Category: diseases

After an incubation period of around 12 days the disease affects the nervous system, causing muscle spasms and rigidity. This can eventually lead to respiratory failure and death.

Who is at risk of Tetanus?

Tetanus spores are found all over the world including the United Kingdom.

How can I prevent Tetanus?

The best method of protection is vaccination. In the UK tetanus vaccination is part of the routine immunisation programme and is given in a combined vaccine with diphtheria as a primary dose and reinforced for the purpose of travel. For those remaining in the UK, current UK guidelines state that a total of five doses of the vaccine are considered to give lifelong immunity — the exception is in the case of a tetanus prone wound when a booster is given as required.

 

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

The most common swine flu virus is the H1N1 subtype, but other subtypes include the H1N2, H3N1, H1N3 …

Symptoms in humans range from typical flu like symptoms such as coughing, fever, sore throat and aching muscles to more serious pneumonia and other respiratory problems which have the potential for developing into life threatening conditions.

Who is at risk of Swine Flu

Swine Flu viruses do not normally affect humans, but where human infection does occur, it usually follows close contact with pigs. Some closed group instances of human-to-human infection have been recorded.

Because the swine flu virus is killed at temperatures of 70°C / 160°F, pork and other meat from pigs is safe to eat if it has been carefully cooked.

What can I do to prevent Swine Flu

There is no vaccine to prevent Swine Flu, but Laboratory tests have shown that the swine influenza virus can be fought with antiviral medication.

Swine influenza is thought to spread in the same way as seasonal flu. Seasonal influenza viruses are usually spread through coughing or sneezing by infected people.

People who are infected by a flu virus are advised to limit their contact with other people as much as possible to avoid the risk of spreading the disease further. Good personal hygiene, such as covering the mouth and nose with a tissue when coughing or sneezing, and regularly washing hands are also thought to help protect those around you.

   

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

When the related episode of the series was shown in the US, officials were concerned that the storyline might worry viewers and they consequently issued a media advisory prior to the showing of the episode. While the programme in question does not conclude a final diagnosis of smallpox, it raises many questions related to public health.

What is the risk of Smallpox

In May 1980 the World Health organisation declared Smallpox as the first disease to achieve eradication. Since that time there have been no cases of smallpox, with the last reported outbreak occurring in Somalia in 1977. Smallpox is a disease that does not occur naturally in the environment. You cannot ‘catch’ smallpox when you visit a foreign country, nor can you get it from people who are visiting your own country. The only way smallpox can be transmitted today is through a deliberate criminal act.

What is Smallpox

Smallpox is a viral infection caused by the variola virus. Its symptoms include a fever, tiredness, aching limbs and general flu-like symptoms. This is followed by a distinctive rash on the arms, legs and face, about 2 days after symptoms start. The rash starts as red marks, which gradually fill with pus and then crust over, falling off after about 3-4 weeks.

Smallpox is particularly contagious during the first few weeks of illness and infection is spread through the air when a person coughs and sneezes. The disease remains contagious until the rash disappears.

What plans are in order in the event of exposure following a criminal act

In the UK, contingency plans are in place should such an event occur. Large stockpiles of vaccine exist and, if given within 4 days of exposure, these are able to lessen the symptoms or even prevent the disease.

If an outbreak should occur infected patients would need to be kept in isolation, and all close contacts would need to be vaccinated within 2-3 days following exposure.

  

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

What is Schistosomiasis?

Flukes, whose life cycle requires fresh water snails, cause Schistosomiasis. Schistosomiasis is contracted through the skin from fresh water contaminated with urine or faeces of an infected person. It is second only to Malaria as a public health problem in tropical and sub-tropical areas, affecting approximately 200 million people in both rural and peri-urban areas. 500-600 million people worldwide are at risk of the disease. Refugee movements in Africa cause spread to wider areas.

Travellers might experience an itching or rash a few hours after contact where the larvae enter the body. A person may remain symptom free until the eggs hatch weeks later, when a fever sometimes occurs. One of 5 types of fluke cause an infection of the bladder and/or bowel, often with bleeding. There are also recent reports of paralysis of the legs.

Who is at risk Schistosomiasis?

Any traveller to areas where Schistosomiasis is endemic (that is: the infection is present in low levels) is at risk. This includes South America, Africa and parts of the Middle East and India, and in Asia. Caution should be taken with diving lessons in fresh water lakes in risk areas!

How can I prevent Schistosomiasis?

Travellers should not paddle or swim in fresh water lakes, streams, rivers or slow running water. Quick drying of exposed areas can offer some protection, due to larvae needing water to survive. Minimal protection is also gained from wearing rubber boots or wet suits.

  

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

What is SARS?

SARS, or SARS-CoV as it was known, was the cause of a global pandemic which began in China in 2002.   The outbreak affected 26 countries.  During the outbreak there were more than 8000 cases globally with 774 deaths. The disease was caused by a coronavirus.  The coronavirus comes from the same family of viruses as the common cold and COVID-19.

The epidemic ended in July 2003 after killing 1 in 10 people who were infected, most those who died were over the age of 65.  Due to the close monitoring of the disease there are currently no known areas of the world with cases of SARS.

SARS caused flu-like illness.  Symptoms included a high fever (>38’C), one or more respiratory symptoms such as a cough, or breathing difficulties.  Symptoms developed around 2-16 days after exposure.

People at risk were those who had close contact  with a person who had SARS; or had recently travelled (within 10 days) to an area reporting cases of SARS. Other symptoms included headache, muscle stiffness, loss of appetite, malaise, confusion, rash and diarrhoea.

What is the risk of contracting SARS?

At the moment there are no known cases of SARS anywhere in the world.  Since the outbreak there have been several laboratory cases of SARS caused by laboratory accidents.

If SARS should re-emerge the following advice would remain in place:

• Wash your hands frequently and make sure you have good personal hygiene
• When travelling make sure you carry some antibacterial wipes for emergencies – especially when you are using public bathrooms
• Maintain good communication with those back at home using e-mail and telephone
• Keep up to date with travel advisories from an up to date source – you should check these prior to travel
• If at any time you feel unwell seek medical attention – make sure your travel insurance is adequate prior to travel.
• Avoid crowded places such as sports events and conferences as well as travel on public transport
• You should also be remember that if you try to take a flight in an infected country and are suffering from a respiratory problem you could be refused access to the flight – if you have an existing condition make sure you have a letter from your doctor!
• Before travelling overseas to certain countries during the “flu” season it is advisable to discuss flu vaccination with your health advisor.

 

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

What is Rabies?

Rabies is a disease transmitted to humans via the bite of an infected animal. Rabies is an acute viral infection, which affects the central nervous system. Symptoms usually begin with a fever, followed by symptoms such as agoraphobia, hallucinations, convulsions and other disturbing behaviour. Untreated rabies always results in death, usually by respiratory paralysis.

Who is at risk of Rabies?

Rabies is endemic (that is: infection is present in low levels) in all areas of the world, with the exception of Antarctica.

How can I prevent Rabies?

For those travelling to high-risk destinations vaccination is the best method of protection. Advice should be sought from a health professional in regard to vaccination. Vaccination prior to travel is often regarded unnecessary for those less than 24 hours away from a vaccine supply. However, vaccination might be advisable for those travelling to areas where supplies of rabies immunoglobulin are currently known to be low even if they are less than 24 hours from medical attention.

The price of the vaccine varies from place to place and it is often cheaper to obtain vaccination from a specialised vaccination centre or Travel Clinic. Price varies due to the method of administration, as the vaccine can be given either intradermally or intramuscularly at differing amounts. It is also essential that travellers avoid stray animals in risk areas.

  

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Polio has an incubation period of about 7-14 days, after which around 90% of cases show no symptoms, producing a lifelong immunity. Others, however, display a flu-like illness and then recover, while about 1 in every 1000 cases of the illness develops a paralytic illness affecting the nervous system, which sometimes leads to death.

Who is at risk of Polio?

Any individual who has not been vaccinated and is travelling or working in an area where Polio is endemic, is at risk of Polio. After an intensive worldwide vaccination programme Polio has been eradicated from most countries, including the United Kingdom. Areas in which Polio is still endemic include areas of Africa, Asia and the Netherlands.

How can I prevent Polio?

Polio vaccination is part of the national vaccine recommendations in the United Kingdom. A course of vaccine is usually started when a child is one month old, given a month apart for three doses. A booster is then given at school entry as part of the pre-school booster, and then again at leaving age around 15-19 years of age. Adults are then given a booster dose if they are travelling, every ten years. The vaccine however can remain in an individual’s stool for up to six weeks after administration and it is important in a home where immunocompromised individuals also live, that strict hygiene is adhered to, especially when handling baby nappies. Even with vaccination, travellers should be aware of good hygiene.

  

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

What is Measles?

Measles is a viral disease, which is highly infectious. It most commonly begins with a fever and blotchy red rash. The rash usually begins on the face and behind the ears, then spreads over the whole body. In 1 to 15 cases complications can occur as a result of the disease. Complications include ear infections, diarrhoea, febrile convulsions, and pneumonia, which lead to death in around 2 out of every 1000 cases. It is spread from person to person via infected droplets in the air.

Who is at risk of Measles?

Any person travelling to an endemic area of the world is at risk of the disease if they have not been vaccinated. Measles is found all over the world including Europe and Asia. In 2015 a USA outbreak began in the California Disney Park and resulted in 17 states being infected.

How can I prevent Measles?

Herd immunity will only exist in a country when uptake for the vaccine is above 95%. In the UK administering the MMR triple vaccine containing Measles Mumps and Rubella is part of the routine childhood vaccination schedule.

For those travelling to high-risk situations within the developing world, vaccination with the triple vaccine (MMR) is recommended.

NON-UK VISITORS TO THIS SITE: Please note that the recommendations outside of the UK can differ and local advice should be sought.

 

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

For which areas is Malarone recommended? Malarone is effective in areas of the world where we are seeing increasing Chloroquine resistance.

Dosage: one tablet per day, starting just 1-2 days prior to arriving in a malaria zone, while away and for just 7 days on leaving the area. This is because Malarone has the ability to act on the liver and blood stage of the malaria infection. This simple regime is believed to increase compliance and will be especially convenient for short holidays and last minute trips to malarial destinations.

Often travellers become concerned if they discover they have been given a different anti-malarial to other people on the same plane going to the same destination. This often happens because there are usually several options for the same destination and the final choice is based on several different factors including price…

The Malaria Reference Laboratory is responsible for drawing up the anti-malarial recommendations for the UK. Each recommendation involves looking closely at epidemiology of the disease, resistance to the malarial parasite and of course the number of cases that are coming out of certain areas in a particular country. The guidelines then reflect the best ‘recommendations’ and alternatives as recommended in the UK. These guidelines are then published and updated on a regular basis and it is up to the travel clinic, practice nurse or doctor to keep up to date with the changes within the UK recommendations.

Now, that is not the whole story – recommending the ‘right’ drug for each person involves a lot more than just looking at a chart and pulling out a drug name. Making a full assessment of each individual and recommending the right drug for a particular individual traveller is often the difficult part.

It is important that when visiting a health professional for advice on anti-malarials that you give them enough information to work with. They need to know where you are travelling to – and be specific; recommendations can differ within a single country or area. Let them know about any stopovers, are you staying in a rural area or in a city – malaria is less of a threat in the cities. What will your altitude be? Malaria is not often found above 2000 metres, although reports from East Africa would suggest changes are occurring in certain parts of the globe.

The time of year is also an important consideration as malaria is seasonal in some areas. The worldwide climatic variations have brought about changes in the pattern of malaria over the last few years. Your health professional will need to know how long you are going to be away as well as your age, and also of importance is the types of medication you are taking and your past medical history.

And that is not the full story – no anti-malarial, however much media attention it receives, is going to be 100% effective and it is important that you also take into consideration how you can prevent getting bitten by mosquitoes in the first place! Recommendations are as they suggest ‘recommendations’ which, when discussed with your health advisor, might differ from the person sitting next to you on the plane – but it doesn’t always mean they’ve got it wrong…

 

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Malaria Facts

Climate greatly affects the feeding and breeding habits of the malaria mosquito. It is prevalent in tropical climates, but usually not higher than 1,500-2,000m above sea levels. Mosquitoes breed only in fresh water. World climate and global warming affect breeding and the spread of malaria. A countrywide change in 2°C can affect numbers of malaria cases over a season.

Medication

If you are visiting a malaria zone, see you TravelHealth advisor at least a month prior to travelling so that suitable medication can be arranged. Most medication is taken for a set period before going, continued while you are in a malaria zone and for a set period on return.

If you suffer from any heart condition, are pregnant, breast-feeding or epileptic, it is important that you inform your travel health advisor as this might influence the medication you are given.

Bite prevention

Mosquitoes feed between dusk and dawn. The mosquitoes tend to respond to light in their feeding habits and are most active in low light hours after dusk and in the hours prior to dawn. Female mosquitoes will take a blood meal just before laying their eggs, which are laid at night. It is therefore important that repellents are used between dusk and dawn to prevent being bitten.

Use a repellent that has DEET, or contains a natural repellent such as lemon and eucalyptus; try to avoid using products that are connected to homemade concoctions!

While clothing alone will not protect you against mosquito bites, it can help in preventing bites when used along with other careful prevention. Clothing that covers the body, such as long trousers and long sleeves; socks etc., worn after dark will lower the risk of being bitten. While mosquitoes are able to bite through many materials, canvas mosquito boots and thick denim jeans will make it more difficult.

Clothing that has been impregnated with permethrin will also help repel mosquitoes. This clothing along with impregnated wrist and ankle bands lower the risk of being bitten.

If you are reluctant to impregnate everyday clothing, impregnated netting worn over the clothing will prevent chemical contact with the skin. It is important that fellow travellers are protected in a similar way, as repelled mosquitoes will go to another person who is not protected!

Research has suggested that mosquitoes are attracted to sweat and so keeping clothes clean, especially socks (!), might help. It has also been suggested that mosquitoes are attracted to dark colours, so wearing light colours or white clothing might help prevent being bitten.

While air conditioning does help keep the mosquitoes away due to the lower temperature, it is important that it is left on all day and that the windows are not left open at night!

Using a mosquito net in an area where malaria is present is a good idea. Ideally the net should be impregnated with permethrin at least every six months or when it is washed.

  

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Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.