Hepatitis A

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 vaccination Avaxim (Hep A) or Twinrix (Hep A & B) or Viatim ( Hep A & Typhoid)


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 vaccination Typhim (Typhoid) or Viatim (Hep A and Typhoid)

Hepatitis B

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 vaccination Engerix B or HbvaxPRO

Japanese Encephalitis

It is a viral illness transmitted by mosquitoes. It can cause inflammation of the brain (encephalitis). It is found in most rural parts of Asian countries. The Illness It is a rare illness. Approximately 1 in 250 people became unwell after infection. Symptoms include high fever, convulsions, headache and neck stiffness. 1 in 300 people develop encephalitis. 20-30 % of severe cases are fatal. Recommended vaccination Ixiaro

Meningococcal Meningitis

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 vaccination ACWY Vax or Menveo. We provide a free certificate.


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. 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. Recommended vaccination Rabies Vax or Rabipur

Yellow Fever

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 like ours. 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 vaccination Stamaril yellow fever


Cholera is an acute diarrhoeal infection, caused by the bacteria Vibrio Cholerae. An estimated 1.3 million to 4 million causes of cholera occur per year with between 21,000 and 143,000 deaths.  Outbreaks can occur in any world region, but are more prevalent in regions where access to clean water and sanitation is not available.Cholera is transmitted by drinking contaminated water or eating food contaminated by faeces, such as shellfish. Person to person contact can occur where there is poor hygiene.Cholera is an easily treatable disease. The prompt administration of oral re-hydration salts to replace lost fluids nearly always results in cure in mild to moderate cases. In especially severe cases, intravenous administration of fluids and antibiotics  may be required to save the patient’s life.It is important to maintain food and water hygiene at all times while travelling, particularly so, if you are carrying out voluntary work or are in remote areas. The cholera vaccine is a safe and effective vaccine for those who are at increased risk of contracting this potentially life threatening illness.The cholera vaccine is an oral vaccine containing inactivated cholera bacteria.

Tick Borne Encephalitis

Tick borne encephalitis is a viral infection affecting the brain and spinal cord. It is found in Central, Northern and Eastern Europe, Russia, Northern China and Mongolia.Transmission occurs through the bite of an infected tick. Peak transmission is in early spring and summer, but can occur all year around. The ticks are found in forested and rural areas. The infection can also be acquired through drinking unpasteurised milk, especially goats milk.The incubation period for the disease is between 2-28 days. The symptoms and severity depend on the infecting strain. There are three strains; European, Far Eastern and Siberian.

The symptoms of the European strain include-flu like illness with high fever. 30% develop signs and symptoms of meningitis and encephalitis with persisting neurological complications in 10-20%. The death rate from the European strain is around 1%.

The Far Eastern strain gives a more severe and prolonged illness with a mortality rate ranging between 5-20%.There is no specific treatment against Tick borne encephalitis.There is a safe and effective vaccine against Tick borne encephalitis. Additional measures include wearing covered footwear and long trousers and checking regularly for ticks after carrying out any outdoor activities in forested areas, such as hiking, camping or fishing.The tick borne encephalitis vaccine is between 98-99% effective against the European strains and is also thought to be as effective against other strains. It is an inactivated vaccine containing dead virus