There are a wide variety of vaccines available to prevent illness on your holiday. CityDoc’s medical team are travel experts and are able to provide free destination specific travel advice. We have locations across the UK to provide easy access to a travel health professional regarding your holiday vaccinations. At our GP lead flagship clinics in Moorgate City of London and the West End London we offer a walk in travel service or same day appointments.

The guide below details the most frequent travel vaccines required for common travel destinations.

Holiday Vaccinations

Cholera-

Introduction

Cholera is an acute diarrhoeal infection. It can kill healthy adults within hours.

The Illness

The disease is characterized in its most severe form by a sudden onset of acute watery diarrhoea that can lead to death by severe dehydration and kidney failure. The extremely short incubation period – two hours to five days – enhances the potentially explosive pattern of outbreaks, as the number of cases can rise very quickly. Cholera is an extremely virulent disease that affects both children and adults.

Treatment

Cholera is an easily treatable disease. The prompt administration of oral rehydration salts to replace lost fluids nearly always results in cure. In especially severe cases, intravenous administration of fluids may be required to save the patient’s life.

Recommended holiday vaccination: Dukoral oral vaccination

Diphtheria

Introduction

Diphtheria is an acute respiratory infection caused by the diphtheria bacterium.This is a serious infection with a high mortality rate, even in Western Europe. The disease is mainly transmitted by droplets from the nose or throat being passed from person to person, e.g. by coughing or sneezing.

The Illness

The incubation period, from infection to symptoms, is usually two to five days.

Diphtheria bacteria can destroy the mucous membrane, so that a thick coating is formed causing serious inflammation of the throat, sometimes causing asphyxiation. Local symptoms consist of a sore throat, coughing and breathing difficulties. Damage to the heart and nervous system occur in advanced stages. Death rates vary depending on country and treatment available (up to 40% in poorer countries).

Recommended holiday vaccination: Revaxis vaccination – Diphtheria, Tetanus and Polio

Hepatitis A

Introduction

Hepatitis A is an infection of the liver caused by the hepatitis A virus. It is spread through contaminated water and food, especially shellfish or through person to person contact where personal hygiene is poor.

Hepatitis A occurs worldwide, mostly in countries where sanitation is poor. It is now rare in Western Europe, Scandinavia, North America, Japan, New Zealand and Australia. Most cases imported into Britain have been contracted in the Indian sub-continent.

The Illness

The illness of all forms of hepatitis is similar. Symptoms include mild fever, gastro-intestinal upset, nausea/vomiting, diarrhoea and abdominal pain. Jaundice may also occur. Infection with hepatitis A results in lifelong immunity.

Recommended Holiday Vaccinations: Avaxim – Hep A or Twinrix – Hep A & B or Hepatyrix – Hep A & Typhoid

Hepatitis B

Introduction

Hepatitis B is an acute infection of the liver. It is usually spread through contaminated blood via sexual intercourse, needle sharing, blood transfusions and injections.The virus can also be passed from mother to baby. Tattooing, body piercing and acupunture are other ways in which the virus may be spread.

Hepatitis B occurs worldwide. Areas where there there is a higher risk of exposure to hepatitis B include Eastern Europe, Russia, India, China, South and Central America, Africa, South East Asia and many south pacific islands.

The Illness

The illness of all forms of hepatitis is similar however infection with hepatitis B is more serious than hepatitis A. Symptoms include mild fever, gastro-intestinal upset, nausea/vomiting, diarrhoea and abdominal pain. Jaundice may also occur.

The illness lasts for about six months. Occasionally, the virus can persist for more than six months in individuals who become chronically infected with hepatitis B. These individuals may be referred to as carriers. Up to a quarter of individuals who are carriers have progressive liver disease which can cause cirrhosis and cancers of the liver.

Recommended Holiday vaccinations: Twinrix – Hep A & B or Engerix B – Hep B or HbvaxPRO – Hep B

Meningococcal Meningitis

Introduction

Meningitis is an inflammation of the lining of the brain and spinal cord and can become very serious. Meningitis is often associated with septicaemia, otherwise known as blood poisoning, which can also be extremely serious.

It is spreads through the air by coughing sneezing or with direct contact of the respiratory secretions of an infected person.

Although most people recover from the disease, some are left deaf or blind, and in others it may prove fatal.
One of the biggest problems with meningitis is that it can develop very quickly. A child (or adult) can seem perfectly well and then, just a few hours later, be extremely ill with the disease. Another problem is that the symptoms can be difficult to distinguish from other, less serious infections.

The Illness

Cold hands and feet, fever, headache, abnormal skin colour, leg pains, aching muscles/joints, stomach pain, pupuric purple red rash (which does not disappear if pressed with a glass tumbler)

Recommended holiday vaccinations: ACWY Vax – meningococcal meningitis

Polio

Introduction

Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children. The virus is transmitted through contaminated food and water, and multiplies in the intestine, from where it can invade the nervous system.

The Illness

Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.

Recommended holiday vaccination: Revaxis – Diphtheria, Tetanus and Polio

Rabies

Introduction

Rabies is an acute viral infection that causes inflammation of the spinal cord and the brain (encephomyelitis). It is usually spread through an infected bite or scratch from a rabid animal, most commonly through a dog bite. In other parts of the world other animals such as bats, monkeys and cats are a source of potential exposure to the disease.Rabies is found in all continents of the world except Antarctica. There are more human cases of the disease in Asia, Africa and South and Latin America.

The Illness

The incubation period for the disease is usually between 3 to 12 weeks but may range from 4 days to 19 years in some cases. The virus causes headache, fever, general weakness and numbness or tingling around the wound site. The disease progresses to muscle spasms, hydrophobia (fear of water) and convulsions. Death is the usual outcome if infected with the rabies virus.

Treatment

There is no specific treatment available for rabies once symptoms develop.

Recommendations for Travellers

Pre-exposure treatment

Vaccination is recommended for all travellers who will be living or travelling in endemic areas and who maybe exposed to rabies because of their travel activities i.e. trekking, working or living in rural areas. Some individuals may require vaccination based upon their occupation. Such occupations include bat handlers, those working in animal quarantine centres and certain HM revenue and customs officers.

Post-exposure treatment

It is imperative to seek medical attention as soon as possible if a bite or scratch is sustained in any rabies endemic area even if pre-travel vaccination has been given. Saliva should be thoroughly washed with soap and water for 10 mins and the wound irrigated with iodine solution or alcohol. This is very effective in removing virus from the bite site, providing it is prompt and thorough. Suturing of the wound site should be avoided and tetanus vaccination should be considered.
 
Reccomended holidayvaccination: Rabies Vax – rabies

Tetanus

Introduction

Tetanus is caused by bacteria, often from soil, entering the body through a wound, cut, burn or an animal bite.
Tetanus is fairly rare in the UK because many people are vaccinated against it but can be common in other countries, particularly in poorer areas.

The Illness

Tetanus initially causes spasm of the muscles nearest to the infected wound and as it spreads other symptoms start, usually in the face.  The most common early sign is a spasm of the jaw muscles – known as lockjaw. Spasms can then occur in the throat muscles, making it difficult to swallow and can become serious with arching of the spine.

Recommended holiday vaccinations: Revaxis – diptheria, tetanus and polio

Typhoid

Introduction

Typhoid is an infectious disease caused by Salmonella typhi which causes severe symptoms in the digestive system. It can be life-threatening, but if treated early antibiotics are effective.

The disease is transmitted from human to human via food or drinking water, and it is therefore mainly hygiene and sanitary conditions that determine its spread. It is primarily for this reason that it is mainly seen in areas with poor sanitation/living conditions.

The Illness

The incubation period is 10 to 20 days and depends on, among other things, how large a dose of bacteria has been taken in.

In the mild disease, the bacterium is eliminated very early in the course of the disease and there are perhaps only mild symptoms. It is possible to become a healthy carrier of infection.

A more serious case of typhoid may include high temperature, sweating, cough, headache, vomiting and constipation (diarrhoea in children).

Recommended holiday vaccinations: Typhim- Typhoid, Viatim- Hep A and Typhoid, Hepatyrix – Hep A and Typhoid

Yellow Fever

Introduction

Yellow fever is a serious viral infection, transmitted by mosquitoes in tropical regions.

In mild cases the symptoms are similar to influenza, but serious cases develop a high temperature and may have a series of after effects, such as internal bleeding, kidney failure and meningitis.

In the UK you can only obtain the yellow fever vaccination from a designated Yellow Fever Clinic.

The Illness

The incubation period from infection to developing yellow fever is 3 to 16 days.

Symptoms include: high fever, generalised symptoms like violent headache, muscular pain, upset stomach and loss of fluid.

The fever dies down after three to four days and the general condition improves. However, in about 15 per cent of cases the fever returns within 24 hours – various systems in the body are affected during this phase. Anaemia (lack of red blood cells) develops as well as liver inflammation, hepatitis and jaundice. The kidneys are also affected and bleeding from the mouth, nose and stomach may occur, which leads to blood in vomit and faeces. The majority of patients who experience bleeding die in a short space of time.

Recommended holiday vaccinations: Stamaril – yellow fever