Travel Vaccinations

Travel vaccinations by disease:

Cholera - £30/dose

Schedule: two doses given 1-6 weeks apart, three doses for children under 6

Level of protection: ≈85%

Duration of protection: 2 years

When to get vaccine: ideally 2 weeks before travel

Type of vaccine: oral solution

What is cholera?

Cholera is a disease, characterised by profuse, watery diarrhoea, caused by certain toxin-producing forms of the bacteria called Vibrio cholera. Cholera is transmitted by ingesting (eating and drinking) contaminated water or food. It is common in many low-income countries and is largely linked to poverty, bad sanitation and poor access to clean drinking water.

What are the symptoms of cholera?

Cholera can be mild or occur without symptoms in healthy individuals. Symptoms include sudden, profuse, watery diarrhoea with associated nausea and vomiting. If untreated, cholera can rapidly lead to serious dehydration and shock; fifty percent of those with serious complications, die. With quick and effective treatment, risk of dying is less than one percent.

How to prevent cholera?

  • Avoid all water that isn’t bottled unless you know it’s been boiled or disinfected. This includes ice, which is very common in spreading cholera.
  • Avoid raw food. As with the water, heat can remove the dangerous bacteria. Your safest bet is any food that’s been cooked very recently.
  • Show caution when swimming in open bodies of water. If there’s no bathroom nearby, some people may have resorted to doing this outside and near the water. Swimming in water that’s infected with feces is already unwanted, but made far worse with the risk of cholera.
  • Know where the nearest medical facility is. Overpopulated regions that are far from these facilities are most susceptible to an outbreak.

Possible risk areas:

Vaccine brands available:

  • Cholera vaccine: Dukoral (oral solution)

Diphtheria - £20

Schedule: one dose

Level of protection: ≈95-100%

Duration of protection: 10 years

When to get vaccine: suitable for last-minute travellers

Type of vaccine: intramuscular injection (diphtheria, tetanus, polio vaccine)

What is diphtheria?

Diphtheria a is highly infectious bacterial infection which can be fatal. Diphtheria is typically spread by coughing and sneezing, close contact with infected people or contaminated clothes and bedding. There is a safe and effective vaccine.

What are the symptoms of diphtheria?

Diphtheria can cause nose and throat infections: a tough ‘leathery’ grey/yellow membrane develops, that affects the soft palate, tonsils and throat. Lymph glands become swollen, prominent and tender, producing a ‘bull neck’. Symptoms include sore throat, difficulty and/or pain on swallowing, husky voice, fever, cough, headache and, if there is airway obstruction, breathing difficulties.

How to prevent diphtheria?

People can carry the diphtheria bacterium harmlessly in the nose and throat (‘carriers’). The diphtheria bacterium is spread when an infected person (patient or carrier) talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby. The diphtheria bacterium is also spread by indirect contact with hands, tissues or other articles soiled by nose and throat discharges, or by indirect contact with skin sores.

Possible risk areas:

Vaccine brands available:

  • Diphtheria, tetanus and polio (DTP) combined vaccine: Revaxis

Hepatitis A - £40/dose

Schedule: two doses, given 6-12 months apart

Level of protection: ≈95-99%

Duration of protection: 1 year after single dose, or up to 25 years after two doses

When to get vaccine: ideally 2 weeks before travel

Type of vaccine: intramuscular injection

What is hepatitis A?

Hepatitis A is a highly infectious virus that can cause inflammation of the liver. Certain travellers are at increased risk of acquiring hepatitis A, including:

  • those who are staying with or visiting the local population
  • frequent and/or long-stay travellers to areas where sanitation and food hygiene are likely to be poor those with existing medical conditions such as liver disease or haemophilia
  • men who have sex with men
  • people who inject drugs
  • those who may be exposed to the virus through their work
  • those going to areas of hepatitis A outbreaks who have limited access to safe water and medical care

What are the symptoms of hepatitis A?

Symptoms are often mild or absent in young children, but the disease becomes more serious with advancing age. Recovery can vary from weeks to months. Following hepatitis A illness, immunity is lifelong. Symptoms may include: fever, loss of appetite, jaundice (yellowing of the eyes and skin), malaise and nausea.

How to prevent hepatitis A?

  • Always wash your hands thoroughly after using the restroom and when you come in contact with an infected person’s blood, stools, or other bodily fluid.
  • Avoid unclean food and water

Possible risk areas:

Vaccine brands available:

  • Hepatitis A vaccine: Avaxim, Havrix, VAQTA
  • Combined hepatitis A and B vaccine: Twinrix, Ambirix

Hepatitis B - £35/dose

Schedule: three doses, at 0, 1 and 6 months

Level of protection: ≈76-96%

Duration of protection: life

When to get vaccine: ideally 4 weeks before travel

Type of vaccine: intramuscular injection

What is hepatitis B?

Hepatitis B is a viral infection of the liver spread by direct contact with the blood or body fluids of an infected person. It occurs worldwide with highest rates reported in parts of East Asia and Sub Saharan Africa. Higher rates of infection are also found in the Amazon, southern parts of Eastern and Central Europe, the Middle East and the Indian subcontinent. Risk for travellers is low although certain behaviours or activities put individuals at higher risk, particularly when these occur in areas where hepatitis B is more common. These behaviours and activities include:

unprotected sex
exposure to blood or blood products through occupation, such as healthcare work
exposure to contaminated needles through injecting drug use, or as a result of accessing medical or dental
participation in contact sports
adoption of children from risk countries
long stay travel

What are the symptoms of hepatitis B?

In the majority of cases of hepatitis B symptoms do not occur. Symptoms more commonly occur in adults than children and may include: jaundice (yellowing of the skin and eyes), loss of appetite, fever and abdominal pain. Persistent infection may lead to liver failure or liver cancer.

How to prevent hepatitis B?

All sexual partners, family and close household members living with a chronically infected person should be tested and vaccinated. It is important to remember that hepatitis B is not spread casually! It is not spread by coughing, sneezing, hugging, cooking and sharing food. It is spread through direct contact with infected blood and bodily fluids.

Possible risk areas:

Vaccine brands available:

Hepatitis B vaccine: Engerix, HBvaxPRO
Combined hepatitis A and hepatitis B vaccine: Twinrix, Ambirix

Japanese Encephalitis - £95/dose

Schedule: two doses at day 0 and 28.

Level of protection: ≈96%

Duration of protection: 1-2 years

When to get vaccine: ideally 1 week before travel

Type of vaccine: intramuscular injection

What is Japanese encephalitis?

Japanese encephalitis (JE) is a viral infection of the brain transmitted to humans by mosquitoes in parts of Asia and the Pacific Rim.

What are the symptoms of Japanese encephalitis?

Most human infections with JE virus do not result in symptoms. When symptoms do occur they include fever, headache and confusion. In symptomatic cases requiring hospitalisation death rates are high and neurological complications are common.

How to prevent Japanese encephalitis?

The most effective way to prevent infection from Japanese Encephalitis virus is to prevent mosquito bites. Mosquitoes bite during the day and night. Use insect repellent, wear long-sleeved shirts and pants, treat clothing and gear, and get vaccinated before travelling.

Possible risk areas:

Vaccine brands available:

  • Japanese encephalitis vaccine: IXIARO

 

Meningitis A, C, W and Y - £45

Schedule: one dose

Level of protection: ≈75-96%

Duration of protection: 5 years

When to get vaccine: ideally 10 days before travel

Type of vaccine: intramuscular injection

What is meningitis?

Meningococcal disease is a rare, but potentially devastating infection. It is caused by the bacteria Neisseria meningitidis of which there are 6 disease-causing strains called serogroups (A, B, C, W, Y and X). Approximately 10 percent of the general population of the UK are thought to carry N. meningitidis in the lining of the nose and throat. Spread between individuals occurs through coughing, sneezing, kissing or during close contact with a carrier.

A certificate of vaccination may be required if visiting Saudi Arabia. Please note only Meningitis C is given in schools. A single vaccine lasts 3 -5 years, this is dependent on Visa requirements.

What are the symptoms of meningitis?

Invasive meningococcal disease usually presents as meningitis or septicaemia. Symptoms of meningitis include: sudden onset of fever, intense headache, neck stiffness, nausea and vomiting. Symptoms of septicaemia include: fever, chills, confusion and a rash. Both conditions may progress rapidly and are serious diseases with high risk of complications and fatality.

How to prevent meningitis?

  • Common bacteria or viruses that can cause meningitis can spread through coughing, sneezing, kissing, or sharing eating utensils, a toothbrush or a cigarette.
  • Wash your hands. Careful hand-washing helps prevent the spread of germs. Teach children to wash their hands often, especially before eating and after using the toilet, spending time in a crowded public place or petting animals. Show them how to vigorously and thoroughly wash and rinse their hands.
  • Practice good hygiene. Don’t share drinks, foods, straws, eating utensils, lip balms or toothbrushes with anyone else. Teach children and teens to avoid sharing these items too.
  • Stay healthy. Maintain your immune system by getting enough rest, exercising regularly, and eating a healthy diet with plenty of fresh fruits, vegetables and whole grains.
  • Cover your mouth. When you need to cough or sneeze, be sure to cover your mouth and nose.
  • If you’re pregnant, take care with food. Reduce your risk of listeriosis by cooking meat, including hot dogs and deli meat, to 165 F (74 C). Avoid cheeses made from unpasteurized milk. Choose cheeses that are clearly labelled as being made with pasteurised milk.

Possible risk areas:

Vaccine brands available:

  • Meningitis ACWY vaccine: Menveo, Nimenrix, MenQuadfi

Polio - £20

Schedule: one dose

Level of protection: ≈95-100%

Duration of protection: 10 years

When to get vaccine: suitable for last-minute travellers

Type of vaccine: intramuscular injection (diphtheria, tetanus, polio vaccine)

What is polio?

Poliomyelitis (polio) is a potentially paralysing, vaccine preventable, viral infection. The virus is transmitted through food or water contaminated by infected human faeces or by direct contact with an infectious person.

What are the symptoms of polio?

Most individuals (about 95 percent) who acquire polio do not develop symptoms. When they do occur symptoms may range from a mild illness with fever, to symptoms of meningitis (inflammation of the lining of the brain) or paralysis.

How to prevent polio?

An effective vaccination against polio is available. In addition to vaccination travellers should ensure good personal hygiene and follow advice on prevention of food and water-borne diseases.

Possible risk areas:

Vaccine brands available:

  • Diphtheria, tetanus and polio (DTP) combined vaccine: Revaxis

Rabies - £60/dose

Schedule: three doses at day 0, 7 and 21 or 28

Level of protection: ≈99-100%

Duration of protection: life, can get single booster dose after a year

When to get vaccine: ideally 4 weeks before travel

Type of vaccine: intramuscular injection

What is rabies?

Rabies is a viral disease transmitted to humans usually by a bite or scratch from an infected animal (usually a dog). Once symptoms are present, rabies is almost always fatal.

What are the symptoms of rabies?

The virus attacks the central nervous system causing, progressive damage to the brain and spinal cord.

How to prevent rabies?

Contact with wild or domestic animals during travel should be avoided.

Possible risk areas:

Vaccine brands available:

  • Rabies vaccine: Rabipur

 

Tetanus - £20

Schedule: one dose

Level of protection: ≈95-100%

Duration of protection: 10 years

When to get vaccine: suitable for last-minute travellers

Type of vaccine: intramuscular injection (diphtheria, tetanus, polio vaccine)

What is tetanus?

Tetanus is a vaccine-preventable disease caused by a toxin produced by bacteria called Clostridium tetani. Tetanus spores are found in soil throughout the world. The disease is acquired when material containing these spores, such as soil, contaminates a wound.

What are the symptoms of tetanus?

Intense, painful contraction and spasm of skeletal muscles. It usually causes lockjaw (trismus) characterised by facial muscles spasm. Other symptoms include: a stiff neck, forceful arching of the back, abnormal breathing and difficulty swallowing. Even with intensive medical support, death occurs in 10 to 20 percent of cases.

How to prevent tetanus?

All travellers should be aware of the risk of accidents, thoroughly clean all wounds and seek appropriate medical attention.

Possible risk areas:

Vaccine brands available:

  • Diphtheria, tetanus and polio (DTP) combined vaccine: Revaxis

 

Tick-borne Encephalitis - £60/dose

Schedule: three doses at 0, 2 and 6 months

Level of protection: ≈90%

Duration of protection: 5 years

When to get vaccine: ideally 3-4 weeks before travel

Type of vaccine: intramuscular injection

What is tick-borne encephalitis?

Tick-borne encephalitis (TBE) is a viral infection usually transmitted through the bite of an infected tick. The disease occurs in parts of central, northern and Eastern Europe, Siberia and parts of Asia.

What are the symptoms of tick-borne encephalitis?

Typically, the disease occurs in two stages: a mild flu-like illness and a potentially serious infection of the central nervous system (brain and spinal cord). TBE is rarely fatal in Europe: however in Asia it can be fatal in up to 20 percent of cases. Long-term neurological complications are common.

How to prevent tick-borne encephalitis?

  • Avoid known heavily tick-infested areas of forest and woodland during the spring, summer and autumn where possible
  • Practise bite avoidance methods: for example wear appropriate clothing and use effective insect repellents
  • Check the body for ticks regularly. The larval forms of Ixodes ticks are tiny and difficult to see
  • Remove ticks as soon as possible by using a pair of fine tipped tweezers or tick remover
  • Avoid consumption of unpasteurised dairy products in areas of risk (a potential route of transmission

Possible risk areas:

Vaccine brands available:

  • Tick-borne encephalitis vaccine: TicoVac

Typhoid - £25

Schedule: injection is one dose, oral vaccine is 3 capsules taken on alternate days

Level of protection: ≈70-80%

Duration of protection: 3 years

When to get vaccine: ideally 2-3 weeks before travel

Type of vaccine: intramuscular injection or oral capsule

What is typhoid?

Typhoid and paratyphoid are infections acquired by the ingestion of food or water contaminated by the bacteria Salmonella Typhi or Salmonella Paratyphi. The majority of global cases of disease occur in Asia, but the disease continues to be a concern in other areas including Africa and parts of Central and South America.

What are the symptoms of typhoid?

Symptoms of typhoid and paratyphoid include: fever, headache, muscle or joint pains, constipation or diarrhoea and a rash. Complications include intestinal bleeding and perforation.

How to prevent typhoid?

You can contract it by eating food or drinking water contaminated by faeces. People infected with typhoid fever can infect others through contact with the hands, or from a water tap or door handle for example. The risk for travellers in most countries is very low with the exception of certain parts of the Indian subcontinent. People travelling under primitive circumstances run the greatest risk. It has emerged that the risk is higher for migrant travellers who return to visit their country of origin.

Possible risk areas:

Vaccine brands available:

  • Typhoid vaccine: Vivotif (oral capsules), TYPHIM Vi (injection)

 

Yellow Fever - £60

Schedule: one dose

Level of protection: ≈95-100%

Duration of protection: life

When to get vaccine: ideally 10 days before travel

Type of vaccine: subcutaneous or intramuscular injection

What is yellow fever?

Yellow fever (YF) is a vaccine preventable viral infection transmitted predominantly by certain species of day biting mosquitoes.

What are the symptoms of yellow fever?

YF virus can cause an illness that results in jaundice (yellowing of the skin and eyes) and bleeding, with severe damage to the major organs. The death rate is high in those who develop severe disease.

How to prevent yellow fever?

Those visiting YF risk areas should practice meticulous mosquito bite avoidance.

Possible risk areas:

Vaccine brands available:

  • Yellow fever vaccine: Stamaril
  • Re-issue of yellow fever certificate: £20

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