4 Blenheim Walk, Leeds LS2 9AE

Phone: 0113 295 4488

Before You Leave

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BEFORE YOU LEAVE

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

  • HOW TO PLAN YOUR TRAVEL IMMUNISATIONS
    • 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

      3A – 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 for any of these vaccines see step 5

      3B – PRIVATE VACCINATIONS
      We are a registered Yellow Fever Centre and can provide private Yellow Fever vaccination to both registered and non-registered patients. Please contact our reception for the current fee for the vaccination and certificate

      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 want to book an appointment for an antimalarial prescription see Step 5C
      These antimalarials; Chloroquine, Proguanil, Chloroquine and Proguanil, can be purchased direct from a pharmacist

      STEP 5 – BOOKING APPOINTMENTS FOR TRAVEL VACCINES AND ANTIMALARIALS AT LSMP (REGISTERED PATIENTS ONLY)

      5A – TRAVEL SUMMARY
      You must have a travel summary in your possession (print of the relevant Internet pages) in order for us to give you travel vaccinations or an antimalarial private prescription and you must bring the print with you to the appointment (booked appointment not ‘same day‘)

      5B – APPOINTMENTS FOR FREE NHS TRAVEL VACCINES
      If you require vaccination with: Diphtheria, Tetanus, Typhoid, Hepatitis A or Cholera, book a 10-minute travel immunisation appointment with a nurse (booked appointment not ‘same day‘). Bring the travel summary print with you to the appointment – if you don’t bring it we will not see you, and you will have to book another appointment

      5C – APPOINTMENTS FOR PRESCRIPTION ONLY ANTIMALARIAL MEDICINES
      View our Malaria Prophylaxis information below, which contains information about antimalarial medicines. You can get prescription only antimalarial medicines from a private travel clinic (as listed in Step 3B), which may be the best option if you are attending there anyway for private vaccinations. Over the counter anti-malarial medicines can be obtained from pharmacies and usually private travel clinics. If you are a registered patient at our practice and want us to give you a private prescription for Doxycycline, Malarone or Mefloquine, make an appointment with a doctor at Leeds Student Medical Practice for this prescription.  Bring the travel summary print with you to the appointment – if you don’t bring it we will not see you, and you will have to book another appointment

  • MALARIA PROPHYLAXIS (PREVENTION)
    • 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. If you are a registered patient of Leeds Student Medical Practice and want to get an antimalarial prescription for Doxycycline, Malarone or Mefloquine, make an appointment with a doctor.  Bring the travel summary print with you to the appointment – if you don’t bring it we will not see you, and you will have to book another appointment

      Antimalarials Without Prescription (Over the Counter)

      OVER THE COUNTER ANTI-MALARIALS

      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

  • REQUEST FOR A LETTER TO TRAVEL ABROAD WITH CONTROLLED MEDICATION
    • 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.

  • OTHER IMPORTANT PREPARATION FOR YOUR TRAVELS
    • 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

      • Take adequate supplies of the antimalarial agent suited to your area of travel and remember to take it. People die every year from malaria in the UK
      • Even with the best prophylaxis you may still catch malaria so have a high index of suspicion
      • Report any unexplained illness with symptoms such as fever, headache, malaise, muscle aches and fatigue
      • Malaria can occur up to two years after being bitten by an infected mosquito
      • If you become unwell with fever up to a year after returning from a Malarious area, see your GP and tell them you have travelled abroad

       

      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