London Travel Clinic

Meningitis B

What is it?

Meningitis B is a highly aggressive strain of bacterial meningitis that infects the protective membranes surrounding the brain and spinal cord. It can be very serious and needs to be treated as a medical emergency. If the infection is left untreated, it can cause severe brain damage and blood poisoning (septicaemia). In some cases meningitis can be fatal.
 
A new vaccine Bexsero had been licensed in the UK, for those aged 2 months and over, to offer protection against Meningitis B. Bexsero is thought to provide 73% protection against meningitis B, which should significantly reduce the number of cases of meningitis.
 

How common is meningitis B?

The charity Meningitis UK estimates that there are 1,870 cases of meningitis B each year in the UK.
 
Meningococcal infection can occur at any age, but around half of cases are in those under 5 years of age, particularly infants less than 1 year.
 
The second main age group is between 15-19 years of age (around 1 in 4 teenagers carry the bacteria).
 
The bacteria, Neisseria meningitidis, normally lives in the back of the throat and nose and around 1 in 10 people carry the bacteria without having the disease. The bacteria is spread through sneezing, coughing and kissing.
 
The "B" strain of meningococcal meningitis accounts for the majority of cases of meningitis in the UK & Europe, and the majority of deaths. Until now, it has not been possible to develop a vaccine and BEXSERO represents a significant step forward.
 

What do we know about the vaccine?

Bexsero is the recently developed vaccine against meningococcus group B, which has now been approved by the Joint Committee on Vaccinations and Immunisations and is licensed for use in the UK.
 
The vaccine is effective against around 88% of the UK circulating strains of meningococcus group B and 78% of the European circulating strains.
 
The vaccine can be administered to infants aged two months or older either by itself, or in combination with other childhood vaccines.
 
The vaccine has been tested in clinical trials involving more than 8,000 people.
 
In infants, it was found to have similar levels of safety and tolerability to other routine childhood vaccines. The most commonly reported side effects were:
 
  • redness and swelling at the site of the injection
  • irritability
  • fever

Vaccine Schedule

Dosage
Vaccination requires a course of two to three doses depending on age.
 
2 – 6 months of age it is a three dose schedule.
 
From 6 months, it is a 2 dose schedule with a further dose within 1-2 years depending on age.
 
All doses are given one month apart for adults and children over 11, and a longer gap between doses in younger children. Younger children may also need a booster dose, though the need for this in adults has not yet been established.
 
Infants Aged 2 months – 5 months
Three doses – First dose given at 2 months of age, 2nd dose not less than 1 month later, 3rd dose not less than 1 month later
Booster- 1 dose between 12 and 23 months of age.
 
Infants Aged 6 months – 11 months
Two doses – 1st dose, 2nd dose not less than 2 months later.
Booster- 1 dose in the second year of life with an interval of at least 2 months between the primary series and booster dose.
 
Infants Aged 12 months – 23 months
Two doses – 1st dose, 2nd dose not less than 2 months later.
Booster- 1 dose with an interval of 12 months to 23 months between the primary series and booster dose.
 
Children Aged 2 – 10 years
Two doses – 1st dose, 2nd dose not less than 2 months later.
Booster- Need for booster doses not yet established.
 
Adolescents (from 11 years of age) and adults
Two doses -1st dose, 2nd dose not less than 1 months later.
Booster- Need for booster doses not yet established.


Categories: All Diseases


Lassa Fever

Disease Fact File

Summary

Lassa fever is present in West Africa. It is a haemorrhagic fever that is spread through rat excrement. Human to human cases have been reported, but these have been confined to areas of very poor sanitation. The risk to travellers is restricted to those staying in areas of very poor sanitation, or those nursing infected patients.


Categories: All Diseases


Malaria

Disease Fact File

Summary

Infected mosquitoes spread malaria. The species that spreads malaria tend to bite between dusk and dawn.

Distribution and Transmission

Malaria is a disease that affects Africa, South and Central America, Asia and the Middle East. Because mosquitoes prefer humid conditions and need fresh water to breed there is often a seasonal increase noted, particularly in those areas that experience heavy rainfall.

Prevention

Prevention of mosquito bites is the first stage of defence. This includes wearing long sleeve shirts and trousers, using a good mosquito repellent, using mosquito nets while sleeping and being especially careful at dawn and dusk. Malaria tablets are also recommended - there are several different prevention medications that are recommended depending on the countries which you travelling through. Please feel free to contact us so we can work out exactly what you need for your travels - should you require prescription tablets we are able to organise this for you.

Signs and Symptoms

The incubation period ranges from 2 weeks - 35 days. The disease presents itself with a range of symptoms that may include:

Fever
Headache and muscle pain
Malaise (tiredness)
Rigors (shivering) and extreme sweating
Diarrhoea, abdominal pain
Dry cough
Jaundice
Anaemia

Emergency Treatment

If you develop a fever while travelling or having returned from your trip it is essential to seek medical advice. Emergency treatment should be carried if you are travelling to remote areas where medical facilities are unavailable.

 

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Categories: All Diseases


Lyme Disease

Disease Fact File

Distribution and Transmission

Lyme disease is transmitted by tick bites. The ticks live on a range of small animals like rodents and birds and larger animals such as deer and dogs.

It is present in Europe (particularly through Scandinavia) and North America (particularly the eastern coast).

Signs and Symptoms

Following an infected bite a rash can occur and spread. This happens 2-6 weeks after the initial bite. Long term symptoms can include neurological (nerve) problems, meningitis, arthritis and dementia.

Recommendation for Travellers

Avoid Tick bites and seek medical treatment especially if you are in a risk area.

Treatment

Antibiotics can be used to treat the illness.


Categories: All Diseases


Varicella (Chicken Pox)

What is it?

The Varicella vaccine protects against chickenpox. It is not a routinely offered vaccination, but some healthcare workers, such as nurses and doctors, need protection if they are working with people vulnerable to infection. 

Vaccine Schedule

Two doses 4 weeks apart
 
Booster – not required after a 2 dose course.

 
Note: Varicella vaccine is a live immunisation. If you require other live vaccinations such as Measles, Mumps & Rubella (MMR), Shingles vaccine (Zostavax), Yellow Fever or a TB vaccine (BCG) then Varicella vaccine must be given on the same day or separated by 4 weeks.
 
For further disease and country recommendations information visit:
 


Categories: All Diseases


Tick Borne Encephalitis

What is it?

Tick-borne encephalitis (TBE) is spread by tick bites. It is a serious infection of the brain and is present in many countries worldwide.
 
Wild animals, particularly rodents, are the main hosts of TBE virus (TBEV) and maintain a reservoir of infection from which ticks act as vectors to humans.
 
Transmission occurs mainly from late spring 'till early autumn in forested/rural areas. 
 
Vaccination is advised for those in risk areas unable to avoid tick bites such as campers, forestry workers and ramblers.
 
There are three main subtypes of tick-borne encephalitis that are found in the following locations:
 
  • European - Western Europe to Russia
  • Siberian - Urals, Siberia, far-Eastern Russia, Finland
  • Far Eastern - far-Eastern Russia, China and Japan 
There are an estimated 10,000 cases annually in Russia and 3,000 in Europe, though the true number of incidents probably exceeds this by an substantial amount.
 
TBE is an emerging disease - incidence has risen dramatically in last 4 decades and is spreading to new areas particularly in Europe.
 
For a list of countries and maps please visit Tick Alert.

Vaccine Schedule

3 years to adult 
 
Standard schedule - 3 doses – day 0, 1-3 months later and 5- 12 months after the second dose.
 
Rapid Schedule - 3 doses - day 0, 14 days later and 5-12 months after the second dose.

Note: If someone is considered to be at high-risk, then medication can be given from 18 months following thorough risk assessment.

Booster – every 3 years after a primary course as above. then every 3 - 5 years if at continuing risk.

Cost Per Dose
£70.00

Avoiding Ticks

Ticks normally become attached to skin or clothing after brushing against bracken or long grass and then migrate to warm moist areas of the body such as groins or axillae to feed.  To avoid this apply an effective insect repellent to skin. DEET insect repellent is recommended.
 
Avoid unnecessary exposure in infested areas. Keep to paths.
 
Clothing should cover the legs with socks outside trousers. Insect repellents can be used to impregnate exposed clothing such as trousers and socks DEET products are recommended. 
 
Avoid untreated/ pasteurised dairy products in countries where TBE is present.
 
Carry a tick remover so ticks can be safely and easily removed as soon as possible.
 
We have a good supply of insect repellents, clothing spray and tick removers in our clinic 

For information on tick-borne encephalitis and country recommendations information visit:
 


Categories: All Diseases


Polio

  
Vaccination Info

Validity - 10 Years          

  
Disease Fact File   

Summary

Polio is predominantly contracted through contaminated food and water, although acute infections may be passed on through the nasopharyngeal droplets.

Distribution and Transmission

Polio has impacted significantly on developing countries resulting in many people being crippled. Effective vaccination has virtually eradicated the disease, with the exception of Asian and African developing countries.

Prevention

It is recommended that travellers to countries endemic with polio vaccinate themselves against polio

Signs and Symptoms

The illness has an incubation period of 7-14 days. With 90% of cases there are no symptoms - sometimes resulting in lifetime immunity. A mild flu like illness with a fever presents in 8% of cases, and the remaining 2% of cases, symptoms include paralysis, bladder dysfunction, impaired swallowing, breathing and speech (bulbar poliomyelitis) which may be fatal.


Categories: All Diseases


MMR (Measles, Mumps and Rubella combined)

What is it?

Measles, mumps and rubella (MMR) viruses are transmitted through airborne droplets spread from the respiratory tract of an infective person. Inhalation of droplets from an infected person, caused by sneezing, coughing or spitting will cause the spread of infection.
 
Occasionally, transmission can occur through the direct contact of throat or nasal secretions of an infected person through kissing or nasal secretions. Measles is one of the most highly communicable infectious diseases. Mainly affects children aged approximately 5 years of age.
 
The virus is found worldwide, but is slowly diminishing in developed countries due to the MMR vaccine.
 

Vaccine Schedule

Two doses – Day 0 and Day 28
 
 
Booster – not required after a 2 dose course.
 
Note: MMR is a live vaccine. If you require other live vaccinations such as Varicella (Chicken Pox) Shingles vaccine (Zostavax) or a TB vaccine (BCG) then the MMR vaccine must be given on the same day or separated by 4 weeks.
 
MMR and Yellow Fever vaccine should not be given on the same day, where possible, but given 4 weeks apart. Where immediate protection is required, the vaccines should be given at any interval. If you are travelling imminently then the nurses will be able to offer specific advice.
 
For further disease and country recommendations information visit:


Categories: All Diseases


Influenza - Flu Vaccine

What is it?

Influenza (flu) is most common in winter and is a viral infection that may have serious complications, particularly in some vulnerable groups of people. The Flu vaccine is updated yearly to offer protection against the most common seasonal risk as identified by the World Health Organisation.
 
The Flu vaccine is inactivated and therefore cannot give you Flu!
 
Vaccination should be considered for those at risk of serious disease or travellers who can be at risk during the winter months, particularly if travelling in large groups or in crowded conditions such as cruise ships and pilgrimages.
 
We offer both individual and corporate Flu immunisation services. To find out more, or book an appointment, please contact us.
 

Vaccine Schedule

 
6months – adult 
1 dose
 
Booster – every year
 

For further disease and country recommendations information visit:
 


Categories: All Diseases


Hepatitis B

What is it?

Hepatitis B is a virus that is spread through infected blood & bodily fluids via contaminated needles and unprotected sexual intercourse. It affects the liver, causing jaundice and occasionally liver failure. It is the most common blood borne infection in the world and is a major cause of chronic liver disease and liver cancer. Vaccination is recommended for those at occupational risk (e.g. health care workers), for long stays in or frequent travel to medium and high risk areas and for those more likely to be exposed such as children (from cuts and scratches) and those who may need surgical procedures.
 

Vaccine Schedule

Routine – Three doses – Day 0, One month later than 6 months after first dose
Accelerated – Four doses – Day 0, Day 7, Day 21 then fourth dose 12 months later
 
Booster – 5 years after a primary course as above which gives lifetime protection
 
Combine this vaccine with a sterile medical kit for use in emergency to reduce risk of infection from other blood borne viruses - available at our clinic.


Categories: All Diseases


 

 
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