Travel Tips Thursday - Philippines

19.11.2019 Category: Travel Health Author: Anna Chapman

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.

Vaccinations

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

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.

Malaria

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.

Insects

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.

The Philippines Department of Health (DoH) declared a national dengue epidemic on 6 August 2019. Continue to follow NaTHNaC advice and take precautions to avoid being bitten by mosquitoes

See our ultimate bug kit.

Water sports

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.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | November 2019

Travel Tips Thursday - Myanmar

19.11.2019 Category: Travel Health Author: Anna Chapman

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.

Vaccines

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.

For more information on our vaccines, please visit our travel and wellness vaccination pages.

Malaria

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.

Insects

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.

First Aid

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.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | November 2019

Travel Tips Thursday - Botswana

19.10.2019 Category: Travel Health Author: Anna Chapman

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.

Vaccines

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.

Find out more information about our travel and wellness vaccinations.

Malaria

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.

Insect prevention

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.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | October 2019

Travel Tips Thursday - Albania

19.09.2019 Category: Travel Health Author: Anna Chapman

Albania, located in Southeastern Europe, is a tourist haven this time of year.

Albania has much to offer, from stunning mountain scenes to crumbling castles to picture-perfect beaches all with easy-going charm and a friendly atmosphere. Right now the tales of its beauty haven’t quite reached the masses, but we have a feeling this is likely to change in the not too distant future.

If you plan on staying in Albania‘s capital, Tirana, be sure to see the rotating restaurant/ bars for spectacular city views.  Or take to the countryside and seashores to take in the ubiquitous sight of the abandoned concrete bunkers of Albania. Fearing invasion during the Cold War, Albania’s leader Enver Hoxha forced his country to build tens of thousands of bunkers throughout the country. These days you’ll see most in a state of slow decay but some have been given a new lease of life as a hotel, home or museum.

Visit Berat, to see the ‘town of a thousand windows’. This fascinating city dates back to the Ottoman Empire. The most striking feature of Ottoman architecture is the collection of whitewashed houses and towering minarets which adorn the hill to its castle. It is easily a highlight of visiting Albania. If, however, you prefer the great outdoors scale the peaks and troughs of the Accursed Mountains and take in the captivating castles of Gjirokastra.

Whatever your plan to do, be sure to follow our top travel tips to stay healthy in Albania.

Routine Vaccinations

All travellers to Albania are advised to be in-date with their routine immunisations. These include diphtheria-tetanus and polio and measles, mumps and rubella. Europe has seen huge outbreaks of measles in recent years. Therefore, all travellers should make sure they have received at least two doses of the vaccination, MMR.

If you’re unsure of your immunity, you can have a simple blood test to find out. Some travellers may wish to consider vaccinations for Hepatitis A and Hepatitis B, Rabies, and Tick-Borne Encephalitis. It is best to book a pre-travel consultation with a travel nurse to discuss your holiday plans. Together you can discuss what vaccines you’ll need.

Trekking and Ticks

The dramatic peaks of the Accursed Mountains spread their spoil between Kosovo, Albania and Montenegro. Those who plan to take advantage of the great outdoors should strongly consider vaccination against tick-borne encephalitis (TBE). TBE is a bacterial infection spread via tick bites or the consumption of unpasteurised dairy produce (between spring to autumn). Contracting the illness causes a fever with neurological complications.  

TBE is vaccine-preventable and consists of 2 doses of the vaccination being given at least 2 weeks apart.  A third dose is given 5-12 months later to give longer-term protection. Travellers should also avoid ticks by wearing long trousers and socks, and using DEET insect repellant. If you spot a tick on you, it needs to be removed promptly with some flat tweezers or a tick remover and cleaned with alcohol to reduce the risk of infection.

Rabies

Rabies is a fatal virus found in the saliva of infected mammals. Travellers can be exposed to it through a bite, scratch or a lick to an open area of skin.  Therefore, you should avoid contact with animals, especially wild and stray animals. The vaccination against rabies means that treatment can be given easily and in the country should a risk of rabies occur.

You will require a series of 3 vaccinations to be given over a 3 week period. Or over 1 week if a rapid course is needed. Travellers at greater risk are those who plan to do outdoor activities such as hiking, trekking, cycling or caving.

For more information on our vaccines, please visit our, travel and wellness vaccination pages.

First Aid Kit

For those trekking in the hills, packing good basic first aid kit is essential. The availability of health care and first aid supplies are very limited in rural areas, particularly outside Tirana. Therefore, you should make sure you bring your own adequate basic provisions. These include pain relief, plasters and medication to treat an upset stomach, such as loperamide and oral rehydration salts. 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.

Access to safe water may be limited. You should consider packing chlorine dioxide tablets to purify your own water. Alternatively, you can purchase a water-to-go bottle which has a built-in filter. If you take regular prescription medication, be sure you pack enough to last your entire journey. And, remember to carry the prescription with you just in case.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | September 2019

Travel Tips Thursday - Tanzania

19.08.2019 Category: Travel Health Author: Anna Chapman

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.

Vaccines

All travellers should ensure they are in date with all their routine immunisations, including diphtheria, tetanus and polio (DTP), and measles, mumps and rubella (MMR). 

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.

For more information on our vaccines, please visit our travel and wellness vaccination pages.

Yellow Fever

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.

Prevent Malaria

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.

Precautions include:

  • 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.

Climbing Kilimanjaro

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.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | August 2019

Travel Tips Thursday - Mozambique

19.07.2019 Category: Travel Health Author: Anna Chapman

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.

Vaccinations

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.

For more information on our vaccines, please visit our, travel and wellness vaccination pages.

…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.

…And Polio?

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.

Malaria

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.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | July 2019

Travel Tips Thursday- Tel Aviv, Israel

19.05.2019 Category: Travel Health Author: Anna Chapman

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.

Vaccines

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…

Sun

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.

Insects

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

Travel Tips Thursday- Bolivia

19.05.2019 Category: Travel Health Author: Anna Chapman

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:

 Vaccines

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

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.

Yellow Fever Map, Bolivia, Yellow Fever Vaccine at Fleet Street Clinic, London

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.

Altitude

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.

Insects

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

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.

First Aid

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.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | May 2019

Travel Tips Thursday - Jordan

19.03.2019 Category: Travel Health Author: Anna Chapman

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

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

Vaccinations

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

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

Food and Water

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

All that bites

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

See our Ultimate Bug Kit.

From red to dead…

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

Book your travel appointment today

By Anna Chapman |  Travel Nurse | March 2019

Travel Tips Thursday - Senegal

19.02.2019 Category: Travel Health Author: Anna Chapman

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

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

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

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

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

Book your travel appointment today

By Anna Chapman |  Travel Nurse | February 2019

Travel Tips Thursday- Holi Festival

19.02.2019 Category: Travel Health Author: Anna Chapman

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.

You can find more about vaccinations on our travel and wellness vaccine pages.

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.

Colour vision…

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.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | February 2019

Travel Tips Thursday- Belize

19.02.2019 Category: Travel Health Author: Anna Chapman

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…

1 – Vaccinations are important.

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.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | February 2019

Travel Tips Thursday - Sri Lanka

19.01.2019 Category: Travel Health Author: Lucy Mildren

Sri Lanka was recently voted as the number one country to visit in 2019 by Lonely Planet. Our travel nurse Lucy spent two weeks exploring this award-winning country and here, she shares her top tips for a healthy trip.

January is an ideal time to visit Sri Lanka thanks to warm temperatures and clear skies. From tea tasting to surfing, hiking to whale watching, this ancient spice island has something for everyone.

Safari

If you are a wildlife lover, taking a guided jeep tour into one of Sri Lanka’s National parks is a must! Amongst the most popular are Yala and Udawalawe, where you are guaranteed to spot elephants by the dozen and if you’re fortunate a leopard. Prepare to wake up early and pack your mosquito repellent – most jeeps leave at dawn for the best chance of sightings, but mosquitos are also the most active during this time.

Although Sri Lanka is currently a Zika free zone, making it a popular choice for honeymooners, it is important to remember that mosquitos transmit other diseases such as Dengue and Chikungunya. Good bite protection is therefore essential and should include a mosquito repellent containing 50% Deet, as well as wearing long and loose clothing – also good for keeping the sun off your skin! Protect yourself from mosquitos with our Ultimate Bug Kit.

Train Rides

With new and improved services throughout the country, train travel is a highlight of any Sri Lankan trip and widely considered as some of the most scenic in the world. The most famous stretch is between Ella and Kandy; a journey that will last around 7 hours and takes you through lush jungle, tea plantations and waterfalls. Remember your antibacterial hand sanitiser though, because, as convenient as the onboard toilet is on a long journey, hand washing facilities aren’t always of a good standard. Perhaps pack some tissue as well!

Curries

Sri Lankan food is delicious and an essential part of the culture. As with all travel to tropical destinations, however, caution should be taken when trying out the local delicacies because contaminated food can cause travellers’ diarrhoea. So, before you sample the famous string hoppers and sambal, here are some simple food and water precautions to avoid an upset stomach:

  • Make sure your food is served piping hot. Be cautious of food that has been sitting at room temperatures such as buffet and street food.
  • Only drink bottled water, with an intact seal. This applies to the water you use to brush your teeth and the ice in your drinks.
  • Avoid salads and uncooked vegetables that may have been washed in contaminated water.
  • Always peel your fruit. If you can’t – don’t eat it.
  • Ensure dairy products are pasteurised – many harmful organisms are transmitted through unpasteurised dairy.

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.

Travellers’ diarrhoea is a common complaint in the returning traveller here at Fleet Street Clinic. If you are still experiencing stomach troubles on your return, our GP’s can run same day PCR testing to find the cause and most appropriate treatment.

If you would like aa travel appointment, you can book online

By Lucy Mildren |  Travel Nurse | January 2019

Travel Tips Thursday - Panama

19.01.2019 Category: Travel Health Author: Anna Chapman

Panama sits on both the Pacific and Atlantic coasts. With its cloud forests, coffee farms, magical islands, world-class diving and a canal that connects two oceans, many people choose to make Panama their holiday destination.

If you plan to go, follow our travel tips to have a safe and healthy holiday.

Vaccinations for vacation

It is advised that all travellers be up-to-date with Diphtheria, Hepatitis A, Tetanus and Polio. Higher risk travellers may want to consider vaccinations against Typhoid, Rabies and Hepatitis B. It is best to speak with a travel expert to see what they advise for you.

You can find more information on our wellness and travel vaccinations.

Prevent mosquito bites

It is no longer necessary to take anti-malarial medication if visiting Panama. However, precautions against mosquito bites should be taken as viruses such as dengue fever, Zika virus and chikungunya can be transmitted in the region. Pack some insect repellent with at least 50% DEET, and take a mosquito net if you plan to stay in traditional accommodation that may not provide one. You can help protect yourself from mosquitos with our Ultimate Bug Kit.

Find out if you need a Yellow Fever Vaccination

Yellow Fever exists east of the Panama canal. If you plan to visit this area the vaccination is recommended. Also, those who plan to enter Panama from a country that has a risk of Yellow Fever (such as Colombia) will need to be in possession of a valid Yellow Fever Vaccination certificate.

Pack a first aid kit

A first aid kit with necessary medication and first aid items is a good idea. Accessing medical care and medical supplies in parts of the region can be difficult, especially for those who plan to visit the San Blas Islands, cloud forests or coffee farms. Those who plan on diving in the Bocas del Toro may wish to take out items such as ear drops for an infection, and antiseptic cream for any coral cuts.

Don’t get travel sick

A huge attraction in Panama is the coastline and archipelago, including the San Blas and the Pearl Islands. Accessing parts of Panama often involves long bumpy journeys by road and boat trips to the islands can often be choppy. If you suffer from travel sickness, ensure you pack medication to prevent this, and take it before you set out on the journey to prevent feeling queasy.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | January 2019

Travel Tips Thursday- Skiing in Europe

19.11.2018 Category: Travel Health Author: Anna Chapman

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

Travel Tips Thursday- Japan

19.10.2018 Category: Travel Health Author: Anna Chapman

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.

Tetanus

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.


Measles Outbreak

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.


The Flu

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 fluThe flu vaccination available in the UK will dramatically reduce the chance of travellers catching the flu while abroad. 

Flight Times

 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.

 

Book your travel appointment today

By Anna Chapman |  Travel Nurse | October 2018

How to calm your flight anxiety before you fly

Read more

Travel Tips Thursday: Dublin

19.09.2018 Category: Travel Health Author: Laura Berry

A weekend in Dublin

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

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

Plan Ahead

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

Clothing

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

Footwear

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

Guinness

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

Natural Beauty

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

Locals know best

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

A bit of history

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

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

Book your travel appointment today

By Laura Berry |  Flu Project Coordinator | September 2018

Travel Tips Thursday: Just back from... South Africa

19.09.2018 Category: Travel Health Author: Anna Chapman

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. 

Other vaccinations to consider; hepatitis A, polio and typhoid.

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.

TRAVEL SICKNESS

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.
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Our experience team of travel nurses can help advise with any queries or more information on South Africa.

Travel Tips Thursday: Madagascar

19.08.2018 Category: Travel Health Author: Anna Chapman

Madagascar

Madagascar is a large country off the south east coast of Africa. It is well known for its rainforests, hiking and diving, beaches and reefs.

Make sure you are aware of what you need, such as visas, vaccines and other medical requirements.

Check your flight route

You may need a Yellow Fever certificate. Whilst most flights involve a change of plane in Paris, some flights route via Nairobi, Kenya. If you have a long lay over in Nairobi you will be required to provide on entry to Madagasgar, a valid Yellow Fever certificate.

Don’t risk rabies

Rabies is a virus found in mammals and is fatal if not treated promptly. Treating rabies can be difficult in Madagascar, but is made much simpler for those who receive rabies vaccinations prior to travel. If the focus of your trip is the mammals of Madagascar, rabies vaccinations pre-trip is strongly recommended.

Banish the bites

Make sure you wear plenty of insect repellent whilst away as Madagascar has several diseases that can be spread via the bite of a mosquito or fly. Insect repellent should contain at least 50% DEET. Anti-malarial medication is always advised for Madagascar. Protect yourself from mosquitos with our Ultimate Bug Kits.

Travel with Insurance

Ensure you take out comprehensive travel insurance before you go to Madagascar, and ensure that it covers you any activities you may have planned (such as scuba diving).

FLEET STREET TRAVEL CLINIC

Book your travel appointment today

By Anna Chapman |  Travel Nurse | August 2018

Travel Tips Thursday: Canada

19.07.2018 Category: Travel Health Author: Anna Chapman

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

Travel Tips Thursday: Bali

19.07.2018 Category: Travel Health Author: Anna Chapman

Bali

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.

Prevention

  • 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

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By Anna Chapman |  Travel Nurse | July 2018

Travel Tips Thursday: Peru

19.07.2018 Category: Travel Health Author: Anna Chapman

Peru

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:

  • Nausea
  • Headache
  • Vomiting
  • Sleeplessness

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.

Best Preventions

  • 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.

Additional Information

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

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By Anna Chapman |  Travel Nurse | July 2018

Travel Tips Thursday: Montenegro

19.06.2018 Category: Travel Health Author: Anna Chapman

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.

Travel Tips Thursday: Croatia

19.06.2018 Category: Travel Health Author: Anna Chapman

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

Travel Tips Thursday: Greek Island Hopping

19.06.2018 Category: Travel Health Author: Anna Chapman

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:

Prevention 

  • 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. 

Book your travel appointment today

By Anna Chapman |  Travel Nurse | June 2018

Travel Tips Thursday: World Cup 2018

19.06.2018 Category: Travel Health Author: Anna Chapman

The World Cup is about to kick off. If you’re planning to visit Russia and watch some games in person, here’s some travel advice from one of our expert travel nurses at Fleet Street Clinic, Anna Chapman.

Travellers to Russia should be up to date with measles, mumps and rubella (usually given in childhood), Hepatitis A and Diphtheria, Tetanus and Polio.

Russia also has a risk of:-

  • Rabies, a virus spread through the bite or scratch of an animal (mainly dogs, cats and bats). It requires 3 vaccinations ideally before departure which can be given over a rapid schedule of 3 weeks.
  • Hepatitis B, a virus spread through blood and bodily fluids. It requires 3 vaccinations ideally before departure which can be given over a rapid schedule of 3 weeks.
  • Tick-borne encephalitis – a bacteria which is spread via tick bites or eating unpasteurised dairy products, primarily in the summer months. It does appear that the stadiums are in cities, but if there are any additions to travel remotely where people will be spending lots of time outdoors, this could be considered.

As always, make sure you take precautions with food and water and pack basic medications and first aid supplies. We have several medical kits available to purchase online.

FLEET STREET TRAVEL CLINIC

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By Anna Chapman |  Travel Nurse | June 2018

Travel Tips Thursday: Just back from...East Timor

19.05.2018 Category: Travel Health Author: Anna Chapman

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

In terms of insect borne diseases, Timor Leste has them all. It has a high risk of dengue fever, Japanese encephalitis and malaria.

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

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By Anna Chapman |  Travel Nurse | May 2018

Travel Tips Thursday: Sweden

19.05.2018 Category: Travel Health Author: Anna Chapman

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. 

Prevention 

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.

 All travellers going to Sweden should ensure that they are in date with their routine immunisations including diphtheria, tetanus and polio (DTP) and measles, mumps and rubella (MMR).

Some travellers may be recommended to be vaccinated against Hepatitis A and B.

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

Travel Tips Thursday: a Kenya Trip of a Lifetime

19.05.2018 Category: Travel Health Author: Anna Chapman

Travel Tips for a Kenya Trip of a Lifetime

Wandering with wildebeests this summer?

The spectacular wildebeest migration sees over 2 million animals traverse the plains of the Serengeti National Park in Tanzania into the Masai Mara Reserve in Kenya. The best time to witness this breathtaking event this year is in June.

If you’re planning to travel to East Africa this summer, here are our top tips for staying healthy:

  • Be sensible with food and water to avoid travellers’ diarrhoea. See our worldwide gastro kits.
  • Take a small first aid kit with you for minor injuries and illnesses, including medications for upset stomachs.  Parks can often be located far from medical help and have medical facilities with varying health standards.
  • Although the main attraction on a safari is the wildlife, remember that rabies exists throughout Africa. Whilst most cases result from dog bites, all mammals have the potential to transmit the virus, and treatment can be difficult to obtain. It is advisable to obtain vaccinations prior to travel.
  • Mosquitoes and insects are ubiquitous in game parks, especially around watering holes. They carry diseases such as malaria, dengue fever, leishmaniasis and sleeping sickness. Take precautions against insect bites by covering up with long loose clothing, wearing insect repellent and sleeping under a mosquito net at night. You can also purchase our Ultimate Bug Kit.
  • With Kenya lying on the equator, the sun’s rays are extremely powerful. Be sun safe by wearing a high factor sunscreen, sunglasses, and hat.
  • Wear light, long-sleeved clothing. Avoid dark clothing – Tse Tse flies are attracted to dark blue colours and can cause sleeping sickness.
  • Ensure you receive your pre travel vaccinations which should include Diphtheria, tetanus and polio (DTP), Hepatitis A and Typhoid, Rabies, Hepatitis b.
  • Don’t forget to take malaria tablets as all of Tanzania poses a risk of malaria.
  • Whilst the Yellow Fever vaccination is not usually recommended for travellers to Tanzania, it may be recommended for parts of Kenya. Additionally , travellers may need to present proof of the vaccinations on entry, depending upon their flight route and countries travelled. Ensure you get up to date advice.

Fleet Street Travel Clinic

By Anna Chapman |  Travel Nurse | May 2018