Vaccinations

You need up to date advice about the country you are travelling to. The requirements for immunisations can change and vary from country to country.

You should leave enough time as it can take some time for the vaccination courses to be completed and be effective. However, it is important to seek advice even if you have left everything to the last minute.

You cannot get travel vaccines free on the NHS.

Anti-malarial drugs

Over 2000 people a year in the UK get infected with malaria whilst abroad. Malaria is caused by a parasite that is transmitted by female mosquitoes when they bite you. There are four species of malaria, of which Plasmodium falciparum is the most dangerous and can lead to cerebral malaria and death.

Malaria usually starts as a fever and feels like having flu.
Other symptoms may include
• diarrhoea,
• headache
• cough
• aching muscles
• tummy ache
• weakness or lethargy
• vomiting
You generally feel very unwell. In a malarial area, an illness with fever should be considered to be malaria unless proved otherwise, and medical help should be sought straight away. REMEMBER the time it takes for your symptoms to develop depends on the type of parasite the mosquito was carrying. Symptoms can take up to 3 months and even up to a year to develop.

You need to carefully check whether the areas you plan to travel are malarial. This needs to be discussed with the travel nurse. The nurse will either recommend anti-malarial tablets, which can be bought from the pharmacy or medication that has to be prescribed by a doctor. Please do as advised so that you have the full protection.

These tablets need to be started before you go and continued for one month after. It is still possible to get malaria when taking the medication, but it is much more common in those who don’t.

It is also important to try and prevent being bitten. Your chances of getting malaria are increased with the number of bites you receive. Mosquitos that transmit malaria bite mainly at night, but this can be any time from dusk onwards.

Use, but don’t rely on
1. Insect repellents containing at least 35%DEEY
2. Wear long, loose, light coloured clothing
3. Take a mosquito net impregnated with permethrin to sleep under.
4. Avoid camping near stagnant water
5. Electric insecticide vaporisers.
6. If your room is not air conditioned but screened make sure shutters are closed from early evening and spray the room with insect repellent.

Malaria Hotspots

Malaria Foundation International

Malaria Prevention Guidelines

Health insurance

Make sure your take out adequate health insurance to cover where you are going, what you are planning to do and for an adequate length of time. We would advise you to make sure it includes adequate medical cover that includes emergency assistance. If appropriate care isn’t available locally you may need to be evacuated or repatriated. Your insurance policy needs to cover this high cost service.

The most common risks to travellers are theft and road traffic accidents, but anyone can unexpectedly fall ill.

Take copies of your travel insurance documents and passport. Leave a copy in the UK as well.

If you are travelling to a European Union country, you can obtain a European Health Insurance Card that entitles you to reduced or free treatment.

First aid kits

It is advisable to travel with a basic first aid kit.

If you are travelling to areas where medical facilities cannot be relied on you may wish to carry a more extensive emergency medical kit, which contains, syringes, needles and stitches. These can be brought from pharmacies and travel clinics. Provided your kit is well packaged and labelled, you should not have a problem at customs.

Over the counter medications
• Pain killers (in blister packs to keep out moisture)
• Anti-diarrhoea tablets
• Water purification tablets
• Insect repellent creams
• Antihistamines

Antibiotics – if you are travelling to remote areas you may wish to discuss with your GP about antibiotics you could take with you. The GP can explain their appropriate use.

NOMAD online travel shop including sterile medical kits
http://www.nomadtravel.co.uk/

Personal health – taking medicines abroad

Remember to adequate supplies of prescription medicines, and if you are away for a long period how to obtain them abroad. You may need a letter from your GP. If you need to take your medication on the airplane a letter will be important for customs. You will need to check with the airline about current restrictions.

For some medicines there are restrictions on the amount you are allowed to take from one country to another. You may need to check with the relevant embassies.

Also remember to take medications for conditions that may flare up occasionally e.g. eczema.

If you have to take medicines at certain times of the day e.g. insulin or the contraceptive pill seek advice before you travel.

Are you worried what to do about periods whilst you are away?

For short trips it is possible to delay an unwanted period either by taking an oral progesterone tablet whilst you are away (please discuss with your practice nurse or GP), or by taking your combined oral contraceptive pill packets without a break i.e. starting the second packet straight after the first. This is called ‘back–to--backing’ the pill. You would then have your normal seven day break at the end of the second packet. This is not possible with biphasic or triphasic pills, see below.

For longer trips there are other options.
• Again you could ‘back – to – back’ the combined oral contraceptive pill. This could be done for up to 3 months in a row. So you would be having 4 periods a year rather than 12. You may find that you start to bleed in the third packet. You cannot do this with certain of the pills called biphasic or triphasic pills, e.g. Binovum, Trinovum, Trinordiol, Logynon
• Depot – Provera, a long acting contraceptive injection. Your periods can often stop with this form of medication. We would suggest if you were interested to try it out well in advance of travel as a few women can bleed irregularly. The injection lasts for 3 months.
• The progesterone only pills. Again a useful side effect of this type of medication can be that your periods cease. However, some women bleed erratically which may be a problem. These types of pills have to be taken within 3 hours each day, except one called Cerazette which has a 12 hour window. There is a long acting form of Cerazette, called Implanon, which is inserted as a small rod under the skin in the upper arm.
• Mirena IntraUterine System IUS – this is a ‘coil’ which is inserted into the uterus. Again in a lot of women it can stop the periods.

We would suggest you make an appointment with the practice nurse or doctor to discuss these options to see which one would suit you best. Please leave enough time to try your method of choice before you travel.

Remember to have a dental check before you go!