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GENERAL PRE-TRAVEL ADVICE

GENERAL PRE-TRAVEL ADVICE

GENERAL PRE-TRAVEL ADVICE

Drinking Water – Essential Tips

Important for reducing risk of traveller’s diarrhoea, as well as other water-borne infections-hepatitis A, typhoid, polio, cholera.

  • We advise against drinking or brushing with tap water
  • Avoid using ice cubes
  • Please drink only boiled water or carbonated beverages.
  • Be wary of bottled water as safety and bottling conditions may not be adequate
  • Boiling water for 3 minutes followed by cooling, kills infection carrying organisms.
  • Filtration devices or chemical disinfection such as chlorine tablets (may not kill all parasitic infections) are also worth considering as alternative

Food Safety

Please adhere to the following advice:

  • Avoid eating unpeeled fruit
  • Please refrain from eating raw vegetables
  • Avoid drinking unpasteurised dairy products
  • Do not eat raw or rare meat, shellfish
  • Ensure that your food is always piping hot

Traveller’s Diarrhoea

Very common: 20-60% incidence depending on destination (high risk regions include: Africa, Asia, Middle East and South America).

Causes:

Bacterial – Bacterial pathogens occur in 80-90% of cases. Common agents include E.coli, Campylobacter jejuni, Shigella spp and Salmonella spp.

Viruses – Norovirus, rotavirus are common causes.

Parasites – Giardia most common, others include Entamoeba.

 

Symptoms

Usually includes the sudden onset of diarrhoea (can be bloody), abdominal pain/cramps, fever, vomiting. Duration typically 3-5 days in bacterial cases, 2-3 days in viral and can be weeks in untreated parasitic infections.

Treatment

Hydration – oral rehydration sachets/solutions

Antimotility drugs – provide symptomatic relief

Antibiotics – in moderate/severe cases have proven beneficial.

We advise to seek medical advice if not improving after 1-2 days, especially in the elderly/children or if symptoms of dysentery (bloody loose motions) are present.

Prevention

The cholera vaccine gives cross-protection against E. coli enterotoxin. Can be effective for traveller’s diarrhea.

Animal Bites Advice

  • Avoid contact with animals especially dogs, monkeys and cats.
  • If bitten wash wound thoroughly with soapy water for 10 minutes
  • Do not suture or close wound
  • Seek urgent medical advice
  • Open water, soil and sand can harbour infection therefore

-avoid swimming in fresh water (risk schistosomiasis)

-avoid walking barefoot on sand/soil, which may be

contaminated with faeces (hookworm infection)

Insect Bite Avoidance

  • Mandatory even if vaccinated or taking antimalarials
  • Plan activities, so you can avoid insect/tick/mite infested areas and maximise preventive measures during peak hours to reduce exposure where possible
  • Day biting mosquitoes-spread infections also including dengue and yellow fever
  • Night biting mosquitoes- spread diseases including malaria and Japanese Encephalitis
  • Sandflies-cause leishmaniasis and are active from dusk until dawn
  • Tsetse fly-cause sleeping sickness and are found within vegetation and grasslands of Sub Saharan Africa, and exhibit day biting
  • Ticks/mites-cause lyme’s disease and tick borne encephalitis, and are found meadows / woodlands / grasslands / forests
  • Protective clothing-long sleeved shirts and pants, tucking in shirts / pants, closed shoes, can add permethrin to clothes for added protection
  • Check skin regularly for ticks/mites during and following outdoor activities
  • Apply insect repellants regularly to exposed areas

Sun Protection

  • Always wear sun protection, using a minimum of SPF 15+.
  • Avoid sun bathing between 12-2pm
  • Wear Sun glasses

Travel Safety

  • Photocopy passport and any certificates
  • Email details of bank, help numbers etc to yourself
  • Email photocopies of certificates etc
  • Know where to get help
  • Obtain Comprehensive insurance including

-Covers for all activities

-Ensure Insurance company aware of any medical problems (may not cover if decline recommended vaccines).

Travel Risk Assessment

At Redwood Pharmacy you will receive a travel risk assessment, which takes into account your specific itinerary, medical history and the type of activities you likely to undertake. Your health professional will use the evidenced based travel health resource-Travax to review the latest destination specific recommendations.

Full Range of Vaccinations

Our clinic stocks an extensive range of vaccinations including less commonly administered vaccines such as Japanese Encephalitis, Meningitis ACYW Vax and Cholera.

Japanese Encephalitis

This is a viral infection, which causes inflammation of the brain. It is transmitted via bites from infected mosquitos. Initially the mosquitos acquire the virus from infected animals such as pigs and then pass it onto humans. The disease is not transmitted from person to person.

It is most commonly seen in South-East Asia and the Indian subcontinent. The specific type of mosquitos which transmit this virus tend to found within rice paddy fields where they breed.

The majority of infected individuals display no symptoms. Approximately thirty percent of infected individuals will die from the disease.

Age range Vaccine Brand Dose Method of Administration Number of doses primary course Interval between doses primary course First Booster dose requirements Second Booster dose requirements
2 months-3 years of age Ixiaro 0.25ml Intramuscular injection to the thigh or deltoid muscle. 2 doses 2nd dose administered 28 days after 1st dose If at ongoing risk for infection (such as travelling to live in endemic country)-First Booster at 12 months

All other Travellers-First Booster at 12-24 months
Unknown
Children over 3 years up until 18 years Ixiaro 0.5ml Intramuscular injection to the deltoid muscle 2 doses 2nd dose administered 28 days after 1st dose If at ongoing risk for infection (such as travelling to live in endemic country)-First Booster at 12 months

All other Travellers-First Booster at 12-24 months
Unknown
Adults 18 years-65 years Ixiaro 0.5ml Intramuscular injection to the deltoid muscle 2 doses Standard Schedule=2 doses given at day 0 and day 28
Rapid Schedule-2 doses at day 0 and day 7
If at ongoing risk for infection (such as travelling to live in endemic country)-First Booster at 12 months

All other Travellers-First Booster at 12-24 months
Second Booster at 10 years if at risk.

Cholera

Cholera is an acute severe illness characterized by very watery loose stool and vomiting. These symptoms can quickly result in dehydration and mortality can occur if rapid antibiotic treatment is not initiated.

It is caused by the bacterium Vibrio Cholerae and generally transmission is through drinking contaminated water.

Age range Vaccine Brand Method of Administration Number of doses Interval Between doses Booster Requirement
From 6 years of age onwards Dukoral Oral 2 doses Minimum interval 1 week
Maximum interval 6 weeks
2 years after 2nd dose if continuing risk
2-6 years Dukoral Oral 3 doses Minimum interval 1 week
Maximum interval 6 weeks
6 months after 3rd dose if further risk of disease

 

Meningococcal Meningitis

Meningococcal meningitis refers to a bacterial inflammation of the lining of the brain and spinal cord. It caused by various subtypes of the bacterium Neisseria Meningitidis. It can cause severe brain damage if untreated. 6 Strains of the bacterium can lead to epidemics (A,B,C,Y,W). An area known as the meningitis belt of sub-Saharan Africa has the highest incidence.

The bacterium spreads directly from person-person through respiratory or throat secretions. Those at particular risk include those living in close proximity such as university students in dormitories. Transmission occurring commonly via kissing, sneezing and coughing.

We have two vaccines available against Meningoccal Meningitis-

 

1.Meningitis ACYW Vaccine

Protects against strains A,C,Y,W.

Age range Vaccine Brand Method of Administration Schedule Number of doses Booster
From Birth to 1 year* Menveo Only Intramuscular injection to the thigh First Dose Given Day O

Second Dose Given One Month Later
2 doses Unknown
From 1 years of age onwards. Menveo or Nimenrix Intramuscular injection to the deltoid muscle One Single Dose 1 dose Unknown

 

  1. Meningitis Group B Vaccine

Protects against Group B.

Age at first dose Method of Administration Number of doses Interval Between Doses Booster Requirement
2-5 months Intramuscular injection to the thigh 3 doses At least 1 month between each dose Yes-One further dose given at 12-15 months of age
6-11 months Intramuscular injection to the thigh 2 doses At least 2 months between doses Yes-One further dose given in 2nd year of life, at least 2 months after 2nd dose.
12-23 months Intramuscular injection to the thigh or deltoid muscle 2 doses At least 2 months between doses Yes-One further dose given 1-2 years after the 2nd dose
2-10 years of age Intramuscular injection to the deltoid muscle 2 doses At least 1 month between doses Unknown
Over 11 years of age Intramuscular injection to the deltoid muscle 2 doses At least 1 month between doses Unknown