Covid-19 Statistics:

UK: Public Health England
Worldwide: The Johns Hopkins Center

Coronavirus Testing:

Covid-19 testing is available at Fleet Street Clinic, including PCR testing for active infection, antibody testing for confirmation of past infection and PCR testing for travel purposes including travel certificate.

Samples can be collected in-clinic, during a home from the nurse or using a self-sample home testing kit.

For more information:

• Covid-19 rtPCR Testing
• Covid-19 rt-PCR Travel Testing
• Corporate Coronavirus Services

Alternatively, please call our reception team on +44 20 7353 5678 to see which option is most appropriate for your current circumstance.

Virtual GP Appointments:

If you have symptoms of coronavirus (a high temperature or a new, continuous cough), please do not leave your home. That includes coming into the clinic, any other GP surgery, a pharmacy or a hospital.

We’d suggest you can book a virtual GP appointment with one of our doctors. You can discuss your health concerns and symptoms by telephone or video call.
Alternatively, you can use the NHS 111 online coronavirus service. If you are experiencing life-threatening symptoms, always call 999 for an ambulance.

If you have symptoms you should self-isolate for 7 days. If you live with someone who has symptoms, you’ll need to self-isolate for 14 days from the day their symptoms started. This is because it can take 14 days for symptoms to appear. More details about self-isolation can be found here.

For further information about coronavirus (COVID-19) or read answers to common questions about it.

How to stop the spread of Coronavirus:

• Wash your hands with soap and water often – do this for at least 20 seconds
• Use hand sanitiser gel if soap and water are not available
• Wash your hands as soon as you get back home
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
• Put used tissues in the bin immediately and wash your hands afterwards
• Do not touch your eyes, nose or mouth if your hands are not clean

Recommended information sources:

Gov.uk: For the latest guidance about coronavirus (COVID-19) for health professionals, businesses, schools and other organisations.

Public Health England: For the latest information about the situation in the UK, along with guidance for what to do if you think you’re at risk. You can sign up for email alerts from PHE concerning coronavirus updates here.

NaTHNaC: For travel health advice for travellers to countries/areas affected by COVID-19

World Health Organization (WHO)

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Our Medical Director and Travel Specialist Dr Richard Dawood, has been at the forefront of the conversation, sharing insight and opinions as the pandemic unfolds:

2021:

The Telegraph: Vaccine passports for travellers ‘unavoidable’

The Guardian: Vaccine passports ‘essential’ for resumption of international travel

2020:

Times letters: Strategy for combating the coronavirus

The Telegraph: Staycations to face masks – 5 ways coronavirus could change the way we travel

The Telegraph: Why flying can make you ill – and how to stay healthy on board a plane

CNN Travel: Travel and the coronavirus pandemic: Everything you need to know

CNN Health: 7 of your latest coronavirus questions, answered

Express: Coronavirus: When will it end? Experts reveal if virus could die off in warmer weather

Express: Coronavirus protection: Best way to prevent the deadly virus spreading through the eyes

2019:

Mirror: Everything you need to know about flu jabs and why you should get one before Christmas

Please note: All information stated is correct at time of posting.

We are hoping you and your family are keeping safe and healthy.

We want to reassure you that we are committed to looking after your health during these trying times.

We have every intention of remaining open so you can access all of our services, however, we have had to make some necessary changes to adapt to the current circumstance.

Temporary Opening Hours:

We have made the difficult decision to temporarily adjust our opening hours. Starting Monday 23rd March, for the foreseeable future, the clinic will be open 9:00am – 5:30pm for face-to-face appointments – we may be able to facilitate virtual clinic appointments outside of these hours.

Virtual Clinic Offerings:

With many of you now working from home outside of London, it makes sense to adapt our services to meet your new needs.

You’ll be able to access a lot of our services through our virtual clinic from Monday 23rd March:

• GP appointments
• Travel consultation for health advice only
• Repeat prescriptions

We are confident that this will not affect the quality of service that we will continue to supply to you.

Reduced Services:

We are running a reduce service for optical appointments. We advise you call our front of house team on +44 20 7353 5678 to make any appointments or alterations.

Booking An Appointment:

To protect the health and wellness of our patients and our team, we’ve decided to turn off online bookings for the time being. Rest assured you can still book appointments, however, this now needs to be done through our friendly reception team on +44 20 7353 5678 to determine if a face-to-face appointment or virtual consultation is required. Due to reduced availability, a deposit is required for all appointments.

Getting in touch:

Due to these unprecedented circumstances, we’re experiencing an increase in phone calls so you may have noticed our call waiting times have been slightly longer than usual. Our reception team are working at full capacity to offer reassurance and to book your appointments, however, please do not hesitate to email us if the phone line is too busy. We will answer all enquiries we receive.

Prescriptions for Medicines & Contact Lenses:

Please note, you can place orders for repeat prescriptions and contact lenses in advance via email here.
Outline your medicine needs and/ or your contact lens prescription and you can either pick your prescription up from the clinic or we can dispense these directly to you via the post.

Feeling unwell?

We would kindly like to remind you that you must not come to the clinic if you are suffering from any of the symptoms below:

• Coughing
• Sneezing
• Running nose
• Sore throat
• High temperature
• Shortness of breath

We are not offering testing for COVID-19 at our clinic but will be sure to keep you informed if this is to change.

Our commitment to our patient’s health and well-being remains our primary focus and we will continue to work safely and strategically during these unprecedented times. If there are any developments that impact these arrangements, we will notify you at the earliest possible opportunity.

Thank you for your support in keeping one another safe.

For more advice on Coronavirus…

On Friday 14th December 2019, The Fleet Street Clinic, along with thousands of people up and down the UK will embrace their craziest & tackiest Christmas jumpers in celebration of Christmas Jumper Day, to raise money for Save the Children.

Save the children, are a fantastic charity who help some of the world’s most vulnerable people, which is why we choose to support them every year.

Save The Children began Christmas Jumper Day with the aim of “making the world better with a sweater”. While it’s an undoubtedly fun and light-hearted occasion, the main focus of the day is to highlight the lifesaving work the charity does. They help bring essential food, healthcare & education to many children who are, for many reasons, currently missing out.

Save the Children aims to create a world where every child survives, learns and is protected. Child poverty, hunger, education and health are just a few of the charities key aims which help children who live in some of the toughest places in the world.

As a healthcare provider, ensuring all children throughout the world have access to health care is extremely important to us. There is a danger that children are being left behind because they are poor, because they are girls or because of their ethnicity.

Last year, Save the Children helped 10.6 million children through their health and nutrition work. This year they plan to help many, many more!

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How can you get involved?

The simplest way of getting involved with Christmas Jumper Day is to join in!

Wear your most eye-catching Christmas jumper and donate some money towards Save the Children.

Make a difference this Christmas!

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

How to Stay Healthy This Winter

When the temperature drops outside, it’s tempting to reach for comforting, high-calorie food and avoid exercise. Feeling cold, along with short days and weight gain can lead to the onset of Seasonal Affective Disorder or depression in the winter months.
Fleet Street Clinic’s Consultant Dietitian, Ruth Kander BSc (Hons) gives some practical advice on what you can do to avoid the winter blues.

Consume a Variety of Foods

By eating foods from all the food groups, you will have all the nutrients you need to stay healthy and keep winter germs at bay whilst maintaining your energy levels.

Eat Plenty of Fruits and Vegetables 

These will give you vitamins and minerals to help your body fight winter bugs. Vitamin C is especially beneficial in the fight against colds and sore throats.  Avoid taking supplements which contain high concentrations of vitamins which can lead to medical problems. Fruit and vegetables high in vitamin C include kiwi, citrus fruits, spinach, pumpkin and sweet potato. Zinc is also a good mineral to help fight winter infections and boost the immune system. Foods containing zinc include fish, oysters, poultry, eggs, milk, unprocessed grains and cereals. If you’re short on time, using a blender to create a vegetable and fruit drink is a great way to pack your diet full of vitamins. Try combining lettuce, cucumber, spinach, ginger, berries and a dash of orange juice and water for a zingy, low-sugar start to the day.

Keep the Pantry Cupboard Well Stocked

Good foods to store include:

• Tinned beans and lentils
• Tinned tomatoes
• Whole-wheat pasta
• Brown rice
• Couscous and noodles
• Wholegrain cereals – for example, Porridge and Weetabix

Plan Your Meals

Make soups and casseroles in advance and freeze. That way you can come home to a nutritious meal in the evenings. Simply take out of the freezer in the morning so that they are ready to heat up after work.

Watch Portion Sizes 

To avoid eating too many carbohydrates, try eating your meals at the table with the TV turned off, use smaller plates and reserve half your dinner plate for vegetables. If you want more after your first serving, have some soup or more hot vegetables.

Stay Active

It’s tempting to reduce your exercise regime in the colder months. But small efforts can go a long way to help stave off winter weight gain. Going for a regular, brisk walk or using an exercise video at home can be enough to maintain your weight and stay healthy over the winter.

Drink Plenty of Fluids

Try to avoid getting dehydrated. This can make you feel overly tired and unnecessarily run down. Drink plenty of fluids throughout the day that are either low calorie or calorie-free – aim for 2 litres a day. Be aware that your daily hot drink from the coffee shop can contain 360 calories or more!
Looking for an alternative to still water? Try green tea, regular tea, herbal teas, regular coffee, hot no added sugar cordial or lemon water.

Consult Fleet Street Clinic

Ruth Kander holds a virtual clinic every Friday from 9am-2pm for individual dietitian consultations and ongoing weight management courses. Please call our reception team on +44 20 7353 5678 if you would like to request a face-to-face appointment

Book Your Dietitian Appointment with Ruth

WINTER FEET – LOOKING AFTER YOUR FEET IN COLD WEATHER

ADVICE FROM OUR PODIATRIST, George Hill

Staying warm when it’s cold outside can be a challenge. Especially when it affects our body’s circulation; our feet and hands can suffer especially. In cold weather, it is a natural response to prioritise the heating of our vital organs. This is so they remain at their optimal temperature for full functionality. This means having cold feet is normal when the temperature drops. Nail growth slows down and skin will often become drier because nutrition to these tissues is affected.
In response to this temperature change, small blood vessels temporarily constrict. As a result, you may see a change in the colour of your skin, which could look pale, blanched and waxy at first, before becoming bluish. This is because the oxygen in the blood has been used up by the tissues. The skin is also cool to touch. Returning to warm conditions usually remedies this and the skin becomes pink and warm again.
However, in some individuals, this response is exaggerated and prolonged. This condition is known as Raynaud’s phenomenon and can be inherited. The same response will occur but much more readily and will last longer. Meaning the colour changes are much more obvious. When the skin is deprived of oxygen for long periods of time, some injury occurs to the soft tissues. This can make fingers and toes numb while they remain cold. When the blood vessels do finally relax and blood returns to the area, fingers and toes can throb and burn, turning bright red with inflammation. Eventually, things return to normal but repeated episodes of this can lead to dry, devitalised skin and changes in nail shape and texture.

Chilblains occur for much the same reason. These are painful, itchy swellings that often occur on the tops of small toe joints but can occur in other bony areas too, such as the back of the heel. Tightly fitting footwear can add to the misery by constricting blood flow further and rubbing on the painful skin. Chilblains are not caused by using hot water bottles, as commonly thought, they are a cold injury to Winter Feet, The attempt to relieve the intense itch by scratching merely worsens the problem, often causing further damage. Itching tends to break the skin and causes sores which can sometimes lead to infections.
Preventative action should reduce the likelihood of chilblains developing, but if they do, an antipruritic (anti-itching) cream or ointment can be obtained from pharmacies, and menthol-based products can also be very soothing.
If the skin becomes broken, antiseptic creams such as Savlon help the skin to heal and prevent infection. Cover with a gauze pad after applying, which can be secured with finger bandage or held in place with a cotton sock.
In the aftermath of chilblains, the affected skin is often dry, thin and rough, so use a moisturising cream to restore normal texture.

Cold feet at night can keep you awake or disrupt sleep.
What can be done to help? If you are susceptible to cold extremities, it is important to keep yourself generally warm. Listen to the temperature forecasts and dress accordingly. As well as suitable outer clothing, trousers, tights or socks will help to keep the whole limb warm. Fibres such as wool or bamboo are good insulators and several light layers, rather than one thick layer, traps more air and heat. Remember to wear roomier footwear to allow for thicker socks without compressing the skin.
Footwear should have a good rubber or composite material sole, to insulate against cold pavements – adding insoles of cork or lambswool can improve insulation and comfort. The sole should have good grip for traction on slippery pavements.
Keep active – this improves circulation, and have plenty of hot drinks and food throughout the day.
At home, a warm (not hot) foot-bath will help. Dry with a rough towel and apply a cream or lotion with a massaging action. Some preparations include ingredients such as capsaicin or ginger, to stimulate circulation. Afterwards, put on loosely-fitting, warm socks or slippers to maintain the effect. If the feet are warm before going to bed, they are likely to stay warm. Bed socks in wool or cashmere can be very helpful. Water bottles or gel pads should not be over-heated, as sensation can be unreliable in cold feet.

People who suffer from eczema will find that cold weather tends to make the skin even drier and more cracked. Use plenty of ointment to keep the skin well hydrated and wear hose to help trap moisture and warmth. Silk is a good choice of material and is thin enough to wear under a thicker, outer sock.
In severe cold weather, you may find you get recurrent problems in your feet. Consult your GP who may advise a prescription drug to relax the constricted vessels and thus improve blood flow to the extremities.

Book Your Winter Feet Podiatry Appointment

For more information about podiatry at Fleet Street Clinic

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

Exercise More – Get Outdoors

Today is National Fitness Day. September is a great time to redress the balance after summer holidays and make a new exercise plan.  Time to get out and get moving!

Regular exercise has many benefits – a healthier heart, increased well-being, and a better quality of life. Research shows that if you exercise with friends, you are more likely to continue to keep fit, as the social environment encourages positive associations with the activity.

Exercising outdoors can contribute to this feeling of wellbeing. Organised outdoor exercise groups have grown in popularity recently, with a wide range of community-based activities across the country. A few of the more popular outdoor exercise activities are detailed here:

Park Run – Over 1 million Britons have taken part in Park Run – the Saturday morning 5k run in local parks across the country.

Project Awesome –  A free community exercise group based in London, Bristol and Edinburgh, Project Awesome is based on high-energy, early morning exercise classes designed to kick-start your day.

Good Gym –  For those who’d like to combine voluntary work with exercise, Good Gym enables you to meet like-minded people to run and work together on community projects in your local area.

British Military Fitness – Operating in parks across the UK,  British military fitness classes are run by serving or former members of the armed forces with recognised fitness training qualifications. Classes are graded by ability group and are for members of the public. They are designed for all abilities, from those just starting to exercise who want to lose weight, to the already very fit.

Open Air Swimming – If you’re a keen swimmer, have you ever tried swimming outdoors? There are many reported benefits to open-air swimming, which can be enjoyed all year round even in the UK, with or without wetsuits. Check Wild Swim for your nearest open-air swimming site.

Getting Fit with Fleet Street Clinic

Our podiatrists can offer advice on appropriate footwear for exercise and our dietician and osteopath can work with you to support your exercise regime, ensuring a holistic approach to achieving a long-term, healthier you.

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

It’s now coming to the end of summer and many of us have spent plenty of time around pools and on the beach. Which can be wonderful, of course. However, bacteria and viruses can thrive in these locations causing foot infections.

George, our podiatrist talks about one in particular: the pesky verruca.

Verrucae are commonly found on the foot and are relatively harmless. However, there is the possibility they have other more sinister properties. Some can become malignant and/ or grow and spread across the foot causing a host of uncomfortable or potentially dangerous problems.

Verruca or Verrucae are caused by the Human Papilloma Virus (HPV). There are hundreds of different types of HPV and different strains infect the body differently. Some types infect the skin, causing verrucae. Even if you come into contact with the virus that causes warts, the risk of becoming infected and developing a wart is small.

Common warts and plantar warts are not usually a serious health concern. These viral warts have not been shown to play an aetiological role in wider known high-risk HPV-linked diseases* such as cervical cancer and Bower’s disease. This is due to HPV presenting as different strains. Having one does not mean you have the other.

*For additional information on HPV’s link to cervical cancer and HPV’s link to Bowen’s disease, we recommend Macmillan’s website.

Contrary to what the old wives tale would have you believe, warts are not caught from touching a toad. Viral plantar warts are in-fact contracted via skin to skin contact or surface to skin contact; among other suggested routes. While common warts are usually painless, plantar warts can be painful because they press inward when you stand on your feet. 

In appearance, these lesions are lumps that are generally circular in shape and appear slightly raised and can be callused over with thicker skin. Some will present with small black/deep-red specks, often noted as the capillary heads and others can be clustered into groups. If you have any small areas of skin you are concerned about then it is important to have these reviewed by your Podiatrist immediately.

For many, a verruca will disappear in a few weeks to months. However, if they do not it is likely you will require treatment to remove them before they grow or spread. Although one small verruca can be pain-free but unsightly, a large cluster can be quite painful to walk on. Adjusting your walk to relieve the pain can lead to further foot complications. So, it is best to take action as soon as possible.

Over the counter treatment options may work for some people. However, stubborn, persistent verruca will require more appropriate specialist treatment and observation. A medical professional should review all lesions. This is very important so to rule out more serious health concerns.

Specialised treatment is often provided with minimal pain with great results. High strength acid paste or cryotherapy using true liquid nitrogen can be the most appropriate methods for nearly all strains of verrucae. Your podiatrist will advise you on the best course of action based on the verruca presentation, your lifestyle and detailed medical history.

We advised you do not begin treatment without consulting a medical practitioner first. Your Podiatrist should be the first port of call when dealing with these pesky verrucae.

Book a podiatry appointment

For more information about our podiatry service, our foot health check-up, cryotherapy and medical pedicures.

By George Hill | Podiatrist | September 2019

Yellow Fever Update:

Recent news reports have raised concerns about yellow fever vaccine safety. It is important to understand the risks and benefits.

For decades, the yellow fever vaccine was considered to be extremely safe. More recently, however, we have become aware of a low rate of serious adverse effects occurring when older travellers are vaccinated for the first time. The two main types of adverse effects are called YEL-AVD and YEL-AND – the first involves damage to organs such as the liver, and the second damages the nervous system. Yellow fever vaccines contain live viruses that do not harm people with a normally functioning immune system but do seem to cause harm in a tiny proportion of people with an ageing immune system, as well as those with reduced immunity from other causes.

In one of the largest medical studies of yellow fever vaccine safety, the rate of YEL-AND in people aged 60-69 was 2.5 per 100,000 people vaccinated, and in over 70s was 1.6 per 100,000. For YEL-AND, the rates were zero and 4.0 per 100,000 respectively.

According to the US Centers for Disease Control, in the absence of a yellow fever outbreak, the “background” risk of yellow fever occurring in unvaccinated travellers on a 2-week trip to a zone where yellow fever is present is calculated to be:

• West Africa: 50 cases per 100,000, with 10 deaths per 100,000
• South America: 5 cases per 100,000, with 1 death per 100,000

Yellow fever vaccinating centres normally explain these risks to everyone they vaccinate, and in particular to travellers aged over 60.  Vaccination for personal protection is recommended where benefit outweighs the risks, and a medical waiver is given when it is not safe for the vaccine to be used. Age alone is not a reason for issuing a waiver.

Other factors that complicate the picture include the following:

• There are active outbreaks of yellow fever in several parts of the world, notably at present in Brazil as well as in several African countries, so the risk to travellers is often much higher than that quoted above.
• Vaccination is the only way to prevent and control yellow fever and is often the only possible public health measure for entire populations.
• Many countries therefore rigorously enforce vaccine requirements as a condition of entry.
• Yellow fever vaccine shortages are common – there is currently a serious shortage in the USA, and the vaccine is not always available when needed.
• Awareness of vaccine risks has come with a stricter approach to recommending vaccine only when travellers are definitely going to be at risk; however, an unintended consequence of this has been to delay the opportunity to vaccinate travellers for the first time until they are older and at greater risk of adverse effects.

The World Health Organization now considers vaccine protection to be life-long, though border officials in several countries do not always recognise this. A small number of recent cases of yellow fever in Brazil among people who had been vaccinated previously has raised further doubt about this policy, and Brazil currently recommends revaccination every 10 years.  Revaccination has not been linked to adverse effects.

There is currently extensive UK press coverage (that has also been picked up in the US) of YF vaccine adverse effects – one death occurred shortly after vaccination in a distinguished cancer researcher, and a psychotic reaction in a former BBC journalist vaccinated in Greece. Both cases were attributed to the vaccine because of the timing. Further clinical details are not available, so we can’t yet be certain of a direct link, but this news will undoubtedly have a considerable impact on public perception of the vaccine.

Written by: Richard Dawood, Medical Director and specialist in travel medicine

Book your yellow fever vaccination today.

Links:

• Cancer pioneer Martin Gore’s sudden death from routine jab  –  Source: The Times
  
• I had a yellow fever jab, then the voices told me: ‘Kill! Kill! Kill!” – Source: The Times

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

Osteopathic manipulation, or HVT (high-velocity thrust) as it is more technically known, is the “click” that many people associate with osteopathic treatment.

It is by no means always used by an osteopath, but when it is, it can prove to be a quick, efficient, and pain-free way of restoring function to a joint.

Many patients’ conditions may not be suitable for HVT, and many may not be keen to have it done anyway. In these cases, the osteopath will treat with a whole collection of other highly effective ways. HVT should be seen as a useful tool in some circumstances, but not a be-all and end-all of osteopathy.

So how does it work?

HVT is placing a short sharp tug though a joint, most often a spinal facet (which is what we will concentrate on here), a click may or may not be heard. The noise itself is a bit of a by-product. What it is has been disputed a little but the generally accepted explanation is that when the joint is stretched, the synovial fluid inside the joint itself physically does not stretch, so gas is forced out of solution causing gas bubbles that allow the joint to gap slightly, causing the clicking noise. This also explains why another click cannot be produced for a little while until the gas has been reabsorbed.
The gapping of the joint is the key to the effectiveness of HVT.

What I must point out at this point though is that the click is not a relocation of a joint.
Barely a day goes past that someone doesn’t tell me their osteopath “clicked something back in” often assuming it was a disc. As much as it can feel miraculous like this sometimes, and a patient can often feel and be quite a bit straighter following treatment, the HVT is about restoring function to the joint, not putting it back in place. Discs especially do not just “pop back in”.

So what does the gapping achieve?

Well, here we have to get a little technical. There are three predominant effects caused by HVT as far as we can tell.

Firstly, post-contractile sensory discharge or PCSD.

Imagine that the brain keeps many muscles at a gentle tension, this allows you to hold your posture. When an area is identified as problematic (painful or inflamed etc), the brain may choose to cause the muscles around the area to spasm, often to protect the area. The spasm itself may cause further pain. This then becomes a vicious circle and dysfunction.

Tension in the muscles is controlled by spindle fibres. This is what detects the short sharp tug of the muscles in HVT. Imagine the short sharp tug as a reset for these fibres. The brain then has to determine the level of muscle tension required and often can reset to the original tension, immediately bringing the joint out of spasm.

Massage of muscles, slow stretching over a longer period, has a similar effect but unfortunately can’t be performed on the small, deep muscles directly around and holding the joint.

Secondly, pain gate theory.

Even when nerves are reporting pain in a certain area, it is important that the body can still detect a soft touch in the same area. To achieve this soft touch and position detecting nerves override deep pain detecting ones. Where you ever told to rub your knee or elbow after you bumped it and it hurt? That’s pain gate, the soft-touch overrides the deep pain. It won’t stop it completely of course but even a little relief will make it feel better. In turn, this may again stop the brain causing the area to spasm.
HVT moves the joint quickly and sharply. This causes the positional detectors to immediately report this to the brain, inhibiting the deep pain.

Thirdly, meniscoid theory.

In a joint, smooth cartilaginous surfaces rub together, but they may not be quite as smooth as we used to think. Small pieces of cartilage appear to be in the joint. Possibly to fill small gaps; craters on a moonscape is a good way to think of it. It has been suggested that when the joint spasms, these small bits of cartilage, which are attached to the capsule around the joint can become trapped out of place. Gapping the joint allows the tethers to the capsule to quickly pull them back into place.

It’s possibly worth pointing out before I finish, that although I said earlier that the click is an unnecessary by-product, I do wonder if it could be argued that the psychological effect of hearing the click could be put forward as a fourth effect. Hearing a click and knowing that it may have relieved a painful joint does often make a patient immediately relax. This may itself be part of the healing process.

Osteopathic manipulation is often a quick efficient way of relieving dysfunction of a joint. It is not a miracle cure. Many other things have to be taken into account for the osteopath to treat fully and effectively.

HVT will not immediately heal damaged tissue or disperse inflammation, but it often is a good way to kick start the process.

Book an osteopathy appointment

By Andrew Doody |  Osteopath | August 2019

What is Cyclospora?

Cyclospora is a tiny, single-celled parasite, spread by contaminated food. It can cause diarrhoea, abdominal cramps, nausea, loss of appetite, bloating, gas, fatigue, mild fever, and weight loss.

 Why is it in the news?

There’s been an outbreak in travellers to Mexico, with at least 204 reported cases in returning holidaymakers since June. However, it is difficult to detect using standard tests. Because it is uncommon in the UK, most labs don’t look for it and may miss the diagnosis. So the true number is probably much higher.

 What’s the most reliable way of detecting it?

The best way is called a rapid PCR test, which detects the parasite’s DNA. The test also looks for DNA and genetic material from 21 other diarrhoea-causing parasites, bacteria and viruses at the same time – so there is a very high probability of finding the right cause. As you’d expect, the test is available at the Fleet Street Clinic. Importantly, we can have a result within an hour or so of receiving a sample.

How can I prevent it?

Outbreaks have been linked to eating fresh uncooked berries/unpeeled fruit and salad items that have not been washed in safe water. Sticking to foods that have been freshly and thoroughly cooked, when you travel, is the safest option.

 How is it treated?

Confirmed cases can be treated with an antibiotic called co-trimoxazole. Some of the more commonly-used antibiotics for travellers’ diarrhoea may not be effective.

If you have any concerns about cyclospora and other parasites, our PCR test service can help detect the exact cause of any issue you might have. What this allows is proper diagnosis and treatment. Usually,  guess-work on what bug a patient is carrying or general prescriptions to tackle the illness might be given by medical professionals. The PCR test offers accuracy like nothing else.

You can book an appointment online.

Imagine you’re holidaying in a tropical paradise, walking barefoot on the beach. Would you consider this a health risk? What if this simple, carefree activity could turn your trip into a nightmare?

Unfortunately, this is what happened to a Canadian couple in the Dominican Republic, who contracted hookworm in Punta Cana after walking on the beach without shoes.

Fleet Street Clinic’s medical director, Dr Richard Dawood, is Telegraph Travel’s medical expert and shared his medical opinion on the case in a recent article. 

The article details the story of the couple, who shared their plight on social media to raise awareness of the parasitic worm infection.

Hookworm can infect humans if soil contaminated with their larva comes into contact with bare skin. Most commonly, hookworm infection can occur in Africa, the Americas, China and south-east Asia, according to the NHS.

Dr Dawood explained to the Telegraph how you can spot a hookworm infection:

“Typically there is a linear rash that follows the track of the migrating larva. It can become almost unbearable itchy, much worse than an insect bite, which is an important clue. There’s a local allergic reaction, which can then blister, making the line pattern harder to spot.”

And how to treat: “There are a number of different anti-parasitic treatments that work, either taken as tablets, or made into a cream and applied locally. The larvae can sometimes also be killed using cryotherapy to freeze them. Blisters or scratching can easily lead to infection, necessitating antibiotic treatment.”

To avoid hookworm, avoid coming into contact with soil or sand that could be contaminated. If walking on the beach, it’s advisable to wear shoes at all times!

Dr Richard Dawood at Fleet Street Clinic

Dr Richard Dawood is founder of Fleet Street Clinic in London and has practiced for over 35 years. He was one of the first doctors in the UK to establish Travel Medicine as a distinct speciality. Richard is the most senior UK travel medicine specialist working exclusively in a private setting.

You can book a travel consultation appointment online.

UPDATED RECOMMENDATIONS FOR Yellow Fever VACCINATION: Nigeria

The World Health Organization recently updated the yellow fever recommendations and requirements for residents and travellers to Nigeria.

As of 1 July 2019, the yellow fever certificate requirement for travellers to Nigeria changed. All travellers aged 9 months or over are now required to travel with a yellow fever vaccination certificate along with a valid visa. Failure to provide a valid certificate where required could deny entry to that country, or result in quarantine.

Previously a certificate was only required for those arriving from risk areas countries. However, an on-going outbreak of yellow fever, which started in September 2017, is continuing therefore a revised classification has been made. Between January and April 2019, a total of 930 suspected cases were reported in 447 Local Government Areas.

Advice for travellers

The Fleet Street Clinic would like to remind all travellers from the United Kingdom that there is a risk of yellow fever transmission throughout Nigeria.

We are a Certified Yellow Fever Centre with availability throughout the week and are usually able to accommodate same day appointments requests.

What is Yellow Fever?

Yellow Fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. There is no specific treatment, although the disease is preventable using a single dose of yellow fever vaccine, which provides immunity for life.

For more information about Yellow Fever & the Vaccine.

Anyone travelling to Nigeria should book a Pre-Travel Consultation. One of our specialist Travel Nurses will access if a Yellow Fever vaccine is suitable for you.

Links:
World Health Organization

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

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

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

But how can you prepare yourself so you remain healthy throughout your holiday?
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.

Greenland is home to truly magnificent mountainscapes and glaciers.

Jakobshavn Glacier, the world’s fastest-moving glacier in the Northern Hemisphere can be found here.

In the Winter, tourist travel to this wonderland to potentially see the wondrous the Northern Lights. Things are quite different in the Summer.

Chasing the Midnight Sun

Summer in Greenland is an image not often associated with the country. Summertime offers eternal light in the land of ‘The Midnight Sun’ whereby the day has neither a beginning nor an end. Those wanting to experience this time-shifting experience must travel north or the Arctic Circle. The low-lying sun makes the surrounding scenery appear almost dreamlike; icebergs and hilltops are bathed in a surreal palette of pink, purple, yellow and red. Travellers to Greenland have options of hiking the land or sailing the fjords between icebergs.

If you plan to travel to Greenland this summer follow our top travel tips to ensure you stay healthy.

Vaccinations

Even though Greenland resides in the Arctic Circle, travellers should still ensure they receive appropriate pre-travel vaccinations. This includes being up-to-date with Measles, diphtheria-tetanus and polio. Greenland has a high risk of Rabies, a virus spread through the infected bite of a mammal. Travellers who plan to trek inland may wish to consider this vaccination before they travel to reduce the risk.

Suncare

Despite Greenland having long, dark winters, the summer months provide almost constant light. Bright sun, combined with the effects of lights reflection from snow and water can increase the risk of sun damage from UV light. Despite temperatures remaining cold, travellers still need to be sun smart. Ensure you wear a high factor SPF, and use lip balm to prevent cracking. Polarised sunglasses that wrap around will prevent the UV rays causing damage to your eyes.

Sea Sickness

Many activities in Greenland involve taking to the water and visiting the infamous Disko Bay in search of Icebergs. Sometimes the seas can be rough which can make for a miserable time if you are prone to travel sickness.

Sea Sickness can be reduced by:

• Sit in the centre of the boat where the motion will be less aggressive

• Close your eyes or focus on a point on the horizon, this can help your inner ear balance.

• Avoid alcohol and large heavy meals, instead, keep hydrated on water and eat smaller lighter meals

• Sucking on a mint or ginger sweet can help with nausea

• Seas Sickness medication tablets

• Patches that can be used to prevent sea-sickness

Trekking

Parts of Greenland can be remote so taking a good First aid kit with you is essential. Basic provisions include pain relief, plasters and medication to treat an upset stomach, such as loperamide and oral rehydration salts. If you take prescription medication to ensure you pack enough and carry the prescription with you. If you plan on trekking the hinterland, pack additional items such as blister dressings and plasters.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | July 2019

June to September is the best months to trek to Machu Picchu, although you can visit all year round. The weather is at its driest and coolest with gloriously sunny days. Trekking to the roof of the Andes is a rewarding experience that many travellers to Peru sign up for. Travellers who are trail-blazing their way on the Inca road to catch a glimpse of the forgotten city should follow our top travel tips to ensure they stay healthy on the road.

Vaccinations

All travellers to Peru should ensure that they are up-to-date with measles, diphtheria, tetanus and polio (DTP), and have received vaccinations against Hepatitis A and Typhoid. There is a risk of Rabies and Hepatitis B in Peru, and all travellers attempting the Inca Trail should consider vaccinations against these.

There is no risk of Yellow Fever on the Inca Trail or Cusco. However, the vaccination may be recommended to travellers who are doing further travel in Peru, such as the Amazon rainforest. Those planning to extend their trip to South America may require the Yellow Fever vaccination for personal protection. Additionally, you may require a valid yellow fever certificate to enter some other countries. It is best to book in a travel consultation with our specialist travel nurses to discuss your route.

Altitude Sickness

The highest altitude of the Inca trail is 4,215m, a whopping 1,800m higher than Machu Picchu itself! Most people start the hike from Cusco which lies at 3,400m, meaning trekking this wonder of the world poses a real risk of altitude sickness. Altitude sickness is unpleasant and can develop into something serious and become life-threatening. It is best avoided by taking time to acclimatise. Ideally, if you are arriving from sea level, spend a few days in Cusco before your trek begins to adjust to the different altitude. Choose a longer trek, a slower ascent over more days will reduce your risk considerably. Alternatively, you can get a prescription of acetazolamide (Diamox) to aid the process. Speak to a specialist travel nurse about this at your pre-travel consultation. Don’t let altitude sickness ruin your trip.

Stay Hydrated

Treks on the Inca trail usually last around 5 days, meaning that an average trekker will probably consume at least 15 litres of water over the course of their trek. Unclean and unsafe drinking water can lead to sickness and diarrhoea so it is important that travellers have access to safe water. Carrying 15 litres of water on the trail is a near impossibility so travellers should ensure that they have a way to make water safe to drink. Carrying water purification tablets, or a bottle with a filter can ensure you have access to safe drinking water throughout.

Travellers Diarrhoea

Travellers diarrhoea and other common gastrointestinal infections can put a dampener on any adventure but especially when hiking. Access to toilets is likely to be limited throughout your journey so it is important to stay healthy. Ensure all food you eat is thoroughly cooked. Pack an alcohol hand gel so you can keep your hand clean before you eat and after using the toilet. It is wise to carry medication with you, so, if you do become unwell you have doctor-approved medication available to take. We recommend packing one of our Worldwide Gastro Kits. Inside there is medicine to prevent and treat travellers diarrhoea, dehydration, mild infections, nausea and vomiting. Hopefully, you won’t have to use this kit, however, for peace of mind, it is better to be safe than sorry.

Foot Health

The Inca trail typically consists of between 6-9 hours of walking a day, with shared tent accommodation. Hiking the Inca Trail through the Sacred Valley to Machu Picchu is both arduous and awe-inspiring. Make sure you have good walking boots that are broken in before you start. Book an appointment with a podiatrist and osteopath if you have any niggles or pain before setting off. Take care of your feet throughout your adventure – keep them clean and dry to avoid problems. Any blisters should be cleaned and covered with a dressing to prevent pain and infection. Pack your own first aid kit with some basic medications for pain, allergies and upset stomachs in case you do become unwell. Access to medical supplies will not be until Aguas Calientes at the end of the trek. You can buy a Fleet Street Clinic Essential First Aid Kit online to save you the hassle of assembling yourself. We would recommend considering a medical pedicure upon your return. Treat our feet a little bit of TLC for taking you on an adventure of a lifetime.

We would encourage all those taking on the Inca trail adventure to consider booking a travel consultation with either myself or another of our specialist travel nurses. We all have extensive knowledge on what vaccines and health precautions you should take on an individual basis to remain healthy throughout your adventure. Chances are at least one of us has done a similar adventure so we can give you some first-hand experience on what to expect too!

Book your travel appointment today

By Anna Chapman |  Travel Nurse | July 2019

The health of both our planet and its people is, without doubt, one of the most important issues of our time. Maintaining healthy wellbeing has been in the public eye for some time now, particularly the topic of how to achieve good mental health. Chinese medical thought and acupuncture treatment can help us understand what we can do to help ourselves to achieve and maintain good health. Its teachings encourage us to inhabit our body, to connect to and to nourish our physical self and the physical world around us. This physical basis provides the root of our mental and emotional well-being.

A holistic treatment

Where Western Scientific Medicine has gone down the microscope to discover the minutiae workings of the human body (cells, biochemicals, genes), the understandings of Chinese Medicine, developed over thousands of years, have focused on how the body systems work together. It observes a person in their environment, their lifestyle, their posture… to understand the causes of ill-health, and the symptoms that arise to alert us to this. The whole body-mind is considered, and treated, to bring us back to good health and well-being.

A leap of faith for our Western minds

Acupuncture is a leap of faith for our Western minds. The concepts on which it is based do not exist in Western thought. You can’t cut open the body and find the meridians which form the energetic framework of the human body, or the Qi (pronounced ‘chee’, meaning energy) which flows through this network to motivate our physiological processes. Similarly, you can’t cut open a light bulb and find electricity. Likewise, you cannot cut open a computer and find cyberspace. It doesn’t mean that these things don’t exist. Proof of their existence lies in their application and the same is true of acupuncture treatment. Only through experiencing acupuncture for yourself will you be able to judge its true value.

Acupuncture helps reduce stress

Acupuncture is often described as incredibly relaxing, regardless of what a person seeks treatment for. Furthermore, most patients report an improvement in energy levels, sleep and a feeling of general well-being.

Acupuncture helps calm the nervous system. As a result, it helps switch off the ‘Fight-Flight’ stress response. Fuelled by adrenaline to keep us alert and primed for action, the stress response helps us to achieve. It is a useful tool for success. If the stress reaction is prolonged and not switched off, problems start to arise.

Heart rate increases, breathing quickens, muscles tighten, blood pressure rises .. it is perhaps not surprising that stress-related ailments are estimated to account for 75-90% of all doctor’s visits. By calming the body and promoting parasympathetic activity, Acupuncture helps improve circulation and reduce general muscle tension. This enhances all body functions not concerned with immediate survival –  immunity, digestion, fertility, rest, recovery, repair. Generally speaking, the results note an overall feeling of relaxation and well-being.

Acupuncture helps manage day-to-day ailments

Our Acupuncturist, Diane, has 25 years experience in Chinese Medicine. She treats a wide variety of day-to-day ailments. Including headaches, IBS, anxiety, infertility. As well as the musculoskeletal pain, which acupuncture is most famous for. Why not book an appointment today to see how acupuncture can help you improve your health and well-being?

If you think you could benefit from acupuncture, you can book your appointment online.

By Diane Timewell |  Acupuncturist | July 2019

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

THE WORLD HEALTH ORGANISATION (WHO), HAS REPORTED THAT POPULATION EXPOSURE TO HEAT IS INCREASING DUE TO CLIMATE CHANGE.

The WHO states, ‘global temperatures and the frequency and intensity of heatwaves will rise in the 21st century as a result of climate change’. Extended periods of heat exposure during the day and night time can increase the amount of physiological stress on the human body.’

The stress caused by heat exposure exacerbates the top causes of death globally. This includes respiratory and cardiovascular diseases, diabetes mellitus and renal disease.

They go on to state, ‘Exposure to excessive heat has wide-ranging physiological impacts for all humans, often amplifying existing conditions and resulting in premature death and disability.’

With the temperature said to continue rising, the WHO also states, ‘Awareness remains insufficient of the health risks posed by heatwaves and prolonged exposure to increased temperatures.’

 So, who is most affected by heat exposure and how will it impact your health?

Who is affected?

Rising temperatures affect the whole population. However, some populations are more vulnerable to exposure to excessive heat. Those include:

• Elderly people
• Infants and children
• Pregnant women
• Outdoor and manual workers 
• Athletes
• Poorer communities

How does heat impact health?

With rapid increases in external temperatures, the body will struggle to regulate our internal temperatures. The knock-on effect of this can result in a number of heat-related illnesses such as heat cramps, heat exhaustion, heatstroke, and hyperthermia. Reported small differences in the seasonal changes have been reported to have increased the number of heat-related illness and even death. Rising temperatures can also worsen chronic conditions such as cardiovascular, respiratory, and cerebrovascular disease and diabetes-related conditions.

What actions can you take to stay cool?

• Aim to keep your living space cool. WHO suggests ‘below 32 °C during the day and 24 °C during the night’
• If it is safe, open your windows at night time to cool your living space.
• Stay out of the heat by staying in the shade and avoiding going outside during the hottest part of the day.
• Take cool showers and wear loose-fitting clothing.
• Drink regularly and avoid alcohol and caffeine.
• Check on vulnerable family members who may be affected by the heat.

What to do if someone shows signs of a heat emergency?

It is extremely important to know what to do when someone is showing signs of heat illness. Everyone should know how to respond to heat emergencies, this can be learnt in first aid courses. 

If one of your family members or someone you assist is showing signs of hot dry skin and delirium, convulsions and/or unconsciousness, call a doctor/ambulance immediately.
Whilst you are waiting for help to arrive place them in a cool place in a horizontal position and elevate their legs. It is now important to initiate external cooling. 

This can be done by: 

• Removing clothing
• Placing cold packs on the neck and groin 
• Spraying cool water on their skin 
• Fanning them
• If they are unconscious, place them on their side

If you or someone you are with is displaying mild signs of heat illness that is not considered an emergency, you might want to consider a same-day GP appointment. You can book an appointment online.

Have you ever thought of applying sunscreen before taking a flight?

If not, you may want to reconsider.

A recent article in the Telegraph Travel with contribution from Fleet Street Clinic’s medical director, Dr Richard Dawood, has highlighted a study published in the Journal of the American Medical Association (JAMA) Dermatology. It reports that pilots flying for about 56 minutes at 30,000 feet were exposed to the same amount of carcinogenic UVA radiation as one would receive 20-minute session on a tanning bed.

The plane’s windshield blocked only about half of the UVA rays, dangerous enough to contribute to cancer risk.

However, applying this potential risk to all types of aircraft and to the cabin space outside the cockpit is “a bit speculative”, notes Dr Dawood. The aforementioned study was based on UV radiation measured from the cockpit of a Socata TBM850, a single turbo-prop private plane.

“Awareness of the issue is a good thing – especially for pilots; and for passengers, sensible use of window shades to avoid strong direct sunlight, which most people probably do anyway,”

– says Dr Richard Dawood.

For more travel advice, contact our expert travel team at Fleet Street Clinic – you can book an appointment online.

Planning a trip abroad?

Whether you’re travelling afar for business or pleasure, the long-haul travel involved can be a daunting prospect. But with a little preparation  you can enjoy a comfortable journey, and prevent the health risks associated with travel.

At Fleet Street Clinic, we regularly see frequent travellers for travel health-related consultations and vaccinations. Our travel experts have compiled some tips to ensure you are in great shape throughout your travels, starting with a healthy outbound flight:

Deep Vein Thrombosis (DVT)

Travelling on long-haul flights with extended periods of immobility can leave you at an increased risk of DVT (blood clots), especially if you have any pre-existing conditions.

To prevent DVT during your flight:

• Wear loose comfortable clothes.
• Keep moving during the flight – get up regularly to walk around the cabin to aid circulation.
• Keep hydrated by drinking plenty of water- drink at least one cup of water for every hour spent in the air.
• Avoid alcoholic and caffeinated drinks.
• Wear compression socks which apply gentle pressure to the ankle to help with blood flow.

Dehydration

Air in the plane’s cabin is recirculated, which results in a loss of moisture. This can cause dry skin, lips, and eyes.

To prevent dehydration:

• Contact lens wearers should remove lenses prior to travel and wear spectacles to avoid dry eyes and prevent damage to the cornea.
• Dry skin should be moisturised, and if nasal irritation occurs, a saline spray can be used.
• Keep hydrated – don’t be afraid to ask cabin staff for water outside of mealtimes.

Travel / Motion Sickness

Motion sickness occurs when there is confusion between what the eyes see, and what the inner ear senses. With turbulence, cramped spaces and lack of fresh air, susceptible travellers can suffer.

To minimise the risk of travel sickness:

• Keep hydrated.
• Avoid large meals prior to and during the flight.
• Request a seat near the front wing – the most stable part of the plane.
• Use preventative medication such as Cinnarizine (to be taken 2 hours prior to boarding the aircraft).

Jet Lag

Flying can leave you feeling sleep deprived and jet lagged.

To reduce avoidable risks and arrive at your destination in good shape, here’s how you can prevent or combat the effects:

• Avoid night-time flights when possible – otherwise make sure you build a rest period into your schedule on arrival.
• Give your body clock clues as to your new time zone – adjust your watch, observe local mealtimes and bedtimes.
• Use melatonin and timed exposure to bright light – talk to your doctor or consult a specialist travel clinic about using medication to aid both sleeplessness and wakefulness.
• Use our Jet Lag Calculator – whether you’re using timed exposure to bright light, melatonin, both or none of these methods, our calculator can calculate timings based on your exact travel details.

Book An Appointment

If you’re taking a long-haul flight and need travel vaccines or advice, you can book an appointment online to ensure a smooth transit to your destination.

Approximately 1 in 4 people in the UK will experience a Mental Health problem.

Unfortunately, how we cope with mental health problems, in general, seems to be getting worse.

Leading to an increased number of self-harm and suicide victims. Spotting early warning signs in the workplace and helping those who may be experiencing workplace problems is an extremely important part in reducing the number of deaths by mental ill health each year.

Stress, anxiety and depression are the biggest cause of sickness absence in our society. At Fleet Street Clinic, we believe in creating safe, healthy workplaces where mental health and physical health of employees are valued equally. Therefore, we believe that investing in mental health first aid training, much like physical first aid training should be part of everyone’s corporate wellbeing strategy.

The Fleet Street Clinic will be running a two-day Mental Health First Aid course delivered by Leigh Mckay. This course is designed for all employees, line managers, HR professionals, OH workers and senior leaders alike who wish to become a qualified mental health first aider. By training your staff you’ll be joining a global movement of over 3 million trained Mental Health First Aiders across 25 countries.

Leigh is a quality assured MHFA instructor accredited by the Royal Society of Public Health. She has a particular interest in psychology and emotional resilience. Leigh has a wealth of experience in delivering the MHFA courses in corporate companies. Plus, she advocates that a workplace and community that promotes wellbeing can have a positive impact on everyone’s physical, mental and emotional health.

What is Mental Health First Aid?

Mental Health First Aid (MHFA) is an Internationally-recognised training course. It teaches people how to spot the signs and symptoms of mental ill health. MHFA won’t teach you to be a therapist, however, just like physical first aid training, it will teach you to listen, reassure and respond, even in a crisis.

A quality assured instructor will deliver the adult MHFA courses, which are for everyone aged 16 upwards. All instructors attend an Instructor Training programme accredited by the Royal Society for Public Health. Therefore, they are specifically trained to keep people safe and supported whilst they study this course.

What will I learn?

Learning will take place through a mix of group activities, presentations and discussions. Throughout the course, you will gain practical skills and awareness about mental health.

This includes:

• A deeper understanding of mental health and the factors that can affect people’s wellbeing, including your own
• Practical skills to spot the triggers and signs of mental health issues
• Confidence to step in, reassure and support a person in distress
• Enhanced interpersonal skills such as non-judgemental listening
• Knowledge to help someone recover their health by guiding them to appropriate support

How will attending an MHFA course help?

There are many benefits to taking part in an MHFA course. Firstly, research and evaluation have shown this course raises awareness of mental health literacy. The more understanding and knowledge about mental disorders lead to better recognition, management and prevention. Secondly, this reduces the stigma attached to ill mental health, especially in the workplace. Further, this course champions its students to increase their confidence in handling mental health issues. But, most importantly, it promotes early intervention. Above all, becoming a Mental Health First Aider can enable the recovery of a sufferer and even save lives.

Course Details:

Date: Thursday 26th & Friday 27th September, 2019
Location: 29 Fleet Street, London, EC4Y 1AA
Cost: £350 per person

Spaces are limited.

To book yourself and/or a colleague on to the Mental Health First Aid course, please email to our Corporate Manager, Caroline McKenzie here.

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

How to Cope During a Heatwave

The UK is currently experiencing a heatwave with temperatures rising to 35 degrees in some parts of the country this week. While sunshine is welcome and the vitamin D is much needed, too much heat can lead to illness. To avoid any heat-related sickness, make sure you are well-prepared! Follow Fleet Street Clinic’s tips to help keep safe during the hot weather.

Risks During the Heat:

• Exposure to such high temperatures increases sweating, and results in loss of fluid and electrolytes causing rapid dehydration. This can result in heat exhaustion or heatstroke which can be life threatening if not dealt with promptly.
• The highest risk  groups are the elderly, babies, children and those with pre-existing medical conditions.
• If you engage in strenuous physical activity this will increase the risk of illness related to the heat.

Top 7 Tips For Beating the Heat

1. Seek shelter and shade during the middle of the day (11am -3pm).
2. If you are outside, ensure you protect your skin against the sun with a high factor sun cream, hat and sunglasses.
3. Wear loose fitting, light-weight and light colour clothing.
4. Keep hydrated by drinking plenty of fluids and eating food with a high water content (such as fruit).
5. Ensure you are taking in sufficient salt in your diet (sweating leads to electrolyte and salt depletion).
6. Avoid caffeine and alcohol, which can worsen heat-related illness.
7. Heat stroke can be a life-threatening emergency and medical help should be sought.

About Fleet Street Clinic

Fleet Street Clinic is an independent healthcare practice in London. For more advice or to book an appointment with our expert medical team, you can book online.

Glastonbury has been going for over 50 years and is back this year following a fallow year last year.

Whether you are a festival first-timer or a seasoned Glastonbury veteran, make sure you follow our top tips on how to stay healthy during festival season.

First things first, facilities…

A major part of festival fun is the back to nature approach to living, so do expect basic living facilities. Facilities at festivals are confined to porta-loos, long drops and communal showers;  a perfect breeding ground for bugs. Dodge the diarrhoea by following some simple rules. Wash your hands where possible, especially before eating and always after the toilet. If running water isn’t available, use hand wipes or hand sanitiser. Pack your own pocket-size alcohol hand gel for when you are on the go.

The Vaccines…

Don’t be fooled into thinking vaccinations are only for those far-flung destinations. Glastonbury is the largest greenfield festival in the world and over the course of a week, home to over 175,000 people. Crowded spaces and shared living areas increase the risk of infectious diseases spreading. Many of which are entirely vaccine preventable. Measles and mumps cases have been on the rise in the UK, so festival goers should check they have received at least 2 doses of the MMR vaccination to ensure they are protected. If there is any doubt you can get immunity tested to put your mind at ease. Young adults and children can also be particularly vulnerable to meningitis, so if you are in this group, make sure that you have also received the recommended  Meningitis ACWY vaccination.

You can find more information on all our vaccinations here.

Eat, drink and be merry…

It is estimated that an average festival goer burns around 9,000 calories and walks over 15 miles. Make sure you fuel your festival by eating plenty, especially if you are drinking alcohol. Keep hydrated and ensure you drink plenty of water to prevent dehydration, especially on those (potentially) hot days.

Come rain or shine…

Glastonbury has seen it all:  heatwaves, rain, floods, cloudless skies. The Great British weather is never predictable and exposure to extreme weather can cause anything from hypothermia to heat stroke. Be prepared for all eventualities. Take warm waterproof clothes that will dry quickly in case of wet weather. Pack cool, light coloured clothing to help you keep cool in the sun. Pack a hat and some good suncream and make sure you wear it! Shady areas are few and far between if you are centre stage for the day, and without sun protection you could end up with sunburn, or worse, heat stroke. You can lean more about staying safe in the heat here.

STI’s

Don’t run the risk of sexually transmitted infections if you decide to go beyond social intercourse. The best way to prevent infections such as chlamydia and gonorrhoea is to use condoms. Some STI’s can take several weeks to present themselves, and in some cases are asymptomatic (display no symptoms at all). It is quick and easy to get checked for STI’s, so if you have any concerns when the festival is over, make sure you get tested.

You can book appointments for all our services online.

Parents are being urged to get their children vaccinated for measles, mumps and rubella following outbreaks of measles across Europe:

Anyone who is eligible to get vaccinated should get the MMR vaccine.

A measles outbreak across Europe has left UK officials urging parents to get their children vaccinated for measles, mumps and rubella.  As measles is highly infectious, anyone who has not received 2 doses of the MMR vaccine is at risk. Particularly those unvaccinated people travelling to countries where there are currently large outbreaks of measles.

In the first three months of this year, there have been 231 confirmed cases of measles and 795 of mumps. While Public Health England (PHE) figures showed while measles cases were lower than the 265 reported during the same period last year, they had more than doubled compared to the 97 reported between October and December. The number of mumps cases has nearly tripled compared to the 275 cases during the first three months of 2018. No new cases of rubella have been reported.

PHE has now appealed to parents to make sure their children receive the MMR vaccine when it’s offered, or to get a GP appointment booked if they missed it. Officials have also warned that not only is measles highly contagious, but it can also kill a child if they are not vaccinated. Anyone who has not received two doses of MMR vaccine is at risk of measles as it is highly contagious.

There have been 3,789 cases of measles in Europe during the first three months of this year, according to the European Centre for Disease Prevention and Control. The highest numbers were in Romania, France, Poland and Lithuania.

Advice for travellers

For all those planning to travel to Europe, make sure you are up-to-date with all currently recommended UK vaccines. This includes two doses of the MMR vaccine for protection against measles, mumps and rubella.

Anyone who is not sure if they are protected should check with their GP practice. Vaccination is usually done within your childhood vaccinations. However, the MMR vaccine is available to all adults and children who have not had their two-dose course. In some cases, the MMR vaccine can be offered to babies from six months of age. Cases such as travelling to countries where measles is common, or during an outbreak situation. Book a travel consultation with our travel nurse for advice on the best option for your children before you travel.

Head of immunisation at PHE, Dr Mary Ramsay, warned with measles outbreaks across parts of Europe, families should make sure they are vaccinated before travelling. ‘There are measles outbreaks happening across Europe so if you are planning to travel, make sure you check with your GP and catch-up if needed.’

Herd immunity

Measles elimination can only be sustained by maintaining and improving coverage of MMR vaccine in children, and by using all opportunities to catch up older children and adults who missed getting the MMR vaccine.

To achieve herd immunity for measles at least 90 to 95 per cent of the population needs to be fully protected. PHE said 94.9 per cent of eligible children aged five received their first dose of MMR in quarter 4 of 2018. However, the second dose of protection falls to 87.4 per cent for children aged five.

Fleet Street Clinic’s medical director, Dr Richard Dawood explains, ‘When the rate of vaccination in the general population falls below 95%, outbreaks occur and can easily spread, with the highest impact on those most vulnerable populations, undermining years of hard work around the world to bring measles under control.’

Vaccination against Measles, Mumps & Rubella

One dose of the MMR vaccine is about 90 to 95 per cent effective at preventing measles. Protection rises to around 99 per cent after the second dose. Two doses of MMR in a lifetime are needed for a person to be considered fully protected.

The MMR vaccine schedule:

• Two doses, to be given at least 4 weeks apart.
• If the first dose is given before 12 months of age (due to the need for early protection), this should be discounted and the child should continue to receive 2 doses as per the normal schedule.
• The vaccine is also available to all adults and children who are not up-to-date with their 2 doses.

Anyone who is not sure if they are fully vaccinated should check with their GP.

You can book all vaccination appointments online.

Travel nurse Anna takes us on a journey to Tel Aviv. A city on Israel’s Mediterranean coast steeped in history and a vibrant cultural scene. From vaccinations to sun protection follow the top tips to travel safely.

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

What is HPV?

Human Papillomavirus, or HPV, is the name of a group of viruses with around 200 different types, that is most commonly passed on via genital contact.

Although HPV is highly common, 90% of HPV infections go away by themselves and do not cause any harm. Most people with HPV never develop symptoms or health problems.

However, it is possible for HPV infections to persist and cause cellular change in your body. This can lead to:

• Cancer of the cervix, vulva, and vagina in women
• Precancerous lesions in men and women
• Genital warts in men and women
• Head and neck cancers in men and women

HPV vaccines have a well-established role in preventing cervical cancers as well as these other aforementioned conditions.

Who Should Be Vaccinated against HPV?

In theory, HPV vaccines are best given to young people before they become sexually active, and therefore before they can be exposed to HPV.

Individuals who are already sexually active might also benefit as they may not have yet acquired all of the HPV strains covered by the vaccine. Patients aged under 16 can only be vaccinated with their parents present.

Why Boys should receive the HPV Vaccine

• About 15% of UK girls who are eligible for vaccination are currently not receiving both doses. This figure is much higher in some areas
• Most older women in the UK have not had the HPV vaccination
• Men may have sex with women from other countries which have no vaccination programme
• Men who have sex with men are not protected by the girls’ programme
• The cost of treating HPV-related diseases is high: treating anogenital warts alone in the UK is estimated to cost £58 million a year, while the additional cost of vaccinating boys has been estimated to cost about £20 million a year

Source: HPV Action 

To book an HPV vaccination for yourself or your child, you can book an appointment online. Or find out more information about HPV here.

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

Sepsis Signs:
World Sepsis Day – 13 September

Sepsis is a global health crisis and affects 27 to 30 million people every year. Out of those affected, 7 to 9 million dies. That’s one death every 3.5 seconds.

Sometimes called the silent killer, Sepsis is a bacterial infection of the blood which can become life-threatening. It is very hard to detect in the early stages, with symptoms similar to many other conditions and illnesses. In the UK alone, around 37,000 people die from sepsis each year.

Thankfully, due to public awareness increasing due to medical bodies and health campaigns, sepsis is being talked about more. As a result, parents and doctors have the condition forefront-of-their mind. The condition is treatable with early recognition and care.

Causes of Sepsis

Bacterial infections are the most common causes of Sepsis. However, Sepsis can also be caused by infections like seasonal influenza viruses, dengue viruses, and highly transmissible pathogens.

Children under 1, the elderly and those with chronic diseases and a weakened immune system are most at risk of sepsis.

Symptoms of Sepsis

Sepsis can display in a variety of ways including:

• Slurred speech or confusion

• Extreme shivering or muscle pain or fever

• Passing no urine all-day

• Severe breathlessness

• It feels like you’re going to die

• Skin mottled or discoloured

If someone is ill and is getting progressively worse with two or more of the above symptoms, then it is advised for you to go to A & E without delay.

Preventing Sepsis

Preventing infection in the first place is the best way to prevent Sepsis from occurring.
This can be done by:

• Vaccinations – protect yourself from diseases which if serious, could lead to Sepsis.
• Hand Hygiene – reduce the spread of diseases and infections.
• Safe Childbirth – reducing infection to the mother and baby.
• Awareness of Sepsis– knowing the causes and symptoms can save lives.

If you think you are experiencing symptoms of sepsis, you should call 111 as you may require immediate medial attention.

For general GP health checks or vaccinations, you can book an appointment online.

Are you considering setting up a corporate health programme for your company?

The benefits of introducing a workplace health and wellbeing programme are clear: it has been proven that a successful corporate wellbeing programme leads to higher productivity, decreases in absenteeism and lower staff turnover. Ultimately, if your employees feeling healthy and looked after at work, it allows them to  reach their potential and helps your company to achieve its business goals.

Perhaps as a result of the growing evidence in favour of such initiatives, businesses are now investing more than ever into corporate wellness programmes.

But with so many options available, how do you begin to create your own bespoke workplace programme? Firstly, be prepared to set aside time and budget. At the initial planning stage, there are several important factors to consider: how to structure the programme to your company’s ethos and business objectives, how to ensure staff involvement (at all levels), considering the size of your workplace, personalisation according to the needs of your company and the requirements of individual employees.

Fleet Street Clinic Corporate Wellbeing Programmes

At Fleet Street Clinic, we create bespoke corporate programmes across the UK. We work with companies of all sizes –  from local businesses to City firms to international media agencies. We have a wealth of medical experts available, from hypnotherapists, osteopaths, dieticians, and can offer all kinds of services on site such as flu jabs, health screens and GP services.

We deliver programmes designed to boost the health and happiness of your staff, building and strengthening your workforce. 

Want to find out more? You can visit our Corporate Healthcare Services page and make an enquiry. One of our Corporate Managers will be in touch soon. 

With November being Mouth Cancer Awareness month, it is important to highlight the signs and symptoms of mouth cancer.

During a dental appointment, your dentist will naturally look for abnormalities within the mouth and these include signs of oral cancer. It is important that in between dental appointments you also take notice of what is going on inside your mouth. If you notice any changes is it essential you tell your dentist or doctor immediately.

Mouth cancer can develop in most parts of the mouth, including the lips, tongue, gums, cheek and the throat. If it is caught early, the chances of surviving mouth cancer are nine out of ten – those odds are pretty good, and that’s why early detection is so important.

– If in doubt, get checked out.

It can be hard to spot symptoms of mouth cancer, which is why it is important to regularly attend your dental appointments. Your dentist can perform a check-up and look for slight abnormalities that you might otherwise miss. If anything is found, your dentist will provide onward referral to a specialist for further investigation.

Given that early detection is so crucial for survival, it’s extremely important that we all know what to look out for. In between dental appointments you should look out for changes in your mouth health that could indicate mouth cancer.

Signs & Symptoms of Mouth Cancer:

Three signs and symptoms not to ignore are:

• Ulcers which do not heal within three weeks.
• Red and white patches in the mouth; or
• Unusual lumps or swellings in the mouth or head and neck area.

If you notice anything unusual in your mouth, it’s advisable to make an appointment with your dentist.

Checking for Mouth Cancer:

When checking for signs of mouth cancer you should follow the following routine:

Head and neck

Check if both sides look the same and search for any lumps, bumps or swellings that are only on one side of the face. Feel and press along the sides and front of your neck being alert to any tenderness or lumps to the touch.

Lips

Pull down your lower lip and look inside for any sores or changes in colour. Use your thumb and forefinger to feel the lip for any unusual lumps, bumps or changes in texture. Repeat this on the upper lip.

Cheek

Use your finger to pull out your cheek so that they can see inside. Look for red, white or dark patches.

Then place your index finger inside your cheek, with your opposing thumb on the outside gently squeeze and roll the cheek to check for any lumps, tenderness or ulcers, repeat this action on the other cheek.

The roof of the mouth

With your head tilted back and mouth open wide, your dentist will look to see if there are any lumps or if there is any change in colour. They will run their finger on the roof of your mouth to feel for any lumps.

Tongue

Examine your tongue, looking at the surface for any changes in colour or texture.

Stick out your tongue or move it from one side to another, again looking for any swelling, change in colour or ulcers. Finally, take a look at the underside of the tongue by placing the tip of your tongue on the roof of your mouth.

The floor of the mouth

Look at the floor of the mouth for changes in colour that are different than normal. Press your finger along the floor of your mouth and underside of your tongue to feel for any unusual lumps, swellings or ulcers.

If you find anything unusual in any of these areas, or are unsure of anything, visit your dentist or doctor as soon as possible.

The best ways to prevent mouth cancer:

• Cut down on alcohol consumption;
• Cut down or stop smoking;
• Getting the HPV vaccine, Gardasil 9; and
• Enjoy a healthy diet.

You can book a dental appointment with Temple Dental.

MARCH IS OVARIAN CANCER AWARENESS MONTH

A vital month raising awareness of ovarian cancer to improve early diagnosis to save lives.

More women died from ovarian cancer in the UK (4,227) than from all other gynaecological cancers combined in 2016, according to Cancer Research UK. However, worryingly one in five women in the UK (22%) mistakenly believe that a smear test (cervical screening) can detect ovarian cancer, according to research Target Ovarian Cancer carried out with YouGov.

We are committed to raising awareness of the disease.

Speak to one of our female GP’s about any concerns you may have about your gynaecological history and your families medical history. During your consultation, we will also conduct a breast check and pelvic examination.

“In the UK a woman dies every two hours from ovarian cancer, but the earlier the diagnosis the better the chances are”

Professor Hani Gabra – Director of Ovarian Cancer Action Research Centre

What is ovarian cancer?

Ovarian cancer is when abnormal cells in the ovary begin to grow and divide in an uncontrolled way and eventually form a growth (tumour). Every year 7,300 women in the UK are diagnosed with ovarian cancer.

Who can get ovarian cancer?

The risk of developing ovarian cancer increases as you get older. The most common type of ovarian cancer is epithelial ovarian cancer, this usually occurs in women older than 50 years old. We don’t know exactly what causes epithelial ovarian cancer. But some factors may increase or reduce the risk.

Factors that increase the risk include:

• getting older
• inherited faulty genes
• having breast cancer before

Factors that may reduce the risk include:

• taking the contraceptive pill
• having children
• breastfeeding

Ovarian Cancer is notoriously difficult to spot.

With non-specific symptoms in the early stages. It is hoped that this new method of early diagnosis could help save lives.

How to recognise the symptoms of Ovarian Cancer:

Early Ovarian Cancer symptoms can be similar to those of other conditions, these some to watch out for:

• Persistent bloating – not bloating that comes and goes
• Pain in the lower stomach and pelvis
• Difficulty Eating and feeling full quickly
• Back pain
• Fatigue
• Change in bowel habits

What should you do if you’re worried?

It is important to contact your GP as soon as possible if you spot any symptoms that are abnormal for you.
We understand talking about your concerns and having an examination can be quite worrying and for some, embarrassing, therefore, to make you as comfortable as possible, all our well woman services are booked with a female GP.

There is an Ovarian Cancer Blood Test – CA 125 available

Levels of protein CA125 in the blood are recognised as a marker for ovarian cancer. This simple and effective blood test will detect early stages of ovarian cancer. You can either have this as a stand-alone blood test or add it on to your medical for an additional cost. Please inquire for prices..

Links:
Target Ovarian Cancer
Cancer Research UK

For more information about Fleet Street Clinic’s Women’s Health Services.

You can also book a GP appointment online.

FINISHING THE LONDON MARATHON

The 2018 London Marathon is just around the corner! Are you preparing for the run this year? If so, you’ll be very aware of the struggle ahead. A challenge like a marathon is incredibly rewarding but also tough on the body. Increasing your exercise capacity to this level pushes the limits of endurance both physically and mentally.

But even though this can feel torturous at times, you should not ignore recurrent pain or discomfort that persists after adequate rest. A common mistake is to push through and wait until pain prevents training before seeking care. By then, prolonged time off is often necessary to heal. It is estimated that 50 to 70 percent of first-time marathon runners drop out before their race.

If you do pick up an injury:

1. First and foremost, stop and get it assessed.
2. Maintain your strength and endurance as much as possible while recovering from your injury. If it prevents you from running, low-impact cardio exercise such as swimming, cycling or pool running can continue to improve exercise tolerance.
3. Don’t be over-anxious to return to running, a good indicator of readiness is once you can walk for 30 minutes without pain during or after, you can begin a slow, careful return to pain-free running.
4. Do not push through the pain.

Moving forward

As you increase your training and running, consider a biomechanical assessment. Slight problems in gait caused by many issues from footwear to posture to old injuries can cause new injuries (knees are particularly susceptible), or cause you to have to slow your pace or walk during the race.

Listen and respond to your body throughout training and recovery, and that finish line is waiting for you!

Post race

As you can imagine, a marathon takes its toll on the body in many ways. A post race assessment is well worth it, to identify any issues caused, not to mention a treatment to work out some of that lactic acid and to restore full function to the joints and muscles.

Our osteopath Andrew Doody and podiatrist George Hill can help with any marathon-related complaints. For more training tips and advice, or marathon injury treatment you can book an appointment online.

Measles Outbreak – What You Need to Know

The WHO has issued a warning about recent outbreaks of measles in Europe and the USA. Cases of measles have risen rapidly in recent months in Italy, Romania and most recently in US.

Measles is a highly contagious virus with potential for serious complications.

Initial symptoms can include:

• Runny nose
• High Temperature
• Spots in the mouth
• Aches and pains
• Sore eyes and swollen eyelids

A rash appears after 2-4 days which can present as blotchy spots, often starting at the head and progressing down.

Medical Advice for Measles

If you think you may be suffering from measles, or are concerned about risk of infection when travelling, please see your doctor straight away.

Travelling to areas with a risk of measles

Make sure you are up-to-date with your vaccinations before you travel, including the measles, mumps and rubella (MMR) vaccine. If your child will be travelling, the MMR can be given from 6 months of age.  If you have not had measles or if you have not had two doses of MMR, you may be at risk.  Measles is easily passed from person to person and can be a serious illness in adults as well as children. It is never too late to have the vaccine.

Call Fleet Street Clinic for medical assistance, advice on vaccinations and travel precautions on  0207 353 5678  email info@fleetstreetclinic.com or book online now. 

Stoptober is a good time to reflect on smoking habits and how to improve health issues related to tobacco use.

Quitting smoking is one of the most effective ways you can improve your health and the benefits start almost immediately. And remember, it’s never too late to quit!

The benefits of stopping smoking

After 20 minutes

Blood pressure and pulse are normalised, blood circulation improves.

After 8 hours

Levels of carbon monoxide in the blood decrease.

After 48 hours

Your sense of smell and taste are improving.

After 2 to 3 days

Less or no phlegm in the throat, fewer breathing difficulties.

After 5 to 7 days

Your breath is fresher, your teeth are cleaner and energy levels higher.

After 2 to 3 weeks

Physical withdrawal symptoms will stop, and you can now go several hours without thinking about smoking. Your risk of blood clots (thrombosis) is reduced.

After 4 weeks

Coughing, blocked sinuses and breathing difficulties should subside. The lungs are better able to resist infection.

After 2 to 3 months

Lung function improves by 5%.

After 1 year

The risk of developing cardiovascular disease is halved.

After 2 to 3 years

The risk of developing severe pneumonia or flu is the same as for a non-smoker. Your risk of heart disease, angina (chest pains) and stroke continues to fall.

After 5 years

The risk of throat, oesophageal and bladder cancer is halved.

After 5 to 10 years

The risk of developing cardiovascular disease or thrombosis is the same as for a non-smoker.

After 10 years

The risk of lung cancer is halved. The risk of developing osteoporosis decreases.

After 15 to 20 years

The risk of lung, throat, oesophageal or bladder cancer is the same as for a non-smoker. But heavy smokers (20 a day) have double the risk of lung cancer for the rest of their lives.

Help with quitting

If you need any advice or help to stop smoking, you can book an appointment with one of our GPs.