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VACCINE PREVENTABLE DISEASES

First of all, it is important to remember that no vaccine is 100% effective in everyone.  For this reason you need to take other precautions to avoid exposure to disease, such as taking care with food and water, avoiding animals and not using un-sterile medical equipment.

You may wish to contact MASTA (Medical Advisory Services for Travellers Abroad). For £3.99 you can obtain a personal travel schedule for every country on your trip, which will advise you about: recommended vaccinations, up to date alerts and warnings for each country including any disease outbreaks, and tailored travel advice for your trip. Bringing this report to your first travel consultation here will save a lot of time.

AVIAN FLU

Take a look at our Avian Flu page for more information.

CHOLERA

A serious bacterial disease, mainly water-borne, with a high mortality rate if untreated.  It causes profuse watery diarrhoea and death can occur rapidly due to dehydration.  Cholera epidemics are most common in refugee camps or disaster zones.  Relief or disaster aid workers should consider requesting the vaccine.

DIPHTHERIA 

A bacterial disease spread by droplets and contact with articles from infected people.  It causes a disease affecting your respiratory system.  Check you have had your childhood vaccinations, and if it is more than 10 years since your last vaccination, you can have a combined polio, diphtheria and tetanus vaccine booster.

HEPATITIS A

A viral infection spread through contaminated food or water.  It is highly contagious and is the most common vaccine-preventable disease in travellers.  Symptoms include fever, nausea, vomiting, dark-coloured urine and jaundice.  A single dose of vaccine followed by a booster 6 to 12 months later will give you an estimated 25 years protection. You can reduce your risk by following the advice in the drinking water and food sections above.

HEPATITIS B, C 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)

    • Sexual contact (this will also put you at risk of other STDs)

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, 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

Hepatitis B is one hundred times more infectious than HIV, and is a leading cause of liver cancer.  Even if you are vaccinated, take precautions to avoid exposure to the virus.  Consider taking a sterile medical pack with you in case of emergencies.

JAPANESE B ENCEPHALITIS

A mosquito-borne viral disease found in rural areas of South-East Asia and the Far East, especially where rice growing and pig farming co-exist.  The risk of infection is greatest during and just after the rainy season.  Most cases of the disease go unnoticed but about 1 in 250 cases becomes clinically apparent and in these individuals the disease can lead to severe encephalitis with permanent brain damage or even death. The Japanese B encephalitis vaccine is a course of three injections given over 4 weeks. There is a charge for this vaccine.

MENINGITIS

Meningitis ACWY is a vaccine against 4 strains of the meningococcal bacterium found in Africa and some parts of Asia, especially India.  Meningococcal infection can affect your brain (meningitis) or your blood (septicaemia) or both.  The vaccine is particularly recommended for those travelling on public transport or living in crowded conditions or working closely with the local population.  A vaccination certificate is required for all travellers to the Hajj or for the Umrah.  A single dose of vaccine provides 3-5 years protection.

POLIO 

A viral disease caused by on of three serotypes of polio virus.  If infected, meningitis or paralysis may occur.  Some countries, especially in West Africa, now have outbreaks of polio following a cessation of the vaccination programme in Nigeria.  Check you have had your childhood vaccinations, and if it is more than 10 years since your last vaccination, you can have a combined polio, diphtheria and tetanus vaccine booster.

RABIES

Rabies is present in many parts of the world. If a person develops rabies death is 100% certain. There are 40,000 deaths worldwide every year from Rabies. Do not be complacent - do not touch any animal, particularly; dogs, cats, monkeys, bats. If you are travelling to remote areas, it is particularly important that you consider have the rabies vaccine before you travel.

WHAT TO DO IF YOU ARE SCRATCHED OR BITTEN BY A MAMMAL IN A COUNTRY WHERE RABIES IS PRESENT



    • Vigorously clean wound with soap and running water for 10 minutes

    • Encourage the wound to bleed a little

      • Apply tincture of aqueous iodine solution if you have any, or 40% alcohol or stronger (e.g. whisky)

      • Obtain information about the animal concerned

      • SEEK MEDICAL HELP IMMEDIATELY (AT THE LATEST WITHIN 24 HOURS OF INJURY). If you have not been vaccinated you will probably require 5 injections plus an injection of rabies immunoglobulin. If you have been vaccinated you may still require 2 further injections within 48 hours

      • Do not allow the wound to be stitched unless absolutely necessary

      • It is vital that you complete the appropriate course of post-exposure treatment offered

      • Please report the incident back to De Montfort Surgery on your return to the UK

    An article in the British Medical Journal in September 2005 reported the case of a British woman who travelled to India. Whilst there she was bitten by a puppy, leaving a slight graze. She had not been vaccinated against Rabies, but thought nothing more about it and did not seek medical help. Three and a half months after returning to the UK she was admitted to hospital with severe shooting pains in her lower back and left leg. She was diagnosed with rabies and died after eighteen days in hospital. There is a charge for this vaccine.

    TETANUS

    A disease caused by the toxin of a bacterium present in soil or manure which may enter the body through a wound, burn or scratch.  The disease leads to muscle stiffness which usually involves the jaw (lockjaw) and can cause death.  If it is more than 10 years since your last tetanus vaccination, you can have a combined polio, diphtheria and tetanus vaccine booster

    TICK-BORNE ENCEPHALITIS

    As the name suggests, is spread by ticks.  However, it can also be acquired by consuming unpasteurised dairy products from infected animals, especially goats.  It is a viral disease which occurs mostly in the summer months in forested areas of Central and Eastern Europe and Scandinavia.  In most cases, the infection has no symptoms.  In the 10% of people where symptoms develop they usually have a flu-like illness with severe headache, joint stiffness and confusion.  These symptoms usually resolve, but in 10% of these cases a second phase of fever occurs which leads to encephalitis and may result in paralysis, seizures or death.

    Avoid contact with ticks by wearing long trousers, avoid long grass and undergrowth if possible and use insect repellent containing at least 50% DEET.  Only 1-2% of ticks are likely to be carrying the virus, but if you find any ticks attached to your skin (check armpits, groin and navel regularly) remove them by grasping with tweezers or fingers, holding as close to your skin as possible, and pull gently and consistently until the tick comes away. If the mouth parts remain stuck in your skin, remove them as soon as possible.

    Vaccination is recommended if you will be spending long periods in infected areas or if you will be camping or working in forests, especially during the summer.  The tick-borne encephalitis vaccine is a course of 3 injections given over 3 weeks.  If you decide to have this vaccine you will need a private prescription from the doctor.

    TUBERCULOSIS (TB)

    A bacterial disease spread through cough and sneeze droplets.  Although it may affect any part of the body, most commonly it affects the lungs.  It occurs in many parts of the world and you can acquire the disease through close contact with an infected person, such as living in the same household.  The BCG vaccine is not believed to give very good protection against TB so if you have a persistent cough when you return (or during your trip if you are travelling for some time) seek medical attention.

    TYPHOID FEVER

    A bacterial disease spread through contaminated food and water and can cause serious disease, the symptoms of which start with diarrhoea and vomiting.  The fatality rate is as high as 20% in untreated cases (1% with prompt antibiotic therapy).  In endemic areas, take care with your food and water even if you have been vaccinated.  A single dose of vaccine lasts for 3 years. You can reduce your risk by following the advice in the drinking water and food sections above.

    YELLOW FEVER 

    A virus carried by the Aedes mosquito, which bite during the day.  It is a serious and sometimes fatal disease which occurs in many parts of sub-Saharan Africa and Central and South America.  Some countries will not let you enter without a valid International Certificate of Vaccination.  You must be vaccinated at least 10 days before travel and there is a charge for this vaccine. There is a cost of £50 to be given this vaccine if you are a patient of the surgery and £75 if you are not registered.

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