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Vaccinations and Medication: Before Travel

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Written by: Dr Seb Kalwij

Disclaimer: this is not a list of recommendations, but diseases to be aware of when you travel. Please consult a medical professional to find out which vaccinations you need before travelling.

Stay Healthy on Your Travels


Use these quick links to navigate to a specific disease.

Before You Travel

Before commencing overseas travel it is important to obtain the relevant vaccines. We are not going to provide a list of recommendations here but instead provide you with some information about some of the diseases that can be acquired overseas. In order to decide if you need vaccines and malaria tablets for your trip you should talk to a qualified health care professional. They will perform a “risk assessment” of your trip looking at – destination, length of trip, intended activities, standard of accommodation etc.
They can then let you know what vaccines you may need and what other health precautions you should take whilst you are away. Do this early – at least two months before you go – as some vaccinations can’t be taken at the same time as others and some take a while to ‘kick in’. Others require booster jabs some time after the initial injection. The injections recommended for each country can change so always check with a professional to find which jabs you need even if you think you know.
You usually need to pay for immunisations – after all it’s your choice to go away – but check prices at your local travel clinic as they may be cheaper than your regular surgery. Also, make sure you keep a record of your jabs, especially your yellow fever certificate, as some countries insist on seeing this before they let you in.

Allergies? Take Extra Care

Allergy sufferers should take particular care abroad and should, where possible, take supplies of relevant drugs with them. So asthma sufferers should take spare inhalers and those with nut allergies should take epipens. Remember to check expiry dates on all these products. If your doctor is unwilling to give you a long-term prescription on the NHS, ask him or her to give you a private prescription. The cost of these is minimal compared to the risk of travelling without the drugs you need. Antihistamine drugs, widely available without a prescription, might help in the event of an unexpected allergic reaction.


Transmission – via food and water contaminated with faeces.
Disease – an acute diarrhoeal illness.
Symptoms – sudden onset of profuse watery diarrhoea, known as rice water stools. Dehydration, circulatory collapse and death can occur.
Treatment – rehydration with either intravenous or oral fluids and antibiotic therapy.
Prevention – scrupulous attention to food and water hygiene. This disease is fairly rare in travellers and tourists.
Vaccine – not available in the UK and not recommended for travellers. The World Health Organisation states that Cholera vaccine is no longer an official entry requirement into any foreign country.

Dengue Fever

Transmission – via mosquitoes.
Disease – a severe flu like illness usually lasting less than 7 days or sometimes the more serious form can occur – Dengue Haemorrhagic fever leading to bleeding, shock and possibly death.
Symptoms – Rash, headache, high fever, painful joints and muscles.
Treatment – There is no treatment for the actual disease only management of the symptoms with Paracetamol, rest and plenty of fluids. For the more serious form of the disease hospitalisation would necessary.
Prevention – Bite avoidance. The mosquitoes that transmit Dengue tend to bite during the daytime.
Vaccine – none available.


Transmission – airborne via respiratory droplets or less commonly by direct transfer of secretions from an infected person e.g. through skin wounds.
Disease – a bacterial infection affecting the upper airways from nose to throat and occasionally the skin. This is complicated by the development of a membrane that can obstruct the airways causing difficulties in breathing.
Symptoms – sore throat, neck swelling, greyish coloured membrane in affected area.
Treatment – infected persons would need to attend a hospital for treatment.
Prevention – immunisation.
Vaccine – Diphtheria is given as part of our childhood immunisation programme and as of 1994 school children aged 15 should have received a combined tetanus / diphtheria booster. Immunisation lasts for 10 years.

Hepatitis A

Transmission – through ingestion of infected faeces. Usually from person to person but can also be through contaminated food and water.
Disease – A viral disease of the liver.
Symptoms – lethargy, lack of appetite, generally feeling unwell. Whites of the eyes or skin may become yellowy (jaundice), stools pale and urine dark.
Treatment – symptomatic. Sufferers can take a long time to fully recover and during this recovery there may be a complete ban on alcohol!
Prevention – immunisation. Avoiding contaminated food and water and oral- anal sex.
Vaccine – a Vaccine is available. One vaccine offers protection for up to a year if this is then boosted with a second injection between 6-12 months then 10 years protection is conferred. Ideally you should have this vaccine 14 days before travel.

Hepatitis B

Transmission – through contact with contaminated blood or bodily fluids.
Disease – A viral disease of the liver.
Symptoms – lack of appetite, vague abdominal discomfort, nausea and vomiting.
Treatment – specialised medical treatment needed.
Prevention – immunisation. Avoidance of risk activities such as unprotected sexual intercourse.
Vaccine – 3 injections are given over a 6-month period. For those with less time prior to departure there are 2 more rapid schedules available – one over 2 months and one over 3 weeks but both these require boosters after 12 months.

Japanese Encephalitis

Transmission – via mosquitoes. Only occurs in central and south east Asia.
Disease – a viral encephalitis (inflammation of the brain).
Symptoms – headache, severe flu like illness, confusion although some cases have no symptoms.
Treatment – none for the disease itself only for relief of symptoms.
Prevention – bite avoidance. Immunisation for those at risk.
Vaccine – a vaccine is available but should only be used by those genuinely at risk of contracting the disease. A course of 3 injections over 30 days or 2 injections at a 7 day interval. Either course should be completed 10 days before travel in case of any adverse reactions to the vaccine.


Transmission – via mosquitoes.
Disease – a parasitic disease affecting the red blood cells. There are four different strains of the disease. The worst type (falciparum) can cause multiple organ failure including cerebral damage and sometimes death.
Symptoms – headache, diarrhoea, high fever, generally feeling unwell or coma. These can take up to one year to occur for certain strains.
Treatment – Anyone exhibiting these symptoms who has travelled to a malarial area in the past year should seek medical help. Prompt treatment is essential in order to preserve life. For travellers who are getting well away from medial facilities in malarial areas it could be prudent to carry a “standby treatment kit”. This enables you to start treatment whilst getting to medical help where they can check you do actually have malaria not some other nasty!
Prevention – This is a multi- pronged approach as no malaria tablet alone is 100% effective. You should be aware of the where the malaria risks are on your trip. Follow the bite avoidance advice and use an anti-malarial that is appropriate to your area of travel. Guidelines for anti- malarials change regularly so make sure you get your information from an up-to-date source rather than on what your mates brother said etc. Completing the course of your tablets post travel is really important as the parasite can be in the liver up to 10 days post bite. Once it is released into the red blood cells it could take a further week for any symptoms to begin (i.e. 2+ weeks later) so if by now you are bored of your pills and you have stopped taking them, you would be susceptible to full blown malaria.
Vaccine – none available yet.


Transmission – airborne, via respiratory droplets.
Disease – a bacterial infection affecting the lining of the brain and spinal cord. It can also present as an infection of the blood stream and major organs (septicaemia).
Symptoms – fever with headaches, neck stiffness, photophobia, blotchy rash.
Treatment – specialised medical treatment needed.
Prevention – immunisation. Avoiding crowded areas or contact with infected persons.
Vaccine – Meningitis C is given for living in the UK. For travel other strains are more common. The combined Aand C vaccine is most commonly given. For religious pilgrims to Mecca, a 4 strain vaccination certificate is required – A, C, W135 and Y. This situation is subject to change as the strains that predominate may change. Vaccination should be taken at least 2 weeks prior to travel.

Poliomyelitis (Polio)

Transmission – via the faecal oral route.
Disease – a viral infection. Severity of illness varies from an asymptomatic one to infection of the motor neurons leading to limb paralysis and breathing problems.
Symptoms – headache, gastric disturbance, neck stiffness and malaise.
Treatment – specialised medical treatment needed.
Prevention – avoiding contaminated food and water. Immunisation.
Vaccine – Polio vaccine is part of the childhood vaccine programme with the final dose being at age14/15yrs. Boosters then required every 10 years. Polio virus has been eradicated from much of the world now and efforts continue to rid the whole world of this disease in the next few years.


Transmission – through a bite, scratch or lick on an open wound from an infected animal.
Disease – an acute viral infection that is almost always fatal.
Symptoms – initially fever, headache and tiredness followed by spasms, mental state changes and coma.
Treatment – none available. If a person is thought to have been in contact with a rabid animal the wound should be thoroughly washed with soap and water to remove as much of the virus as they can. They should then attend for medical help as soon as they can. Persons bitten need “post exposure” treatment, which consists of an injection of rabies immunoglobulin followed by as series of 5 further vaccines. This immunoglobulin is in short supply in much of the developing world.
Prevention – avoiding contact with warm blooded animals in countries that are known to have rabies. Immunisation pre travel is available.
Vaccine – a course of 3 injections given over 28 days prior to travel is available. This is called “pre exposure” rabies. It does not make travellers immune to the disease but in the case of a bite etc it will reduce the treatment needed to only 2 vaccines completely negating the need for the immunoglobulin. This also buys the travellers little more time in which to find the post exposure treatment.


Transmission – through tetanus spores that are present in soil entering the body through a cut or wound.
Disease – an acute disease with muscular rigidity and painful contractions.
Symptoms – severe and painful muscles, breathing problems.
Treatment – specialised medical treatment needed.
Prevention – Immunisation.
Vaccine – Tetanus vaccine is part of the childhood vaccine programme with the final dose being at age 14/15yrs. Boosters are then only required after a tetanus cut or injury if the time lapsed since the last booster is greater than 10 years. Travellers should consider being up-to-date with tetanus in preparation for travel.

Tick Borne Encephalitis (European)

Transmission – through the bite of a tick. Occurs only in central and eastern Europe.
Disease – a viral illness causing swelling of the brain.
Symptoms – headache, neck stiffness, confusion.
Treatment – symptomatic relief only.
Prevention – avoidance of tick bites. Immunisation.
Vaccine – a vaccine is available. 2 doses are given at a 4-12 week interval.

Tuberculosis (TB)

Transmission – airborne.
Disease – TB can affect any part of the body but is mostly see in its respiratory form.
Symptoms – weight loss, night sweats, cough, fever.
Treatment – specialised medical treatment needed.
Prevention – avoid overcrowded places and contact with infected persons. Avoid dinking unpasteurised milk. Immunisation.
Vaccine – BCG vaccine available in the UK. If travellers have not been immunised in their life and are at risk then immunisation needs to be taken about 2-3 months prior to departure.


Transmission – through consuming contaminated food and water.
Disease – a bacterial infection of the intestine.
Symptoms – prolonged feverish illness with lethargy, stomach pains, constipation and headaches.
Treatment – with antibiotics.
Prevention – good food and water hygiene. Immunisation.
Vaccine – vaccination lasts for 3 years. It should be taken at least 2 weeks prior to travel.

Yellow Fever

Transmission – via mosquito bites.
Disease – a viral hemorrhagic fever with a 5-80% mortality rate.
Symptoms – flu-like illness, jaundice.
Treatment – specialised medical treatment needed.
Prevention – bite avoidance. Immunisation.
Vaccine – a single vaccine gives protection for 10 years. For entry to certain countries a certificate of vaccination is compulsory. Vaccination takes ten days to be come effective.

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