Sign “Way to Mount Everest Base Camp” – Mount Everest (Sagarmatha) National Park
Trekking holidays in places like Nepal, Peru and climbing Kilimanjaro are becoming ever more popular amongst travellers. 30,000 people attempt to climb Kilimanjaro every year, with 6 to 8 people dying on the mountain each year. (1)
This is a really good question! Ready for the science bit? Altitude generally refers to the height above sea level. High altitude is generally considered anywhere above 2500m.
At high altitude, atmospheric (air) pressure is lower than that at sea level. Decreased air pressure means there is less oxygen. So for example, there is approximately 66% less oxygen in each breath on the summit of Everest than at sea level.
High Altitude |
Very High Altitude |
Extreme Altitude |
| Between 2400-3658m | Between 3658-5500m | Between 5500-8848m |
| Cochabamba, Bolivia 2550m |
La Paz, Bolivia -3658m
|
Mt Everest summit -8850m |
| Bogota, Colombia- 2645m
|
Lhaza, Tibet -3685m
|
|
|
Quito, Ecuador -2879m
|
Everest Base Camp -5500m | |
| Cuzco, Peru -3225m |
(2)
So what’s so important about oxygen? Simply put, it is needed to keep your body alive. It gives you energy, it’s important for brain function and for all those other things that it does for the body to function normally without you even realising it!
Our bodies are accustomed to working where we live, and when we go higher our bodies need to adapt. Altitude starts to have an effect on our bodies around 1500 – 2000m. So it starts to behave slightly differently as it tries to compensate for the change in oxygen levels. The decrease in pressure means you take in less oxygen and this can make it more difficult to breathe. Our bodies adapt by breathing faster and deeper, increasing the heart rate, and adjusting its blood chemistry such as making more red blood cells to carry oxygen around.
This response or adaption is called acclimatisation. It takes approximately 3-5 days to occur but can vary between individuals and conditions.
Because of these changes in your body, there are some ‘normal’ symptoms that you will notice at higher altitudes while your body is acclimatising and adjusting to the reduced availability of oxygen. They include:
Trekker resting in height mountain India
The lack of oxygen above 2400 metres (8000 ft) can cause serious illnesses.
There are three forms of altitude sickness, the first two are neurological forms of altitude illness:
Symptoms of AMS appear 6 to 12 hours after you climb to or arrive at high altitude, although it can take up to 24 hours to develop. Symptoms include headaches, sleep disturbance, tiredness, shortness of breath, loss of appetite, nausea and vomiting. If you get symptoms of AMS you should take this as a warning sign that you may develop more serious altitude sickness called high altitude cerebral oedema (HACE). 10% of people with AMS will develop HACE. [4]
This is as a result of swelling of the brain and is typically characterized by the onset of confusion, altered consciousness and or loss of coordination. AMS commonly precedes HACE.
This affects the respiratory system where fluid builds up in the lungs and is also very dangerous. HAPE symptoms normally develop 2- 4 days after arrival at high altitudes above 2,500 metres and include: breathlessness, cough, bubbling sounds in the chest and pink spit. HAPE can develop even if you have not had symptoms of AMS.
Both HACE and HAPE are uncommon, but can develop very quickly and can be fatal within hours. If you develop symptoms of HACE or HAPE you need urgent medical attention and should go down to a lower altitude immediately.
It is difficult to predict the susceptibility of a traveller to AMS, and physically fit travellers are not necessarily at lower risk. If you have previously had AMS you may get it again.
Rapid ascent without a period of acclimatisation puts a traveller at higher risk. In a study, 84% of trekkers who flew directly to 3,860m were affected by AMS. (5)
Follow the Golden Rules
If you feel unwell at altitude it is altitude illness until proven otherwise.
Never ascend with symptoms of AMS.
If you are getting worse (or have HACE or HAPE), go down at once. (7)
Reduce your risk by:
If you rest and do not climb any higher symptoms of AMS usually improve in a few hours or days. DO NOT climb any higher.
Taking over the counter medication such as paracetamol may help with headaches and anti-sickness drugs like promethazine will help nausea and vomiting. Keep hydrated by drinking plenty of clear fluids and avoid alcohol. If you do develop AMS make sure you do not venture off on your own as you could develop more serious symptoms at any time.
If symptoms get worse or do not improve you MUST rapidly go (or be taken) to a lower altitude (at least 500 to 1,000 metres lower).
You should NEVER leave anyone with AMS on their own – they can become very ill very quickly.
Acetazolamide (Diamox®) can be prescribed to try and prevent AMS. Diamox reduces the headache of AMS and increases blood oxygenation at high altitude by altering the body’s acid-base balance. Diamox should be taken 24 hours before arrival at high altitude and continued for 2 days once the highest altitude is reached. A trial course of 250mgs per day for 2 days is recommended before going to a remote location where a severe allergic reaction could prove difficult to treat if it occurred.
Diamox is not suitable for everyone. Your nurse will make a risk assessment to see if it is suitable for use.
Acetazolamide is not a ‘magic pill’, and cure of AMS is not immediate. It speeds up a process that may normally take 24-48 hours to about 12-24 hours.
Put simply acetazolamide (Diamox) works by forcing the kidneys to excrete bicarbonate, the base form of carbon dioxide. It speeds up the acclimatisation process, stimulates breathing during the night and lessens the symptoms of AMS.
Common side effects include:
Less common side effects include:
Acetazolamide hides symptoms of AMS – FALSE
Acetazolamide speeds up acclimatization. As acclimatization occurs your symptoms resolve, reflecting improving health. Acetazolamide does not cover up anything, if you are still unwell with AMS, you will still have symptoms. If you feel well, you are well.
Acetazolamide will prevent AMS from worsening during ascent – FALSE
Acetazolamide does not protect against worsening AMS with continued ascent.
It does not change GOLDEN RULE 2 – NEVER ASCEND WITH SYMPTOMS OF AMS. Lots of people who have developed HACE AND HAPE believed this myth.
If Acetazolamide is stopped, my symptoms will worsen – FALSE
There is no rebound effect. If acetazolamide is stopped, acclimatization slows down to your own intrinsic rate. If AMS is still present it will take longer to resolve. If AMS is not present, then you don’t need to accelerate acclimatization if you ARE already acclimatized. You won’t become ill by stopping your acetazolamide. (6)
Sussex Travel Clinic can prescribed Diamox for adults from 18 years old – call 01273 749100 or 01903 254774 to book an appointment or book ONLINE.
For further advice visit:
Happy travelling!
References
Bibliography
Medex – Travel at High Altitude
International Climbing and Mountaineering Federation
Sussex Travel Clinic are pleased to announce they will be holding a FREE full training day for local practice nurses on April 22nd 2016 at Worthing College . The day includes a presentation by a fantastic speaker – Cathy O’Malley – travel health nurse specialist (download our flyer for more information). This day will provide excellent educational opportunities and professional development for all who attend. We look forward to seeing you on the day.
To book a place please Download application form
Travelling with an allergy can be difficult and without being prepared could end up with you needing medical treatment following exposure to an unknown source of your allergy. Food allergies can cause problems when ordering food in restaurants and communicating can be difficult. Follow our advice to make sure you have a safe and healthy trip.
Allergic reactions are caused by allergens. Almost anything can be an allergen for someone. Common allergens include: pollen, house dust mite, food, animals and chemicals. Symptoms of an allergic reaction can range from a runny nose, itchy eyes, skin rashes to the more severe form of allergy; anaphylaxis. Allergy is very common and it affects approximately one in four of the population in the UK. Each year the numbers are increasing by 5% with as many as half of all those affected being children.
Anaphylaxis is a severe allergic reaction that can affect the whole body, often within minutes of exposure to an allergen but sometimes it can occur after several hours. Anaphylaxis can be fatal if not treated quickly.
Anaphylaxis can be caused by many different things. These include foods such as nuts: peanuts, almonds, walnuts, cashews, Brazils, sesame, fish, shellfish, dairy products and eggs. Non-food causes include wasp or bee stings, natural latex (rubber), penicillin or any other drugs or injections.
Symptoms include: flushing of the skin, hives, swelling of the throat, difficulty breathing, nausea, vomiting, collapse and unconsciousness.
Most allergic reactions can be treated successfully with antihistamine tablets or cream. If you have had a previous anaphylactic reaction your doctor or specialist will have prescribed you an Epipen which contains Adrenaline (also known as epinephrine). Adrenaline works by constricting blood vessels and relaxing smooth muscles in the lungs to improve breathing. It stimulates the heartbeat and helps to stop swelling around the face and lips. The Anaphylaxis Campaign have produced a video on how to use your Epipen.
If you have a known allergy you should follow these advice tips to make sure you stay safe and healthy on your trip:
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Don’t let a medical condition stop you this summer. Here at The ID Band Company we have a wide range of bracelets, necklaces, ID cards and bag straps that can stand the heat whatever you’re up to. From talisman necklaces to leather straps, silicon bands to children’s allergy bags, there’s something for everyone.
Made of high quality, sturdy materials, all ID Band products either come pre-engraved for set medical conditions or can personalised with the exact details you want. Help medical staff to correctly diagnose you should an emergency arise by including your medical condition name and facts, and give family members peace of mind by having their contact details engraved too.
If you’re heading off to somewhere exotic this summer, choose from 16 language options for your engraving. This coupled with the universal medical symbol means you’ll still be understood, no matter how far away you go. All engraving is water resistant so ideal for any water based activities you may get up to.
All our products are timelessly stylish and can be worn for any occasion, so you can wear them for all occasions and concentrate on enjoying your summer time, whether at home or abroad.
Get 5% discount off any products purchased from the ID Band Company
Further information can be found on the following websites:
Written by Jane Bell RGN
Are you part of a charity or are you a volunteer?
Are you going abroad on a trip?
Do you want to have a chance of winning £100 worth of travel products?
Here at the Sussex Travel Clinic we are offering the opportunity to enter our free monthly prize draw, where you get the chance of winning £100 worth of travel products.
Entering this prize draw is simple. All you have to do is have the vaccines for your trip with us, fill in one of our slips, and pop it in the box.
Do you find yourself saying ‘I never win anything’ or ‘Why do I need £100 worth of travel products anyway?’ Never say never. You may need something you didn’t realise or even something that you don’t necessarily have to take abroad. What about something that you could use at home like a tick out remover for the dog or Bimuno for daily use to help with your digestive system?
If you already have all your products for your trip, what about buying something useful to donate to your charity. Such as mosquito nets.
Reference:www.netsforlifeafrica.org
We have a range of stock consisting of mosquito nets and repellents, water purification tablets, Bimuno, travel towels, first aid kits and much more.
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![aquapure-traveller-water-purification-bottle-359-p[ekm]350x522[ekm]](http://localhost/wp-content/uploads/2015/03/aquapure-traveller-water-purification-bottle-359-pekm350x522ekm.jpg)
The winner will be picked at random on the last working day of the month and will be contacted on that day or the following day.
Not sure what you would pick or what you may need? There is always a member of staff on hand to help make the selection if required.
The prize draw is available in both of our clinics in Worthing, West Sussex and Hove, East Sussex.
So do you want to have a chance of winning £100 worth of travel products? Enter our prize draw today!!
I personally think that mosquitoes are one of the most deadly killers on this planet! You may want to argue that fact with me if you’re faced with a tiger in the jungle though!
They are responsible for infecting humans with a multitude of nasty diseases, such as:
Malaria – Africa, South and Central America, Asia and the Middle East – bite in hours of darkness dusk to dawn
Yellow Fever – tropical areas of Africa, South America, Eastern Panama and Trinidad – bite daylight hours dawn to dusk
Japanese Encephalitis – South East and East Asia and the Pacific – bite in hours- of darkness dusk to dawn
Dengue Fever – Caribbean, South and Central America, Mexico, Africa, the Pacific Islands, SE Asia, Indian sub-continent, Hawaii,and Australia – bite in daylight hours dawn to dusk
Chikungunya – Africa, South-East Asia, the Indian sub-continent and the Philippines. Occasionally, the virus can be found in other countries where the mosquito that spreads Chikungunya can also be found – bite in daylight hours dawn to dusk
There are some other rather exotic sounding diseases that mosquitos can transmit; Zika virus, Rift Valley fever, Ross River fever, Filariasis and West Nile fever to mention but a few.
Tiny little blood suckers. Sometimes they can be difficult to spot, they can be as small as a poppy seed! After having a feed, adult ticks can swell up to the size of a small pea and become much lighter in colour.
They can infect you with Tick Bourne Encephalitis, Rocky Mountain Spotted fever, Lyme disease and Crimean-Congo Haemorrhagic Fever.
Ticks can’t jump or fly they normally hitch a lift and become attached to skin or clothing after brushing against bracken or long grass, they then wander off to warm moist areas of the body such as groins or armpits to have a meal.
Try to wear long trousers and tuck them into your socks, not an attractive look I know, but vital. Don’t forget to consider using insecticide spray to treat your clothes. Wear a hat in forested areas they can drop from trees.
Check your body regularly for ticks, have a ‘tick buddy’ who can check difficult to reach areas!
Carry a tick remover or fine tipped tweezers so that ticks can be safely and easily removed. You should always try to remove ticks as soon as possible. Get the tick remover or tweezers as close to the skin as possible, then slowly and firmly pull upwards until the tick releases your skin. Don’t twist or jerk the tick, this can cause the mouth-parts to break off and remain in the skin, which can lead to infection if left. If this happens, try to remove the mouth-parts with tweezers.
DON’T – crush or squeeze the tick’s body or hit with books or try to burn or freeze it, or use petroleum jelly or liquid solutions to suffocate the tick as this may shock the tick and prompt it to regurgitate saliva into the bite wound and spread infection.
After removing the tick, it’s a very good idea to wash your hands and the affected area with soap and water, then treat the bite area with an antiseptic.
Well, you’ve got Trypanosomiasis (African and American), Leishmaniasis, Onchocerciasis and Bartonellosis to worry about!
Only a few of these diseases can be prevented by medication or vaccination so really the only way of protecting yourself is by keeping your insect bites to a minimum.
Find out more about these diseases on Fit for Travel
Clothes are your best protection – normally only use repellents on remaining exposed areas of skin.Wear loose fitting, light coloured clothing. Mosquitos can bite through tight clothing. You can also treat clothes with permethrin spray (an insecticide that kills insects on contact) this should only be used on clothing NOT skin.
Insect repellent – DEET has been proven to be the most effective preparation in preventing mosquito bites, it is the repellent of choice in areas with diseases such chikungunya and dengue.
DEET has been used as an insect repellent for around 50 years and it is available in different concentrations.
50% concentration is recommended.
DEET can be used for children over the age of 2 months. For children, use clothing as the main barrier and repellent on any remaining exposed areas of skin.
If you are taking a baby under two months travelling to countries with risks of the above diseases get expert advice about suitable repellents.
It can be used in pregnancy and breast feeding women.
If you are using sunscreen, it is advised that repellent must be applied after sunscreen.
Remember to remove repellent with soap and water when it is no longer needed.
Do not spray directly onto faces, spray on hands first and then apply to face. Wash hands after applying to prevent contact with lips and eyes.
Never use on cuts, abrasions or irritated skin.
Always follow manufacturer’s instructions.
Alternative recommended insect repellents are those containing Picaridin 20% or Saltidin 12.5% and these can be used for children aged two years and older (NATHNAC)
Oil of lemon eucalyptus-based repellent is also available however this repellent only lasts as long as 15% DEET and so needs applying more frequently. Lemon eucalyptus essential oil is a different product and is not recommended as an insect repellent. (NATHNAC)
It is best to avoid sunscreen that is combined with repellent.
If you think that you or your children are reacting to an insect repellent, stop using it, wash treated skin and then seek advice from a doctor.
In your room or tent – Consider using plug-in or battery operated vaporisers that release an insecticide mist in your room.
Try to stay in accommodation that is air-conditioned, this usually reduces the number of insects in your room.
If you are visiting high risk malaria areas you should sleep under a mosquito net that has been treated with insecticide. The World Health Organisation (WHO) recommends this type of net. The insecticide used in these nets mean that a mosquito will be killed on contact if it lands on the net.
Don’t forget the daytime biters! Those that sleep during the day, particularly young children, or sick or older people, should also sleep under a net. Cot nets are available.
Check your net for holes before you use it. If you find a hole then this can be easily mended by either using a mosquito net repair kit or simply by using a needle and thread. Tape is useful to repair large tears.
Make sure you tuck your net under mattresses or ground sheets to stop the insects getting in to share your bed with you. So do ensure that you buy a big enough net. It would be sensible to buy an impregnated net in the UK and take it with you rather than relying upon what’s there, the nets at your holiday destination may not be of good quality, or treated with insecticide or they might even be invisible!
Check your window and door screens or shutters to make sure that there are no holes in them, holes will allow insects entry into your sleeping area. Remember to shut all screens and shutters before dusk and until dawn to avoid insect entry into rooms.
Also useful to prevent any unwanted guests making an appearance in the night, after all you don’t want to wake up to any surprises do you? Mosquito repellent coils can reduce insect bites by repelling and killing mosquitos, so they may be useful for some travellers, but they should only be used outdoors, not in your room.
There is no proof (scientific or otherwise) that bath oils, electronic “buzzers”, essential oils, garlic, homeopathic remedies, odour baited mosquito traps, tea tree oil, skin moisturisers, smoking, vitamin B tablets or yeast extract (Marmite®), prevent insect bites.
Citronella based repellents are not recommended, as they do not protect you for very long. (NATHNAC)
Have a great trip and don’t forget…night, night, sleep tight, don’t let the bed bugs bite!
References
http://www.fitfortravel.nhs.uk/advice/general-travel-health-advice/insect-bite-avoidance.aspx
http://www.nathnac.org/travel/misc/travellers_mos.htm
http://www.who.int/whr/1996/media_centre/executive_summary1/en/index9.html
https://www.lifesystems.co.uk/
http://www.careplus.eu/en/
They bite during daylight hours, breed in stagnant water and find us tasty.
These mosquitoes can be recognised by the white stripes around their legs, you’d have to catch one though to check!
They can also spread dengue and west Nile fever.
The name chikungunya comes from a word in the Makonde language (one of the native languages in Tanzania) that means ‘that which bends up’. This is due to the crippling joint pain caused by the virus (Public Health England – April 2014)
Map from CDC website
The incubation period can be 2-12 days, but is normally 3-7 days.
It normally starts with a sudden onset of fever and pain in the joints.
The joint pain is often very unbearable, but usually lasts for a few days or may persist for weeks.
Other common symptoms can include:
Often diagnosis can be confused with other viral illnesses such as dengue fever in areas where these infections also occur. Symptoms can vary in each individual from mild or non-existent to severe.
Most people make a full recovery, but in some cases, joint pain and arthritis may continue for several months or even years.
Occasionally eye, neurological and heart complications can occur, and gastrointestinal complaints.
Serious complications are uncommon, but in older people the disease can contribute to the cause of death.
Children may develop neurological symptoms such as seizures as a complication of the disease.
Chikungunya cannot be directly spread from person to person. When the mosquito feeds on the blood of a person infected with chikungunya, the virus enters and multiplies within the mosquito. After about 8 to 10 days, the mosquito can transmit the virus to another human by biting them, and can do this for the rest of its life.
If a person gets chikungunya abroad and becomes ill on their return to the UK, they can’t pass the infection onto anyone else. This is because the Aedes mosquito is not present in the UK, as the temperature is not consistently high enough for it to breed.
(Public Health England – April 2014)
There is no particular anti-viral treatment for chikungunya. Headache and fever symptoms can be treated symptomatically. Some people need to be admitted to hospital if their illness is severe or if complications arise.
Chikungunya can be diagnosed with a blood test.
There is no vaccine or drug to prevent chikungunya.
The only way to prevent chikungunya is to avoid mosquito bites by using insect repellents and wearing appropriate clothing. Aedes mosquitoes bite during the day particularly around dawn and dusk.
Clothes are your best protection – normally only use repellents on remaining exposed areas of skin.
Wear loose fitting, light coloured clothing. Mosquitos can bite through tight clothing.
You can also treat clothes with permethrin spray (an insecticide that kills insects on contact) this should only be used on clothing NOT skin.
Insect repellent – DEET has been proven to be the most effective preparation in preventing mosquito bites, it is the repellent of choice in areas with diseases such chikungunya and dengue.
DEET has been used as an insect repellent for around 50 years and it is available in different concentrations.
50% concentration is recommended.
DEET can be used for children over the age of 2 months. For children, use clothing as the main barrier and repellent only where necessary.
It can be used in pregnancy and breast feeding women.
If you are using sunscreen, it is advised that repellent must be applied after sunscreen.
Remember to remove repellent with soap and water when it is no longer needed.
Do not spray directly onto faces, spray on hands first and then apply to face. Wash hands after applying to prevent contact with lips and eyes.
Never use on cuts, abrasions or irritated skin.
Always follow manufacturer’s instructions.
Alternative recommended insect repellents are those containing Picaridin 20% and these can be used for children aged two years and older (NATHNAC)
Oil of lemon eucalyptus-based repellent is also available however this repellent only lasts as long as 15% DEET and so needs applying more frequently. Lemon eucalyptus essential oil is a different product and is not recommended as an insect repellent. (NATHNAC)
It is best to avoid sunscreen that is combined with repellent.
If you think that you or your children are reacting to an insect repellent, stop using it, wash treated skin and then seek advice from a doctor.
In your room – Consider using plug in vaporisers that release an insecticide mist in your room
Try to stay in accommodation that is air-conditioned, this usually reduces the number of insects in your room.
Those that sleep during the day, particularly young children, or sick or older people, should sleep under a mosquito net that has been treated with insecticide. The World Health Organisation (WHO) recommends this type of net. The insecticide used in these nets mean that a mosquito will be killed on contact if it lands on the net. Cot nets are available.
Carry a sewing kit and tape to repair any holes or tears.
There is no proof (scientific or otherwise) that bath oils, electronic “buzzers”, essential oils, garlic, homeopathic remedies, odour baited mosquito traps, tea tree oil, skin moisturisers, smoking, vitamin B tablets or yeast extract (Marmite®), prevent insect bites.
Citronella based repellents are not recommended, as they do not protect you for very long. (NATHNAC)
Further advice about insect bite prevention can be found on the following websites:
Come down and speak to one of our lovely team for advice.
January 2015
Reference/bibliography list:
Fit for Travel – http://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/chikungunya-fever.aspx
TRAVAX – http://www.travax.nhs.uk/diseases/non-vaccine-preventable/chikungunya.aspx
Gov.UK – Public Health England – https://www.gov.uk/chikungunya
WHO – http://www.who.int/mediacentre/factsheets/fs327/en/
Tuberculosis (TB) is a bacteria that can invade any part of the body but most commonly the lungs are affected.
There are 2 types of TB infection
1- Active TB – this can take months or years to develop.
2- Latent TB- has no symptoms and is not infectious to others .
However 10- 15 % of people with latent TB can go on to develop active TB in their lifetime.
Africa has the highest TB infection rate with more than 300 people per 100:000. The UK has a very low number of TB cases 13:100:000 (1)
TB is caught by inhaling the droplets that are spread by coughing sneezing and spitting. The risk of infection is highest in situations of close prolonged contact with infected persons.
The symptoms of TB include any of the following :
Although TB is a very serious condition it can be treated successfully with antibiotics.
There is a vaccine available to prevent TB called BCG but it is only effective in the under 16 – 35 year age group.There are no studies that prove effectiveness beyond age 35 years of age.
The UK BCG vaccination programme was discontinued in 2005 as a result of the continuing decline of TB infection in the UK indigenous population. The UK programme is now focused on targeting those babies and children most at risk of exposure to Tb( 4 )
Most travellers are considered to be at low risk of catching TB.
Risk of exposure increases in those travellers living and working in close contact with the local populations in high risk TB countries for prolonged periods of time ( > 3 months) and those working with TB infected persons. Travellers that have other health conditions that affect their immune system they could be more at risk of catching TB.
1. My child missed their BCG vaccination at school, why has it been stopped?
Rates of TB in the UK population have fallen to very low levels over the past 15 years. The BCG vaccination programme was changed to reflect this and is now only given to people in at-risk groups.
(http://www.nhs.uk/Conditions/vaccinations/Pages/bcg-tb-vaccine-questions-answers.aspx#teenagers)
2. I am travelling abroad and want the bcg vaccine but have been told I don’t meet the criteria?
The vaccine is recommended for those under 16 years who are going to live or work with local people for more than three months in a country where the annual incidence of TB is 40/100,000 or greater.
3. Can you catch TB on an aeroplane?
TB is a difficult disease to catch because it requires prolonged exposure to an infected person. For example, you are very unlikely to catch it by sitting or standing next to someone who is infected. The CDC and WHO have concluded that the risk of TB transmission on an aircraft does not appear to be greater than in other confined spaces.
(https://www.nathnac.org/pro/factsheets/TB.htm)
4. I had BCG vaccine as a child how long does it last? Do I need a booster?
Protection has been shown to last for 10 to 15 years (WHO, 1999). Although the protection afforded by BCG vaccine may wane with time, there is no evidence that repeat vaccination offers significant additional protection and repeat BCG vaccination is not recommended.
5. I am under age 35 and planning to work on an orphanage in Kenya for 3 months and am worried I may catch tb but have been told I can’t have the vaccine- Why?
BCG is not usually recommended for people aged over 16 years, unless the risk of exposure is great e.g. healthcare or laboratory workers at occupational risk. There is insufficient data on the protection afforded by BCG vaccine when it is given to adults – aged 16 years or over and virtually no data for persons aged 35 years or over.
http://www.nhs.uk/Conditions/Tuberculosis/Pages/Symptoms.aspx
6. I had BCG vaccine ages ago can I have a test to prove I am still immune?
There is no test to demonstrate immunity to Tuberculosis . Evidence of a previous BCG vaccination includes: documentary evidence; a clear, reliable history of vaccination; or evidence of a characteristic scar.
7. What happens if I do catch TB after travelling to a risk country?
You would be referred to a specialist for treatment. Treatment for tuberculosis (TB) depends on which type you have, although a long course of antibiotics is most often used.
8. How will I know if I have caught TB ? What are the symptoms ?
The symptoms of tuberculosis (TB) depend on where the infection occurs. TB usually develops slowly. Symptoms may include: persistent cough /breathlessness/lack of appetite and weight loss/ a high temperature / night sweats/extreme tiredness or fatigue. If you experience symptoms you should see your GP as soon as possible.
To book an appointment for a BCG vaccine please call 01273 749100 or 01903 254774 or book online
Shingles is a viral illness that can last anything from 1 to 4 weeks. The main symptoms are pain followed by an itchy, blistering rash. Any part of your body can be affected, including your eyes and your face, although the most common areas affected are the chest and abdomen, normally just on one side. Shingles typically starts with a headache, fever, and tiredness and you will probably feel unwell.
Approximately 90% of adults in the UK have had chicken pox, they are all at risk of developing shingles. After you have had chicken pox the virus travels up the nerve root and lies dormant (it goes to sleep for a bit). Shingles occurs, often years later, when the virus re-activates (wakes up again), and travels back up the nerve pathway. We don’t really know why it wakes up. It can occur at any age but tends to occur more often in people aged over 50 or people who have immune system conditions. It is thought about 1 in 4 of us will have shingles at least once in our lifetime, and some of us can get it more than once.
People who have not had chickenpox cannot get shingles.
You can’t catch shingles from someone with chicken pox, it is caused by your own dormant sleeping chicken pox virus reactivating or waking up.
You cannot catch shingles from each other, but you can catch chickenpox through direct contact with the shingles blisters if you haven’t had it before.
The pain accompanying shingles has been described as a constant burning, shooting or stabbing pain, it can be mild or severe. The area of affected skin is often very sensitive to touch. It is common for the pain to start a few days before you develop the rash and it can last for days, weeks or in some cases for months after the rash has gone.
Generally, most people recover from shingles but some people may go on to experience long-term nerve pain known as Post-herpetic Neuralgia (PHN), this can persist for many months, or for some people even years.
PHN is not very common in people under the age of 50. But about 1 in 4 people over 60 with shingles will have pain that lasts for more than a month.
The older you are, the more likely it is to happen.
No, there is no cure for shingles, but there is treatment available to help relieve the symptoms until it gets better. The earlier you see a doctor, the earlier treatment can start and this can help to reduce the severity of the symptoms and reduce the risk of complications developing. The seriousness of shingles will differ from person to person and can be really unpleasant for some people.
The shingles vaccination used in the UK is called ZOSTAVAX.
It contains a weakened form of the chickenpox virus that causes shingles. You cannot get shingles from the vaccine, it helps to build up your body’s immunity to the virus, so that the next time it re-activates in your body you will fight it off more easily. It can be given at any time of the year.
It will reduce your chances of developing shingles by more than a third. If you do go on to have shingles, the symptoms will be milder and will not last as long as they would have if you had not had the vaccination.
It is given as an injection into the upper arm. Lots of evidence shows that the new shingles vaccine is very safe. All medicines are tested to assess their safety and effectiveness before they are allowed to be used. Once they have been issued with a licensed for use, their safety continues to be monitored. It is already in use in several countries, including the America and Canada, and no safety concerns have been raised.
Side effects are usually quite minor and don’t last very long. Approximately 1 in 10 people get symptoms that may include headaches or flu-like symptoms. You may get some redness or tenderness where the injection was given. If your symptoms last for more than a few days or you get a rash at the site of the injection you should see your GP.
You should not have the shingles vaccine if you:
Yes, the shingles vaccine works very well in people who have had shingles before and it will boost your immunity against further shingles attacks.
However, it is recommended that you wait for one year after having a shingles attack before having the vaccination. The natural boosting that occurs following an episode of shingles makes the benefit of having the shingles vaccine immediately following recovery limited. If you have had two or more episodes of shingles in one year should see your GP and have immunological investigation prior to vaccination, your GP may need to refer you to a specialist for this.
The shingles vaccine is a live immunisation. If you require other live vaccinations such as Measles, Mumps & Rubella (MMR), Varicella (Chicken Pox) Yellow Fever or a TB vaccine (BCG) then the shingles vaccination must be given either on the same day or separated by 4 weeks. All other vaccines can be given at the same time as the shingles vaccine, it’s an ideal time to get your flu vaccine too!
No, the shingles vaccine is only licensed for use in those aged 50 years and older.
The shingles vaccine should not be given to people currently receiving oral or intravenous antiviral medications such as Acyclovir or within 48 hours after stopping this treatment. This is because the therapy may reduce the response to the vaccine.
If you need to start taking antiviral medications these should not be started within two weeks after receiving the shingles vaccine as this may also reduce the effectiveness of the vaccine.
If you are just using topical antiviral agents such as acyclovir cream you can have the shingles vaccine.
Sussex Travel Clinic – Zostavax vaccination costs £190
One dose – no booster required
http://www.immunisationscotland.org.uk/vaccines-and-diseases/shingles.aspx
http://www.shinglesaware.co.uk/
http://www.nhs.uk/Conditions/vaccinations/Pages/shingles-vaccine-questions-and-answers.aspx
http://www.nhs.uk/Conditions/Shingles/Pages/Introduction.aspx
http://www.shinglessupport.org/
https://www.gov.uk/government/publications/shingles-herpes-zoster-the-green-book-chapter-28a
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