Travel advice vaccinations: Thinking of a holiday abroad? Then read our latest travel advice article on Vaccinations, some of which are free from your practice nurse or GP..

These can vary across practices, but the free Vaccinations usually include: Typhoid, Hepatitis A, Meningitis C, and Tetanus, Diphtheria, and Polio (which are combined in one vaccine).

You should in an ideal world: Plan your travel vaccinations well in advance. If possible, you should see your GP at least three months before you are due to travel, for the latest travel information on vaccinations.

• Its important to note that: – Some jabs need to be given gradually over 3 months before travel, in order for them to work properly. So try not to leave it till the last minute.

For the Caribbean as an example, you should have travel vaccinations against both tetanus and hepatitis A as a minimum.

Below are some are countries, which you will be required to have vaccinations, and or take Malaria medication..

Thailand

If you are travelling to Thailand, you will usually be advised to have vaccinations against diphtheria, tetanus, poliomyelitis, and hepatitis A. You may also be advised to have immunisations for typhoid, tuberculosis, rabies, hepatitis B, and Japanese B encephalitis.

Brazil

If you are travelling to Brazil, you will usually be advised to have vaccinations against diphtheria, tetanus, hepatitis A, and yellow fever (mainly for Western Amazonian areas and the Iguacu Falls). You may also need to have vaccinations against typhoid, hepatitis B, rabies and tuberculosis.

Japan

As well as ensuring that your UK vaccinations and boosters are up to date, if you are travelling to Japan, you may be advised to have vaccinations against Japanese B encephalitis and hepatitis B, although they are usually only needed if you are going to be visiting remote areas.

Africa

In some areas of the world, such as Africa, there is a risk of catching malaria. See your GP or pharmacist for advice about malaria tablets.

Caribbean (including the Bahamas, Jamaica, and Cuba)

For many countries in the Caribbean, you will need to have vaccinations against tetanus and hepatitis A. Depending on exactly where you are travelling to, you may also need to be vaccinated against hepatitis B, rabies, diphtheria, typhoid, yellow fever, and tuberculosis.

As well as having any new vaccinations, you should make sure your existing vaccinations, such as polio and tetanus, are up to date and, if necessary, have booster jabs.

For more on What travel vaccinations do i need? Go to http://www.fitfortravel.nhs.uk/home.aspx

This is a Consumer travel advice & issues post by Cheaperholidays.com - Cheap holidays from the UK -

Travel advice vaccinations

Travel news Malaria Advice: Popular holiday destinations at risk from Malaria include: The Gambia, South Africa, Malaysia, Thailand and Asia to name but a few.

So do take precations to prevent contracting this sometimes fatal insidious disease, the consequences of a Malaria infection can last long after you have returned from holiday.

Taking Anti-Malaria Tablets

• Start Malaria medication, normaly a week before travel as guided by your travel health advisor or Doctor.
• Take the tablets absolutely regularly, preferably with or after a meal.
• It is extremely important to continue to take them for four weeks after you have returned, to cover the incubation period of the disease.
• Atovaquone/proguanil (Malarone) requires only 7 days post-travel)

Malaria kills within 24 hours in some severe cases, last year 5 UK holiday makers died from being infected…

Drugs Most Commonly Used for Malaria Prevention

Travellers must always, through discussion with their doctor or pharmacist, make sure they use a drug which they can tolerate (only the more common side effects are given here) and one which is appropriate for their destination(s). No drug is 100% effective.

In Britain, chloroquine and proguanil can be purchased from local pharmacies or chemists. All other drugs require a doctor’s prescription.

Chloroquine (licensed for prophylaxis in UK)

Preparations available: Avloclor® (Zeneca) and Nivaquine® (Rhône-Poulenc Rorer). Adult dose is 2 tablets (each containing 150mg chloroquine as base) taken once a week. Nivaquine is available in syrup form.

Consider a trial course before departure, if using this regime for the first time, to detect if you are likely to get side effects (e.g. for two weeks). Otherwise, when possible, chloroquine should be started one week before exposure (to ensure adequate blood levels), throughout exposure and for 4 weeks afterwards.

Nausea and sometimes diarrhoea can occur which may be reduced by taking tablets after food.
Headache, rashes, skin itch, disturbance of visual accommodation (often expressed as blurred distance vision which may take up to 4 weeks to reverse) or hair loss may warrant changing to alternative drugs.

Retinopathy (eye changes) which can be permanent is unlikely to occur until 100g have been consumed (i.e. over 5 years treatment at prophylactic doses).
Caution in liver and renal disease.

Can aggravate psoriasis and very occasionally causes a convulsion so it should not normally be used in those with epilepsy.

Chloroquine is very toxic in overdose – parents must take special care to store the tablets safely.
It is generally accepted, as a result of long usage, to be safe in pregnancy.

Proguanil (licensed for prophylaxis in UK)

Preparations available: Paludrine® (Zeneca). Adult dose is 200mg daily.
Can normally be used continuously for a period of up to 5 years.

One or two doses should be taken before departure. It should be continued throughout exposure and for 4 weeks afterwards.

Anorexia, nausea, diarrhoea and aphthous (simple) mouth ulcers can occur.
Can delay the metabolism of the anticoagulant, warfarin, and result in bleeding.

Those planning to take warfarin must discuss this with their doctor before starting any treatment.

Caution in renal impairment.
Considered to be safe in pregnancy, but folate supplement is advised.

Mefloquine® (licensed for prophylaxis in UK)Preparations available: Lariam® (Roche). Adult dose is 250mg weekly.

One dose should be taken a week before departure and it should be continued throughout exposure and for 4 weeks afterwards however three (3) doses at weekly intervals prior to departure are advised if the drug has not been used before – this can often detect, in advance, those likely to get side effects so that an alternative can be prescribed.

Not licensed in Britain for use for more than 1 year (in countries where it is licensed for more than 1 year, additional side-effects are rare).

Nausea, diarrhoea, dizziness, abdominal pain, rashes and pruritis can occur.
Headache, dizziness, convulsions, sleep disturbances (insomnia, vivid dreams) and psychotic reactions such as depression have been reported.

These reactions most commonly begin within 2-3 weeks of starting the drug and may be worse if alcohol is taken around the same time as the mefloquine.

Avoid in epilepsy, if there is a close family history of epilepsy (e.g. parents or siblings) or if there is a history of psychiatric illness.

Caution, and avoid if alternatives are available, in severe renal or liver failure and those with heart rhythm defects. Also caution in those taking digoxin, beta or calcium channel blockers when arrhythmias and bradycardia can occur.

Although there is no evidence to suggest that mefloquine has caused harm to the foetus it should normally be avoided during the first trimester of pregnancy or if pregnancy is considered possible within 3 months of stopping prophylaxis.

Doxycycline (licensed for prophylaxis in UK)

Preparations available: Doxycycline (non-proprietary), Vibramycin® (Invicta). Adult dose is 100mg daily.
Can normally be used continuously for a period of at least 6 months – be guided by your doctor.

Consider a trial course before departure, if you are using this regime for the first time, to detect if you are likely to get side effects (e.g. for one week).

Otherwise doxycycline need only be started just before exposure (e.g. 2 days), continued through exposure and for 4 weeks afterwards.

When other tetracyclines are being already used for acne this will provide protection against malaria so long as an adequate dose is taken (you can change to 100mg doxycycline per day if your doctor agrees).

Erythema (sunburn) due to sunlight sensitivity can occur. Use of sunscreens is especially important and if severe, alternative prophylaxis should be used.

Heartburn is common so the capsule should be taken with a full glass of water and preferably while standing upright.

Contraindicated in pregnancy (including one week after completing the course), breast feeding, in those with systemic lupus erythematosis, porphyria and children under 12 years because permanent tooth discoloration can occur.

It may reduce the effectiveness of the oral contraceptive pill, you should discuss this with your family planning advisor.

Occasionally anorexia, nausea, diarrhoea, candida infection and sore tongue (glossitis) have been reported and rarely hepatitis, colitis and blood dyscrasias.

Atovaquone plus proguanil (licensed for prophylaxis in UK)

Preparations available: Malarone®. Adult dose is one tablet daily – each tablet contains 250mg atovaquone plus 100mg proguanil. Child doses will be based on the weight of the child but will be once daily also.

DO NOT confuse with Maloprim® which is not now advised for prophylaxis since more effective alternatives are available.

Should be taken for 1 or 2 days before entering the malarious area, throughout exposure, and for 7 days after leaving the infected area. Licensed for trips of up to 28 days but there is no evidence of increased side-effects if used for longer.
Atovaquone/proguanil need only be commenced one or two days before exposure.
Abdominal pain, headache, anorexia, nausea, diarrhoea, coughing and aphthous (simple) mouth ulcers can occur.

Absorption may be reduced in diarrhoea and vomiting, and blood levels are significantly reduced with concomitant use of tetracyclines, metoclopramide and especially rifampicin or rifabutin.

The proguanil component can delay the metabolism of the anticoagulant, warfarin, and result in bleeding. Those planning to take warfarin must discuss this with their doctor before starting any treatment.

Caution in renal impairment.

Lack of experience in pregnancy and during breast feeding means that it should be avoided in these circumstances unless there is no suitable alternative.

The high cost makes popular for short trips.

This is a Consumer travel advice & issues post by Cheaperholidays.com - Cheap holidays from the UK -

Malaria risk on holiday