Travel Advice
Lister Medical Centre Travel Clinics
Our Practice Nurses run travel advice clinics, not only to provide the appropriate vaccinations but to give practical advice on travelling abroad.
Appointments should be booked at least 8 weeks prior to travel in order to achieve the appropriate level of immunity. There is a fee for yellow
fever vaccination; yellow fever vaccination is a mandatory requirement for entry into a number of countries.
Visit Fit for Travel to obtain information on the vaccination you require for your destination.
The Foreign Office: Advice, assistance and travel tips for British nationals travelling oversees: http://www.fco.gov.uk/travel
To apply for, renew or amend a British passport including an application form: http://www.ukpa.gov.uk
European Health Travel Card (EHIC) apply on line
Information
You can be vaccinated against:
| Diphtheria |
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| Hepatitis A |
Advice |
| Hepatitis B |
Advice |
| Cholera |
Advice |
| Meningitis - gives 3-5 years' cover |
Do you need malaria prophylaxis for your destination? Advice |
| Polio - a full course lasts 10 years |
Advice can be obtained from the practice nurse |
| Rabies - 2 injections one month apart |
Advice |
| Tetanus - a full course lasts 10 years |
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| Typhoid - a single dose gives 3 years cover |
Advice |
| Yellow Fever - a single dose gives 10 years cover |
We can vaccinate you against yellow fever even if you are not registered here. |
| You may need malaria prophylaxis for your destination. Consult your chemist. |
Note that we longer provide a course of Japanese encephalitis vaccines at this surgery.
Malaria Prevention
2000 imported cases into the UK with 10 deaths per year. Take your antimalarial medication for 7 days before entering the malarious area and for 28
days after leaving the area.
No prophylaxis is completely safe.
Avoid being bitten. Sleep in a screened room. Use equipment (purchased from chemist) to kill mosquitoes entering the room. Wear long sleeves and
trousers at night. Use repellents on exposed areas of skin.
Take prophylaxis for 1 week prior to departure (2 and a half weeks in the case of mefloquine), while abroad and for 1 month on return.
For further information: http://www-micro.msb.le.ac.uk/224/malaria.html
No protection is 100% safe. Consider malaria in the case of a fever or 'flu-like illness within one year of overseas travel in an infected area
(especially in the first three months)
Prophylaxis with anti-malarial medication is dependent on
the area you are travelling to. Telephone: Malaria reference library (24 hour help line) 09065 508 908 (calls cost £1 per minute)
Hepatitis A
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Hepatitis B
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Hepatitis A is caused by the hepatitis A virus.
Transmission occurs if the faeces of an infected
person is transferred orally to another individual through poor hygiene. This can occur if the person preparing food has not washed his/her
hands after using the toilet. Particular care should be taken with uncooked food such as salads which may have been washed in contaminated
water, or ice cream. Similarly, shell fish, living in water contaminated by sewage can transmit the disease. Do not drink the local tap water
or use it to clean your teeth unless to know it is safe.
The disease takes 6-12 weeks to develop. Signs of the disease are: jaundice, fatigue, abdominal pain, loss of appetite and diarrhoea. These
symptoms may last several weeks.
15% of people infected go on to have relapsing symptoms for 6-9 months.
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Hepatitis B is caused by the hepatitis B virus.
Transmission occurs by a body fluid of an person carrying the virus being passed to a susceptible individual. Such transmission can occur
through unsafe sex, intravenous drug users sharing a needle or an infected blood transfusion or blood product.
The use of condoms gives a measure of protection but should not be considered to be 100% effective.
The disease may take 4 months to develop and presents similarly to hepatitis A. The infection is lifelong and can cause cirrhosis, liver
cancer, liver failure and death in a proportion of those infected.
Some people can we found as "asymptomatic carriers" of the virus without having presented with the illness but can pass it on to
others.
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Sunstroke and Heat Exhaustion
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Diarrhoea
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Exposure to high temperature may lead to either excessive fluid loss (heat exhaustion) or failure of heat mechanisms and unusually high
temperature (heatstroke).
The onset of heatstroke may be preceded by headache, dizziness and fatigue. Sweating is usually decreased and the skin is hot, flushed
and dry.
In severe cases, the patient may experience disorientation unconsciousness or convulsions.
Emergency treatment is by cooling the individual by wrapping them in wet towels or clothes. Immersion in a stream or the sea will help if
appropriate.
The patient should be taken to hospital as soon as possible.
Heat exhaustion (because of excessive fluid loss) may lead to fatigue, weakness, anxiety and sweats. The individual may cold, pale, clammy
and may faint.
Treatment should consist of placing the individual flat with their head slightly lower down. When they begin to recover small amounts or
rehydrating fluid should be given.
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Diarrhoea is an intestinal disorder characterised by abnormal fluidity and frequency of bowel movements caused by increased motility of the
colon. The stools are watery and are passed at least three times a day.
Severe diarrhoea is dangerous because is causes rapid depletion of sodium and water, both of which are necessary for life.
Children are particularly susceptible to dehydration because of their large skin surface area relative to their size. Treatment should
be given with oral rehydrating fluid (best bought before travelling). If the child has persistent vomiting, medical advice should be sort.
Similarly, bloody diarrhoea in any person will need medical attention, with anyone not responding to oral fluids or with diarrhoea occurring
with vomiting and/or fever.
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Human Immunodeficiency Virus (HIV)
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Yellow Fever
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The acquired immunodeficiency virus has its effect by killing and damaging cells of the body's immune system. This then prevents the ability
to fight infections and certain cancers.
HIV is transmitted in the same way as hepatitis B, that is through contamination of body fluids by unsafe sex, the sharing of needles by
intravenous drug users or through contaminated blood transfusions or blood products. Preventative advice given for hepatitis B, applies to
with this infection.
Remember that although a condom gives a measure of protection, it cannot be considered 100% reliable.
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Yellow fever is a viral illness transmitted through the bite of a mosquito. Symptoms occur 3-6 days after being bitten and consist of fever,
muscle pains, backache and headache. After a further 3-4 days, 15% of those affected enter "the toxic phase" with jaundice,
abdominal pain, vomiting and bleeding from the gums and mouth. A half of all people in the toxic phase die from renal failure. There is no
specific treatment other than supportive care.
Visit this web site for further details on the subject and on
vaccination.
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Typhoid Fever
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Deep Vein Thrombosis
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Typhoid fever is caused by the bacterium, salmonella typhi which may be found in the faeces or blood of those having this illness but also in
asymptomatic "carriers".
The disease is got by eating food or drink contaminated with the bacteria or if sewage containing the bacteria gets into the drinking water
supply.
The symptoms of the disease are fever, headache, abdominal pains and a rash of flat, rose coloured spots.
Treatment is by antibiotics and the necessary supportive care.
The avoidance of typhoid fever is by careful hygiene in the preparation of meals and the avoidance of food which might be suspect.
In addition, local water should not be drunk unless known to be safe. Instead, bottled water should be drunk and used to clean teeth.
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Deep vein thrombosis (DVT) occurs when blood "pools" in the calves or pelvis. This may occur on long haul aeroplane travel where
the individual is sitting for a long period of time in one position. The risk is the formation of a blood clot, then becoming detached and
passing to the lungs, causing respiratory collapse.
To try and prevent a DVT, alcohol should be avoided and plenty of water drunk on the journey. Avoid sitting in one position for too long.
Loose clothes should be worn and effort should be make to exercise the feet by moving them around or walking about in the plane. An aspirin
taken 2 hours before the flight may prevent a blood clot forming. Asthmatics, people with a history of gastric or duodenal ulcers or those
who may be allergic, should not take aspirin.
See Department of Health Web site |
Other useful web sites:
Typhoid
http://www.netdoctor.co.uk/travel/diseases/typhoid.htm
Japanese encephalitis
http://www.cdc.gov/ncidod/dvbid/jencephalitis/index.htm
Rabies
http://www.cdc.gov/ncidod/dvrd/rabies/introduction/intro.htm
Extra Tips:
Never bathe in surface water, river or lakes unless you know they are free from Schistosomiasis (Bilharzia). In snake infected area tuck your
trousers tightly around your ankles and always shake your shoes before putting them on!
If you are going on a trek in the wild and off the beaten track, tell the local embassy where you are going and when you intend returning.
If you are going on an exotic holiday visit http://www.masta.org a website which provides a
database and information on health hazards in 250 countries, plus advice on immunisation and travel products.
Altitude Sickness
Cold is a factor generally experienced at altitude. Take precautions.
Altitude-induced illnesses include Acute Benign Mountain Sickness, the symptoms of which include headache, nausea, dizziness, loss of appetite,
vomiting and insomnia, which can progress to Acute High Altitude Pulmonary & Cerebral Oedema, a life threatening disorder. Often occurs with
rapid ascent to high altitude.
Avoidance of these conditions is best achieved by maximising the opportunity to acclimatise & this should be in the itinerary. Any onset of
symptoms should prompt consideration of descent, or at least the decision to go no higher. Continued symptoms should trigger shift to a lower
altitude.
Prophylaxis: for susceptible travellers, or if natural acclimatisation not possible, give Acetazolamide. Effective in preventing altitude illness,
but may not prevent against cerebral or pulmonary oedema. Parasthesia in fingers & toes is a common side effect in the first 2 days of
treatment. Sulphonamide allergy & impaired renal function are contra-indications to it's use.
Click for more details.
Medical Contraindications for air travel
| Anaemia |
If haemoglobin is less than 7.5g/dl |
| Cardiac failure |
If uncontrolled |
| Cerebral Infarction (Stroke) |
Until convalescence is completed |
| Contagion |
(and communicable diseases). Until non-infectious |
| COPD |
Pre-book in-flight oxygen. but should not fly if short of breath at rest or after walking 50 metres |
| Deep vein thrombosis |
(acute) Until stabilised medically with resolution of the clot |
| Fractures |
Up to 48 hours after application of plaster cast |
| Haemorrhage |
If recent and gastrointestinal |
| Heart Attack-uncomplicated |
Wait 3 weeks after MI if back to normal routine |
| Heart attack-complicated |
Wait until stable for at least 6 weeks |
| Jaw |
Wired Fracture. Unless with escort with wire cutters |
| Operations |
Normally 5-14 days. Retinal detachment may be 6 weeks |
| Middle ear infection (ear ache) |
Until condition resolved |
| Pneumothorax (collapsed lung) |
2-3 weeks after successful drainage and check x-ray |
| Pregnancy |
After 36 weeks (32 weeks for multiple pregnancies) Check with your airline company. |
| Psychiatry |
Unpredictable, aggressive or disruptive behaviour |
| Respiratory disease |
Marked breathlessness at rest |
| Sickle Cell (crisis) |
Until 10 days later |
| Sinusitis |
(severe) Until the problem has resolved |
| Any condition |
That may be made worse by flying |
| Unstable conditions |
That have a risk of deterioration prejudicial to the person |
For further information contact The Aviation Health Institute (AHI) Telephone 01865 739681 or web site
Medicines:
If you take regular prescription medicines, ensure that you have an adequate supply to cover the length of your trip. You might not be able to
obtain the exact drug abroad and the quality may be questionable.
Insurance:
Ensure you have adequate travel insurance. In Europe form E111, obtainable from the Post Office, will enable you to receive medical treatment in
countries of the European Union.
Sometimes we suggest our travellers visit private travel clinics for specialist vaccines or
because it may be quicker for you to be seen if travelling at very short notice and we have no available appointments. Below are a list of available
clinics.
Private GP Services Travel Clinics
Chelmsford Medical Centre, 85-89 New London Road, Chelmsford
01245-253777
Springfield Hospital, Lawn Lane, Chelmsford.
01245-234134
Same day appointments; open to 9pm three days a week; no consultation charge.
The Hospital for Tropical Diseases Travel Clinic
Mortimer Market
Capper Street
off Tottenham Court Road
London WC1E 6AU
Appointments: 0207 388 9600 Fax: 0207 383 4817 http://www.thehtd.org
The Royal Free Travel Health Centre
Pond Street
London NW3 2QG
Appointments: 0207 830 2885
Fax: 0207 830 2741
Fleet Street Travel Clinic
29 Fleet Street
London EC4Y 1AA
Appointments: 0207 353 5678
Fax: 0207 353 5500
Trailfinders Travel Clinic
194 Kensington High Street
London
Tel: 0207 938 3999
British Airways Travel Clinics in London
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