Japanese encephalitis
Travellers to South East Asia and the Far East should be immunised if staying a month or longer in endemic areas during the transmission areas. Other travellers with shorter exposure periods should be immunised if the risk is considered sufficient (DOH Guidance). NATHNAC reports 30,000 to 50,000 cases are being reported each year. It is a leading cause of viral encephalitis in Asia
IXIARO – 2 doses may be given from Age 18 or ‘older’ teenagers. Antibodies are seen up to 3 years and probably should be boosted then. There is no specific individual treatment but supportive treatment.
The world is again joining together on September 28th to raise awareness and understanding about the importance of rabies prevention. Rabies is the oldest and deadliest disease known to mankind and The Travel Clinic Ltd is supporting this initiative.
Led by the Alliance for Rabies Control and supported by numerous human and animal health organizations worldwide, World Rabies Day is a unique campaign that brings together hundreds of thousands of people across the world to reinforce the message that rabies is a preventable disease, yet kills 55,000 people needlessly each year, half of which are children under the age of 151.
Although the efficacy and safety of modern cell culture vaccines have been recognized, some Asian countries still produce and use nervous tissue vaccines, which are less effective, require repeated visits to the hospital and often have severe side-effects. Moreover, these patients do not receive the necessary rabies immunoglobulin, because of a perennial global shortage and because of its high price, so that it is unaffordable in countries where canine rabies is endemic.
People most at risk of rabies live in rural areas of Africa and Asia. An estimated 31 000 people die from dog rabies in Asia each year. In Africa the annual death toll is 24 000. Dog rabies is responsible for more than 14 million courses of post-exposure treatment to prevent the onset of disease. The economic burden of rabies in the developing world also takes a large toll. The average cost of rabies immunizations after a suspicious animal bite is US$ 40 in Africa, and US$ 49 in Asia. This post-exposure treatment is a major financial burden for most households in these countries, where the average wage is about US$ 1 to US$ 2 per day, per person.
Poor people, especially children, are at highest risk of dog rabies. About 30% to 60% of the victims of dog bites (the primary mode of virus transmission) are children less than 15 years of age. Children often play with animals and are less likely to report bites or scratches.
In areas known for rabies, professionals with frequent exposure to animals (e.g. veterinarians), or who spend a lot of time outdoors (e.g. wildlife specialists or researchers), particularly in rural areas, should be vaccinated preventively. This also applies to travelers and hikers who visit areas where bats are commonly found. Rabies immunoglobulin (antibody) vaccines - which are recommended for use in Category III cases and for exposures in immunosuppressed people - are expensive and can be in short supply or non-existent in most developing countries. Purified equine (horse) rabies immunoglobulin provide at least a partial solution to current problems of insufficient quantities and the high cost of human immunoglobulin in developing countries.1 WHO. Human and Animal Rabies, Rabies: A neglected zoonotic disease. Available at: http://www.who.int/rabies/en/. Accessed on July 23, 2008.
Ten Top Tips - What to pack
· EX4
A fabric spray which repels mosquitos , ticks and bugs and can survive 35 washes. Treat fabrics before leaving for your trip.
· DEET (N,N-Diethyl-m-tolumide)
DEET has been in use as an insect repellent for around 50 years and it is available in different concentrations ranging from 20% to 100%. The duration of protection varies depending on the concentration chosen. 20% DEET will give protection for between 1 & 3 hours, 30% DEET can last up to 6 hours and 50% can last up to 12 hours. There is no added protection over 50% DEET.
· SUNSCREEN first, then apply insect repellent. The only protection at the moment against Dengue Fever is insect repellents and clothing sprays.
· SUN HAT - Slip , slop,slap as the Australians say slip on a shirt, slop on the sunscreen and slap on a Sun hat
· Microfibre Travel towel, big enough to use as a sarong if sharing bathrooms.
· WHIZZ - what every woman needs! Whether stuck on the M25 or facing revolting toilets! As recommended by the Nurses at The Travel Clinic Ltd!
· Vaccinate or learn how to protect yourself.
· Malaria tablets if needed. Check out www.malariahotspots.co.uk or http://www.nathnac.org
· Diarrhoea treatment – Consider oral rehydration salts or a short course of ciprofloxacin (an antibiotic for first line treatment of diarrhoea).
· Medical kit sterile needles and syringes if travelling away from reliable medical care.
· LOCATE - The Foreign Office says : What are the benefits of registering with Locate? If a major catastrophe occurs or if family and friends need to get in touch with you, The Foreign Office can help with Locate. It only takes a few minutes to register your travel or residence information online and the local British Embassy will know you are coming. You only need to register for the service once and then update your account when you make a new trip abroad or change your country of residence.
WHIZZ FREEDOM
What is Whizz Freedom?
The World’s first antibacterial and hydrophobic urine director for leisure use and mobility impaired users
Unique Features
- Antibacterial – allows the device to be re-used many times with no degradation in its hygienic properties
- Hydrophobic – it can be flicked dry (no need to rinse it each time)
- Highly portable – cleverly made, it will fold up when put in your pocket and spring back into shape when you need it
The Whizz Freedom is a soft, gentle and ingenious device that allows women of all ages to wee in a standing up, sitting down or lying down position without undressing, The Freedom means no more waiting, squatting, holding on or hiding.
Called a “urine guide” (also referred to as urine disposer or portable loo), its carefully and cleverly designed highly flexible lily shape fits comfortably against the outer curves of the human body and is externally held against the groin. Once you start, nature and gravity do the rest! Urine is directed away from the body, so there are no flowbacks, splashes or spills, and you don’t even have to remove outer or under clothing!
CE marked, FDA approved, and medically approved, the Freedom preserves dignity and liberty, whatever the circumstances, by giving women the choice to wee wherever and whenever they want. Used by our Travel Health Nurses, it has been very helpful when stuck on the A14 for hours on end!
thank you!!
Our thanks go to Sheila Garnham from Lensfield Medical Practice who pointed out that Twinrix is not as yet licensed for Day 0, 7 and 21 although very commonly used off license!
A WHO report estimates a global deficit of 2.3 million doctors, nurses and midwives
Mary’s honeymoon
We are pleased to announce Mary Kedward, our MD, is finally getting married to her long term partner, engineer, Nigel Matthews at the end of August 2010.
Both Mary and Nigel enjoy travelling and will be spending their honeymoon at a turtle sanctuary off the coast of Malaysia.