Hajj and Umrah are religious pilgrimages to Mecca, Saudi Arabia. Hajj is a mandatory Pilgrimage for every Muslim to take once in their lifetime, given that the individual is physically and financially able.

It takes place in the last month of the Islamic calendar and is taken annually by 2.5 million Muslims worldwide pre-pandemic. Whereas, Umrah is a shorter pilgrimage to Mecca taken any time of the year. 

Muslims from all over the world gather annually in Mecca in a display of unity, faith and solidarity. Due to the large number of participants performing the pilgrimage there are some health risks you should be aware of.

There are also health requirements set by the Health Ministry of Saudi Arabia that you could affect your VISA. It is good to be aware of those requirements before travelling. 

COVID-19 Requirements:

Ministry of Health KSA states that in order to perform Hajj pilgrims, one must have the proof for the following: 

• A full course of COVID-19 vaccinations (second dose of a two dose vaccine or received a single dose vaccine) approved by the Saudi Ministry of Health. The approved vaccines’ list can be found here – Ministry of Health Approved Vaccines. 
• There is no longer a requirement for PCR testing to perform Hajj or to enter KSA. 

Vaccine Requirements:

A pre-travel consultation should be scheduled at least 4 weeks before your trip.
Any mandatory or advised vaccinations will be discussed with a nurse and can be given in the appointment. Follow up doses can also be arranged in the appointment.

Before travelling to Hajj or Umrah, it is recommended that pilgrims be up-to-date with all of their wellness vaccinations.

– Meningitis

All British citizens travellers performing Umrah or Hajj are required to submit a valid Meningitis ACWY vaccination certificate in order to obtain a visa.  The MenACWY vaccine protects against meningitis (strains A, C, W & Y) and sepsis. Adults and children over the age of 2 are required to have the vaccine and provide evidence of immunisation no less than 10 days before you plan to arrive in Saudi Arabia. This requirement also applies to seasonal workers in Hajj areas.
You may also want to consider Meningitis B vaccine – this is not a mandatory VISA requirement.

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

– Covid-19

All travellers must be vaccinated against Covid-19 to perform Hajj Pilgrim. The vaccines that are approved by the Ministry of Health KSA can be found here – Ministry of Health Approved Vaccines.  

– Polio

Travellers from countries reporting positive environmental sources samples of circulating vaccine derived polio virus 2 (cVDPV2), including the UK, are recommended to be vaccinated with at least one dose of IPV within the previous 12 months and at least four weeks prior to arrival, however there is no polio vaccination certificate requirement. 

A polio certificate requirement will only apply to UK pilgrims if they are travelling to KSA via a country reporting WPV1, cVDPV1 or cases of cVDPV2 or Acute Flaccid Paralysis, and not if they are travelling directly to KSA from the UK. 

If you require a vaccination, you can choose from our available appointments online – click to book your appointment. 

– Flu Vaccine

Since both Hajj and Umrah both pose crowded conditions and close contact, seasonal flu vaccination is advised, especially for those who are more vulnerable to severe influenza diseases. This precautionary measure will help reduce the potential spread of the flu.

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

– Hepatitis B

Hep B is spread by contaminated blood and bodily fluid. Pilgrims who intend to shave their heads as one of the rites of Hajj should consider taking the vaccination. Although licensed barbers performing head shaving are obliged to use a new blade for each pilgrim, unlicensed barbers may not adhere to this practice. Vaccinations require 3 injections to be given over a 3 week period and can be given from birth. 

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

– Rabies

Rabies is  spread through the bite of an infected animal such as cats, dogs, monkeys and bats. Saudi Arabia is classified as a high-risk country for rabies. Full protection is achieved with 3 doses – 3 vaccinations usually given over a 3 week period, however, we do offer a rapid course which can achieve full protection in 7-days.  The rabies vaccine can be given from birth.

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

TRAVELLERS’ DIARRHOEA

Travellers’ diarrhoea can occur in up to 60% of travellers. Although most cases are mild, taking sensible precautions with food and water can reduce the risk. Carrying medicines for self-treatments is useful such as antibiotics – take our Online Travellers’ Diarrhoea Consultation to see if it is suitable for us to prescribe you standby Travellers’ Diarrhoea treatment.

The best protection are preventative measures such as  drinking bottled or purified water, washing your hands thoroughly and frequently and eating well-cooked, hot food.

Fore more information on Travellers’ Diarrhoea.

CLIMATE HEALTH

Saudi Arabia has had some of the hottest temperatures on record this year. Exposure to such high temperatures increases sweating, and results in loss of fluid and electrolytes which can cause rapid dehydration. This can result in heat exhaustion or heat stroke which can be life threatening if not dealt with promptly. 

Heat related illness can be avoided by the following:

• Seek shelter and shade during the middle of the day (11am-3pm) when temperatures are the hottest
• If you are outside, ensure you protect your skin against the sun with high factor sun cream
• Wear loose fitting, lightweight and light colour clothing 
• Keep hydrated by drinking plenty of fluids
• Ensure you are taking sufficient salt in your diet (sweating leads to electrolyte and salt depletion)
• Avoid caffeine and alcohol, which can worsen heat related illnesses

GENERAL HEALTH:

Both Hajj and Umrah pilgrimages require strenuous effort, it is worth considering having a full body medical check up before you travel to ensure you are in good health. To prepare for the miles of walking, try increasing your physical activities to improve mobility and movement. In case of unforeseen circumstances, remember to pack a first aid kit and extra supplies of any prescribed medication you are currently taking. We have an onsite pharmacy if you’d like to purchase any of these items during your appointment, speak with your GP or nurse whilst at the clinic.

DENGUE AND MALARIA:

Dengue is spread by day-biting mosquitoes and Malaria by mosquitoes that are active at night. You can reduce your risk of insect bites by using effective insect repellents and protective clothing. You can also sleep under a mosquito net that is impregnated with insecticide to have a peaceful sleep. 

If you require complete protection from bugs and mosquitoes, you can check out our ultimate bug kit here.

Delaying your period:

If you decide you would like to delay your period for pilgrimage, you can do so by taking hormonal medication. In advance of your trip, book an appointment with a GP to discuss your options as soon as possible.

When you get home:

If you return home unwell it is important to book an appointment with a GP to determine the cause. If your symptoms worsen or becoming life-threatening do not wait to see a doctor, go straight to A&E for urgent medical care.

If you return with a stomach bug or persistent travellers’ diarrhoea, you may want to consider booking a Gastrointestinal (GI) Panel PCR test – it looks for any microbes (bacteria, viruses & parasites) that may be causing your symptoms and can quickly identify the exact cause. Results can be provided in as little as 1-hour, so that accurate and effective treatment can begin straight away. Firstly, you need to book a GP appointment, express your interest in a GI PCR test and they will advise whether you are suitable or not.

Travelling with children can be an enlightening and wonderful experience for the family – creating memories and opening their minds to other cultures and ways of life. But on the flip side it also can be quite daunting, especially if this is your first time travelling with children. The best way to establish a safe travel experience abroad is to take early precautions.

Before Your Travels

When it comes to travelling with children, careful planning and preparation should be considered. It is highly advised to have a travel consultation well in advance of your travels. The travel nurse will make you aware of any travel risks and take into consideration your child’s current wellbeing. Depending on where you are travelling, your child may require certain vaccinations. 

These preventative measures will safeguard your child from any diseases or illness. 

Your may be advised the following vaccinations: 

• Rabies
• Yellow Fever
  –  Some countries require this as a condition of entry and will ask for proof of vaccination when you arrive into the country.
• Hepatitis A 
• Typhoid 
• Tick-borne Encephalitis 
• Japanese Encephalitis 
• Hepatitis B
• Meningitis ACWY
• Cholera

All vaccinations require a duration of time following vaccination to reach full protection, usually 10 – 14 days, so factor this time in before your travels. In addition, some vaccinations require a multi-course dose before they are considered effective, such as rabies which requires 3 vaccinations to be considered a complete course. Book a travel consultation early to ensure you have enough time before you travel.

In addition to travel vaccinations it is worth discussing any upcoming childhood vaccinations that could be beneficial to have at the same time so your child is protected against any other common diseases that aren’t necessarily associated with just travel.

If you intend to go to countries with a high malaria risk it is important to discuss antimalarial protection  during your travel consultation. Malaria can be fatal and there is a higher risk for children. Antimalarials (malaria tablets) are generally taken for a duration before, during  and after your trip  and need to be purchased in advance of your travels. There are a number of different types and are suitable for different people so it is important to discuss your options with a travel health expert. The tablets work by ensuring the malaria parasite doesn’t reach unmanageable numbers, keeping you healthy whilst you travel. 

Travelling abroad can be exhausting, especially for young children. Jet Lag is known to cause temporary sleep disturbance, which can have an impact on your mental health and other bodily functions. To prepare ahead, The Jet Lag Calculator can tell you how long it will take the body to adjust to your new time zone when you travel – and to adjust back again when you come home.

To undergo a Pre-Travel Consultation, book online or for more information on Travel Health Services.

During Your Travels

Travelling can sometimes result in unexpected situations. For the protection of your child/ren and your family in general, always carry a First Aid Kit. This will reduce your need to seek medical aid for minor accidents or journeys to a chemist, especially if local towns are at a further distance.

When travelling to warmer climates, sun safety is crucial as young children are more vulnerable to sunburn from outdoor activities. To protect the skin apply sunscreen of at least SPF 30, with broad spectrum UVA and UVB protection throughout the day. In addition, hot weather can also pose a risk of dehydration and heat stroke. Ensure you and your child are hydrated throughout the day by drinking  water from a safe source. This can be bottled water, boiled water, or water that has been filtered. 

To further avoid traveller’s diarrhoea:

• Wash your hands regularly, especially before eating
• Carry an alcohol-based sanitiser 
• Keep children from crawling or sitting on the ground
• Avoid swimming in contaminated water
• Don’t swallow any shower or pool water
• Eat raw fruits and vegetables only if washed in clean water or peeled 
• Stick to foods that are well cooked and served hot
• Stick to canned or bottled beverages
• Avoid food that has been sitting on a buffet to avoid contamination

We have launched a new, free online consultation for Travellers’ Diarrhoea – by answering a few simple medical questions about yourself, we can check if antibiotics are recommended for your trip. You can pay online and we’ll dispatch them directly to you if you are suitable. 

Alternatively, you can have a more comprehensive travel consultation in-clinic with one of our experienced travel nurses. 

For more information on the prevention and treatment of Travellers’ Diarrhoea.

The feeling of discomfort from bug bites can truly be a nightmare whilst travelling. Insect bites such as mosquitoes, ticks, biting fleas and kissing bugs can cause pain, irritation and even spread diseases. However, they can be avoided through protective clothing. Our Ultimate Bug Kit  has everything you need from repellents to aftercare. Alternatively, you could purchase individual items and create your own kit.

After Your Travels 

Travelling can expose your child to certain diseases. If your child falls unexpectedly ill – contact your doctor or emergency services right away. A high temperature/ fever could mean an infection. For most people, travellers’ diarrhoea usually clears up within a few days. However, if your stomach bug has been ongoing for weeks after returning home, then you will need to do testing to investigate the root cause. Viruses, bacteria or parasites all cause similar symptoms but require an entirely different treatment approach. Our Gastrointestinal (GI) Panel PCR test looks for any microbes that are causing your symptoms and can quickly identify the exact cause of your Travellers’ Diarrhoea. Results can be provided in as little as 1-hour, so that accurate and effective treatment can begin straight away.

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

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

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

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

Bosnia is where East meets West.

It is a country on the Balkan Peninsula in southeastern Europe and has become somewhat a destination for adventurous travellers.

Beautiful Ottoman architecture, rugged mountains, captivating castles, raft-able rivers, and humble hiking trails are all reasons why travellers are choosing Bosnia as their next travel destination. The unveiling of the Via Dinarica mega hiking trail means the number of tourists to the Balkan country of Bosnia Hercegovina is expected to rise steeply. The 1930km trail provides a corridor linking traditional cultures between the former Yugoslavian nations. So whether you plan to mill about the city of Mostar, stroll the streets of Sarajevo, or take a hike in the hillside, ensure you follow our top travel tips to stay healthy.

Vaccinations

All travellers are advised to be in date with their routine immunisations, including diphtheria, tetanus and polio (DTP) and measles, mumps and rubella (MMR). Europe has seen huge outbreaks of measles this year alone, so all travellers should make sure they have received at least two doses of the measles-containing vaccination. A simple blood test can be done for all those who are unsure about their immunity. Some travellers may wish to consider vaccinations for Hepatitis A and Hepatitis B, rabies and tick-borne encephalitis. The activities you plan to do whilst travelling will determine which vaccines would be required. If you have any doubts or concerns, we also suggest booking a pre-travel consultation with a specialist travel nurse to discuss your options.

Find out more about our travel and wellness vaccinations.

Trekking and Ticks

Bosnia offers a wealth of outdoor activities. Those who plan to take advantage of the great outdoors should strongly consider vaccination against tick-borne encephalitis (TBE). TBE is a bacterial infection. Usually, it is spread through an infected tick bite. However, during Spring to Autumn, the consumption of unpasteurised dairy produce also carries a risk. Contracting the illness causes a fever with neurological complications.  It is vaccine-preventable. Protection requires  2 doses of the vaccination, given at least 2-weeks apart.  A third dose is given 5-12 months later to give longterm protection. You should also avoid ticks by wearing long trousers and socks. Using DEET insect repellant should also repel them.

If you spot a tick on you, it needs to be removed promptly. Use some flat tweezers or a tick remover and clean the bite with alcohol to reduce the risk of infection.

See our Ultimate Bug Kit.

Rabies

Rabies is a fatal virus that can be found in the saliva of an infected mammal. Most commonly a wild dog. Exposure can happen through a bite, scratch or a lick to an open area of the skin. You cannot catch rabies from another person and it cannot spread through unbroken skin. You should, where possible avoid contact with animals when travelling, especially wild or stay animals.

Rabies is almost always fatal once symptoms appear, but treatment before this is very effective. Pre-travel rabies vaccination offers great protection. And means that in the unlikely event you come into contact with the rabies virus, fast and effective treatment can be given easily and in the country of the incident.

Pre-travel rabies protection requires a series of 3 vaccinations given as injections into your upper arm. Your vaccines will be given over a 3-week period, or over 1 week if an accelerated course is needed, prior to travel. Travellers at greater risk are those who plan to do outdoor activities such as hiking, trekking, cycling or caving. You should consider a rabies vaccine if you plan to do any of these activities whilst visiting Bosnia.

First Aid Kit

For those trekking in the hills, packing good basic first aid kit is essential. When travelling in rural areas, access to healthcare can be limited. Travelling with a medical kit will give you access to basic provisions needed to treat minor injuries and pains.

Basic provisions include pain relief, plasters and medication to treat an upset stomach, such as loperamide and oral rehydration salts. If access to safe water may be limited, consider packing chlorine dioxide tablets. Cuts, scapes blisters and even a twisted ankle can occur, so take blister pads, some waterproof dressings and a bandage to deal with any minor injuries whilst you are there. If you take regular prescription medication, ensure you pack enough for the duration of your trip and carry the prescription with you.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | August 2019

Tanzania is the perfect haven for adventurous travellers. Not only does it boast three of Africa’s Seven Natural Wonders, but it is home to the ancient nomadic stewards, the iconic, Maasai people. It is also the perfect place for an African safari adventure, with it’s 16 national parks accounting for more than 30% of the country.  

Tanzania is blessed with the highest peak in Africa. Mount Kilimanjaro beckons visitors from all over the world. It is the world’s highest free-standing volcano and gets an estimated 30,000 travellers attempting to summit the peak each year. Climbers by the thousands venture here to challenge themselves on its muddy slopes, rocky trails and slippery scree.

It’s crowning jewel is the island, Zanzibar. The island is famous for its mix of exotic white sand beaches, dense palm trees and coral seas. A true paradise. It hosts famous spice plantations and is rich with diverse culture. Unguja (the main island in Zanzibar) is also home to many endangered species including the red colobus monkey and green turtle.

Whether you are visiting for an action-packed safari, challenging yourself to reach the peak of Mt. Kilimanjaro or relaxing on the island of Zanzibar, ensure you follow our top travel tips to stay healthy in Tanzania.

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

Japan is hosting the biggest Rugby event of the year in September.

Starting 20th September, across 12 Japanese cities, 48 matches will be played to determine the winner of Rugby World Cup 2019. Millions of people from around the world are expected to travel to Japan to attend this amazing sporting event. Much like any other reason for travelling, it does come with some health risks.

Big sporting events, like the Rugby World Cup, attract huge numbers of people which increases the risk of getting sick and spreading diseases. Venues are sometimes described as giant Petri dishes, where viruses and bacteria can flourish and spread. 

But how can you prepare yourself so you remain healthy throughout your holiday?
Be prepared…

Get Vaccinated

It is advised that individuals are up-to-date with routine immunisations including diphtheria, tetanus and polio (DTP). 

If you plan to venture outside of the major cities and explore Japan whilst you are there, you may need to consider some travel vaccines, such as Rabies and Hepatitis A or Hepatitis B. If those plans include visiting more rural areas, Japanese Encephalitis could be considered. For those trekking, hiking or camping, a vaccination against tick-borne encephalitis will provide protection against the disease. 

MMR is a must

Ensure you are immune to measles before you travel. Japan has had multiple large outbreaks of measles this year and it is a highly contagious disease. 

The best protection against measles is to ensure you have received 2 doses of the MMR vaccine. You may not have received the full course during your childhood vaccines which means you’re not fully immune. A simple blood test can determine immunity if you are unsure. 

Beware of Flu Season

Flu season for the Northern Hemisphere begins in Autumn, which coincides with the start of the Rugby World Cup. It’s possible people could pick up the flu virus at these events as the Flu is a highly contagious viral disease. Transmission of the flu is always amplified when large groups of people congregate in enclosed space.  People travelling to and from mass gatherings can also spread flu to other communities and to family members when they get home. An infected person can transmit the virus before even realising they are sick. 

Getting a flu vaccine every year is the best way to avoid getting seasonal flu. 

Those travelling from mid-September onwards should consider getting the flu jab as soon as it becomes available.

Find out more about our travel and wellness vaccinations.

Minimize Your Risk

Besides the flu vaccine, here are a few tips on how to minimize your risk of contracting an illness at the Rugby World Cup:

1. Keep a distance from people coughing and sneezing – droplets from coughs or sneezes containing flu virus can travel at least 3 feet, so keeping this distance from sick people can help lower your chance of becoming ill.
2. Wash your hands often, before eating or after contact with sick people, public places and bathrooms to limit your chances of contact with the virus.
3. Carry hand sanitizer to use when hand washing is inconvenient or not available. Ensure it has a minimum of 60% alcohol content to be most effective.
4. Avoid touching your mouth, nose and eyes with your hands.
5. Use clean, disposable tissues to wipe your mouth or blow your nose. Throw away used tissue immediately after use.
6. Avoid getting overly cold and wet by wearing appropriate clothing.
7. if you are already sick, wear a face mask to help lower the chance of spreading your illness to others.

First Aid

Despite having a good reputation for health care, it’s worth being prepared for minor illnesses and injuries when travelling abroad. Pack an essential First Aid Kit for your travels and include some basic items such as pain relief, plasters, antiseptic creams and something to treat minor wounds. Being able to treat minor accidents whilst abroad means less time hunting down a pharmacy or time wasted visiting a doctor should you need it. 

For convenience, we sell a ready to go Essential First Aid Kit, available online.

You can book a pre-travel consultation online.

For more details about the Rugby World Cup.

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

A safari in Namibia is a unique experience in Africa. It has the highest sand dunes on the continent, the world’s oldest and uninhabited deserts, the Skeleton Coast and a lush jungle to the north. Whatever you have planned on your trip, ensure you follow our top travel tips to stay healthy.

Vaccines

All travellers need to ensure they are up-to-date with Hepatitis A, Typhoid and Diphtheria, Tetanus and Polio (DTP). These are your basic traveller vaccine requirements. You may wish to consider further vaccinations against Rabies and Hepatitis B.

There is no risk of Yellow Fever in Namibia, however, travellers who will arrive in Namibia having transited from a country with a risk of Yellow Fever will be required to be in possession of a valid Yellow Fever Certificate.
Countries this would apply to include Kenya, Nigeria, Zambia, Ethiopia, Brazil, Peru and Bolivia. For the full list of countries with risk of yellow fever transmission as per the World Health Organisation.

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

Malaria

There is a risk of malaria in the northern areas of Namibia of the Kunene River, Caprivi and Kavango regions and Etosha National Park. Windhoek, Swakopmund and the Skeleton coast have a low risk of malaria. If you intend to visit malarial regions, ensure that you take the antimalarial medication with you. Mosquitoes that are responsible for the spread of malaria are most active between dusk and dawn, and therefore you need to be extra cautious during this time against mosquito bites.

Insects

Ticks, flies and mosquitoes all have the ability to transmit unpleasant disease in Namibia. The best prevention against these diseases is to avoid mosquito bites. Cover up as much as possible and apply a minimum concentration of 50% DEET to any areas of exposed skin. Clothes can be treated with permethrin before setting off to provide an extra level of protection. Sleep under a mosquito net especially if you plan to stay anywhere remote or rural.

See our Ultimate Bug Kit.

Food and water

Travellers should exercise caution with food and water when travelling to Namibia to avoid tummy troubles. Do not drink tap water in Namibia, stick to bottled water or water that has been boiled. If you are undertaking a self-drive trip and plan camping in remote areas it is a good idea to take either a water bottle with a filter or some chlorine dioxide tablets to make water safe to drink should you not be able to find a shop with bottled water. The Namib Desert is one of the aridest in the world so always ensure you pack extra water.

See our Worldwide Gastro Kit to help with any travellers tummy troubles.

Book your travel appointment online today.

By Anna Chapman |  Travel Nurse | June 2019

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

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

We are very sorry to hear that Interhealth is ceasing to trade. As a hugely respected health practice, it is a great loss for Travel Medicine in the UK.

Fleet Street Clinic is in contact with Interhealth to offer support and provide continuity of medical care for existing individual and corporate Interhealth clients as required.

If you are looking for continuity with Interhealth services as an individual, or if you require corporate services such as Occupational Health and Travel Healthcare including travel vaccinations, please get in touch.

For more information please call Fleet Street Clinic on 0207 353 5678  or email at  info@fleetstreetclinic.com

Uzbekistan is home to spellbinding architecture and ancient cities. In terms of sights alone, Uzbekistan is Central Asia’s biggest draw and most impressive showstopper. Fabulous mosques, medressas and mausoleums are just some of the pulls for tourists when visiting Uzbekistan while more eccentric views can be seen at the fast disappearing Aral Sea and Nuratau Mountains.

Travel Nurse, Anna, shares her top tips on how to stay healthy during your trip to Uzbekistan.

Vaccinations

Ensure you are up-to-date with your travel vaccinations. The minimum advised for a trip to Uzbekistan is diphtheria tetanus and polio, and Hepatitis A. Typhoid, Hepatitis B and Rabies can be considered by some travellers. It is advisable to attend for a pre-travel assessment with a travel nurse 6-weeks before your trip as some vaccinations requires several injections to complete the course.

Food and water

Precautions against the dreaded traveller’s diarrhoea should be taken to prevent an upset stomach ruining your trip. Do not drink tap water in Uzbekistan, stick to bottled water or water that has been boiled. If you are trekking or visiting remote areas it’s a good idea to take either a water bottle with a filter or some chlorine dioxide tablets to make water safe to drink, should you not be able to find a shop with bottled water.

Sour milk dishes dominate the Uzbek cuisine. Cue caution if you want to try ‘kurt’, the famous fermented cheese balls. There is a risk of a bacterial disease called brucellosis that can be spread through unpasteurised dairy products such as cheese and milk.

Travelling further afield

Uzbekistan forms one of the countries on the old silk route. If you plan on a tour of the ‘Stans’ or attempting the whole Beijing to Istanbul route, you may need to consider other travel health precautions. Depending on your route, and also the time of year you intend to travel, you may wish to consider vaccinations against Tick-Borne Encephalitis and Japanese Encephalitis.

Altitude

Khazret Sultan, Uzbekistan’s highest peak stands at 4643m. Many popular walking and hiking routes such as Big Chimgan exceed over 3000m, making altitude related illnesses a hazard. Tips for reducing altitude sickness include a slow ascent route, keeping hydrated, ensuring that your sleeping altitude doesn’t exceed 500m per day. Diamox (acetazolamide) is a prescription medication that can reduce the symptoms of altitude related illness.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | April 2019

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

Vaccinations

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

Water

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

Food Safety

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

First Aid

The availability of health care and first aid supplies are limited in Morocco. Whether you are visiting the median of Marrakesh or ambling around the Atlas, taking a good first aid kit with you is essential – click here to buy online now.
Basic provisions include pain relief, plasters and medication to treat an upset stomach, such as loperamide and oral rehydration salts. If you take prescription medication to ensure you pack enough and carry the prescription with you.

Altitude

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

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

Book your travel appointment today

By Anna Chapman |  Travel Nurse | April 2019

Boating in the Bahamas

The best way to see the Bahamas is by boat. As an archipelago of over 700 islands and cays all strung together like pearls over a turquoise sea, the majority of visitors choose to cruise to see the many delights that this country has to offer. Whether you only visit the Bahamas or take an all-encompassing Caribbean cruise, it is important to remember those travel vaccinations and travel health advice are essential if you are to enjoy a happy healthy holiday.

Here are our top travel tips for staying healthy in the Bahamas…

Vaccinations

All travellers should be in date with diphtheria, tetanus polio and Hepatitis A. There is no risk of the Yellow Fever virus in the Bahamas, however, if your cruise takes you to an area that does have a risk of the virus (such as South America), you will need to provide evidence of vaccination in the form of a valid Yellow Fever certificate. Cruise ships are confined spaces with a high volume of passengers which makes you more susceptible to infections. If you plan on travelling during the winter months, it is sensible to consider a flu vaccination as respiratory viruses can spread easily.

Sun

The Bahamas lie in the tropical Caribbean seas making the sun, sea and sand the major attraction.  Remember to be sun safe. Wear a high factor sun cream throughout your holiday. The sun’s rays are particularly strong between 11am-3pm so it’s best to avoid direct exposure during this time. Slap on a hat, slip on a shirt and slop on some sunscreen.

Insects

The Bahamas have a risk of dengue fever, chikungunya and the Zika virus. These illness are spread via the bite of an infected Aedes mosquito. Whilst causing mild illness in many, they can cause more serious complications and are best avoided. Zika virus is associated with a serious complication during pregnancy and those who are pregnant or plan to become pregnant soon after the trip are advised against travel to the area. There are no specific vaccinations against these mosquito-borne viruses so bite prevention is the only defence. Cover up exposed skin and wear an insect repellent containing at least 50% DEET.

See our Ultimate Bug Kit.

Gastro Kit

The majority of Bahamian cuisine comes straight out of the sea. Whilst seafood and fish are delicious, ensure that any food consumed is cooked thoroughly and served fresh to you. The Bahamas has an abundance of fresh tropical fruit but it is wise to adhere to the ‘cook it, boil it, peel it or forget it’ saying to avoid the dreaded traveller’s diarrhoea. We advise travellers to take a gastro kit with them which can help prevent and treat the commonest gastrointestinal symptoms that occur when travelling.

Cruise Health

If you do plan to see the Bahamas by boat, ensure you follow some sensible precautions to avoid getting sick from fellow passengers. Wash your hands regularly, make use of the alcohol-based sanitizers stations on board, carry a small alcohol-based hand sanitiser to keep your hands clean when off the ship. Ensure you stay hydrated, but make sure you drink water from a safe source (bottled, boiled or purified).

Book your travel appointment today

By Anna Chapman |  Travel Nurse | March 2019

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

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

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

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

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

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

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

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.
______________________________

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

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

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

Anna Chapman, one of our experienced Travel Nurses, gives her top 5 reasons why having a travel consultation is so important … food for thought if you’re planning a trip abroad.

1 – Reputable advice from a trusted source

Clinics that specialise in travel have practitioners who have completed extra qualifications in travel medicine, such as a Diploma in Travel Medicine, Diploma in Tropical Medicine and Certificate of Travel Health.  These qualifications ensure the practitioner gets specialist knowledge that is kept up-to-date by attending conferences and participating in research in the field.  Many practitioners who work in travel medicine have experienced health care abroad, through extensive personal travel or through working or volunteering.  This means the travel advice that a patient receives is always current and accurate.

Our travel nurses at the Fleet Street Clinic have a Diploma in Tropical Nursing and a Certificate in Travel Health and both GPs have a Diploma in Travel Medicine and a Certificate in Travel Health.  All the practitioners in our Travel Clinic have travelled extensively and practiced their profession in developing countries.  This means they are more aware of the risks that travellers face and have a greater understanding of how to deal with health issues on the road.

2 – Personalised travel consultation

No two people are the same and no two travel itineraries are the same.  Travel consultations take this into account and give detailed and bespoke travel advice, not only for the itinerary but also for the individual.  Seeing a practitioner face-to-face means that personal risks can be evaluated to ensure all travel health needs are met, rather taking a “one size fits all” approach.

3 – Travel health is NOT just about travel vaccinations

Whilst vaccinations are important, there are many aspects to staying healthy while abroad.  In addition to vaccinations, there are considerations such as avoiding insect bites, use of medical kits, coping with jet lag, use of stand-by medications and coping with altitude sickness – all things that can be discussed when you have a travel consultation

4 – On-going care

Just because you have had your vaccinations before your trip, it doesn’t mean that your care ends when you leave the clinic. Specialist clinics can provide on-going care for subsequent trips and/or post-travel health concerns

5 – Time to talk

When a clinic has a specialist travel service, ample time is allocated to each appointment.  Having a team of dedicated staff committed to travel medicine means that appointments can be completely flexible and can accommodate individuals, groups or families, both at the clinic or off-site, as well as offering appointments for last minute travellers.

You can book a travel health consultation online.  Or see here, or more information about our travel health services.