivating castles, raft-able rivers, and humble hiking trails are all reasons why travellers are choosing Bosnia as their next travel destination. The unveiling of the Via Dinarica mega hiking trail means the number of tourists to the Balkan country of Bosnia Hercegovina is expected to rise steeply. The 1930km trail provides a corridor linking traditional cultures between the former Yugoslavian nations. So whether you plan to mill about the city of Mostar, stroll the streets of Sarajevo, or take a hike in the hillside, ensure you follow our top travel tips to stay healthy.
All travellers are advised to be in date with their routine immunisations, including diphtheria, tetanus and polio (DTP) and measles, mumps and rubella (MMR). Europe has seen huge outbreaks of measles this year alone, so all travellers should make sure they have received at least two doses of the measles-containing vaccination. A simple blood test can be done for all those who are unsure about their immunity. Some travellers may wish to consider vaccinations for Hepatitis A and Hepatitis B, rabies and tick-borne encephalitis. The activities you plan to do whilst travelling will determine which vaccines would be required. If you have any doubts or concerns, we also suggest booking a pre-travel consultation with a specialist travel nurse to discuss your options.
Trekking and Ticks
Bosnia offers a wealth of outdoor activities. Those who plan to take advantage of the great outdoors should strongly consider vaccination against tick-borne encephalitis (TBE). TBE is a bacterial infection. Usually, it is spread through an infected tick bite. However, during Spring to Autumn, the consumption of unpasteurised dairy produce also carries a risk. Contracting the illness causes a fever with neurological complications. It is vaccine-preventable. Protection requires 2 doses of the vaccination, given at least 2-weeks apart. A third dose is given 5-12 months later to give longterm protection. You should also avoid ticks by wearing long trousers and socks. Using DEET insect repellant should also repel them.
If you spot a tick on you, it needs to be removed promptly. Use some flat tweezers or a tick remover and clean the bite with alcohol to reduce the risk of infection.
See our Ultimate Bug Kit.
Rabies is a fatal virus that can be found in the saliva of an infected mammal. Most commonly a wild dog. Exposure can happen through a bite, scratch or a lick to an open area of the skin. You cannot catch rabies from another person and it cannot spread through unbroken skin. You should, where possible avoid contact with animals when travelling, especially wild or stay animals.
Rabies is almost always fatal once symptoms appear, but treatment before this is very effective. Pre-travel rabies vaccination offers great protection. And means that in the unlikely event you come into contact with the rabies virus, fast and effective treatment can be given easily and in the country of the incident.
Pre-travel rabies protection requires a series of 3 vaccinations given as injections into your upper arm. Your vaccines will be given over a 3-week period, or over 1 week if an accelerated course is needed, prior to travel. Travellers at greater risk are those who plan to do outdoor activities such as hiking, trekking, cycling or caving. You should consider a rabies vaccine if you plan to do any of these activities whilst visiting Bosnia.
First Aid Kit
For those trekking in the hills, packing good basic first aid kit is essential. When travelling in rural areas, access to healthcare can be limited. Travelling with a medical kit will give you access to basic provisions needed to treat minor injuries and pains.
Basic provisions include pain relief, plasters and medication to treat an upset stomach, such as loperamide and oral rehydration salts. If access to safe water may be limited, consider packing chlorine dioxide tablets. Cuts, scapes blisters and even a twisted ankle can occur, so take blister pads, some waterproof dressings and a bandage to deal with any minor injuries whilst you are there. If you take regular prescription medication, ensure you pack enough for the duration of your trip and carry the prescription with you.
By Anna Chapman | Travel Nurse | August 2019
Tanzania is the perfect haven for adventurous travellers. Not only does it boast three of Africa’s Seven Natural Wonders, but it is home to the ancient nomadic stewards, the iconic, Maasai people. It is also the perfect place for an African safari adventure, with it’s 16 national parks accounting for more than 30% of the country.
Tanzania is blessed with the highest peak in Africa. Mount Kilimanjaro beckons visitors from all over the world. It is the world’s highest free-standing volcano and gets an estimated 30,000 travellers attempting to summit the peak each year. Climbers by the thousands venture here to challenge themselves on its muddy slopes, rocky trails and slippery scree.
It’s crowning jewel is the island, Zanzibar. The island is famous for its mix of exotic white sand beaches, dense palm trees and coral seas. A true paradise. It hosts famous spice plantations and is rich with diverse culture. Unguja (the main island in Zanzibar) is also home to many endangered species including the red colobus monkey and green turtle.
Whether you are visiting for an action-packed safari, challenging yourself to reach the peak of Mt. Kilimanjaro or relaxing on the island of Zanzibar, ensure you follow our top travel tips to stay healthy in Tanzania.
You should consider specialist travel vaccinations prior to travel. Hepatitis A and Typhoid are highly recommended. Furthermore, some travellers may also wish to be vaccinated against Rabies, Hepatitis B and Cholera for extra precautions. Especially if travelling to more rural areas.
In Tanzania, there is no risk of yellow fever. If you are only travelling directly from the UK and back, it generally isn’t advised to have yellow fever vaccine. There is, however, a requirement for travellers to have a certificate of vaccination if they enter Tanzania from another country that has Yellow Fever. Bordering countries such as Kenya, Uganda, Rwanda, Burundi & DRC would all require a certificate. In this instance, a vaccination or a waiver certificate may be advised. It is best to speak with a specialist travel nurse, who will look at your route and access what vaccinations and certificates you would require.
Whether you plan to visit Zanzibar or the mainland, all areas of Tanzania have a risk of malaria. Therefore, you should take anti-malarial medication. Malaria is spread by mosquitoes that are most active between dusk and dawn. A common question is whether or not you need to take them if you plan to trek Mount Kilimanjaro. Even though the risk of malaria is low in areas above 2,500m, the start and finish of the trek take you well below this altitude. In short, you should take medication to prevent it. You should take precautions to reduce the risk of being bitten in the first place.
- Wear long, loose clothing
- Wear plenty of mosquito repellent with a minimum of 50% DEET
- Use clothes spray containing permethrin – you can spray before you travel for short-duration trips
- Sleep under a mosquito net
See our Ultimate Bug Kit for everything you need to keep the mosquitos at bay.
If you are trekking Kilimanjaro, make sure your pre-travel plans take this into account. Trekking is physically demanding and exposes you to the risk of altitude sickness. The summit of the peak is 5,895m and treks can take anything from 5-9 days. Altitude sickness is unpleasant. Not only this but it can develop into something more serious and become life-threatening. Take time to acclimatise. This will reduce your risk of developing altitude sickness. Ideally, choose a longer trek. A slower ascent over more days will reduce your risk considerably. Alternatively, you can get a prescription of acetazolamide (Diamox) to aid the process. Speak to a specialist travel nurse about this at your pre-travel consultation. Don’t let altitude sickness ruin your trip.
By Anna Chapman | Travel Nurse | August 2019
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.
UPDATED RECOMMENDATIONS FOR Yellow Fever VACCINATION: Nigeria
The World Health Organization recently updated the yellow fever recommendations and requirements for residents and travellers to Nigeria.
As of 1 July 2019, the yellow fever certificate requirement for travellers to Nigeria changed. All travellers aged 9 months or over are now required to travel with a yellow fever vaccination certificate along with a valid visa. Failure to provide a valid certificate where required could deny entry to that country, or result in quarantine.
Previously a certificate was only required for those arriving from risk areas countries. However, an on-going outbreak of yellow fever, which started in September 2017, is continuing therefore a revised classification has been made. Between January and April 2019, a total of 930 suspected cases were reported in 447 Local Government Areas.
Advice for travellers
The Fleet Street Clinic would like to remind all travellers from the United Kingdom that there is a risk of yellow fever transmission throughout Nigeria.
We are a Certified Yellow Fever Centre with availability throughout the week and are usually able to accommodate same day appointments requests.
What is Yellow Fever?
Yellow Fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. There is no specific treatment, although the disease is preventable using a single dose of yellow fever vaccine, which provides immunity for life.
For more information about Yellow Fever & the Vaccine.
Anyone travelling to Nigeria should book a Pre-Travel Consultation. One of our specialist Travel Nurses will access if a Yellow Fever vaccine is suitable for you.
World Health Organization
Japan is hosting the biggest Rugby event of the year in September.
Starting 20th September, across 12 Japanese cities, 48 matches will be played to determine the winner of Rugby World Cup 2019. Millions of people from around the world are expected to travel to Japan to attend this amazing sporting event. Much like any other reason for travelling, it does come with some health risks.
Big sporting events, like the Rugby World Cup, attract huge numbers of people which increases the risk of getting sick and spreading diseases. Venues are sometimes described as giant Petri dishes, where viruses and bacteria can flourish and spread.
But how can you prepare yourself so you remain healthy throughout your holiday?
It is advised that individuals are up-to-date with routine immunisations including diphtheria, tetanus and polio (DTP).
If you plan to venture outside of the major cities and explore Japan whilst you are there, you may need to consider some travel vaccines, such as Rabies and Hepatitis A or Hepatitis B. If those plans include visiting more rural areas, Japanese Encephalitis could be considered. For those trekking, hiking or camping, a vaccination against tick-borne encephalitis will provide protection against the disease.
MMR is a must
Ensure you are immune to measles before you travel. Japan has had multiple large outbreaks of measles this year and it is a highly contagious disease.
The best protection against measles is to ensure you have received 2 doses of the MMR vaccine. You may not have received the full course during your childhood vaccines which means you’re not fully immune. A simple blood test can determine immunity if you are unsure.
Beware of Flu Season
Flu season for the Northern Hemisphere begins in Autumn, which coincides with the start of the Rugby World Cup. It’s possible people could pick up the flu virus at these events as the Flu is a highly contagious viral disease. Transmission of the flu is always amplified when large groups of people congregate in enclosed space. People travelling to and from mass gatherings can also spread flu to other communities and to family members when they get home. An infected person can transmit the virus before even realising they are sick.
Getting a flu vaccine every year is the best way to avoid getting seasonal flu.
Those travelling from mid-September onwards should consider getting the flu jab as soon as it becomes available.
Minimize Your Risk
Besides the flu vaccine, here are a few tips on how to minimize your risk of contracting an illness at the Rugby World Cup:
- Keep a distance from people coughing and sneezing – droplets from coughs or sneezes containing flu virus can travel at least 3 feet, so keeping this distance from sick people can help lower your chance of becoming ill.
- Wash your hands often, before eating or after contact with sick people, public places and bathrooms to limit your chances of contact with the virus.
- Carry hand sanitizer to use when hand washing is inconvenient or not available. Ensure it has a minimum of 60% alcohol content to be most effective.
- Avoid touching your mouth, nose and eyes with your hands.
- Use clean, disposable tissues to wipe your mouth or blow your nose. Throw away used tissue immediately after use.
- Avoid getting overly cold and wet by wearing appropriate clothing.
- if you are already sick, wear a face mask to help lower the chance of spreading your illness to others.
Despite having a good reputation for health care, it’s worth being prepared for minor illnesses and injuries when travelling abroad. Pack an essential First Aid Kit for your travels and include some basic items such as pain relief, plasters, antiseptic creams and something to treat minor wounds. Being able to treat minor accidents whilst abroad means less time hunting down a pharmacy or time wasted visiting a doctor should you need it.
You can book a pre-travel consultation online.
The Southern African nation, Mozambique is gaining popularity amongst the adventure traveller community. Often referred to as ‘The Pearl of the Indian Ocean’, it is well off the usual tourist trail of Africa. Mozambique offers rustic beaches, delightful architecture, superb national parks, and plenty of diving opportunities.
Many choose to start their adventure exploring the capital city, Maputo. It is easy to understand why. It is rich in culture with beautifully preserved Portuguese colonial architecture. You could easily spend a week enjoying the hospitality of the friendly locals, eating the delicious food and partying the night away. Maputo is a largely-underestimated African capital city.
Mozambique is also known for having some of the most pristine dive sites in the world. Tofo is arguably one of the greatest places on Earth to see megafauna marine life. Crystal clear water provides perfect visibility to view the abundant marine life. The beautiful tropical Islands of the Bazaruto and Quirimbas Archipelagos are some of the most romantic and secluded beach destinations in the world – ideal for honeymooners.
Whatever your holiday entails, ensure you read out top travel tips to stay healthy in Mozambique.
Travellers should ensure they are up-to-date with their routine immunisations including measles, mumps and rubella (MMR) and diphtheria-tetanus and polio (DTP). Additional travel vaccinations are advised including hepatitis A, typhoid, rabies and hepatitis B. It’s best to speak with a travel nurse about any specific travel vaccinations you may need in a pre-travel consultation.
…What about Yellow Fever?
Yellow Fever is a viral haemorrhagic illness spread from the infected bite of the Aedes mosquito. Whilst it can occur in parts of Africa, there is no risk of Yellow Fever in Mozambique. Therefore, travellers do not need to be vaccinated.
The only exception to this will be for travellers who are entering Mozambique from a country which does have a risk of the illness. In this case, it is best to speak to a travel nurse to see if you require the vaccine. If you do, you will need to be in possession of a Yellow Fever Vaccination certificate as a condition of entry. Ask your travel health specialist for advice.
Polio is a viral infection. As it is contagious, you can get polio from contact with an infected person. In addition, consuming food or water that has been contaminated by a person with poliovirus also puts you at risk. There has been a worldwide effort to eliminate polio, which is proving highly successful. However, Mozambique still remains at risk due to vaccinate-derived circulating strains. All travellers should ensure they are up-to-date with their polio immunisation. The polio vaccine is a combination vaccination, given with diphtheria and tetanus. It provides protection for 10 years.
If you plan to stay for longer than 4 consecutive weeks, it’s advised that your polio vaccine be administered within the last 12-months. You should also have the dose recorded on an International certificate of vaccination prophylaxis card as proof of immunisation. Furthermore, long-term travellers to Mozambique may be required to show this when they leave the country, as proof they have been immunised.
All of Mozambique has a risk of malaria. Malaria is an infection spread by the Anopheles mosquitoes which are most active during dusk till dawn. You should take strict precautions against mosquito bites. This includes wearing long loose clothing and using an insect repellent with a minimum of 50% DEET. You can reduce the risk of indoor mosquito activity with the use of plug-in vaporisers. Plus, sleeping under a mosquito net can help reduce night-time bites.
We recommend taking antimalarial medication for the duration of your trip. As there are different options available, it’s best to speak to a travel nurse to find the best option for you and your family.
See our Ultimate Bug Kit.
Special precautions post-Cyclone Idai
Cyclone Idai battered the coast of Mozambique on the 9th March 2019. The storms brought heavy rains, winds and flooding. As a result of the initial impact alone, there were hundreds of fatalities. The storm created many serious health risks. Firstly, like most natural disasters, the storm has displaced a huge number of local people. Which as a result, will increase the risk of diseases spreading. Secondly, it has placed a strain on the countries structural and health infrastructure. Which as a result, and can lead to further flooding and increases the risk of water-borne infections such as cholera. Thirdly, the increase of water has led to an increase in breeding sites for mosquitoes. Therefore, there is an increased risk of malaria and other mosquito-transferred diseases.
Although the risk for tourists will be much lower than that of the local population, extra precautions to avoid infectious diseases should be taken. You should pay extra attention to the food and water hygiene you consume. This will minimise the risk of you getting a diarrhoeal illness.
If you are travelling to an area with a known outbreak, the Cholera vaccine can be considered. Similarly, those undertaking humanitarian work or those with inadequate access to safe water and sanitation should also consider the vaccine.
By Anna Chapman | Travel Nurse | July 2019
Greenland is home to truly magnificent mountainscapes and glaciers.
Jakobshavn Glacier, the world’s fastest-moving glacier in the Northern Hemisphere can be found here.
In the Winter, tourist travel to this wonderland to potentially see the wondrous the Northern Lights. Things are quite different in the Summer.
Chasing the Midnight Sun
Summer in Greenland is an image not often associated with the country. Summertime offers eternal light in the land of ‘The Midnight Sun’ whereby the day has neither a beginning nor an end. Those wanting to experience this time-shifting experience must travel north or the Arctic Circle. The low-lying sun makes the surrounding scenery appear almost dreamlike; icebergs and hilltops are bathed in a surreal palette of pink, purple, yellow and red. Travellers to Greenland have options of hiking the land or sailing the fjords between icebergs.
If you plan to travel to Greenland this summer follow our top travel tips to ensure you stay healthy.
Even though Greenland resides in the Arctic Circle, travellers should still ensure they receive appropriate pre-travel vaccinations. This includes being up-to-date with Measles, diphtheria-tetanus and polio. Greenland has a high risk of Rabies, a virus spread through the infected bite of a mammal. Travellers who plan to trek inland may wish to consider this vaccination before they travel to reduce the risk.
Despite Greenland having long, dark winters, the summer months provide almost constant light. Bright sun, combined with the effects of lights reflection from snow and water can increase the risk of sun damage from UV light. Despite temperatures remaining cold, travellers still need to be sun smart. Ensure you wear a high factor SPF, and use lip balm to prevent cracking. Polarised sunglasses that wrap around will prevent the UV rays causing damage to your eyes.
Many activities in Greenland involve taking to the water and visiting the infamous Disko Bay in search of Icebergs. Sometimes the seas can be rough which can make for a miserable time if you are prone to travel sickness.
Sea Sickness can be reduced by:
Sit in the centre of the boat where the motion will be less aggressive
Close your eyes or focus on a point on the horizon, this can help your inner ear balance.
Avoid alcohol and large heavy meals, instead, keep hydrated on water and eat smaller lighter meals
Sucking on a mint or ginger sweet can help with nausea
Seas Sickness medication tablets
Patches that can be used to prevent sea-sickness
Parts of Greenland can be remote so taking a good First aid kit with you is essential. Basic provisions include pain relief, plasters and medication to treat an upset stomach, such as loperamide and oral rehydration salts. If you take prescription medication to ensure you pack enough and carry the prescription with you. If you plan on trekking the hinterland, pack additional items such as blister dressings and plasters.
By Anna Chapman | Travel Nurse | July 2019
June to September is the best months to trek to Machu Picchu, although you can visit all year round. The weather is at its driest and coolest with gloriously sunny days. Trekking to the roof of the Andes is a rewarding experience that many travellers to Peru sign up for. Travellers who are trail-blazing their way on the Inca road to catch a glimpse of the forgotten city should follow our top travel tips to ensure they stay healthy on the road.
All travellers to Peru should ensure that they are up-to-date with measles, diphtheria, tetanus and polio (DTP), and have received vaccinations against Hepatitis A and Typhoid. There is a risk of Rabies and Hepatitis B in Peru, and all travellers attempting the Inca Trail should consider vaccinations against these.
There is no risk of Yellow Fever on the Inca Trail or Cusco. However, the vaccination may be recommended to travellers who are doing further travel in Peru, such as the Amazon rainforest. Those planning to extend their trip to South America may require the Yellow Fever vaccination for personal protection. Additionally, you may require a valid yellow fever certificate to enter some other countries. It is best to book in a travel consultation with our specialist travel nurses to discuss your route.
The highest altitude of the Inca trail is 4,215m, a whopping 1,800m higher than Machu Picchu itself! Most people start the hike from Cusco which lies at 3,400m, meaning trekking this wonder of the world poses a real risk of altitude sickness. Altitude sickness is unpleasant and can develop into something serious and become life-threatening. It is best avoided by taking time to acclimatise. Ideally, if you are arriving from sea level, spend a few days in Cusco before your trek begins to adjust to the different altitude. Choose a longer trek, a slower ascent over more days will reduce your risk considerably. Alternatively, you can get a prescription of acetazolamide (Diamox) to aid the process. Speak to a specialist travel nurse about this at your pre-travel consultation. Don’t let altitude sickness ruin your trip.
Treks on the Inca trail usually last around 5 days, meaning that an average trekker will probably consume at least 15 litres of water over the course of their trek. Unclean and unsafe drinking water can lead to sickness and diarrhoea so it is important that travellers have access to safe water. Carrying 15 litres of water on the trail is a near impossibility so travellers should ensure that they have a way to make water safe to drink. Carrying water purification tablets, or a bottle with a filter can ensure you have access to safe drinking water throughout.
Travellers diarrhoea and other common gastrointestinal infections can put a dampener on any adventure but especially when hiking. Access to toilets is likely to be limited throughout your journey so it is important to stay healthy. Ensure all food you eat is thoroughly cooked. Pack an alcohol hand gel so you can keep your hand clean before you eat and after using the toilet. It is wise to carry medication with you, so, if you do become unwell you have doctor-approved medication available to take. We recommend packing one of our Worldwide Gastro Kits. Inside there is medicine to prevent and treat travellers diarrhoea, dehydration, mild infections, nausea and vomiting. Hopefully, you won’t have to use this kit, however, for peace of mind, it is better to be safe than sorry.
The Inca trail typically consists of between 6-9 hours of walking a day, with shared tent accommodation. Hiking the Inca Trail through the Sacred Valley to Machu Picchu is both arduous and awe-inspiring. Make sure you have good walking boots that are broken in before you start. Book an appointment with a podiatrist and osteopath if you have any niggles or pain before setting off. Take care of your feet throughout your adventure – keep them clean and dry to avoid problems. Any blisters should be cleaned and covered with a dressing to prevent pain and infection. Pack your own first aid kit with some basic medications for pain, allergies and upset stomachs in case you do become unwell. Access to medical supplies will not be until Aguas Calientes at the end of the trek. You can buy a Fleet Street Clinic Essential First Aid Kit online to save you the hassle of assembling yourself. We would recommend considering a medical pedicure upon your return. Treat our feet a little bit of TLC for taking you on an adventure of a lifetime.
We would encourage all those taking on the Inca trail adventure to consider booking a travel consultation with either myself or another of our specialist travel nurses. We all have extensive knowledge on what vaccines and health precautions you should take on an individual basis to remain healthy throughout your adventure. Chances are at least one of us has done a similar adventure so we can give you some first-hand experience on what to expect too!
By Anna Chapman | Travel Nurse | July 2019
Parents are being urged to get their children vaccinated for measles, mumps and rubella following outbreaks of measles across Europe:
Anyone who is eligible to get vaccinated should get the MMR vaccine.
A measles outbreak across Europe has left UK officials urging parents to get their children vaccinated for measles, mumps and rubella. As measles is highly infectious, anyone who has not received 2 doses of the MMR vaccine is at risk. Particularly those unvaccinated people travelling to countries where there are currently large outbreaks of measles.
In the first three months of this year, there have been 231 confirmed cases of measles and 795 of mumps. While Public Health England (PHE) figures showed while measles cases were lower than the 265 reported during the same period last year, they had more than doubled compared to the 97 reported between October and December. The number of mumps cases has nearly tripled compared to the 275 cases during the first three months of 2018. No new cases of rubella have been reported.
PHE has now appealed to parents to make sure their children receive the MMR vaccine when it’s offered, or to get a GP appointment booked if they missed it. Officials have also warned that not only is measles highly contagious, but it can also kill a child if they are not vaccinated. Anyone who has not received two doses of MMR vaccine is at risk of measles as it is highly contagious.
There have been 3,789 cases of measles in Europe during the first three months of this year, according to the European Centre for Disease Prevention and Control. The highest numbers were in Romania, France, Poland and Lithuania.
Advice for travellers
For all those planning to travel to Europe, make sure you are up-to-date with all currently recommended UK vaccines. This includes two doses of the MMR vaccine for protection against measles, mumps and rubella.
Anyone who is not sure if they are protected should check with their GP practice. Vaccination is usually done within your childhood vaccinations. However, the MMR vaccine is available to all adults and children who have not had their two-dose course. In some cases, the MMR vaccine can be offered to babies from six months of age. Cases such as travelling to countries where measles is common, or during an outbreak situation. Book a travel consultation with our travel nurse for advice on the best option for your children before you travel.
Head of immunisation at PHE, Dr Mary Ramsay, warned with measles outbreaks across parts of Europe, families should make sure they are vaccinated before travelling. ‘There are measles outbreaks happening across Europe so if you are planning to travel, make sure you check with your GP and catch-up if needed.’
Measles elimination can only be sustained by maintaining and improving coverage of MMR vaccine in children, and by using all opportunities to catch up older children and adults who missed getting the MMR vaccine.
To achieve herd immunity for measles at least 90 to 95 per cent of the population needs to be fully protected. PHE said 94.9 per cent of eligible children aged five received their first dose of MMR in quarter 4 of 2018. However, the second dose of protection falls to 87.4 per cent for children aged five.
Fleet Street Clinic’s medical director, Dr Richard Dawood explains, ‘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.’
Vaccination against Measles, Mumps & Rubella
One dose of the MMR vaccine is about 90 to 95 per cent effective at preventing measles. Protection rises to around 99 per cent after the second dose. Two doses of MMR in a lifetime are needed for a person to be considered fully protected.
The MMR vaccine schedule:
- Two doses, to be given at least 4 weeks apart.
- If the first dose is given before 12 months of age (due to the need for early protection), this should be discounted and the child should continue to receive 2 doses as per the normal schedule.
- The vaccine is also available to all adults and children who are not up-to-date with their 2 doses.
Anyone who is not sure if they are fully vaccinated should check with their GP.
You can book all vaccination appointments online.
Travel nurse Anna takes us on a journey to Tel Aviv. A city on Israel’s Mediterranean coast steeped in history and a vibrant cultural scene. From vaccinations to sun protection follow the top tips to travel safely.
All travellers are advised to ensure that they are in date with their routine vaccinations. Measles outbreaks have been reported in Israel since September 2018, and there are concerns that the increase of travellers heading to Israel for Passover in mid-April could see cases rise. Travellers should ensure that they have received two doses of measles vaccination (often referred to as the MMR) prior to departure.
Other travel vaccinations to be considered are diphtheria, tetanus and polio, and Hepatitis A. Some travellers may also wish to consider vaccinations against Hepatitis B and Rabies. It is always best to discuss which vaccinations are necessary for your trip with a travel nurse.
However, vaccinations cannot protect you from many diseases and dangers in Israel, the risk can be reduced through your behaviours…
Israel lies within the sub-tropical region with a Mediterranean climate. Summer temperatures can reach 40 degrees Celsius, and even higher in the Negev desert. Don’t let the Mediterranean summer breezes deceive you and stay sun safe. Keep hydrated, wear a high factor sunscreen and avoid the suns rays between 11am-3pm when at its strongest.
Food and Water
Israel is foodie heaven but travellers should still maintain good food and water practices to avoid tummy trouble whilst away. Avoid tap water and ice made from tap water: stick to bottled water. Ensure you wash your hands thoroughly before eating and after using the toilet. Ensure all food you eat is cooked thoroughly and served straight to you. For those who would still like the freedom to eat and drink without worry, it is advisable to carry a gastro kit with you. Inside will be various medications that can assist with travellers’ diarrhoea, should it occur.
Mosquitoes and sand flies can be particularly problematic during the summer months. Not only can their bites cause irritation, but they can also spread diseases such as West Nile Fever, dengue fever and leishmaniasis. There are no specific vaccinations and preventative treatments for these diseases, and bite avoidance is the only way. Try and cover up especially between dusk and dawn, and wear a good insect repellant that contains at least 50% DEET.
See our Ultimate Bug Kit.
From Red to Dead…
From the riches of the coral seas in the red 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.
You can book all vaccination appointments or travel consultations online.
By Anna Chapman | Travel Nurse | May 2019
Bolivia is famous for its salt flats and varied terrain spanning over the Andes Mountains, the Atacama Desert and Amazon Basin rainforest. Located in South America, the climate varies drastically from one eco-region to the other. Travelling around Bolivia you’ll experience different climatic extremes, such as humid tropical climates to subtropical climates to desert-polar climates. It is important to seek travel advice before travelling as medical advice can vary dependent on the area/s you plan to visit.
Our general advice includes:
Routine immunisations are a high priority; it is good to check that they are all up-to-date before travelling anywhere. Given the current worldwide outbreaks, we strongly recommend checking your immunity status to measles. A simple immunity test can confirm all those who are unable to source vaccine proof. The best protection against measles is having 2 doses of a measles-containing vaccination, such as the MMR.
Travel vaccinations for Bolivia vary depending on where you plan to travel, and what you plan to do. It is best to book a consultation with a travel nurse to discuss your upcoming adventure. They will assess what risks you will potentially be exposed to. From this, they can develop a bespoke treatment plan specifically for your holiday.
As a minimum, travellers should be protected against Hepatitis A, and diphtheria, tetanus and polio. Certain travellers may consider vaccinations against typhoid, Rabies, Hepatitis B and Yellow Fever.
Yellow Fever is an unpleasant virus spread by the Aedes aegypti mosquito. This mosquito tends to bite during the day and is present in many lowland areas of South America and in all areas below 2,300m in Bolivia. Travellers who intend to visit the lowlands, such as the Chaco, Santa Cruz district and the Amazon may be advised to have the vaccine.
If your travel route includes other South American countries, you may also require the vaccination and an accompanying Yellow Fever Certificate in order to enter that country. The vaccination is not suitable for everybody. A careful risk assessment should be undertaken by a practitioner that specialises in the vaccine. Yellow Fever can only be given at designated Yellow Fever vaccination centres (YFVCs) – Fleet Street Clinic is a registered clinic.
Bolivia is home to some of the highest peaks of the Andes mountains, with elevations of over 6,000m. The frequently visited cities of La Paz, Potosi and Uyuni all soar over 3,500m, making altitude sickness a real risk. 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. Book a pre-travel assessment and speak to a travel nurse about your options.
Mosquitoes, bugs and flies do more than just bite. They have the ability to transmit diseases that aren’t always preventable by vaccination or medication. Illnesses such as dengue fever, chikungunya, Zika, yellow fever, malaria and sleeping sickness are a few risks.
The best prevention is to entirely avoid mosquito bites. Cover up as much as possible and apply a minimum concentration of 50% DEET to any areas of exposed skin. Spraying your clothes with permethrin before travelling can provide extra protection. Sleep under a mosquito net, especially, if you plan to stay anywhere remote or rural.
See our Ultimate Bug Kit.
Malaria occurs in the northern parts of Bolivia, in the Beni and Pando districts. Travellers heading to these areas should ensure they take anti-malarial medication. Mosquitoes that spread malaria are predominantly night-time biters. So, extra precautions should be taken between dusk and dawn. Any travellers who experience fever or flu-like symptoms on return from their trip should ensure they get tested for malaria, as unfortunately, no single prevention method is 100% effective.
Whilst medical services and pharmacies are available in bigger cities, access to basic services is limited or even non-existent in the remote regions. Travel prepared and take a small medical kit that can treat basic complaints. Pack painkillers, antiseptic cream, plasters or dressing, and medication in case you suffer from an upset stomach. Head over to our online shop to purchase an essential first aid medical kit. This contains all your travelling medical essentials.
If you are prone to allergies, a non-drowsy antihistamine is helpful. Furthermore, if you take prescription medication, be sure to pack enough to last you for your entire trip.
By Anna Chapman | Travel Nurse | May 2019
The risk of rabies is still widely unknown to the general public.
If caught and symptoms develop, rabies is almost invariably fatal.
Rabies is spread through the saliva of an infected animal and is present in over 150 countries worldwide. Up to 100 children die each day from rabies, and more than 55,000 people a year are killed from the disease, mainly in Asia and Africa.
If bitten or scratched by an infected animal you need to act quickly. Even with pre-travel vaccinations, a course of post-exposure vaccinations are required to prevent disease. If you haven’t had pre-travel vaccinations, the treatment is much more intense. If treatment is given correctly and promptly after exposure, then rabies can be cured but once symptoms develop, it is too late.
Some countries are deemed high-risk of rabies.
Considering this, it’s alarming when we experience resistance from travellers who feel this vaccination isn’t necessary for travel, especially if they are visiting a high risk location.
We feel so passionately that if you are travelling somewhere with a known risks of rabies it only seems sensible to protect yourself against it. Rabies is a vaccine-preventable disease, so make sure you get vaccinated before you travel.
For more information on rabies and travel health, visit our rabies page here.
The Fleet Street Clinic is passionate about travel. We have provided rabies vaccinations for over 20 years. Our team of expert travel medical professionals provide advice and detailed consultations to ensure you have a healthy trip.
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.
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.
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.”
“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.
Uzbekistan is home to spellbinding architecture and ancient cities. In terms of sights alone, Uzbekistan is Central Asia’s biggest draw and most impressive showstopper. Fabulous mosques, medressas and mausoleums are just some of the pulls for tourists when visiting Uzbekistan while more eccentric views can be seen at the fast disappearing Aral Sea and Nuratau Mountains.
Travel Nurse, Anna, shares her top tips on how to stay healthy during your trip to Uzbekistan.
Ensure you are up-to-date with your travel vaccinations. The minimum advised for a trip to Uzbekistan is diphtheria tetanus and polio, and Hepatitis A. Typhoid, Hepatitis B and Rabies can be considered by some travellers. It is advisable to attend for a pre-travel assessment with a travel nurse 6-weeks before your trip as some vaccinations requires several injections to complete the course.
Food and water
Precautions against the dreaded traveller’s diarrhoea should be taken to prevent an upset stomach ruining your trip. Do not drink tap water in Uzbekistan, stick to bottled water or water that has been boiled. If you are trekking or visiting remote areas it’s a good idea to take either a water bottle with a filter or some chlorine dioxide tablets to make water safe to drink, should you not be able to find a shop with bottled water.
Sour milk dishes dominate the Uzbek cuisine. Cue caution if you want to try ‘kurt’, the famous fermented cheese balls. There is a risk of a bacterial disease called brucellosis that can be spread through unpasteurised dairy products such as cheese and milk.
Travelling further afield
Uzbekistan forms one of the countries on the old silk route. If you plan on a tour of the ‘Stans’ or attempting the whole Beijing to Istanbul route, you may need to consider other travel health precautions. Depending on your route, and also the time of year you intend to travel, you may wish to consider vaccinations against Tick-Borne Encephalitis and Japanese Encephalitis.
Khazret Sultan, Uzbekistan’s highest peak stands at 4643m. Many popular walking and hiking routes such as Big Chimgan exceed over 3000m, making altitude related illnesses a hazard. Tips for reducing altitude sickness include a slow ascent route, keeping hydrated, ensuring that your sleeping altitude doesn’t exceed 500m per day. Diamox (acetazolamide) is a prescription medication that can reduce the symptoms of altitude related illness.
By Anna Chapman | Travel Nurse | April 2019
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.
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.
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.
By Anna Chapman | Travel Nurse | April 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
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
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
The Blue Hole in Belize is famous for being a natural wonder with a unique diving experience. It’s world-class diving rates as one of the top 5 diving sites in the world. Belize is a great travel destination for the adventure traveller.
Avoid getting that sinking feeling by following our top 5 tips for staying healthy…
Ensure you are up-to-date with your travel vaccinations including diphtheria, tetanus and polio and Hepatitis A. Speak to a travel nurse before you travel to ensure you are protected for your trip, especially if you have multiple destinations planned.
2 – Pack a small first aid kit.
A small first aid kit packed with travel essentials will cover you for minor injuries. Forceps or tweezers are useful for removing foreign bodies, such as sea urchin spines, and antiseptic wash or cream can be used to treat any coral cuts or abrasions. We stock a perfect essential first aid kit on our online shop.
3 – Be sun-safe to avoid sunburn.
Be conscious of how much sun exposure you get. The Caribbean sun can be strong with an increased risk of sunburn if you’re not careful. Wear sunscreen in between your dives with a protection level of at least SPF50 and spend time in the shade, especially in the midday sun between 11am and 3pm. Cover up with clothes, a hat and sunglasses to protect your skin, scalp and eyes.
4- Keep hydrated.
Although you are surrounded by water, diving and the sun exposure can cause dehydration. Ensure you drink plenty of fluids to prevent it. It is best to avoid drinking tap water directly, unless using a water bottle with a filter or chlorine dioxide tablets, both of which will make the tap water safe to drink. Another alternative is to buy bottled water with a seal although, those trying to reduce their plastic footprint should opt for the former options.
5 – Avoid sea sickness.
The journey from the mainland to the blue-hole can take up to 3 hours and is often crossing bumpy seas. If you are prone to travel sickness you may want to ensure you pack some medication to prevent this so not to interrupt your experience.
By Anna Chapman | Travel Nurse | February 2019
Have a bug-free beach life
Apart from causing an itch and inflammation, mosquitoes can leave more than just an irritation.
In the Caribbean, they have the ability to transmit diseases such as Dengue Fever, Zika Virus and Chikungunya.
Mosquito bite avoidance is recommended, here are our recommendations on how:
- Cover up with clothing
- Use insect repellents containing a minimum of 50% DEET on any exposed skin
- Consider treating clothes with permethrin
- Sleep under bed nets and use insect screens on doors.
- Reduce mosquito breeding sites by removing any water containers from outdoor areas
- Use air-conditioning
- Consider the use of plug-in electrical vaporisers which deter mosquitoes
- Use our Ultimate Bug Kit.
Dengue Fever & Chikungunya
There is currently no vaccine available to prevent either dengue nor chikungunya in travellers. However, without mosquitoes, individual sufferers are not directly contagious.
The risk for both diseases is thought to be higher during periods of intense mosquito feeding activity (two to three hours after dawn and during the early evening).
There is currently no vaccine available to prevent the ZIKV infection in travellers. Those infected with the infection normally have no symptoms. When symptoms do occur they are usually mild and short-lived. Serious complications and deaths are not common.
The concerns with the Zika virus and primarily to do with birth defects and as a result pregnant women should postpone non-essential travel until after pregnancy. More information on Zika Virus and pregnancy concerns from Public Health England.
So say ‘zip off’ to zika and ‘do one’ dengue and enjoy a bug-free beach life!
If you would like more travel advice we’d recommend an appointment with one of our travel nurses. You can book your travel appointment online.
By Anna Chapman | Travel Nurse | November 2018
Be sun smart on the slopes
Even if it is snowing, don’t assume that the sun’s rays are safe. The sun’s rays reflect off the snow and intensify them. Ensure you wear a high factor SPF, and use lip balm to prevent cracking. Polarised sunglasses that wrap around will prevent the UV rays causing damage to your eyes.
Don’t get caught out in the cold
Winter temperatures on the slopes often fall below zero, putting travellers at risk of cold-related injuries such as hypothermia and frostbite. When travelling in cold climates, ensure you wear warm clothing in layers. Heat is rapidly lost through hands and feet, so wearing a hat and gloves will help minimise heat loss.
Stopping altitude sickness at the summit
Some of Europes best slopes are found at altitudes higher than 2500m putting skiers at risk of altitude sickness. If you plan on skiing from the summits, make sure you prepare. Know the altitude you are going to, and recognise the symptoms of altitude sickness. Skiers could consider the use of altitude sickness medication acetazolamide (more commonly knows as Diamox) to prevent developing altitude related illness.
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
Public Health England has issued a health warning aimed at travellers highlighting the risk of rabies.
Following the recent news whereby a UK resident sadly died after becoming infected with rabies following a cat bite during a visit to Morocco, there is need to remind travellers of the dangers of viral infections when outside of the UK.
Rabies is a virus infection of the brain which is usually transmitted from contact with an infected animal, through injuries such as bites and scratches.
Dogs are the main source of infection in most parts of the world, although almost any mammal can become infected.
Although not a concern in the UK, PHE highlights the dangers of animals whilst travelling:
‘Rabies is common in other parts of the world, especially in Asia and Africa. All travellers to rabies-affected countries should avoid contact with dogs, cats and other animals wherever possible, and seek advice about the need for rabies vaccine prior to travel.’
When visiting countries with rabies endemic it is best to avoid contact with animals especially stray or wild animals.
People are usually infected following a deep bite or scratch from an animal with rabies, and transmission to humans by rabid dogs accounts for 99% of cases.
The virus cannot infiltrate intact skin.
Initial symptoms of rabies include a fever with pain and unusual or unexplained tingling, pricking, or burning sensation (paraesthesia) at the wound site. As the virus spreads to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops.
What to do if bitten?
If a traveller has been bitten or licked, they should immediately wash the wound with soap and water as soon as they can. That will inactivate and wash out a lot of the virus (if there is virus present), and urgently seek medical care.
Once symptoms have developed, left untreated rabies is almost always fatal. Rabies is a 100% vaccine-preventable disease.
You should consider getting vaccinated against rabies if you are travelling to a country which is considered high-risk especially if you’re planning on travelling to more remote locations.
Rabies vaccination requires a course of 3 vaccinations for complete protection. Depending on how much time you have prior to travelling would determine which course of treatment is suitable for you.
Alternatively, those with time constraints can opt for the accelerated rabies vaccination course.
The accelerated option can be provided over 7 days; giving full protection within a week.
This option is suitable for spontaneous travellers and last-minute business trips to countries affected by rabies.
All travellers who think they have been exposed to the rabies virus should urgently seek medical care and post-exposure vaccinations.
- If you’ve had your immunisations, you will require two doses of rabies vaccination, 3 days apart.
- If you are exposed to rabies and have not been vaccinated, a more intensive treatment of 5 vaccinations over a 30-day period, plus an injection of immunoglobulin is required.
Overall travellers should take precautions when travelling to countries where rabies is present.
Rabies: The Facts by The World Health Organisation
For more information on the risk of rabies in different countries, see the country information pages on the National Travel Health Network and Centre’s (NaTHNaC’s) website, TravelHealthPro.
Autumn in Japan
Japan’s Autumn runs from September – November and attracts many visitors each year to view the beautiful changing of the Autumn foliage, known as koyo.
Taking outings to appreciate the beauty of autumn has been a custom in Japan for centuries. For many years now, this has become a popular activity for tourists too. Visitors explore the whole country to find the best ‘Autumn’ spots to view the natural beauty of landscapes bursting with yellow, orange and red leaves.
This activity tends to divert travellers away from the urban cities and into rural environments. Unfortunately, this increases exposure to some harmful diseases.
If you’re planning a trip to Japan this autumn….check out our travel vaccination advice.
Whether you are visiting the ultra-modern counterpart of Tokyo or taking a trip to Japan’s must-see landmark of Mount Fiji, traveller’s should ensure they are up-to-date with their tetanus vaccine. The vaccination is a combination vaccine with diphtheria and polio (DTP), which is routinely given to all children in the UK. However, you should ensure you and your children are up-to-date with your routine vaccinations before travelling. The vaccine can be given once every 10 years to those at risk.
Arm yourself with Insect Repellent
You can catch a number of diseases from mosquito and tick bites. You can minimise your risk by wearing long loose clothing and wearing plenty of insect repellant with a minimum of 50% DEET. Our Ultimate Bug Kit is available to purchase online.
Japanese Encephalitis (JE) is transferred by mosquito bites. There is an increased risk for those travelling in rural areas with rice fields, marshlands, or pig farming areas. It is advised to avoid these areas, particularly during mosquito feeding times, dawn and dusk.
Those travelling to the Ryukyu Islands (Okinawa) should consider the Japanese Encephalitis vaccination as the highest risk season is typically April to December. Travellers with long-stays planned in rural area’s should also strongly consider the Japanese Encephalitis vaccine.
Tick-Borne Encephalitis (TBE) is transmitted by ticks and rarely by unpasteurised milk and dairy products. Travellers are at increased risk of exposure during outdoor activities in areas of vegetation (gardens, parks, meadows, forest fringes and glades). Ticks are usually most active between early spring and late autumn. We’d advise those travelling during that time to consider the TBE vaccination.
The main affected area is Hokkaido although there is a possible risk in Shimane Prefecture, Honshu.
Those travellers who aren’t planning on getting vaccinated should avoid eating and drinking unpasteurised milk products. We’d advise all adventurous eaters to consider the TBE vaccination prior to travelling.
Earlier this year we saw outbreaks of measles across the globe, including a large outbreak in Okinawa in Japan. Most countries routinely immunise children against measles, in combination with mumps and rubella (the MMR). However, if for some reason you or your child have missed this then receiving two doses of the MMR vaccination before travelling will give effective protection. A simple blood test can determine immunity. Those found non-immune should book in for the vaccinations prior to travel.
Seasonally Japan suffers from regular outbreaks of flu. Tokyo and other major metropolitan centres in Japan are very dense, which increases the spread of the flu. The flu vaccination available in the UK will dramatically reduce the chance of travellers catching the flu while abroad.
A flight from the UK to Japan are over 11 hours direct. Prolonged periods of immobility on long-haul flights pose a risk of developing a blood clot or, deep vein thrombosis (DVT). Travellers can minimise the risk of this by ensuring they keep mobile and hydrated on the flight, avoid wearing restrictive clothing, and wearing flight stockings to aid circulation.
Altitude illness in Japan
Rapid exposure to low amounts of oxygen at high elevation can cause altitude sickness. There are a number of places in Japan which are higher than 2,500 metres, such as Mt Fuji, 3,776m.
Travellers should avoid travelling from altitudes less than 1,200m to altitudes greater than 3,500m in a single day. An ascent above 3,000m should be gradual. Travellers should avoid increasing sleeping elevation by more than 500m per day. Also, ensure a rest day (at the same altitude) every three or four days.
By Anna Chapman | Travel Nurse | October 2018
Our travel clinic nurse, Anna Chapman, has just returned from an amazing two weeks travelling around South Africa.
Many items were ticked off her bucket list including a stay in Cape Town, a visit to the Winelands of Franschhoek and Stellenbosch and a stopover in Hermanus and Touwsrivier in the Western Cape. It was a busy trip!
Anna shares her top travel health tips for staying healthy on the road.
TRAVEL VACCINATIONS ARE A MUST!
Make sure you get your travel vaccinations in plenty of time prior to travelling. Book a travel consultation appointment 4-6 weeks before your flight to discuss health safety and vaccination recommendations. Travellers with a pre-existing health problem should book an appointment with a GP even earlier. Often vaccines are left to the last minute and not prioritised but it is important to protect yourself against life-threatening diseases.
South Africa is a huge country and the vaccinations you need will depend on exactly where you plan to stay, visit and what you plan to do. Depending on where you enter the country, high-risk areas may require you to provide proof of yellow fever vaccination on entering.
The far eastern provinces and game parks of South Africa pose a risk of malaria. If you are planning a safari, find out which reserve you will be visiting to determine if you will require anti-malarial medication. There are numerous game parks in the east and centre of the country which are malaria free. We also recommend our Ultimate Bug Kit to help protect you from mosquitos.
BE MINDFUL OF THE WATER DROUGHT
There has been a severe drought in South Africa, particularly in the Western Cape. At present, there are active water restrictions in place throughout. You should be mindful of water consumption and comply with local restrictions.
As a result, many toilets no longer have running water to wash your hands with and instead offer hand sanitiser. Make sure you take your own hand sanitiser with you just in case the public facilities run out. Good hand hygiene is key to preventing upset stomachs otherwise known as travellers’ diarrhoea. Travellers should consider booking the drinkable vaccination, Dukoral, which protects against cholera and travellers’ diarrhoea. It would probably be worthwhile in taking a diarrhoea treatment pack with you on your travel as well.
The Western Cape and the Cape of Good Hope is known for stormy seas. If you are prone to travel sickness and plan on taking any boat trips, make sure you pack seasickness medication. Whale watching is a popular tourist activity, and even the short boat ride from Cape Town to Robben Island can be rough enough to make those susceptible to seasickness feel queasy.
OVERNIGHT FLIGHT RISKS
Most travellers enter South Africa in a direct overnight flight from the UK. With only an hour time difference from the UK, people use this flight to catch up on sleep before they land. Sitting immobile for prolonged periods can put you at risk of a deep vein thrombosis. Minimise the risk by staying hydrated, keeping mobile and wearing compression stockings throughout the flight
IMPORTANT AFTER TRAVEL APPOINTMENTS
Travellers returning with diarrhoea should seek medical care if symptoms do not improve within three days. At Fleet Street Clinic, we have an on-site PCR machine which is able to identify the cause of travellers’ diarrhoea to produce a rapid report. Our GP’s can identify the exact cause, provide an accurate diagnosis and prescribe the correct treatment.
Medical advice should be sought earlier for those who are elderly, children and other vulnerable travellers if they are showing signs of dehydration.
Our experience team of travel nurses can help advise with any queries or more information on South Africa.
Sri Lanka – Vaccinations
All travellers should ensure they are in date with Diphtheria, Tetanus, Polio, Hepatitis A and Typhoid. Vaccinations against Rabies, Hepatitis B and Japanese Encephalitis may be recommended for some travellers, depending on the itinerary and of activities and places to visit.
Although malaria is very low risk in Sri Lanka, viruses such as dengue fever and chikungunya fever are present. Prevention for these comes from minimising mosquito bites, so take some insect repellant with 50% DEET, wear long loose clothing, and take a plug in vaporiser to use in your room to ensure your room stays mosquito free.
Food, Water and Sun
Prevent traveller diarrhoea by ensuring the food and water you consume is safe. It is always a sensible idea to take some alcohol-based hand gel with you to clean your hands before eating. Enjoy the sun sensibly by using a high factor sun screen, and avoiding direct sunlight between 11am and 3pm when the suns rays are strongest.
Medications and first aid supplies are harder to source in Sri Lanka. It is always a good idea to take your own supply of basic medications and first aid supplies with you in order to treat minor ailments and injuries.
FLEET STREET TRAVEL CLINIC
By Anna Chapman | Travel Nurse | August 2018
Hiking in Halifax or off-roading in the Rockies?
Despite the cosmopolitan cities on Canada’s coasts, the real allure of this country is the vast wilderness and countryside that lies between. Whether it be by hiking, camping, canoeing, or cycling, adventure travel in this country is on the up. When travelling to well-developed countries where healthcare standards are the same as our own, many travellers don’t consider travel health, nor taking first aid supplies or medications with them. However rich the country, travellers facing remote destination should always be prepared with some basic medications and supplies on hand to treat the most minor of injuries. First aid supplies can vary from a couple of plasters to comprehensive medical and trauma kit, and the kit you decide to take will depend upon what you intend to do whilst away.
Here is a guide on what to pack in your adventure medical kit:
- Cuts bruises scrapes and strains are the most common injuries when doing outdoor adventures.
- Take some antiseptic cream and waterproof dressings in various sizes and a few bandages in case of sprains or strains.
- If you plan on trekking, compeed blister pads and zinc oxide tape works wonders.
- Basic medications to relieve minor illnesses – painkillers, and antihistamines and antacids
- Tummy trouble can be tiresome. Take alcohol hand gel to keep your hands clean on the road, and medication such as loperamide and rehydration salts if you do get sick.
- Bug proof yourself. Midges can be present which cause irritation and some areas can have ticks which spread disease. Take repellent to prevent, and a steroid based cream in case you so get bitten.
- Take ample supply of any prescription medication you take regularly and carry the prescription with you in case you require replenishment.
The Fleet Street Clinic stocks travel sickness medication, travel vaccines and medical travel kits. Our experienced travel clinic nurses can help advise with any queries or more information on Canada.
Book a travel consultation appointment online.
By Anna Chapman | Travel Nurse | July 2018
Bali ranks as one of the most popular destinations to visit in Asia. It is crowned as the jewel of the Pacific ocean, with its white powder beaches, tropical waters and lush green rain forests. However, those who seek out this tropical paradise will need to spend an average of 18 hours travel time to reach the island, and will need to take more than one flight.
Be aware, long haul flying can increase the risk of a Deep Vein Thrombosis (DVT). A DVT can form in the legs when a person is immobile – usually in a confined space for a long period of time. The longer the period of immobility, the greater the risk of developing a DVT. It is also worth noting that a DVT can break off and travel through the veins to other parts of the body such as the lungs where it can be life threatening, while certain medications and medical conditions can increase an individuals chance of developing a DVT.
- Ensure you stay mobile. Get up regularly, and walk around the plane to keep your circulation going.
- Do exercises that help your calf muscles contract in order to aid circulation.
- Keep hydrated by drinking plenty of non-caffeinated and non-alcoholic beverages.
- Wear loose and comfortable clothes to prevent any physical restrictions.
- Consider wearing compression flight stockings.
The Fleet Street Clinic stock compression stockings, travel vaccines and medical travel kits. Our experience team of travel nurses can help advise with any queries or more information on Bali.
Travellers should also be up to date with vaccinations against Diphtheria, Tetanus and Polio, Hepatitis A and Typhoid. Vaccinations against Japanese Encephalitis, Rabies and Hepatitis B should also be considered.
FLEET STREET TRAVEL CLINIC
Peru is a fabulous destination for trekking. Whether it be hitting the 2400m mark of the Inca Trail to Machu Pichu or the dizzying heights of Ausangate at 6000m above sea level, preparation for travelling at altitude is key.
At heights of 2500m and above, air pressure is only half of what it is at sea-level, leading to a reduction in the amount of oxygen available. This ascent to high altitude is what causes altitude sickness, or acute mountain sickness. Subsequently, if one rapidly ascends to high altitude, and the body has not had sufficient time to acclimatise, altitude sickness can occur.
Mild symptoms can include:
However, altitude sickness can quickly evolve into more serious forms that affect either the lungs or the brain. Specifically, pulmonary or cerebral odema (a build-up of fluid in the lungs or brain) can develop, which can be fatal.
- Ascend to altitude slowly
- Do not exceed a sleeping altitude of 10,000 feet for the first few nights
- Do not exceed your sleeping altitude by 1000 feet per day
- Ensure you maintain good hydration and nutrition
Is there medicine for altitude sickness?
Many people who are travelling to altitude use DIAMOX (Acetazolomide). These are tablets that can help speed the body’s acclimatisation, and they are available at Fleet Street Clinic. Acetazolomide can be used as both a preventative medicine and as a treatment.
It is recommended that all travellers are up to date with their routine immunisations when travelling to Peru. All travellers should ensure that they have received a vaccination against diphtheria, tetanus, and polio in the last ten years. All travellers are advised to ensure they have been vaccinated against Hepatitis A and Typhoid.
There may be a need for additional immunisations. Depending on the nature of the trip, destinations visited, and the duration of both travel and activities, other vaccinations could be considered. These include:
There is a risk of malaria in areas of Peru and antimalarial medication may be advised. Furthermore, prevention against insect bites in Peru is essential.
FLEET STREET TRAVEL CLINIC
I’ve just returned from Montenegro, which is a beautiful country and still relatively undiscovered in terms of European tourist destinations. The beautiful beaches, Venetian towns and stunning scenery make a trip really worthwhile.
One of the great pleasures of travelling is to be able to enjoy local cuisine and gastronomic specialities of the region. It can help you discover the culture of a place and connect with local people in an authentic way.
However, the last thing you want is for travellers diarrhoea to ruin a trip. The majority of tummy trouble abroad happens in the first week of travel and is caused by bacterial infections (such as salmonella) which can’t be prevented by vaccination. They are found in unclean water and ill-prepared food, and the only defence against them is to be careful with food and water whilst away.
How to help avoid dodgy tummies while away:
- Ensure food is cooked and served hot immediately.
- Don’t eat unwashed or unpeeled raw fruit and vegetables.
- Don’t drink tap water – bottled water is easily available and those hiking or camping in remote areas will need to be prepared to purify water themselves
- Wash hands before each meal and after going to the toilet. Alcohol hand gel can be used when hand washing facilities are not available
- Avoid easting unpasteurised dairy produce.
You can buy a Worldwide Gastro Kit online to
Other items for considering when in Montenegro:
- Tick-borne encephalitis can be an issue in Montenegro for those travellers heading off into the mountainous regions during the summer months. Although primarily spread via the infected bite of a tick, the illness can also be contracted via unpasteurised dairy products, so best to avoid the traditional Montenegrin cheese that is offered in these areas. There is a vaccination against the illness that is highly effective.
- Consider a vaccination against Hepatitis A which can occur in areas of Montenegro where travellers cannot guarantee they have safe access to water. Those who are camping or hiking in remote areas should ensure that they have a way to secure a safe water supply, either by boiling water, using a filter or chlorine dioxide tablets. Hepatitis A is a virus that affects the liver and is vaccine preventable.
The Fleet Street Clinic stocks medication for travellers diarrhoea, medical travel kits and our experienced travel clinic nurses can help advise. If you’ve been on holiday and suffering from a lingering tummy bug, you can get a same-day diagnosis and medication using our PCR machine, you can email or call us to find out more.
Do I need vaccinations for Croatia?
The answer is, yes.
Croatia sits on the Dalmatian coast of Europe and is only a short flight from the UK. With abundant sunshine, long coastlines and fascinating history and architecture, Croatia is an enchanting country with so much to discover beyond Dubrovnik.
There is a common misconception that only far flung exotic destinations require travel vaccinations. This simply isn’t true. Whilst certain diseases such as malaria are found within the tropics, travellers to Europe should still seek out pre-travel advice to ensure that they are protected for their trip.
What vaccinations do I really need?
- You should be up to date with the diphtheria, tetanus and polio vaccinations, which can be given every 10 years.
- Europe has seen large outbreaks of measles in recent years, so travellers should ensure that they have received 2 doses of the measles, mumps and rubella vaccination (known as the MMR).
What about other vaccinations?
Depending on the activities you have planned for Croatia, you can consider additional vaccinations.
- If you can’t guarantee access to safe food and water, you should consider Hepatitis A vaccinations.
- If you plan to enjoy the countryside and activities such as hiking, camping, cycling, you may wish to consider vaccinations against Rabies and Tick-borne Encephalitis.
The Fleet Street Clinic stocks travel sickness medication, travel vaccines and medical travel kits. Our experienced travel clinic nurses can help advise with any queries or more information on Croatia.
Fleet Street Travel Clinic
Holidaying in the Greek Islands this year?
Island hopping in Greece is an enchanting way to explore the country’s vast collection of 6,000 islands. With whitewashed houses, tavernas and beautiful beaches at every stop, it’s a trip everyone should take once in their life.
There are many ferry routes between the mainland and islands. Some people can manage travelling by boat, whereas others may suffer from sea sickness. Days or weeks on a boat can be miserable for those who are prone to sea sickness, yet there are effective treatments and tips for those who are vulnerable to reduce the risk.
What is Sea Sickness?
Sea sickness is similar to motion sickness, caused by repetitive movements when travelling, like floating up and down on a current. The inner ear sends signals to your brain as well as signals from your vision, with the two signals contradicting each other it confuses the brain. These confusing messages cause you to feel unwell and can cause dizziness, vomiting and nausea.
Despite being common, those prone to travel sickness may wish to take sea-sickness medication with them if they intend to do any island hopping. There are some tips that you can take on board and put your body and mind at ease:
- Sit in the centre of the boat where the motion will be less aggressive
- Close your eyes or focus on a point on the horizon, this can help your inner ear balance.
- Avoid alcohol and large heavy meals, instead keep hydrated on water and eat smaller lighter meals
- Sucking on a mint or ginger sweet can help with nausea
- Seas Sickness medication tablets
- Patches that can be used to prevent sea-sickness
The Fleet Street Clinic stocks travel sickness medication, medical travel kits and our experienced travel clinic nurses can help advise.
By Anna Chapman | Travel Nurse | June 2018
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 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!
Anna Chapman, one of our experienced Travel Nurses, gives her top 5 reasons why having a travel consultation is so important … food for thought if you’re planning a trip abroad.
1 – Reputable advice from a trusted source
Clinics that specialise in travel have practitioners who have completed extra qualifications in travel medicine, such as a Diploma in Travel Medicine, Diploma in Tropical Medicine and Certificate of Travel Health. These qualifications ensure the practitioner gets specialist knowledge that is kept up-to-date by attending conferences and participating in research in the field. Many practitioners who work in travel medicine have experienced health care abroad, through extensive personal travel or through working or volunteering. This means the travel advice that a patient receives is always current and accurate.
Our travel nurses at the Fleet Street Clinic have a Diploma in Tropical Nursing and a Certificate in Travel Health and both GPs have a Diploma in Travel Medicine and a Certificate in Travel Health. All the practitioners in our Travel Clinic have travelled extensively and practiced their profession in developing countries. This means they are more aware of the risks that travellers face and have a greater understanding of how to deal with health issues on the road.
2 – Personalised travel consultation
No two people are the same and no two travel itineraries are the same. Travel consultations take this into account and give detailed and bespoke travel advice, not only for the itinerary but also for the individual. Seeing a practitioner face-to-face means that personal risks can be evaluated to ensure all travel health needs are met, rather taking a “one size fits all” approach.
3 – Travel health is NOT just about travel vaccinations
Whilst vaccinations are important, there are many aspects to staying healthy while abroad. In addition to vaccinations, there are considerations such as avoiding insect bites, use of medical kits, coping with jet lag, use of stand-by medications and coping with altitude sickness – all things that can be discussed when you have a travel consultation
4 – On-going care
Just because you have had your vaccinations before your trip, it doesn’t mean that your care ends when you leave the clinic. Specialist clinics can provide on-going care for subsequent trips and/or post-travel health concerns
5 – Time to talk
When a clinic has a specialist travel service, ample time is allocated to each appointment. Having a team of dedicated staff committed to travel medicine means that appointments can be completely flexible and can accommodate individuals, groups or families, both at the clinic or off-site, as well as offering appointments for last minute travellers.
Just back from…East Timor
Our travel clinic nurse Anna has been travelling in East Timor, the South East Asian nation inhabiting half of the island of Timor, which became independent from Indonesia in 2002. Here, Anna shares with us her top travel health tips from the area.
Exploring East Timor
East Timor is ringed with rugged beaches and pristine coral reefs. It is one of the most exciting places to dive in the world.
Battling the bugs
Whilst vaccination against Japanese Encephalitis can be sought prior to travel, and malaria prophylaxis can be used, it is still essential to avoid getting bitten in the first place.
- Take plenty on insect repellent that contains at least 50% DEET. This can be hard to come by in country so stock up before you go. Ensure it is applied both day and night time, but especially during dawn and dusk. The sunrise and sunsets are beautiful in East Timor, but it does tend to be the highest period for mosquitoes.
- Take long trousers and a long sleeve tops to wear at dawn and dusk, especially if sitting outside in the morning and early evenings when mosquito activity is at its highest.
- Take a mosquito net. The majority of accommodation on the coastal areas is basic, thatched huts and windows with shutters, meaning mosquitos have a free passage from the outside into your sleeping quarters. Make sure the the net is treated with permethrin, kept down over your bed to avoid unwanted mosquitoes invading your bed space.
- Plug in vaporisers can be useful to use to prevent mosquitoes entering your room. Unfortunately, many areas in Timor do not have access to continuous electricity, making electrical vaporisers rather ineffective. Instead use mosquito coils which can be burned like an incense stick to provide up to 10 hours of mosquito relief.
- After-bite cream. Even with the best of intentions, people can still be bitten. Taking a steroid based bite cream will help to reduce the itch and inflammation associated with any mosquito bites you many encounter.
To help keep mosquitos at bay, you can purchase our Ultimate Bug Kit online.
Fleet Street Travel Clinic
By Anna Chapman | Travel Nurse | May 2018
Tick-borne encephalitis in Sweden
The summer months are great for exploring Scandinavia. What many people don’t realise is that vaccinations against Tick-borne encephalitis should be considered if your travel plans take you out into the countryside. If you plan on spending time in forested areas, particularly around Gothenburg, Upland, Sodermanland and the Islands around Stockholm, you could be at risk of the disease.
What is Tick-borne Encephalitis (TBE) ?
TBE is a viral infection that affects the central nervous system. It is spread via the bite of a tick, or by ingesting unpasteurised milk and dairy precasts from animals that carry the diseases. Transmission season is usually in the summer months between April and October. There is an effective vaccination available against tick borne encephalitis to prevent the disease. It requires 2 vaccinations 14 days apart with a booster dose given 1 year later.
Other countries that have a risk of the disease include Eastern and Western Europe, Russia, Finland, China and Japan.
In addition to the vaccination, preventing tick bites is really important, especially if you plan to do outdoor activities such as camping, hiking in rural areas during transmission seasons.
You can prevent ticks by:
- Wearing DEET insect repellent with a minimum of 50% DEET concentration.
- Wearing long trousers and tucking them into your socks, and shirts with long sleeves.
- Treating clothes with permethrin.
- Inspecting your body for ticks and removing them promptly.
- You can purchase out Ultimate Bug Kit.
Although rabies is not present in terrestrial animals in Sweden, bats can still carry the virus. Those travellers who plan on exploring caves, such as in Abisko in Lapland may wish to consider being immunised against rabies prior to travel.
Fleet Street Travel Clinic
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:
- 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.
- 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 Encephalitis – vaccination 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.
By Anna Chapman, Travel Nurse at Fleet Street Clinic
There is currently an outbreak of Cyclospora related to travel in Mexico.
A Public Health England Health Protection Report highlights 204 confirmed cases since June 1st, 2016.
The cases are mainly associated with travel to Mexico, specifically the Riviera Maya Coast. The average incubation period is a week and infection is characterised by watery diarrhoea, fatigue, muscle pain, weight loss, nausea and low-grade fever. The foods previously involved in cyclospora outbreaks include soft fruits, such as raspberries, and salad products such as coriander, basil and lettuce. If untreated the illness can last for several weeks.
The Fleet Street Clinic can run a stool sample test that can diagnose Cyclosporiasis among many other causes of diarrhoea in returning travellers, and you will get your reults back in an hour of the test being done. If you are worried about any symptoms you have post travel to Mexico or any other country then call our reception team on 02073535678.
Or you can book an appointment online.
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.