Travel Health

Posted by Heather Doggett on 11 May 2018

We are all probably looking forward to our summer holiday by now, many of us having already planned or booked it.  Then there is the serious matter of trying to lose a pound or two before we go, and of course thinking about our holiday wardrobe!  In the midst of all of this – and I guess it is because it is ever so slightly boring – we forget to consider our travel health requirements in a timely manner.  So, this is your (hopefully) in time heads up to get organised.

 

Travel Vaccines

Prior to travelling anywhere overseas, it is worth checking that your routine UK vaccinations are up to date. Specific travel vaccination is generally only required if you are travelling to areas such as Central and South America, parts of Africa, the Asian sub-continent or South East Asia.  What vaccinations you require will depend on where you are going and what you will be doing.  A 2 week five star hotel stay in Thailand is very different to 6 months back-packing in rural Thailand for example.  Exposure risks are completely different and therefore travel vaccine requirements need to be considered with this in mind.

Hepatitis A and Typhoid are probably the most commonly administered; typhoid only lasts for 3 years so check this is not out of date.  There has been a worldwide shortage of Hepatitis A and B vaccine since last year.  Supplies are now starting to filter through but there are still constraints on availability so if this is required see your GP or travel clinic at least 8 weeks before travel.   Some vaccinations require multiple doses so you need the time for these to be given.

There are currently numerous reports of outbreaks of measles throughout Europe. Travel may increase an individual’s risk of exposure to measles virus. Two doses of MMR vaccine, at least one month apart, are required to give adequate protection.  Confirm that children have received their recommended doses of MMR at 12-13 months of age and again pre-school around 3 years 4 months. Unvaccinated adults who have not had measles themselves should seek advice from a healthcare professional regarding measles vaccination.

Tick borne encephalitis (TBE) is prevalent in some Northern European, Balkan and Scandinavian countries. If you are undertaking a walking or camping vacation in the endemic areas, you may wish to consider being vaccinated against TBE.

 

Mosquitos

Malaria – anti-malarials may be required for some areas of travel.  There are several types of medication available all of which need to be started prior to travel and finished after you have returned –  it is vital that the course is completed. These mosquitos tend to bite from dusk until dawn.

Mosquitos are also responsible for transmitting diseases such as dengue fever, chickungunya fever, yellow fever and the zika virus.  These mosquitos tend to bite during the day.  Insect repellent containing DEET minimum 30% is recommended as the most effective repellent along with covering exposed skin with clothing.  If applying during the day, always apply sunscreen first, allow this to absorb and then apply the repellent.  Re-apply regularly.

 

Ten Tips for Healthy Travel

Before Trip

  • Seek consultation with a travel medicine specialist at least six weeks before travel.
  • Ask about special vaccines that are recommended for specific destinations.
  • First aid and medical kit containing regular and special medication for the trip – carry in hand luggage.
  • Evacuation and travel insurance to cover health emergencies while abroad.

During Trip

  • Take precautions against malaria when you visit areas at risk. Prevent mosquito bites and take malaria pills as advised.
  • Road safety is important – wear safety belts in cars, helmets on bikes and avoid night time driving.
  • Abstain from casual sex or practice safe sex with condoms to prevent HIV and other sexually transmitted diseases.
  • Verify and consume safe water and food. Have a supply of medicine for self treatment of diarrhoea.
  • Excessive sun exposure should be minimised by the use of sunscreen. Sun can be more intense over water, snow and at altitude.
  • Leave animals alone. Animal bites or scratches can transmit rabies. Seek help if bitten.

 

For more information on travel health I would recommend the Fit for Travel or NaTHNaC websites; these provide comprehensive information where you can look up country specific advice.  For the latest advice for travel safety and security refer to the Foreign and Commonwealth Office website.  Happy and safe travelling!

 

Alison Lambert

 

 

 

 

 

 

 

 

 

 

 

 

A colleague’s husband completed the bowel screening test when it arrived on his doormat not so long ago.  A positive result saw him referred into the NHS system, with his local hospital offering a faultless treatment plan from start to finish.  Yes, he did have bowel cancer – it is unlikely that he would have known about this until the disease was a lot further progressed had he not undertaken the screening.  Following successful surgery he has made an excellent recovery and will simply remain on the colorectal team’s ‘radar’ for follow-ups over the next 5 years.

  • In some areas of the UK only a third of those who receive the test in the post complete it. Thousands of people are missing out on the best way to detect bowel cancer early. Bowel cancer is the UK’s second biggest cancer killer, however it shouldn’t be because it is treatable and curable especially if diagnosed early. Nearly everyone diagnosed at the earliest stage will survive bowel cancer but this drops significantly as the disease develops.  Most people with bowel cancer are diagnosed when they are over the age of 50, but more than 2,400 people under 50 are diagnosed each year in the UK. While this is only around 5% of those diagnosed, this number is slowly increasing. Bowel cancer UK suggest that younger bowel cancer patients have a very different experience of diagnosis, treatment and care.  As a result of this they launched the ‘Never Too Young’ campaign in 2013.

 

SIGNS AND SYMPTOMS

The symptoms of bowel (colorectal) cancer can be:

  • Bleeding from your bottom and/or blood in your poo
  • A change in bowel habit lasting for 3 weeks or more especially to looser or runny poo
  • Unexplained weight loss
  • Extreme tiredness for no obvious reason
  • A pain or lump in your tummy

 

What increases your risk?

Although the exact cause of bowel cancer is unknown, there are certain factors that may increase your risk:

  • You are more at risk over the age of 50 – 95% of cases occur in the over 50s
  • You have a significant family history of bowel cancer. People with a first degree relative (mother, father, brother, sister, child) under 45 or with two or more first degree relatives with bowel cancer may be considered for further testing
  • You have polyps in your bowel – polyps are like small spots or cherries on stalks and most do not produce symptoms. Polyps can lead to bowel cancer if left untreated.
  • You have long-standing inflammatory bowel disease e.g. Crohns disease or colitis
  • You have type 2 diabetes

 

What reduces your risk?

Scientists believe that around half of all bowel cancers could be prevented by having healthier lifestyles:

  • Keep a healthy weight and exercising regularly
  • Stop smoking
  • Cut down on red and processed meats
  • Eat at least 5 portions of fruit and vegetables every day
  • Consume no more than 14 units of alcohol per week for women, 21 units for men
  • Take part in bowel screening when invited

 

More information on all of the above can be found on the Bowel Cancer UK website – a key part of their work is educating patients, the public and healthcare professionals about bowel cancer by providing expert information and training.  They will give a free 30 minute talk to private, public and voluntary sectors and this is an ideal way to raise awareness.  In the meantime, let’s make April the month we send our screening samples back, stop ignoring those symptoms that have not gone away, start talking about bowel cancer rather than dying of embarrassment and increase awareness in any way we can.