4 Blenheim Walk, Leeds LS2 9AE
4 Blenheim Walk, Leeds LS2 9AE
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IMMUNISATIONS and ANTI-MALARIALS
Make sure you plan your travel vaccinations well in advance, you will often need to start receiving immunisations at least 8 weeks before you leave Leeds
STEP 1 – OBTAIN A FREE TRAVEL SUMMARY
To obtain any travel related vaccinations from Leeds Student Medical Practice you must first obtain a free travel summary. This is a medical travel guide containing a personal travel schedule for every country on your trip. It will advise you about recommended vaccinations and antimalarial requirements for your trip
We recommend www.masta-travel-health.com (MASTA will also allow you to book an appointment on-line for private immunisations)
You will need to enter your personal travel schedule for every country on your trip. It will then advise you about recommended vaccinations and anti-malarial requirements. Please print a copy of your personal travel summary
STEP 2 – DECIDE ON YOUR VACCINES
Your travel summary will tell you which immunisations are mandatory, which ones are strongly recommended, and which ones you may wish to consider. It is up to you to decide which immunisations you would like to have
STEP 3 – PLAN YOUR VACCINATION SCHEDULE
3 – FREE NHS VACCINATIONS
Diphtheria, Tetanus, Typhoid, Hepatitis A, can all be obtained free of charge from your GP surgery. In some circumstances Cholera immunisation is also available on the NHS, but there is a prescription charge to pay at the pharmacy. If you are a registered patient of Leeds Student Medical Practice and wish to book an appointment, please contact us.
All other vaccinations on your travel summary are treated as private for travel purposes, you can obtain them from private travel clinics such as:
STEP 4 – ANTIMALARIAL MEDICINES
Decide whether you need to take antimalarial medicine. Your travel summary will tell you if antimalarial medicine is advised for your trip. For details of the specific drugs recommended we advise using www.fitfortravel.nhs.uk.
These antimalarials; Doxycycline, Malarone (Atovaquone and Proganuil) or Mefloquine (Lariam) these are available from a private travel clinic (as detailed in Step 3B), or by paying for a private prescription from a GP which you use to purchase the antimalarials from a pharmacist. If you are a registered patient of Leeds Student Medical Practice and to discuss antimalarial tablets, please contact us.
These antimalarials; Chloroquine, Proguanil, Chloroquine and Proguanil, can be purchased direct from a pharmacist.
Decide whether you need to take antimalarial medicine. Your travel summary will tell you if antimalarial medicine is advised for your trip. For details of the specific drugs recommended we advise using www.fitfortravel.nhs.uk.
These antimalarials; Chloroquine, Proguanil, Chloroquine and Proguanil, can be purchased direct from a pharmacist
Malarone is now available from some online pharmacies without prescription under the brand name of Maloff Protect
These antimalarials; Doxycycline, Malarone (Atovaquone and Proganuil) or Mefloquine (Lariam) are available from a private travel clinic such as:
You can also obtain a private prescription from a GP which you use to purchase the antimalarials from a pharmacist.
| Chloroquine (Nivaquine 150 mg Avloclor 155mg) | Proguanil (Paludrine 100mg) | Chloroquine and Proguanil (Paludrine 100mg/Avlocor 155mg) | |
|---|---|---|---|
| Effectiveness | Not 100% | Not 100% | Approximately 70% |
| Most notable adverse effects | Headache, nausea, vomiting, allergy. With prolonged use reversible hair loss can occur | Nausea, vomiting, mouth ulcers. With prolonged use reversible hair loss can occur | Headache, nausea, vomiting, allergy, mouth ulcers. With prolonged use reversible hair loss can occur |
| Frequency of doses | 2 tablets once a week (every 7 days) taken with water after food (one missed dose can result in temporary loss of protection) | 2 tablets daily with water after food (one missed dose can result in temporary loss of protection) | Chloroquine 2 tablets once a week and Proguanil 2 tablets daily, with water after food. (one missed dose can result in temporary loss of protection) |
| Start time before entering malaria area | 1 week | 24 hours | 1 week |
| Duration of medication required after leaving malaria area | 4 weeks | 4 weeks | 4 weeks |
| Main contraindications | Epilepsy, psoriasis, (children require different doses) | Severe renal failure, (children require different doses) | Epilepsy, psoriasis, children under 1yr (children require different doses) |
| Approximate costs | £3 for 28 tablets, to cover for a 14 day holiday (7 weeks of medication) [Sold only as pack to cover two people] | £11 for 98 tablets, to cover a 14 day holiday (7 weeks of medication) | £19-£24 Travel Pack to cover a 14 day holiday (7 weeks of medication) |
These antimalarial drugs are obtainable over the counter (OTC) from a pharmacy for travellers to areas which are chloroquine-sensitive. The pharmacist will advise you which antimalarials you require. Tell the pharmacist if you are pregnant or are planning to become pregnant
There is a choice of antimalarial prophylaxis (preventative drugs) for your proposed travel abroad
If you are having intradermal anti-rabies vaccination you must complete the course before starting antimalarial drugs. Intramuscular rabies vaccination is not affected by anti-malarials
Remember that Malaria can kill (on average there are 7 deaths per year in the UK from Malaria) so Malaria prophylaxis is very important. Even though you are taking anti-malarials there is still a small chance that you may develop Malaria even after you return to the UK, accordingly please be alert to symptoms; flu-like illness, fever, headache, joint aches. Seek medical advice promptly if you suspect Malaria
Remember to use avoidance measures whilst abroad; mosquito repellants containing DEET, cover up body dusk until dawn, mosquito nets (preferably impregnated with permethrin)
Antimalarials On Prescription
PRESCRIPTION ONLY ANTI-MALARIALS
| Mefloquine (Lariam) | Doxycycline | Malarone (Atovaquone & Proganuil) | |
|---|---|---|---|
| Effectiveness | V. good (~90%) | V. good (less evidence) | V. good (less evidence) |
| Most notable adverse effects | Nausea, vomiting, dizziness, sleep disturbance, stomach upset. More rarely psychiatric disturbance,fits,rashes and heart problems | Photosensitivity rash (up to 3%), Gastrointestinal | Relatively low |
| Frequency of doses | Weekly | Daily (one missed dose can result in temporary loss of protection) | Daily |
| Start time before entering malaria area | 2-3 weeks | 1-7 days | 1 day |
| Duration of medication required after leaving malaria area | 4 weeks | 4 weeks | 1 week |
| Main contraindications | Epilepsy, psychiatric disorders, early pregnancy, scuba diving (see section below) | Children, pregnancy | Pregnancy |
| Cost for a trip of 28 days (Guide only) | £20 to £30 (depends on chemist) | £14 to £30 (depends on chemist) | £84 to £110 (depends on chemist) Note: Licensed for trips of 28 days or less but see: Important note on Malarone below |
IMPORTANT NOTE ON MALARONE
Many countries do not restrict the length of time Malarone can be taken although the UK product license states it can only be taken for travel up to 28 days. There is a report of Malarone use for periods from 9 to 34 weeks, in which there was no excess of adverse effects and no appearance of unexpected adverse effects [Overbosch 2003]. The Advisory Committee on Malaria Prevention concludes that there is no evidence of harm in long-term use and suggests that it can be taken confidently for travel up to one year or longer. Nevertheless, long-term use of Malarone should be prescribed with careful consideration until additional post licensing experience is available
You need to find out exactly what information is needed by the tour operator as requirements do vary.
Sometimes travel operators will accept the ‘right hand side’ of the prescription as proof of repeat medication. There is no charge for this and can be issued at the time of a consultation with a GP or a nurse practitioner.
On other occasions, a GP/nurse practitioner may be required to write a letter – if this is the case you will need to attend LSMP in person to complete a consent form. You will be charged £8 and the turnaround time for these requests is 7 days.
If anything different to the above is required, you will need to make an appointment with a GP/nurse practitioner.
LARIAM & SCUBA DIVING
Lariam (mefloquine) is an anti-malarial drug used in regions of the world where chloroquine resistant falciparum malaria is prevalent. E.g. East Africa, South East Asia
Possible side effects of Lariam such as dizziness, blurred vision and a disturbed sense of balance are common and could cause problems for divers. These effects can often imitate or even worsen the symptoms of Decompression Illness (DCI). There could also be confusion between the side effects of Lariam and the symptoms of DCI or nitrogen narcosis resulting in a misleading diagnosis
Therefore, Lariam must not be taken by persons intending to take part in scuba diving
The manufacturers of Lariam recommend that it should not be taken by persons who carry out tasks demanding fine coordination and spatial discrimination, including scuba diving. If Lariam is taken, these persons should refrain from such activities during and for at least three weeks following use
MALARIA GENERAL GUIDANCE
Malaria is probably the most common and most serious disease you will be exposed to when travelling. Malaria is caused by a microscopic parasite transmitted by female mosquitoes when they take a blood meal at your expense. There are four species of malaria parasite, of which Plasmodium falciparum is the most dangerous and can lead to cerebral malaria and death
Malaria usually starts as a fever and you will feel very unwell. Other symptoms may include diarrhoea, headache or a cough. In a malarious area, all illnesses with fever should be considered to be malaria until proved otherwise. Seek medical help as soon as you can if you become ill
Check carefully the areas you plan to travel to and take anti-malarial tablets (prophylaxis) if advised by the travel-health nurse or doctor. Some tablets can be bought over the counter in a chemist but others are only available on prescription. Do not take over-the-counter tablets if prescription-only prophylaxis has been advised
You can get malaria even when taking prophylaxis, but this happens more commonly in individuals who forget to take one or more tablets. It is essential that you take the tablets you are prescribed regularly and on time and for the whole of the recommended time after leaving a Malarious area (sometimes for 4 weeks after)
Mosquitoes that transmit malaria bite mainly at night, but this can be any time from dusk onwards and even just after dawn. Use insect repellent containing at least 35% DEET, wear long, loose clothing when possible and consider taking a mosquito net impregnated with Permethrin to sleep and rest under. These can be bought in outdoor/camping shops which stock a full range of products. Do not rely on insect repellent and mosquito nets alone if you have been advised to take prophylaxis as well; all forms of protection are important
Insect Bites
Mosquitoes, certain types of flies, ticks and bugs can transmit many different diseases. e.g. malaria, dengue fever, yellow fever. Some bite at night, but some during daytime. The main way to avoid illness is to avoid being bitten:
If your room is not air conditioned, but screened, close shutters early evening and spray room with knockdown insecticide spray. In Malarious regions, if camping, or sleeping in unprotected accommodation, always sleep under a mosquito net (impregnated with Permethrin). Avoid camping near areas of stagnant water, these are common breeding areas for mosquitoes etc
Electric insecticide vapourisers are very effective as long as there are no power failures! Electric buzzers, garlic and vitamin B are not effective
Cover up skin as much as possible if going out at night, (mosquitoes that transmit malaria bite from dusk until dawn). Wear light coloured clothes, long sleeves, trousers or long skirts
Use insect repellents on exposed skin. (Choose those containing DEET or eucalyptus oil base. A content of approximately 35% DEET is recommended for tropical destinations.) Clothes can be sprayed with repellents too. Impregnated wrist and ankle bands are also available. Check suitability for children on the individual products
Report any unexplained illness with symptoms such as fever, headache, malaise, muscle aches and fatigue
INSURANCE
Make sure you have full medical insurance covering all activities you are likely to take part in, and make sure it is a repatriation policy. The biggest risks to travellers abroad are theft and road accidents. Make copies of your travel insurance documents, take one with you and leave a copy with a contact in the UK. If you can, scan them and e-mail them back to yourself. Do the same with your passport and tickets etc. Keep a copy of your travel insurance company telephone number and your insurance document number with you at all times
If you are a UK resident, you can obtain a European Health Insurance Card, this entitles you to medical treatment that becomes necessary, at reduced cost or sometimes free, when temporarily visiting a European Union (EU) country, Iceland, Liechtenstein, Norway or Switzerland. You can apply on-line (at least 6 weeks before departure)
LOCAL KNOWLEDGE
Look up information, medical and otherwise on the area you will be travelling to and draw up a list of items you need to take (including medical kit). Be aware of the medical conditions you are likely to encounter and read up on them
PERSONAL HEALTH
Make sure you have adequate supplies of any regular or intermittent medications you take. Have a full dental check up a couple of months before you go (see our Dentists in this area page)
FIRST AID KIT
Put together a medical kit appropriate to the nature of your trip
PERSONAL SAFETY
Objective Travel Safety runs regular courses specifically designed for students planning gap year travel