Going abroad is very common these days that it is often easy to forget the precautions necessary. You will need to complete and return a Travel Risk Assessment Form at least 6-8 weeks before travel. (Failure to do so may result in us being unable to assist you with your NHS Travel Vaccinations and you may be asked to attend a Private Travel Clinic for all your Travel Vaccinations). Unfortunately, if you give us less than 3 weeks’ notice, we will not be able to assist you, and you will have to attend a Travel Clinic. Our Nursing Team will review your Travel Form, and they will advise you of vaccinations that are needed and what medications, if any, you also need.
Please Note: The NHS Prescribing authority does not allow us to supply you with more than three months’ supply of your usual medication) there may be a charge for some travel medication. Make sure you have adequate medical insurance. If you are visiting an EU country you will need form E111. These can be obtained from a post office.
Take these simple precautions to make sure your holiday isn’t one to remember for the wrong reasons.
- Carry a small first aid kit.
- Maintain essential personal hygiene.
- Many diseases are insect borne and rabies is widespread. Beware of bites from insects and animals.
- Use sun creams often. Remember and observe the power of the sun.
- Sexually transmitted diseases (AIDS included) are a major health threat throughout the world. Condoms offer some protection.
- If you are advised by your doctor to take anti-malarial tablets, do not forget that you need to start taking them one week before travel and continue for four weeks after you return. (Please refer to our list of charges for travel injections, vaccines and medication.)
First Aid Kits
- Aspirin (soluable) 300mg. (not for those with asthma or a history of stomach ulcers.
- Paracetamol Mixture (Disprol or Calpol) good for pain and reduces fever.
- Cough Linctus (pholcodine) for dry coughs.
- Friar Balsam or menthol crystals for steam.
- Antiseptic solution for cleaning grazes and cuts.
- Soothing lotion (Calamine) for chicken pox, sunburn or insect bites
- Thermometer – for children, Feverscan forehead thermometers are quick for children.
- Cotton wool for cleaning grazes and cuts.
Travel Clinic General Information
Travel Clinic is held at Hartfield Surgery
Are you planning a trip abroad and seeking travel health advice?
Hartfield Surgery offers a travel clinic service which is run by our Practice Nurses. You need to complete and return your Travel Risk Assessment form at least 6-8 weeks before travel. (Failure to do so may result in us being unable to assist you with your NHS Travel Vaccinations and you may be asked to attend a Private Travel Clinic for all your Travel Vaccinations) Unfortunately, if you give us less than 3 weeks’ notice, we will not be able to assist you, and you will have to attend a Travel Clinic.
When you have returned your completed travel form, it will be reviewed by our Nursing Team , you will then be contacted by the Surgery to arrange a travel appointment at Hartfield. Our Nursing Team will advise you what vaccinations are required and what medications, if any, you also need. We can assess your risks, the recommended vaccines, any necessary malaria tablets (if you are travelling to a malarious region) and the advice most appropriate to your needs.
Under the services a GP provides for travel there is an obligation to give vaccines to provide protection against hepatitis A, typhoid, tetanus, polio and diphtheria, and travel advice free of charge. However, any other vaccines which may be required are not free on the NHS and cannot be given by our surgery.
Please note we are not a Yellow Fever Centre but do hold details of local centres, the nearest being in Crowborough at Saxonbury House Surgery , please telephone 01892 603131.
Please collect a form from the surgery, complete and return it. If you have computer access, we would also ask you to go to www.fitfortravel.nhs.uk and look up the destination you are travelling to, print off the information, read it and bring it to your appointment.
Travel Clinic Leaflet
This leaflet is designed to remind you of some of the information the travel health adviser gave you when you visited for your travel appointment. PLEASE READ IT. The information will help you to stay healthy on your trip.
Diseases can be caught from drinking contaminated water, or swimming in it. Unless you know the water supply is safe where you are staying, only use (in order of preference).
- Boiled water
- Bottled water with the seal intact or canned drinks
- Water treated by a sterilising agent.
- This includes ice cubes in drinks and water for cleaning your teeth
It is safer to swim in water that is well chlorinated. If you are travelling to Africa, South America or some parts of the Caribbean, avoid swimming in fresh water lakes and streams. You can catch a parasitic disease called schistosomiasis from such places. This disease is also known as Bilharzia. It is wise never to go barefoot, but to wear protective footwear when out, even on the beach. Other diseases can be caught from sand and soil, particularly wet soil.
Contaminated food is the commonest source of many diseases abroad. You can help prevent it by following these guidelines:
- ONLY EAT WELL COOKED FRESH FOOD
- AVOID LEFTOVERS and REHEATED FOODS
- ENSURE MEAT IS THOROUGHLY COOKED
- EAT COOKED VEGETABLES, AVOID SALADS
- ONLY EAT FRUIT YOU CAN PEEL
- NEVER DRINK UNPASTEURISED MILK
- AVOID ICE-CREAM and SHELLFISH
- IN GENERAL, AVOID BUYING FOOD FROM STREET VENDOR STALLS
Another source of calories is alcohol! If you drink to excess, alcohol could lead you to become carefree and ignore these precautions.
Two phrases to help you remember;
“COOK IT, PEEL IT, OR LEAVE IT.”
“WHEN IN DOUBT, LEAVE IT OUT”
Many diseases are transmitted by what is known as the route. To help prevent this, always wash your hands with soap and clean water after going to the toilet, before eating and before handling food. Using a hand gel is another sensible option.
This is the most common illness that you will be exposed to abroad and there is no vaccine against it at present. Travellers’ diarrhoea is caused by eating and/or drinking food and water contaminated by bacteria, viruses or parasites. The risk of illness is higher in some countries than others. High risk areas include North Africa, sub-Saharan Africa, the Indian Subcontinent, S.E. Asia, South America, Mexico and the Middle East.
Medium risk areas include the northern Mediterranean, Canary Islands and the Caribbean Islands. Low risk areas include North America, Western Europe and Australia. You can certainly help prevent diarrhoea in the way you behave – make sure you follow the food, water and personal hygiene guidelines already given.
Travellers diarrhoea is said to occur when you pass 3 or more loose stools in a 24 hour period often accompanied by stomach pain, cramps and vomiting. It usually lasts 2-4 days and whilst it is not a life threatening illness, it can disrupt your trip for several days. The main danger is if dehydration occurs during the illness, and this, if very severe, can be life threatening if it is not treated. Treatment is therefore REHYDRATION. In severe cases and particularly in young children and the elderly, commercially prepared rehydration solution is extremely useful. This can be bought in tablet or sachet form from a chemist shop e.g. DIORALYTE; or ELECTROLADE;. (Dioralyte Relief; is a formula containing rice powder which also helps to relieve the diarrhoea, particularly useful in children). Prepare all products according to instructions, taking care regarding their use in very small children and seeking medical advice where necessary).
Anti diarrhoeal tablets can be used for adults but should never be used in children under 4 years of age, and only on prescription for children aged 4 to 12 years. Commonly used tablets are Imodium, Lomotil; or Normaloe;. None of these tablets should ever be used if the person has a temperature or blood in the stool.
DO SEEK MEDICAL HELP IF THE AFFECTED PERSON HAS:-
- A temperature
- Blood in the diarrhoea
- Diarrhoea for more than 48 hours (or 24 hours in children)
- Becomes confused
(Please note, a woman taking the oral contraceptive pill may not have full contraceptive protection if she has had diarrhoea and vomiting. Extra precautions must be used – refer to your; information leaflet. If using condoms, use products which are CE approved
Hepatitis B and HIV Infection
These diseases can be transmitted by:
- Blood transfusion
- Medical procedures with non sterile equipment
- Sharing of needles (e.g. tattooing, body piercing, acupuncture and drug abuse
- Unprotected sexual contact
Ways to protect yourself:
- Only accept a blood transfusion when essential. If travelling to a developing country, take a sterile medical kit
- Avoid procedures e.g. ear or body piercing, tattooing and acupuncture
- Avoid casual sex, especially without using condoms
- Remember – excessive alcohol can make you carefree and lead you to take risks you otherwise would not consider
Mosquitoes, certain types of flies, ticks and bugs can cause different diseases. e.g. malaria, dengue fever, yellow fever. Some bite at night, but some during daytime, so protection is needed at all times.
AVOID BEING BITTEN BY
- Covering up skin as much as possible if going out at night, (mosquitoes that transmit malaria bite from dusk until dawn). Wear loose fitting clothes, long sleeves, trousers or long skirts and socks
- Use insect repellents on exposed skin. (DEET containing products are the most effective. A content of up to 50% DEET is recommended for tropical destinations.) Clothes can be sprayed with repellents too or clothing specific sprays. Check suitability for children on the individual products. If using sunscreen always apply first followed by an insect repellent spray on top. If room is not air conditioned, but screened, close shutters early evening and spray room with knockdown insecticide spray. In malarious regions, if camping, or sleeping in unprotected accommodation, always sleep under a mosquito net (impregnated with permethrin). Avoid camping near areas of stagnant water, these are common breeding areas for mosquitoes etc
- Electric insecticide vaporisers are very effective as long as there are no power failures. There is no scientific evidence that electric buzzers, savoury yeast extract, tea tree oil, bath oils, garlic and vitamin B are effective
If you are travelling to a malarious country, the travel health adviser will have given you a separate leaflet with more details, please read it. REMEMBER, malaria is a serious and sometimes fatal disease. If you develop flu like symptoms, including fever, sweats and chills, feeling unwell, headaches, muscle pains, cough, diarrhoea, then seek medical advice immediately for advice and also mention where you’ve been abroad, this is vital, don’t delay.
Rabies is present in many parts of the world. If a person develops rabies, death is 100% certain. There are 3 RULES REGARDING RABIES.
- Do not touch any animal, even dogs and cats.
- If you are licked on broken skin, scratched or bitten in a country which has rabies, wash the wound or area thoroughly with soap and running water for a minimum of 5 minutes then apply an antiseptic solution if possible e.g. iodine or alcohol. Such precautions also apply if you are licked by an animal with their saliva coming into contact with your eyes or inside of your mouth (essentially any mucous membranes)
- Seek medical advice IMMEDIATELY, even if you have been previously immunised, this is essential
Major leading causes of death in travellers are due to swimming and traffic accidents. You can help prevent them by taking notice of the following PRECAUTIONARY GUIDELINES.
- Avoid alcohol and food before swimming
- Never dive into water where the depth is uncertain
- Only swim in safe water, check currents, sharks, jellyfish etc
- Avoid alcohol when driving, especially at night
- Avoid hiring motorcycles and mopeds
- If hiring a car, rent a large one if possible, ensure the tyres, brakes and seat belts are in good condition
- Use reliable taxi firms
- Know where emergency facilities are
Take out adequate insurance cover for your trip. This should possibly include medical repatriation as without it, this service if needed is extremely expensive. If you have any pre existing medical conditions, make sure you inform the insurance company of these details and check the small print of the policy thoroughly. If you travel to a European Union country, make sure you have obtained an EHIC card before you travel which takes some time to obtain. Further information about the EHIC is found at www.nhs.uk/NHSEngland/Healthcareabroad and to make an application go to http://www.ehic.org.uk
Please note additional travel insurance is still advised.
It is sensible on any long haul flight to be comfortable in your seat.
Exercise your legs, feet and toes while sitting every half an hour or so and take short walks whenever feasible. Upper body and breathing exercises can further improve circulation.
Drink plenty of water and be sensible about alcohol intake which in excess leads to dehydration.
Further information can be obtained from the websites detailed at the end of this leaflet with more specific advice and information on travel-related deep vein thrombosis.
Sun and Heat
Sunburn and heat-stroke cause serious problems in travellers, but in the long term can be a serious cause of skin cancer. Long term damage to the skin due to sun exposure can lead to skin cancer. There is no such thing as a safe suntan but the following advice should be taken
- Increase sun exposure gradually, 20 minutes limit initially
- Use sun blocks which contains both UVA and UVB protection and sufficient sun protection factor (SPF) and a minimum of SPF 15. Children under 3 years should have a minimum SPF 25 and babies under 6 months should be kept out of the sun at all times. Reapply often and always after swimming and washing. Read manufacturer instructions
- Always apply sunscreen first followed by an insect repellent spray on top. Wear protective clothing; sunhats, T shirts and sunglasses etc. Avoid going out between 11am – 3pm, when the suns rays are strongest
- Take special care of children and those with pale skin/red hair
- Drink extra fluids in a hot climate
- Be aware that alcohol can make you dehydrated
Interesting web site addresses and further information:
Scottish NHS public travel health site
National Travel Health Network and Centre
Foreign and Commonwealth Office
Malaria for the general public
World Health Organisation
Original work by Jane Chiodini © Updated November 2010
Travel Information – Specialist Organisations
All of the following specialist organisations have frequently asked questions (FAQs) on travel, or have leaflets, which may be downloaded or requested.
020 7786 4900
British Lung Foundation
020 7688 555
British Heart Foundation
020 7935 0185
020 8765 7200
Association of British Insurers
0845 120 2960
The Royal Society for Disability and Rehabilitation (RADAR)
020 7250 3222