In most cases the virus causes mild flu like symptoms 3-14 days after the bite from an infected mosquito. Other symptoms might include eye pain, vomiting and a rash on the skin. These symptoms usually last 3-6 days.

Only 1 in 150 infected persons can go on to develop a more severe form of the disease, with increased age (over 50) being an indicator for higher risk. Severe symptoms include fever, weakness, vomiting and a change in mental behaviour. These symptoms can eventually lead to death.

Who is at risk of West Nile Virus?

Up until 1999 this disease was mainly found in Africa, Egypt, South-east Asia and the Southern parts of France. The first recorded cases in the Western Hemisphere were reported in New York in 1999 and since 2000 many cases have been reported throughout the United States and Canada. Any person travelling to these areas is at risk of the disease.

Risk is seasonal in most places and will therefore vary at different times of the year – however those travelling to the Southern States of the United States should be aware that the risk remains all year. The CDC website can provide up to date information on currently infected areas.

What can I do to prevent West Nile Virus?

There is no vaccine to prevent WNV in those travelling to high-risk areas — prevention of bites from mosquitoes is the best line of protection. Most of the mosquitoes bite from dusk to dawn and a good repellent should be used during this time, however in some areas day biters have been found so use repellent accordingly.

 

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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.

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What is Yellow Fever?

Yellow Fever is a virus, which is spread via the bite of an infected mosquito. The disease exisits  in tropical areas of Africa and South America. While the disease is not found in Asia – the potential is there for spread due to the presence of the Ades mosquito, which is responsible for its spread.

Yellow Fever is recognised in two different forms – urban and jungle. Urban Yellow Fever occurs in the cities and is spread from mosquito to human to mosquito. In the jungle form Yellow Fever is spread from mosquitoes to monkeys and also to humans.

The disease presents itself after an incubation period of about 3-6 days with flu like symptoms, with death occurring in around 5% of those who become infected. There is no treatment for Yellow Fever, and so relief of symptoms is the primary course of action.

Who is at risk of Yellow Fever?

Any traveller to areas where Yellow Fever is endemic (that is: the infection is present in low levels) is at risk. This includes areas of Africa and South America.

How can I prevent Yellow Fever?

Travellers should obtain the necessary vaccination and a certificate of vaccination when travelling to endemic areas of the world.  This certificate is the ONLY internationally regulated certificate. The WHO recommends it for all travellers to endemic areas, as well as for those coming from an endemic area to an area of potential transmission. The purpose of the certificate is not only to protect the traveller but to also protect those in areas of the world where infection is possible due to the presence of the Ades mosquito. It is essential to ensure that the traveller plans ahead due to the shortages of vaccine at this present time.

Also see Preventing Bites.

  News and References 

• May 2016 – Independent reports that “Yellow Fever – World on brink of global emergency over deadly outbreak, academics warn”
• JAMA Article May 2016 – A Yellow Fever Epidemic
• Find a Registered Yellow Fever Clinic near you

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.

Typhoid is a Bacterial Infection

Typhoid is an infection caused by bacteria.  The bacteria is similar to the one that causes salmonella food poisoning.  You can become infected with Typhoid after eating or drinking infected food and water. The time between becoming infected and the first symptoms is around 1-3 weeks.  The disease can occur in any age group.  The disease is rare in children under 2 years of age.

Symptoms usually appear over the course of a month.  Once infected you might experience headaches and tiredness. This can progresses to aching muscles and stomach pains. Some people have a ‘rose spot’ rash after the first week of infection. Constipation can occur followed by bloody diarrhoea and a high temperature. If the disease is not treated quickly it can lead to death.  After contracting the disease you can pass the infection to others for 6 weeks to 3 months.

Typhoid is Present around the World

Typhoid is mainly present in South America, Africa and areas of Asia.  Therefore there is a higher risk if you travel to undeveloped areas of the world.

It is also important to understand that Typhoid can potentially occur anywhere in the world.  This is due to the way the disease spreads and the speed of travel. Natural disasters and imported cases can allow for outbreaks in parts of the world that would normally be considered low risk areas.

Typhoid can be Treated with Antibiotics 

Antibiotics can be used to treat mild cases, if the disease is diagnosed early. However, late diagnosis usually requires hospitalisation and  carries the risk of serious complications or death.

Vaccination can help Prevent Disease

Getting vaccinated (injection or oral) is a good idea when you are traveling to risk areas, and for occupational risks. Also vaccination against both Hepatitis A and Typhoid as a two-in-one injection is also available.

As vaccination does not provide 100% protection, it is also important to avoid food and drink which could be infected. You should also wash your hands properly before eating or using the bathroom.

References and Resources

• National Health Service advice on Typhoid
• World Health Organisation Fact Sheet on Typhoid
• The Department of Health Green Book On-line provides a full detailed explanation of Typhoid vaccination in the UK.

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Note: This information is intended to complement and not replace the relationship you have with your existing family doctor or travel health advisor.  Please discuss your travel health requirements with your regular family doctor, pharmacist or practice nurse.

Tuberculosis is spread from person to person via droplets in the air from coughing or sneezing. On rare occasions, it is spread via contaminated milk in the tropics.

Once an individual is infected they can remain without symptoms or go on to experience weight loss and general ill health. Tuberculosis most commonly affects the lungs and is accompanied by persistent coughing, blood stained sputum (phlegm), chest pain and fever.

Who is at risk of Tuberculosis?

Tuberculosis is found all over the world with China and India having the highest number of cases and Africa having the most deaths. In the UK, there has been a 25% increase in cases in the last ten years mainly among those from Asian backgrounds.

TB can only be caught from someone who already has the disease.

In the UK, routine vaccination of all school children is no longer practiced (DOH July 2005). A new vaccination programme now targets those children and adults at highest risk to the disease.

For those travelling to high-risk areas, such as Africa, Southeast Asia and parts of South America, proof of immunity is recommended.

How can I prevent Tuberculosis?

Partial protection is gained through BCG vaccination. The vaccination is only given at the presentation of a negative mantoux or heaf test. Only newborn babies are vaccinated without the test.

It is essential for all travellers going overseas to have a test and the subsequent vaccination if required. It is possible that immunity after vaccination is not lifelong and therefore all persons moving abroad to work in risk areas should consider testing, especially if the vaccination scar is not present. For advice regarding BCG, you should make an appointment with your family doctor or Travel clinic nurse.

For those with TB, treatment involves a variety of antibiotics taken over a period of months. The treatment will cure the disease ONLY if the treatment is continued until the end of the course. Because many people feel better, they stop taking the medication and this results in a recurrence of the disease.

NON-UK VISITORS TO THIS SITE:

Please note that the recommendations in other countries may differ from those in the UK and local advice should be sought.

European BCG Recommendations

Australian BCG Recommendations

American BCG Recommendations

Resources for TB

The DOH has provided answers to many common concerns about the jab

NHS Immunisation Information Service has produced multi-lingual fact sheets about TB and other vaccine preventable diseases

Amazon has a collection of books covering history and medical treatment of TB including Timebomb: The Global Epidemic of Multi-drug-resistant Tuberculosis (Paperback) £6.95

Health Protection Agency provides excellent information and reports on Tuberculosis with latest health reports and epidemiological data from the UK and abroad.

  

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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 Tick Borne Encephalitis?

Tick Borne Encephalitis is a viral disease spread via the bite of an infected Ixodes tick. It can also be transmitted via unpasturised milk from infected goats or cows. Ticks bite humans when they walk through undergrowth or grasses where contact is made. Peak biting times are during the warmer months of August, or following a warm humid summer in September and October. After an incubation period of 2-28 days, symptoms begin with a fever and can progress at varying degrees. Death rates are highest in the elderly.

Who is at risk of Tick Borne Encephalitis?

Tick Borne Encephalitis is a risk for travellers going to endemic areas; that is: areas where infection exists at low rates. It is most prevalent in Europe and Asia in long grass and undergrowth, at a tick infection rate of 5%. A variation of Tick Borne Encephalitis occurs in Russia and China.

How can I prevent Tick Borne Encephalitis?

While a vaccination is available for those at high risk, travellers should try to avoid areas where the disease is prevalent. If it is essential to go walking in long grass or undergrowth, suitable clothing should cover arms and legs, with trousers tucked into socks for protection. DEET can also be used as a repellent. Those trekking can impregnate cloth with permethrin to use as a ground sheet to sit on in infected areas.

If a tick gets onto the skin, it should be removed using the correct technique of pulling it straight from the skin using tweezers or a similar instrument, not twisting.

  

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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.

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.