Travel Health


Introduction

Want to avoid that trip where the sight-seeing mainly involves the toilet and wash basin? Did you know you there is a vaccine (taken as a drink) that will reduce your risk of Traveller's tummy? Want to know more about travel health - then this page is for you.

Following the example of the BBC, I apply this caveat: The article is a general guide and does not replace the advice of a medical practitioner or pharmacist. Neither I nor this website are liable for the contents of any external internet sites listed.

I'm sure no one reading this will be travel abroad without health insurance, but have a look at the article on travel insurance. It identifies gotchas and points to check in Insurance policies. For EU/UK residents it also covers the free EHIC, and UK arrangements with non-EEA countries for medical treatment.


Immunisations/Vaccinations:

Our favourite sites for information:

Our Travel Research Tools enable you to access both US CDC and UK NHS health, vaccination, and malaria advice for any country.

mdtravelhealth.com Its information, by country, is well laid out, it is easy to see what vaccinations are appropriate, there are clear sections on what precautions you should take during your visit. It is USA based and claims to be updated daily, it is linked from the NHS website so I guess it has a good reputation.

NaTHNaC created by the UK NHS for health professionals has comprehensive information and advice by country.

Timescale:

Consider immunisation months before your travel, some vaccines or courses have to be started well in advance of your holiday.

Where do I get my vaccinations?

I'm a US resident:

CDC's find a clinic page.

I'm a UK resident:

Your Doctor's Surgery. They will probably be provided by a practice nurse who will also have access to information on what vaccinations you will require. But ensure the nurse has not missed any that you have identified from the above sources. Discuss it, there may be valid reasons for exclusion, or you may have valid reasons for inclusion.

Private Travel Clinic - The NHS website implies that you may have to use a private travel clinic for some of the vaccines. However, I had no problems obtaining the whole A to Z (well Cholera to Yellow Fever anyway) through my NHS Doctor. Depending on the number and type of vaccinations, you may have to make a number of trips to the surgery.

Will I have to pay?

NHS Doctors Surgery: some vaccines are free others are charged (in 2005 I paid £25 for Hep B; £35 for Yellow Fever & £110 for 3 rabies injections).

Private Clinics - £50 per injection?



Protection against Travellers' diarrhoea aka Delhi Belly:

picture of toilet roll

Also see Travelers Tummy - prevention & treatment.
Dukoral is a vaccine that you take as a drink in a 2 dose course (it cost me £35 in 2005). It is licensed in the UK as a Cholera vaccine, but studies show that it also provides protection against the commonest form of Travellers diarrhoea caused by enterotoxigenic E coli, and in other parts of the world it is licensed for this purpose.

During my gap year I mainly stayed in hostels so I often ate what and where the "locals" ate. I never suffered from stomach bugs whereas some of the travelling companions I met up with were ill despite being very careful with what they ate. I can't say whether this was merely luck on my part or because of the Dukoral vaccine.

Due to its UK license I guess the Doctor/Nurse will only be prepared to provide this vaccine if you are travelling to a country where there may be a risk of Cholera. All vaccines have potential risks and side-effects; you should discuss this at your doctors surgery. As a non-medic I didn't see anything that frightened me when I googled Dukoral.

If you have taken Dukoral, it does not mean you can relax on food or water hygiene - it is not 100% effective against Cholera let alone other tummy bugs.



Malaria

"Approximately 1,500 travellers return to the UK with malaria every year. In 2008, there were 1,370 cases of malaria reported and six deaths in the UK ... Most UK travellers who catch malaria either do not take any malaria tablets or do not take the right tablets for the part of the world they visit." (from NHS website)

Is the area I'm visiting affected, and what Antimalarial tablets should I take?

First I will also use another caveat from one of my Lonely Planet guidebooks "You must get expert advice as to whether your trip actually puts you at risk".

Malaria is gaining resistance to the antimalarials throughout the world; so one "brand" of tablet may provide protection in one country (or even one part of a country) but not another.

FitForTravel and www.mdtravelhealth.com both provide details of areas affected within a country and suitable tablets. It is worth visiting both sites, as one may provide more detail than the other for a particular country; and recent news on malaria drug resistance may be identified on one site before the other.

Malaria tablets have drawbacks, you may have to obtain and start taking them a few weeks before you visit an affected area, you have to remember to take them during and after your trip. The biggest drawbacks are the side effects; see NHS malaria prevention page. You should contact your doctor to discuss which tablets you can tolerate.

Antimalarials do not provide 100% protection so you must also take measures to prevent being bitten.

Where to buy antimalarials (UK only):

Some antimalarial drugs can be very expensive, and you may need to obtain a private subscription from your Doctor. Don't forget you will need enough tablets to cover the pre and post holiday parts of the antimalarial course. There can be big differences in prices so shop around.

In 2010 my father found that Superdrug and Tesco pharmacies were the cheapest for Malarone, and his local chemist agreed to price match. Best Internet prices were only slightly cheaper.

There is a risk of purchasing counterfeit or substandard drugs over the internet. The UK General Pharmaceutical Council (GPhC) has a logo scheme to help the public to identify legitimate pharmacies. Web-sites may fake this logo, but as it includes the pharmacy's registration number you can verify it at the GPhC site. If you are buying online, visit the GPhC via your own link (not one given on the "pharmacy's" website) and go back to the Pharmacy via the web address listed on the GPhC site to avoid being tricked into using an illegitimate site with a similar web address.


Bite Prevention:

You may have chosen not to take antimalarials because the area you are visiting is classified as "minimal risk". Minimal does not mean zero risk, and sites such as traveldoctor.co.uk advise that you still take precautions to prevent mosquito bites.

Short of wearing a space suit you can never be confident you won't be bitten, but you can minimize the chances.

The internet has many articles on avoiding bites; your guidebook may also have a section on malaria. Health and Travel sites advise the use of insect repellents containing DEET. It can be used on children aged over 2 months with caution: see this NHS page. It covers bite prevention and includes a box on the safety of DEET products and their usage. See also mdtravelhealth.com which has a useful section on insect and tick protection for applicable countries.


last updated 16 May 2011 | Author Andy W+