Medical Information
As a retired GP I take the medical planning of my holidays very seriously and it is very important to be well protected when you go on holiday especially if you are going off the beaten track.
My old general practice offers a full range of holiday vaccinations as well as being a Yellow Fever centre but I am aware that not all practices offer this and you may need to go to a travel clinic to obtain your vaccines or anti-malarial medications. To find your nearest one just type travel clinic near me into google. The National Travel Health Network and Centre (NaTHNaC) is an excellent site for travel advice. We used it at the surgery for our travel advice. It is easy to use and helps you plan what things you will need for your trip.
Vaccinations
Standard childhood UK vaccines like tetanus are covered by the NHS as are Hepatitis A and typhoid vaccines. I would recommend that you are up to date with your standard UK vaccines such as diptheria, tetanus, polio. Hepatitis A and typhoid are good vaccines to have for almost any holiday destination outside Europe or North America but consult the NaTHNaC website for specific advice on a destination.
All other vaccines are not covered by the NHS and you will need to pay a fee for these.
The need for extra vaccinations tends to depend on how far off the beaten track you are going, any risk you may be open to if you are working abroad and how much cover you want to have for your trip. The extra commonly administered vaccines for various locations around the world are
Cholera – may be available on the NHS in certain circumstances
Rabies
Meningitis
Japanese Encephalitis
Tick Born Encephalitis
The NHS website on these vaccines is helpful
Yellow Fever
Yellow Fever vaccination is mandatory for some countries in Africa and Central/South America. If you are visiting a country where it is mandatory you will need to show your International Yellow Fever Certificate to enter the country. One vaccine in most cases gives lifelong immunity.
The vaccine is only administered in specialist Yellow Fever Centres. For your nearest clinic click on the link below
Yellow Fever is a live vaccine and has a number of important contraindications and possible adverse effects. One of the main issues is that the risk of complications becomes much more common over the age of 60. The worst adverse reactions to the vaccine can be very serious and in some cases fatal and therefore it is important to take this into consideration if you are booking a holiday where Yellow Fever Vaccination is mandatory, you are over 60 and have not had the vaccine. In some circumstances it is possible to obtain a medical exemption certificate if the vaccine is contraindicated or if it is felt that the risk of the vaccine is greater than the risk of contracting yellow fever. For more information click on the button below
In addition to using a local yellow fever centre if you have complex needs e.g immune suppression or aged over 60 to get the best advice another option is to use the travel clinic at the Hospital for Tropical Diseases in London.
Anti-Malarial Medication
Anti-malarials are also not available on the NHS. They can be bought from your GP surgery, from a travel clinic or online if you know what you want. There are lots of online providers who all offer a similar service. However Superdrug have a clear and easily navigable website with a clear pricing outline on the final page and I now tend to use them.
They will take you through a medical questionnaire to check you have no contraindications to the medicine that you are requesting. It is easy to look up what anti-malarial medication you may need from the NaTHNaC site
The Standard anti-malarials are
Malarone daily tablet – only need to start 1-2 days before entering malarial area. Need to be continued for one week after leaving malarial area
Proguanil & Chloroquine – Proguanil taken every day and chloroquine once a week. Well established and well tolerated treatment. Need to start one week before entering malarial area and continue for four weeks after leaving malarial area
Mefloquine- once a week tablet. Effective but some people experience feeling of depression on this medication and it is not advised for people who have suffered with mental health problems. It is sometimes recommended to start it two to three weeks before entering malarial area to make sure you are not experiencing side effects. Continue for four weeks after leaving malarial area
Doxycyline – Effective and well established treatment. Will usually be the cheapest option. Can cause nausea in some people so it should be swallowed with plenty of water and taken with food. Need to start it 1-2 days before entering malarial area and continue for four weeks after leaving malarial area
Medications
If you are on regular medication make sure you remember to pack sufficient quantities for your trip.
Other medications to consider taking are paracetamol or ibuprofen for pain/anti-inflammatory. Electrolyte sachets (like Dioralyte) as fluid replacement in cases of diarrhoea.
Insect Repellents
There are a large number on the market. However many of the products sold are not very effective. In reality there are only 4 truly effective insect repellants.
DEET – historically there were some question marks about its safety however there have now been a host of studies that have found no adverse effects from using DEET
Picaridin
IR3535
PMD (oil of Lemon Eucalyptus) this is a good choice if you want to use a natural product and it is an effective insect repellant.
Therefore if you are buying an insect repellant make sure it has one of these 4 ingredients in it
Deep Vein Thrombosis Prevention
Flights or journeys by road longer than 4 hours may increase your risk of developing a blood clot in your legs (known as a DVT or Deep Vein Thrombosis) which can be a serious medical condition. This is especially true if you are pregnant, on the contraceptive pill or on HRT. Age is also a factor and as a GP I always recommended to anyone over 50 that they should wear support flight stockings if they have a flight longer than 4 hours. These can be bought from a chemist or online. You can reduce the risk further on the flight by drinking plenty of fluids, avoiding alcohol and moving around and stretching your legs when possible.
Safe Travelling
You need to start planning your medical arrangements for travel as soon as possible. Immunisations tend to be given about four weeks prior to travel.
Most illnesses which people get on holiday are not prevented by immunisation. Drink safe water, avoid ice in drinks, avoid over exposure to sun and insect bite prevention are all very important measures to avoid illness.
If you become ill when travelling especially with a fever do not delay in seeking medical help locally. The local doctors will be expert at treating local health problems and delay in treating conditions like Malaria or complications of a DVT can be fatal.
The NaTHNaC has an excellent section on safe travelling