TRAVEL
VACCINATIONS
TRAVEL
VACCINATIONS
American Centre for Disease Control
Depart of Health's travel page
In the case of serious illness it is probably preferable to return as soon as possible. This may well be covered on your travel or medical insurance policy. For those travelling in Europe, reciprocal medical care may be obtained by completing an El II, and returning it to the Post Office before travel.
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Travel Immunisations all immunisations are now available from the surgery.
It is recommended that you see the Practice Nurse at least 3 months before travel for advice and discussion about which vaccines you will require.
These may include some of the following:
Tetanus Polio
Typhoid Yellow fever
Hepatitis A Hepatitis B
Meningitis A&C Rabies
TRAVEL POINTS
LEG THROMBOSIS (DVT’S) Thrombosis is the term used to describe a blood clot, which forms in situ in the blood vessels which in the case of flying can be occur in the calf or pelvic veins. These thrombosis, once formed can travel rapidly up the blood vessels and impact in the pulmonary blood vessels of the lungs and if large enough can prove fatal , ranging from hours to 10 days later. Calf vein thrombosis can be suspected by the presence of a swollen painful cal, although many go un noticed.
Thrombosis can occur to anyone , although those most at risk , are those women on the pill, smokers , the obese , and those in a post operative state .
Flights over 4 hours are considered a particular risk.
Prevention 1. Avoid excess alcohol, hydrate well with plenty of non alcoholic drinks
2. Try to keep the legs moving with exercises , and on long flights , take short walks around the plane.
3. Class 1 compression stockings . In the Lancet Vol 357 12th May 2001. 10 % of patient's developed symptomless DVTs without stockings and oppossed to non with wearing stockings .
4. Aspirin . Aspirin inhibits platelet aggretion , a may reduce DVT's , but it would be required to be taken at least 7 days before a flight to be effective .
5. Avoid crossing your legs for prolonged periods .
6. Patients with a strong family history of DVTs or those with a previous flight induced DVT should have a blood screen ( thrombophilia screen) . If a defect detects an increase risk of clotting these patients will benefit from using heparin before the flight.
SUB-AQUA DIVERS should avoid diving 24 hours prior to flying due to the increase in the bends.
DRINKING WATER should ideally be bought in sealed bottles, boiled, treated with filters or the addition of iodine (4 drops at 2% per litre of water). This water should also be used for cleaning teeth. Avoid ice in drinks.
FRUIT and RAW VEGETABLES should be washed with sterilised water or eaten at one's discretion.
ULTRA VIOLET LIGHT PROTECTION. Excessive sun exposure increases the risk of premature skin ageing, skin cancer and cataracts. Therefore avoid excessive sun exposure arid consider sun blocks in extreme heat. a single episode of moderate sun burning in a child carries an increased lifetime risk of future skin cancer.
SEXUAL DISEASES. A disproportionate number of sexually transmitted diseases are contracted abroad (80% of the total cases of heterosexual aids contacts). Therefore avoid casual sex or use a condom.
ACCIDENTS account for the majority of ill-health and death whilst abroad. Therefore, care should
be taken in embarking on any adventurous sport without first checking the equipment thoroughly.
KITS containing sterile sutures, syringes, needles and dressings are obtainable from the practice nurse in travel packs for about £ 12. (price may vary)
DIARRHOEA WHILE ABROAD
Most forms of diarrhoea whilst abroad are simply as a result of different spicy foods or different bowel bacteria and will frequently settle within 48 hours without treatment. Minor episodes of diarrhoea are caused by contaminated water or undercooked meat and shellfish, which should be avoided.
The mainstay of treatment is rehydration with fluids, non-fizzy coke with added salt provides good balance. Similarly, coconut juice direct from the coconut is an ideal balance or alternatively dehydration mixtures obtained before travel, either Dioralyte or Rehidrat can be used.
Stomach cramps and diarrhoea are best relieved with Imodium capsules, which should be used until after the diarrhoea stops.
The presence of blood, mucus, often with a fever, represents dysentery normally Shigella or salmonella bacteria. The antibiotic Ciproxin will reduce the duration of dysentery, but is normal1y best taken after a stool analysis. In the Tropics amoebic dysentery, and for Nepal travellers Giardia, which produces an eggy breath, require metronidazole, which can often be bought over the counter In all cases, if the diarrhoea persists, it is best to get samples cultured either abroad or on return to your GP.
MALARIA PROPHYLAXIS
Further details are available from the Malaria Advice Line 0906 5508908
There has been a steady increase in malaria infections following the return of travellers from South East Asia and Africa in the last few years, despite taking anti-malaria prophylaxis. It is essential that anyone going to malaria areas takes the appropriate prophylaxis for one week before arid continuing for four weeks after. This is not prevention against malaria. It is also important to reduce mosquito contacts. At night burning coils and mosquito nets, preferably impregnated with insecticide, provide useful protection. Nevertheless any fever within a year of returning from the malaria area requires assessment from a doctor to exclude malaria.
Mefloquine probably is the best antimalarial medication in high risk areas e.g. Sub Saharan Africa. it can cause anxiety and therefore although recommended first line treatment it should always be tried for a few weeks before travel to assess whether or not it suits you as there are alternatives . A new alternative Malorone has far less potential psychiatric side-effects and only need to be started 3 days prior to travel and continued to 1 week after . It is however much more expensive.
USEFUL MEDICINES TO TAKE ABROAD
Topical antifungals DAKTARIN and CANESTEN for vaginal thrush.
Topical antibiotics AUREOMYCIN or BACTROBAN CREAM.
Water purification IODINE 2% SOLUTION.
Anti-diarrhoea preparations IMODIUM 2 caps initially followed by I after each loose motion.
Antibiotics AMOXICLLLIN for respiratory and superficial infections
METRONIDAZOLE for tropical parasitic gut infections.
(These may be prescribed by your doctor if he deems it necessary).
