Being well prepared before you travel will ensure that you minimise the risk of preventable ill health whilst abroad. Exposure to these risks will depend on where you are travelling, how long you are travelling for and your living conditions. If you are going away and are unsure of what precautions you should be taking, or whether you require vaccinations, please call and book an appointment with one of our GPs who will be happy to provide you with all the necessary information.
Below you will find advice on how to deal with the most common problems you are likely to encounter, how best to prepare yourself for travel and how to ensure you return home in good health.
The advice is of necessity quite general and applies to healthy adults. Children’s needs can differ so please seek advice from one of our GPs.
Make sure you are up to date with all necessary immunisations. All of these can be done at The Harley Street General Practice, with the rare exception. Ideally, you should book in to see one of our GPs as soon as you know you are travelling to see what is needed and plan a timetable for vaccination. But most can be administered on the day.
Some vaccinations need several weeks to be fully active or a course of injections may be required. A good source of independent travel advice telling you likely vaccination requirement on the web is www.fitfortravel.scot.nhs.uk.
We are also a registered Yellow Fever Vaccination Centre and so are able to administer this vaccine and give a mandatory certificate which is required for entry into some countries.
Malaria is widespread in tropical and sub-tropical areas of the world and is spread by the bite of an infected mosquito. Infection produces fever and, in some cases, complications affecting the kidneys, liver, brain and blood. Malaria can be fatal. Precautions should be taken if you are going to visit, travel through, or even just stop over in a malarial country.
Avoidance of mosquito bites is the single most important preventive measure, particularly with increasing resistance of the disease to drug treatment. This can be simply achieved by taking the following precautions:
Malaria Prevention tablets are vital in some areas where the above measures, although still essential, are unlikely to give adequate protection on their own. Our GPs will advise you if anti-malarial tablets are required for where you are travelling to (i.e.in high-risk areas) and if so, which ones are recommended. Some are prescription only.
Even if you have taken the most appropriate tablets none of these anti-malarial precautions can give absolute protection. So if you develop influenza-like symptoms, especially associated with shivering/shaking attacks (rigors) while abroad, or even within a year of returning from a malarial area or after discontinuing prophylaxis, you should seek medical attention urgently. You should tell the GP of your recent travel to a malarial area.
Long haul flights of more than 5 hours time difference result in appreciable jet lag characterised by various symptoms including fatigue and inability to sleep at the new night time, headache, irritability, loss of concentration and gastrointestinal problems (indigestion, loss of appetite and bowel irregularities). The body will take longer to adjust if the flight is eastwards rather than westwards and adjustment is slowed by lack of sleep during the actual journey, the stress of travelling and alcohol. It is clear that work performances after arrival can be affected and since it may take 5 days to fully adjust, any measures that will help prevent jet lag are worthwhile.
Exposure to sun leads not only to premature ageing of the skin, but also increases the risk of melanoma and other skin cancers. This risk is greater in those who are fair skinned or on certain medications such as diuretics or tetracycline antibiotics commonly used to treat acne. Sunscreen preparations containing agents protecting against the harmful effects of both UVA and UVB irradiation should be used at all times. Eye protection is advised by wearing sunglasses with UV light filters to reduce the long term risk of cataract formation.
Two common problems associated with excessive sun are detailed below with advice on how to deal with them.
this is a common, intensely itchy rash that occurs in hot climates when the skin becomes red with small spots. The key to treatment is preventing sweating by reduced exertion, taking cool showers, dusting with talcum powder and wearing loose, cotton clothing. Calamine lotion and antihistamine tablets such as Clarityn or Zirtek, available over the counter at chemists, will help relieve the itching. If you are prone to this problem you are advised to commence treatment before arrival.
over exposure to the sun can cause redness, tenderness and blistering of the affected area of skin. Further exposure should be avoided until the symptoms have settled remembering that UV light can still cause damage by penetrating thin clothes, clouds, water and even shade. Cool showers, Calamine lotion and ‘after sun’ creams provide soothing relief. Avoid bursting blisters as this can lead to infection.
Wherever you are in the world you need to be careful what you eat and drink. Food and water can be contaminated in a variety of ways and this includes the water in swimming pools. Travellers’ diarrhoea, typhoid and hepatitis A can all be caught by eating contaminated food or water. Simple precautions to take include:
This is a very common and troublesome complaint. If the diarrhoea is accompanied by persistent vomiting, a high fever or the passage of blood in the stools then prompt medical advice should be sought. Otherwise, ensure that you remain well hydrated by drinking plenty of fluids and avoiding any dairy products. Anti-diarrhoeals such as Imodium are useful to reduce the frequency of diarrhoea in the short term, but if symptoms persist beyond 3-4 days, again seek medical advice. Research has shown that most cases of travellers’ diarrhoea responds to two doses of Ciprofloxacin 500mg taken at an interval of 12 hours. Your GP may be prepared to prescribe this if your trip is 'high risk' and there are no contra-indications to you taking this medication.
Any diarrhoeal illness will result in significant loss of body fluids, partly from the diarrhoea itself and partly from the tendency to stop eating and drinking. It is vital to prevent dehydration by taking frequent small drinks of mineral water or by using oral rehydration salts such as Dioralyte.
The prevalence of many sexually transmitted infections is greater in many parts of the world when compared to the UK. You should regard casual sexual relationships as risky and take great care to avoid the potential for acquiring infection. Condoms are an absolute necessity and whilst substantially reducing the risk of sexually transmitted infection, they do not offer complete protection.
Many people are concerned about their personal risk of a DVT which is a clotting of the blood in a deep vein of the lower leg. If this occurs it usually causes pain, redness and swelling in the affected calf. Medical attention should be sought immediately, especially after a long air flight or other journey. Sometimes a DVT can be fatal if the clot breaks off and makes its way to the lungs where it can then affect the lungs’ ability to take in oxygen.
You should always discuss any travel plans with your GP but you may find the following information helpful:
Flying itself is not harmful to your unborn child at any stage in pregnancy but please note that:
The most important aspect of malarial prophylactics is mosquito bite precautions. This area is covered in some detail elsewhere in this information leaflet.
Some vaccines can be given during pregnancy. The risk of contracting a serious illness must be weighed against the small, theoretical risk to the pregnancy of the vaccine. If you are planning to conceive, you should inform your GP prior to travel vaccinations.