On Monday 3/12/12 we received news that the recommendations for malaria tablets required for India has changed.

The main change in the new guidance is that it now is recommended that you take prescription only anti-malarials as first line to risk areas in India, as opposed to over-the-counter medication.

There is also a new malaria map indicating new areas where malaria tablets may be required.

The map can be accessed here:

http://www.fitfortravel.nhs.uk/destinations/asia-(east)/india/india-malaria-map.aspx

 

Frequently Asked Questions

What should I do if I am travelling to India soon?

If you are travelling to India soon, look at the malaria map and check to see if the region you are travelling to now requires malaria tablets. If you now require prescription only tablets please call the clinic on 01273 749100 or book online

I already have malaria tablets for my trip, what should I do?

If you are still in the UK and you have the over- the- counter medication Paludrine and Chloroquine then we would recommend that you change these to a prescription only medication such as Malarone, Doxycycline or Mefloquine before you depart for India.

I am in India at present, what should I do?

Please check the map and see if the regions you are travelling to are a high risk for malaria. If you are currently taking malaria tablets please check to see which ones you have been given. If you are taking Paludrine and Chloroquine continue taking these, but please be aware they may not be as protective as prescription only medications. You should practice strict insect bite avoidance- see below. If you look at the map and find you now require malaria tablets you may want to consult with a travel clinic in India. A list of travel clinics can be found on the International Society of Travel Medicine website – www.istm.org

I recently travelled to India and did not take anti-malarials, but it looks like I travelled to a risk area- what should I do?

Be vigilant for symptoms of malaria- If you feel UNWELL with symptoms which – include fever, cough, diarrhoea and flu like symptoms – SEEK URGENT MEDICAL ATTENTION. Malaria symptoms can present up to 1 year after visiting an area where malaria is present

 

Insect Bite Avoidance

• Use a DEET based insect repellent on any exposed skin. Wear day and night but be extra careful between dusk and dawn when the mosquitoes that spread malaria are more active.
• Sleep under a mosquito net that has long lasting Impregnation.
• If you have air – conditioning use it- mosquitoes do not like the cold air.
• Consider using a plug in mosquito repellent for your room or use a clothing spray on clothes for extra protection.
• Wear long sleeved clothing and trousers, especially of outdoors after sunset.

 

 

These are some common questions that we get asked in travel health consultations.

What is Hepatitis B?

Hepatitis B is a virus that is spread by blood and infects and damages the liver. It is the most common blood borne virus worldwide and is a major cause of chronic liver disease and liver cancer. The virus is 50-100 times more infectious than HIV. [1]

How can I catch Hepatitis B?

The virus is also present in other body fluids e.g. saliva, vaginal fluid and semen. The virus can get in through open wounds ,cuts, scratches and contaminated needles. The virus can survive outside the body for at least a week so surfaces contaminated with dried blood pose infection risk. [2]

Injecting drugs and sharing needles puts people at high risk of becoming infected, however, travel also puts people at risk if they are not vaccinated.

More than 12% of cases in the UK are thought to result from people travelling to and working in countries where there is increased risk of hepatitis b infection.  [3]

Travellers most at risk are those who suffer accidents that result in requiring medical treatments abroad where unsterile or re used equipment may be used. About 8% of travellers are sick enough to require medical treatment in developing countries.  [4]

Should I get a Hepatitis B Vaccine before travel?

The UK National Vaccination Programme does not vaccinate against Hepatitis B routinely, therefore, Hepatitis B vaccination should be considered for those travelling to developing countries .Those travellers at particular risk are those who are volunteering e.g. aid workers and those assisting with construction e.g. helping building schools. Travellers participating in school projects abroad will mix with potentially infected children in schools and may be accidently exposed to the virus e.g.  through contact sports injuries or maybe volunteering in orphanages with sick children .Other travellers that are at risk are those whose work people work abroad puts them at risk e.g. body guards/police/ and travellers who adopt risky behaviours such as unprotected sex.

Travellers with any chronic diseases are potentially going to need medical attention whilst travelling so should consider vaccination.

Hepatitis b vaccination is a course of 3 injections >There are two schedules that may be offered according to time left to the traveller before departure.

Schedule 1: Day 0 1st vaccine Day 7 2nd vaccine Day 21 3^rd vaccine

(This schedule requires a 4^th vaccine 1 year later)

Day 0 1^st vaccine 4 weeks later 2^nd vaccine 5 months later 3^rd vaccine

(This schedule requires a 4^th vaccine 5 years later)

Cost – £40 per dose.

To book a Hepatitis B vaccine please call 01273 749100 or book ONLINE

 

Hepatitis B vaccine does not protect you against other blood borne infections such as HIV and Hepatitis C. There are no vaccines available to prevent these infections. We recommend that you carry your own sterile needle kit for use in a medical emergency. These can be purchased in clinic or in our shop.

 

 

 

References

1. http://www.britishlivertrust.org.uk/home/the-liver/liver-diseases/hepatitis-b.aspx

2. http://www.britishlivertrust.org.uk/home/the-liver/liver-diseases/hepatitis-b.aspx

4. http://www.britishlivertrust.org.uk/home/the-liver/liver-diseases/hepatitis-b.aspx

4.  http://www.travmed.com/healthguide/ch1.htm

 

 

 

 

 

 

 

 

 

 

 

 

The Health Protection Agency (HPA) publish a weekly National Influenza Report which monitors the levels of flu activity in the UK. Current levels remain low, however, most cases peak between December and March, so there is still time to get a flu vaccine before influenza activity increases.

Influenza or ‘Flu’ is a respiratory illness caused by the influenza virus. Symptoms include: fever, a cough, aches and pains, headache and sore throat.  For most people flu is just a nasty illness, however, some people can develop more serious illnesses. Complications include: bronchitis and secondary bacterial pneumonia.

To book a flu jab please call 01273 749100 or book online

We can offer on site flu vaccination for companies with 10 or more staff. Please contact us to find out more.

 

 

Dengue fever in Madeira  (Portugal) 

A recent outbreak of Dengue fever has been reported from Maderia. A total is 52 laboratory confirmed  cases of dengue fever have been reported in Madeira since the outbreak began on  3 October [1].  It is believed that a further 404 probable cases have been reported. Forty patients  have required hospital treatment, no deaths have occurred. A total of cases of dengue have been  reported in European travellers who visited Madeira during late September and  early October .  The cases include travellers from France (2), Sweden (1)  and England (1). The case from England is recovering well at home.

Advice for Travellers

Dengue Fever is spread through mosquitoes that bite in daylight hours. Travellers should avoid mosquito bites.

• Use a 50% DEET based insect repellent on exposed skin.
• Wear long sleeved clothing and trousers.
• Use a clothing treatment spray.
• Consider sleeping under a mosquito net.

If you feel unwell with any of the following symptoms such as fever, severe  headache, muscle pain and a rash within 14 days of visiting Madeira you should seek medical advice.

There is no vaccine available to protect against dengue.

1. http://www.nathnac.org/pro/clinical_updates/denguemadeira_251012.htm

 

Sanofi Pasteur MSD has voluntarily recalled 16 batches of  Typhim Vi® typhoid vaccine due to concerns about the effectiveness of some of  the vaccines. These batches were distributed from 7 January 2011.

There is no safety concern regarding the recalled vaccines,  and revaccination is not recommended.

Typhoid is transmitted via contaminated food and water. No typhoid vaccine is 100% effective, therefore all travellers are advised to follow strict food and water hygiene advice.

Follow this guidance to reduce your risk of illness:

• Don’t drink or clean your teeth with tap water.
• Drink bottled or boiled water only. Check the seals of bottled water have not been tampered with.
•  Use chlorine water purification tablets as an alternative where boiling is not possible, as they kill most bacteria and viruses.
• Be careful what you eat. Foods that carry a higher risk of illness include: salad, raw fruit and vegatables, unpasteurised dairy products, reheated food, undercooked or raw shellfish, take aways and street food and food that has been allowed to sit around at room temperature.
• Carry an alcohol hand gel to use if you can not wash your hands.

If you feel unwell on your return from a trip to a typhoid risk area, be alert to symptoms of typhoid and see your doctor immediately if you feel ill with any of the following symptoms:

Typhoid can be a mild, flu-like illness. Most people get a fever and a headache.

Symptoms appear about a week after you have eaten or drunk something contaminated with the bacteria and include:

• A rose coloured body rash.

• Chills and muscle aches.

• Stomach pain with constipation or diarrhoea.

• Loss of appetite

• Sickness

If you feel unwell after a trip abroad please contact your GP or call NHS Direct on 0845 4647

Should I have another typhoid vaccine?

There is currently a UK shortage of injectable typhoid vaccine so re-vaccination is not recommended. If you are a frequent traveller to high risk areas you may want to have the oral typhoid vaccine which is currently still available. It is taken in tablet form over 5 days and costs £30 per dose. Supplies will be limited and re-vaccination is not recommended if you are not at risk of typhoid exposure.

To book a typhoid vaccine please call 01273 749100.
Please note due to the large number of people affected by this vaccine recall Sussex Travel Clinic is unable to answer calls regarding the above information.

We will shortly be contacting anyone who has been given the recalled typhoid vaccine in our clinic by email or letter with further advice.

If you require further information please visit the HPA website.

 

Are you on Facebook and Twitter ?

If the answer is yes, then start following us….

We regularly update our Facebook page with news from the Foreign and Commonwealth Office (FCO) keeping you up to date and informed about worldwide events that may occur when you are on your travels.

Sussex Travel Clinic will be running some exciting competitions over the coming months and will post details on their pages.

Not only will you benefit from updates, but you can also post and share your pictures from your travels round the world on our facebook page.

We love to hear your news and stay in touch.

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Today is World Rabies Day – 28 September 2012

World Rabies Day is an initiative of the Global Alliance  for Rabies Control  set up with the aim to raise awareness about the impact of human  and animal rabies.

55,000 people worldwide die from rabies every year, most cases are in Africa and Asia. Rabies is spread through the bite, scratch or lick on broken skin, from an infected wild or domestic animal. The most  important source of rabies throughout the world is uncontrolled rabies in dogs, with children at particular risk of exposure.

The inaugural World Rabies Day was held in 2007, and  continues annually with events being held in 150 countries. A total of 182  million people have been educated and 7.7 million dogs have been vaccinated  against rabies as a result.

Advice for Travellers

• If you are travelling to a rabies risk area you should avoid contact with any wild or domestic animals, including bats.
•  Pre – exposure Rabies vaccination should be given to adults and children at increased risk of  rabies including those who are travelling to remote areas where medical care  and post-exposure prophylaxis with rabies vaccine and rabies immunogloblin may not be available.
• You should seek urgent medical advice if you receive a potential rabies exposure when travelling in a rabies risk country.

To find out more and watch videos about Rabies, symptoms and prevention visit the World Rabies Day site.

To book a rabies vaccine please call 01273 749100.

 

 

 

TYPHOID VACCINE

Our supplier Sanofi Pasteur has informed us that currently they are out of stock of injectable typhoid vaccine and will be until January 2013. Sussex Travel Clinic is offering the Oral Typhoid Vaccine Vivotif as an alternative during this time.

Vivotif is taken on day 0, day 2, and day 5. Cost – £30 per course.

Vivotif is a live vaccine but can be given with other live vaccines and does not need to be separated by 4 weeks like other live vaccines do.

RABIES VACCINE

Both UK suppliers of rabies vaccine Novartis and Sanofi Pasteur are  currently out of stock of rabies vaccine and normal supplies will not start until November 2012.

Sussex Travel Clinic have made the decision to administer rabies vaccine intraderamally(ID) to ensure our rabies supply lasts through the shortage period.

ID Rabies is given on day 0, 7 and 21 or 28.

Please note: Rabies vaccine administered by ID technique should only be administered by those trained in ID technique. All nurses at Sussex Travel Clinic are trained to give ID injections.

FLU VACCINATIONS

Sussex Travel Clinic now has flu vaccines in stock for those not eligible for an NHS flu vaccine. Cost £18

We also offer an onsite flu vaccine service for businesses with 10 or more employees.

To Book please call 01273 749100 or use our ONLINE booking via our website.

Sussex Travel Clinic stocks a wide range of mosquito nets and insect repellents. If you are travelling to an area where malaria is present you should sleep under an impregnated mosquito net. The World Health Organisation (WHO) recommends that your net should be impregnated with long lasting impregnation. These nets protect you from mosquito bites by killing the mosquito on contact and the impregnation lasts for 2 years or over, making them ideal for long trips.

We stock a wide range of nets to suit all needs. If you are planning a camping trip then the pop up dome mosquito net would be ideal. The net simply pops up and down and is lightweight and easily transported if you are travelling around. Our best selling mosquito net for backpackers is the Lifesystems Ultra Net- this compact net is lightweight and includes a hanging kit.

Our range of insect repellents include everything from DEET 50+ and DEET 100+, to natural repellents such as Alfresco. If you are travelling to an area where malaria is present it is recommended that you use an insect repellent with DEET in it. The higher the concentrate of DEET, the longer the repellent will last on your skin.

Tips to avoid insect bites

• Sleep under an impregnated mosquito net
• Wear insect repellent on any exposed skin
• Wear loose fitting and long clothing
• If you have air conditioning – switch it on- mosquitoes do not like the cold air
• Use a clothing treatment spray for extra protection
• Use a plug- in mosquito repellent in your room

To purchase a mosquito net or insect repellent simply pop into clinic during our opening hours or buy ONLINE