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- 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: Brazil

19.05.2019 Category: Travel Health Author: Anna Chapman

Brazil: Yellow Fever

The incidence of Yellow Fever cases in Brazil has been increasing recently, with over 1000 cases of Yellow Fever in Brazil since July 2017. The cases were reported in Sao Paolo, Minas Gerais, Rio de Janeiro, Espiritu Santo and Distrito Federal.

As well as an increase in human cases of yellow fever, 738 cases of yellow fever virus in monkeys have been reported. Since the outbreak, several unvaccinated travellers have contracted yellow fever, and there has been at least one death. Due to the ongoing outbreak, travellers going to at risk areas of Brazil are advised to get the Yellow Fever vaccination.

In addition the World Health Organisation also advised travellers heading to the states of Parana, Santa Catarina and Rio Grande do Sul should receive the vaccination, irrespective of location.

What is Yellow Fever?

Yellow Fever is a flavirus found in the tropics of Africa and South America.

Monkeys are a natural carrier for the virus and it is spread between monkeys and humans via the bite of an aedes mosquito.

Illness: It causes an acute viral illness which has a 50% mortality rate.

Prevention: The yellow fever vaccination should be considered for travellers who are visiting a high risk area. A single vaccination affords life long protection. The vaccination many not be suitable for everyone, so ensure you seek a full travel consultation.

Map of current areas with a risk of Yellow Fever

 

Book your travel appointment today

By Anna Chapman |  Travel Nurse | February 2019

Do you need a Rabies Vaccine for your next trip?

19.05.2019 Category: Travel Health Author: Anna Chapman

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.

You can book a travel consultation or rabies vaccination appointment online.

Travelling abroad this summer?

10.05.2019 Category: Travel Health Author: Anna Chapman

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

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

Measles:


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. 

Hepatitis:


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.

Malaria:


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

Infectious diarrhoea:


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

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

Richard Dawood, Medical Director of the Fleet Street Clinic. 


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

Travel Tips Thursday - 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- 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 - 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- Germany Christmas Markets

19.11.2018 Category: Travel Health Author: Anna Chapman

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

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

Coughs, sneezes and Christmas wheezes

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

Festive Flu

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

Have a Merry measle-free Market

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

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

Book your travel appointment today

By Anna Chapman |  Travel Nurse | November 2018

Travelling for Diwali

04.11.2018 Category: Travel Health Author: Anna Chapman

Diwali, the Festival of Lights, will be celebrated all over the world on October 19.

Will you be travelling abroad to join the festivities?  Make sure you prepare for a safe and healthy trip.

Advice for travellers

Last minute advice is invaluable – be sure to see your healthcare provider to discuss your trip. Vaccines and malaria tablets, if required, can be given just before travel. If you have any medical conditions, discuss your travel plans with your doctor or hospital specialist, even if vaccines or malaria tablets are not needed.

Reduce your risk of illnesses such as travellers’ diarrhoea by avoiding high-risk food and water and wash hands thoroughly.

Take care to avoid insect bites. If you are taking malaria tablets, remember to complete the course of tablets as recommended.

Watch for symptoms such as fever or flu-like illness which require urgent medical attention. Travellers with fever, bloody diarrhoea, abdominal pain, confusion, jaundice or a rash need to seek immediate emergency advice from a doctor or clinic.

Take care with your safety, especially in busy areas, around water and while in cars or public transport.

For more detailed advice about your travel destination, book a travel consultation appointment.

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

Mexico... Dia de  Los Muertos

19.10.2018 Category: Travel Health Author: Anna Chapman

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

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

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

Banish the bugs

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

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

Hepatitis A

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

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

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

Book your travel appointment today

By Anna Chapman |  Travel Nurse | October 2018

How to calm your flight anxiety before you fly

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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

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By Anna Chapman |  Travel Nurse | August 2018

Travel Tips Thursday Sri Lanka

19.08.2018 Category: Travel Health Author: Anna Chapman

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.

Insect Precautions

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.

First Aid

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

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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

Summer Trekking

19.07.2018 Category: Travel Health Author: Anna Chapman

SUMMER TREKKING

Do you enjoy the great outdoors and active holidays? If so, you may be contemplating a trekking adventure. Top summer trekking destinations include Cotopaxi, Ecuador, the Atlas Mountain Range in Morocco, The Ladakh Ranges in India and Mont Blanc in the French Alps.

Fleet Street Clinic offers travel tips for trekkers from Anna Chapman, one of our specialist travel nurses, to help prepare for your holiday and make the most of your adventure.

  1. Ensure that you are up to date with vaccinations. Some regions in South America or Africa require you to provide evidence of  Yellow Fever vaccination.
  1. The most common illness amongst travellers is upset stomachs. Pack hand sanitiser to use when soap and water for hand washing is unavailable. Take water purification tablets if you have not got access to safe water. Medicines such as rehydration salts and anti-motility medicines can be helpful if you do become unwell.
  1. Most trekking routes are at high altitudes. Understand the effects of altitude sickness. Take time to acclimatise to altitudes and consider taking medication such as Diamox to reduce the severity of acute altitude sickness.
  1. Look after your feet. Invest in good trekking boots, socks and wear them in before you go. Keep your feet dry when trekking by changing your socks and using foot powder. Zinc oxide tape or Compeed dressings can be helpful if you do get blisters.
  1. Pack suitable clothing. Trekking in mountain ranges usually involves variable temperatures: Warm days, thin air, strong sunshine and cool nights. Pack breathable clothing, a waterproof jacket and warm base layers. Sun protection is essential, especially in high altitude ranges, so apply the “Slip, Slop, Slap” rule. Slip on a shirt, slop on some sunscreen and slap on a hat.

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

World Malaria Day

25.04.2018 Category: News Author: Anna Chapman

World Malaria Day

Reaching the zero Malaria target

World Malaria Day takes place on 25th April each year, highlighting the global efforts to control malaria and celebrate the gains that have been made. Since 2000, the world has made historic progress against malaria, saving millions of lives. However, half the world still lives at risk from this preventable, treatable disease, which costs a child’s life every two minutes.
The heartbreaking truth is that malaria is a preventable and treatable disease.
In Western countries, nearly all malaria is caused by travelling, which is why it’s important to be prepared before you visit an area at risk of malaria. On World Malaria Day,  April 25th, the World Health Organisation has called for a focus on uniting the world to beat the disease once and for all.

How You can Prevent Malaria

Together with diagnosis and treatment, in areas where malaria is rife, WHO recommends:

  • Using antimalarial medication
  • Spraying indoor walls and your clothing with insecticides
  • Using insecticide-treated nets and window screens
  • Wear light-coloured, long sleeve clothing
  • Get rid of any stagnant water

Since 2017, the World Health Organization has supported a group of 21 malaria-eliminating countries through a special initiative called the “E-2020”. This report charts their progress towards a common goal: eliminating malaria within the 2020 timeline. According to this report, 8 E-2020 member countries reported zero indigenous cases of malaria in 2020, a remarkable achievement in view of the ongoing global COVID-19 pandemic. Maintaining zero cases is a testament to their commitment to protect hard-won gains and keep the disease at bay. You can find more on this report here.

More Information

Read more about malaria and how to you can prevent it.

For further information and a consultation with an experienced member of our travel team, you can book an appointment online here.

Just back from...Cape Verde

27.02.2018 Category: Travel Health Author: Anna Chapman

Just back from….Cape Verde

Out travel clinic nurse Anna has just returned from the beautiful islands of Cape Verde. At Fleet Street Clinic, we’re seeing increasing numbers of people who are planning to travel to this area, known for its stunning beaches and Creole Portuguese-African culture.

Anna said “The highlights of my trip were definitely walking through the lunar-like landscapes on the Serra Malagueta on Sao Tiago Island, seeing humpback whales and dolphins off the coast of Maio Island and the windswept beaches of Porto Ingles, Maio”.

Are you planning a trip to Cape Verde? Here’s what you should remember before you go:

Vaccinations

Ensure your vaccinations are up-to-date. Here is a list of recommended vaccinations travellers should consider.

Insects

Whilst Cape Verde islands are over 400 miles away from mainland Africa.  Both the Aedes and Anopheles mosquito have found a home there, bringing the risk of viral infections such as dengue fever and Zika virus. Late 2017 there had also been reports of malaria cases in the capital Praia, Santiago Island. Whilst the risk to travellers is low, it is essential to avoid mosquito bites by covering up with long loose clothing and using insect repellent with DEET.

Sun

Cape Verde lies within the tropics which means the suns rays are incredibly strong. The main allure of this country is its long sandy beaches and crystal clear waters which can pose a risk of sunburn and heat-related illness. Ensure you apply a high factor sunscreen, avoid direct sunlight between the hours of 11am-3pm whilst at it’s strongest and stay hydrated to reduce the risk of heat-related illnesses.

Watersports

Cape Verde is popular with water sports enthusiasts, especially surfers, windsurfers and divers. The warm sea temperatures mean that any cuts and scrapes can become easily infected, so taking minor first aid items such as antiseptic and plasters should be taken to treat any injuries promptly.
Those who are undertaking water sports should consider wearing sunglasses with polarised lenses to help reduce the glare from the water.

Those who are prone to ear infections can consider taking an ear spray to reduce the risk. All travellers should ensure that their travel insurance policy covers such activities.

Thinking about polarised sunglasses? Come along to our Maui Jim event at Whitby and Co on Friday to find out more.

First aid Kit

Cape Verde is made up of 10 islands, and inter-island transport often involves a flying. Apart from the capital Praia, many islands have limited shops and pharmacies. Therefore if you become sick whilst away, obtaining medications to treat minor illnesses and injuries can be difficult. It is best to be self-sufficient. If you take prescription medication, ensure you pack enough to last you your trip, and take the prescription with you. Taking medications such as painkillers, antihistamine and medication for an upset stomach is also sensible as mild illnesses can often ruin a holiday and simple medication may not be readily available. Fleet Street Medical Kits contain everything you need. 

Travelling soon?

If you’re planning to travel to Cape Verde or elsewhere and you’re unsure about the health precautions you should be taking, talk to us at Fleet Street Clinic, your travel health experts in central London. You can book an appointment online.

Rio Carnival - Travel Health Advice

19.02.2018 Category: Travel Health Author: Anna Chapman

RIO CARNIVAL

Rio carnival is a huge pull for travellers heading to Brazil. With over 2 million people attending, it is the biggest carnival in the world, and probably the most colourful!

If you’re lucky enough to be going to the carnival this year, you’ll get the most out of the experience if you prepare beforehand and have a worry-free trip!  Here are our top travel health tips to read before you go.

RECOMMENDED VACCINATIONS

Yellow Fever:

  • There have been outbreaks of Yellow Fever in Brazil, including the city of Rio de Janeiro. We advise all travellers that are heading to Rio to ensure that they have received a yellow fever vaccination 10 days prior to travel to ensure they are fully protected.
  • Yellow Fever vaccination is highly recommended for certain areas of Brazil, including the cities of Manaus, Belo Horizonte, Cuiaba, and Brasilia
  • There is a high risk of Yellow Fever in the Amazon and in Iguazu Falls, so if you plan to do any onward travel after carnival we recommend obtaining the vaccination
  • If you are planning to travel to other areas of South America before or after the trip, you may be required to have the Yellow Fever vaccination, and hold proof in the form of an International Certificate of Prophylaxis

Hepatitis A is a viral infection spread via contaminated food and water. A first dose of the vaccination protects for a year, a second dose given 6 months later protects for 25 years+

Typhoid is a bacterial infection through contaminated food and water(gives 3 years protection)

Tetanus, Diphtheria, Polio is a routine immunization given in childhood, but travellers should ensure they have received a dose of the vaccination in the previous 10 years

Measles, Mumps, Rubella  – make sure you have received a primary course of MMR vaccinations (usually given in childhood) and unimmunised adults should receive their vaccine

OTHER VACCINES TO CONSIDER

Rabies – Travellers should be aware that Brazil is a high-risk country for Rabies and an intermediate risk country for Hepatitis B and those considering visits to remote regions or for prolonged visits may wish to be vaccinated; especially as urgent Rabies treatment can often be difficult to obtain in certain areas.

Malaria – a parasitic infection that is spread via mosquitos that are most active between dusk and dawn. It occurs in the Amazon region and the northeast of the country, and malaria prophylaxis is strongly recommended if visiting these regions or if going to Manaus.

MOSQUITO PRECAUTIONS

Dengue Fever, Chikungunya Fever and Zika virus can occur throughout all of Brazil.  Brazil These viruses are spread by mosquitos that are most active during daylight hours. There is currently no vaccination or preventative medication for such illnesses.

Minimising insect bites that can transmit disease is essential.  This involves covering up with clothing and ensuring insect repellent that contains a minimum of 50% DEET is worn to prevent mosquito bites. Using plug-in vaporisers in rooms to reduce mosquitoes and sleeping under bed nets will help.

Our Ultimate Bug Kit contains everything you need to keep mosquitos at bay.

ZIKA 

Zika virus is especially serious in those individuals who are pregnant or planning to become pregnant at the time of travel. As Zika is an emerging virus, it is essential to keep informed with the most up-to-date advice. We are able to offer Zika testing and counselling if you have concerns about Zika virus.

HEAT

The average temperature in Rio in February is 29 degrees.  This means that both heat and sun protection is required.  This means avoiding direct sunlight between 11-3pm and seeking shade and wearing a sun cream with a high SPF to prevent burning.

HYGIENE

Often travelling to different countries can result in travellers’ diarrhoea, which can be caused by bacteria, viruses or parasites.  It is important to practice safe food and hygiene practices such as:

  • Washing hand thoroughly with soap and water or alcohol gel before food consumption
  • Ensuring drinking water is safe by avoiding ice, drinking bottled water or having a reliable method of water purification (such as filtering or chemical sterilisation)
  • Ensuring food is well cooked and served hot. Avoid salads or fruit that may have been washed in unsafe water
  • All travellers should take medications with them to treat travellers’ diarrhoea. This can include rehydration salts, anti-diarrhoeal medication and even antibiotic treatment – see our Worldwide Gastro Kit.

FLEET STREET CLINIC

For more advice from our expert travel team on safe travels in Brazil, book a travel consultation appointment.

By Anna Chapman |  Travel Nurse | February 2018

Top 10 Travel Health Tips for the 2016 Olympic and Paralympic Games in Rio de Janeiro

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Top 10 Travel Health Tips for the 2016 Olympic and Paralympic Games in Rio de Janeiro

19.05.2016 Category: Travel Health Author: Anna Chapman

Will you be traveling to Rio de Janeiro to attend or work on the Rio 2016 Olympics and Paralympics games?  It is a common phenomenon for people to focus heavily on attending or working at the Olympics – then having to spend much of their time seeking medical care, having to leave early, or even be hospitalised, for a problem that should have been resolved prior to travel.

Take a moment to review our travel health checklist for Rio 2016 to help keep you enjoying your time at the games!

Before you go:

>>Come and see us four weeks before you depart – don’t forget to bring along a record of any past vaccines you have received.

1.    Vaccinations

Routine vaccines should be up to date.

  • Diphtheria/Tetanus/Polio (within past 10 years)
  • MMR
  • Possibly pneumococcal vaccine for adults aged over 65
  • Chickenpox (varicella) – CDC recommended as these are routine immunisations is USA
  • Whooping Cough (Pertussis) – CDC recommended as these are routine immunisations is USA

Travel vaccines: The following travel vaccines may also be recommended for your trip:

  • Hepatitis A
  • Typhoid
  • Hepatitis B –
  • Yellow fever (certificate NOT required for entry – may be required by other countries for onward travel)
  • Rabies
  • Flu (Southern hemisphere strains – ask us for details)

While you are there:

2.    Insect-borne diseases

Dengue, chikungunya and Zika are mosquito-borne virus infections that cause rash, fever, joint and muscle aches, and eye pain or conjunctivitis.

Malaria

Rio de Janeiro is malaria-free, with no risk of yellow fever at present.

If you will be travelling to the Amazon basin or other places in South America that have a risk of malaria, you may need to take preventive medication.

Preventing insect-borne diseases

Vaccination gives long term protection against yellow fever and malaria medication is an important precaution if you are at risk.

Bite avoidance is the best available approach.

Preventing bites

Reduce your risk of dengue, chikungunya, Zika, yellow fever and malaria by doing all you can to reduce the numbers of bites. Disease-carrying mosquitoes bite during the day as well as in the evening and at night:

  • Cover up
  • Using plenty of DEET-containing insect repellent
  • Wear clothing impregnated with permethrin when working in the open
  • Using mosquito nets or plug-in killers in your room at night
  • Using our Ultimate Bug Kit.

3.    Food and water safety

Gastro-intestinal illness is by far the most likely problem that visitors to the Olympics will encounter. On a recent 8-week stadium tour of South America, up to 40% of tour members experienced travellers’ diarrhoea. Hot, crowded conditions and a “mass gathering” environment add to the risk: it is very important to take extra care with food hygiene.

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.

 

4.    Sun and heat exposure

  • Cover up & wear a hat
  • Good quality sunglasses
  • Stay well hydrated – even more important should you become ill with travellers’ diarrhoea.
  • Use plenty of high SPF sunscreen (Apply insect repellent after sunscreen; reapply both regularly).

5.    Sexually transmitted infection

There are very high rates of sexually transmitted infections, blood-borne infections, and HIV. Avoid putting yourself at risk, or travel with appropriate barrier contraception.

6.    Personal security and safety

This has been a real problem in Rio in the past, and in other parts of Brazil: be alert to the risks. According to the FCO, “Crime levels are high. Violence and crime can occur anywhere and often involve firearms or other weapons. You should be vigilant, particularly before and during the festive and carnival periods.” Visiting favelas is not advisable.

Rape and other sexual offences against tourists are rare, but there have been attacks against both men and women. Some have involved ‘date rape’ drugs. Buy your own drinks and keep them within sight at all times.

Brazil has a high road traffic accident rate and a zero tolerance policy on drink driving. Always wear seatbelts.

7.    Medical kit

Pack a travel medical kit. Include all prescription and over-the-counter medicines you rely on using at home – medicines you take only occasionally as well as regularly (most medicines are easily available in Brazil but are packaged in Portuguese with much scope for confusion). Take first aid items. Include medicines for travellers’ diarrhoea (oral rehydration solution,nausea medication, loperamide, antibiotics). Take insect repellent, plug-in mosquito killers, and permethrin. Consult us for further advice, or to provide bespoke supplies. See more about our kits here.

8.    Local medical care

Public hospitals provide free emergency care but are not recommended. English is not widely spoken, you may need an interpreter. Many private hospitals offer a very high standard of care.

Recommended hospitals:

  • Hospital Samaritano
  • Hospital Pro Cardiaco
  • Americas Medical City

The emergency ambulance number is 192.

There are no reciprocal health agreements in place so comprehensive travel insurance is essential. We recommend membership of the Blood Care Foundation, available at very low cost, to guarantee access to safe blood for transfusion.

9.    Getting there (and back): Flying and DVT

The direct flight time from London to Rio is approximately 12 hours: consider the risk of DVT, wear comfortable non-restricting clothing for the journey, keep well hydrated, stretch and move frequently, and don’t take sleeping pills or excessive alcohol if the journey will be spent in an upright, seated position. Consider wearing compression stockings. If you have any increased risk factors for DVT, talk to us about further steps that may be advisable.

Use our free calculator to see your DVT level of risk by clicking here.

After your return home

10. Post Travel Health

Report symptoms (e.g. fever, flu-like illness, rash, continuing diarrhoea) promptly, seek medical advice.

Don’t forget to mention your time in Brazil to anyone looking after you, if you need medical attention for any reason up to one year following return home.

If you need a pre-travel consultation, or have a health concern following a trip abroad, you can book an appointment online.

Further advice:

Centers for Disease Control & Prevention (US advice): http://wwwnc.cdc.gov/travel/notices/alert/2016-summer-olympics-rio

National Travel Health Network & Centre (NATHNAC) UK: http://travelhealthpro.org.uk/olympic-and-paralympic-games-2016-brazil/

Health Protection Scotland: http://www.fitfortravel.scot.nhs.uk/advice/general-travel-health-advice/rio-2016-olympicparalympic-games-brazil.aspx

European Centre for Disease Prevention and Control: http://ecdc.europa.eu/en/publications/Publications/Risk-assessment-mass%20gathering-Rio-2016-10May2016.pdf

Lancet Infectious Diseases: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(16)30069-X/fulltext

Blood Care Foundation: http://www.bloodcare.org.uk

Foreign & Commonwealth Office: https://www.gov.uk/foreign-travel-advice/brazil/safety-and-security