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Routine Travel Vaccinations
Do you think you need routine travel vaccinations? If so, which do you need and which can you do without? You’ll find out when you make an appointment with us to chat about your travel arrangements and destination/s.
It’s important to an appointment in good time, ideally at least six weeks before you go. Bear in mind you’ll probably need a second appointment, when you’ll actually be given your shots and doses. This second appointment should be at least 2 weeks before your departure date, to give the vaccines the time they need to do their work.
We’ll provide the latest expert advice about which jabs and doses you need for your particular destination and personal circumstances. Here’s a general overview of the routine travel vaccines you might need.
The 14 most common travel vaccinations
- Cholera
- Diphtheria
- Hepatitis A
- Hepatitis B
- Japanese encephalitis
- Meningococcal meningitis
- MMR (measles, mumps and rubella)
- Polio
- Rabies
- Tetanus
- Tick-borne encephalitis
- Tuberculosis
- Typhoid
- Yellow fever
Details about common holiday vaccinations
Cholera vaccination – Recommended if you’re going to a place where the disease is common or there’s an outbreak, especially aid workers and people who travel to remote areas where there’s no access to medical facilities.
The vaccine usually comes in 2 doses, as a drink, 1-6 weeks apart. Children age 2-6 need a third dose 1-6 weeks after the second. You should take your final dose at least a week before you leave. If you’ve been vaccinated in the past, you’ll need a booster.
Diphtheria vaccination – A three-in-one vaccination against diphtheria, polio and tetanus is given to all UK children. You should only need a booster if you’re going to a place where diphtheria is widespread and your last vaccination was more than a decade ago.
Hepatitis A vaccination – This is recommended if you’re going to a place where hepatitis A is widespread, particularly if you’ll be staying there for some time or going to an area with particularly poor sanitation.
You can expect a single vaccination, an injection, with an optional booster 6-12 months later. This’ll offer protection for around 20 years. You should have the first injection at least two weeks before you leave, although it can be given as late as the day you depart.
You can also get jabs offering combined protection against hepatitis A and hepatitis B or typhoid , a good idea if you’re travelling to a risky area.
Hepatitis B vaccination – This is highly recommended if you’re going to an area where the disease is common, and/or if your personal circumstances put you at extra risk. Unprotected sex, injecting drugs and playing contact sports all increase the risk.
The vaccination involves 3 injections, sometimes spread over six months, sometimes over a much shorter period.
Japanese encephalitis vaccination – Recommended if you’re staying at least a month in a place where it’s widespread, particularly when you’re going in the rainy season, visiting rural areas, cycling, hiking or camping.
It’s worth bearing in mind that Japanese encephalitis is rare in Japan itself, thanks to mass immunisation.
Vaccination consists of two jabs, the second 28 days after the first. In an idea world you’ll have the second dose a month before you travel.
Meningococcal meningitis vaccination – Recommended if you’re travelling to an at-risk area or the things you’ll be doing there put you at extra risk, for example staying in a vulnerable area for some time. Everyone travelling to Saudi Arabia for the Hajj or Umrah pilgrimages must show proof they’ve been vaccinated.
The ACWY vaccine you’ll be offered is a single jab and you should have it 2-3 weeks before you leave, even if you already had a meningitis C vaccination as a child.
MMR vaccination – This protects against measles, mumps and rubella and it’s given to every UK child as 2 injections, one at 12-13 months old and the other when they start school. If you haven’t had them, MMR vaccination is a good move if you’re going to an area where the diseases are common or there’s an outbreak.
Adults can take their two doses one month apart and children can have them three months apart.
Polio vaccination – This protects against diphtheria, polio and tetanus and is given to every child in Britain. Boosters are only important if you’re going to a place where the disease is common and you were vaccinated more than a decade ago.
Rabies vaccination – If you’re going to a place where rabies is common, staying there a long time, staying where medical facilities are limited or doing things that could increase your risk of being bitten – for example cycling – you need jabs.
Vaccination typically involves 3 injections. The second takes place 7 days after the first and the third 14-21 days after that. You won’t need a booster unless the last time you had a jab was more than 10 years ago and you’re going to a high-risk area.
Tetanus vaccination – See polio, above.
Tick-borne encephalitis vaccination – This is usually only recommended if you’re staying in a high risk area for some time, or will be hiking or camping in at-risk areas during late spring or summer.
The vaccination comes as 3 jabs, the second given 1-3 months after the first. This keeps you immune for around a year. The third jab takes place another 5-12 months later gives you immunity for as long as 3 years, but the course can be accelerated if necessary with 2 jabs 2 weeks apart.
Booster doses of the vaccine may be recommended every three years, depending on your circumstances.
Tuberculosis vaccination – British children get a TB jab when they’re little. The BCG jab is recommended for people under 16 years old who will be working or living with locals for 3 months or more, or if they haven’t already had the jab, which consists of a single injection.
Typhoid vaccination – This is a good idea if you’re going to a place where the disease is common, especially when you’ll be working or living with locals, or exposed frequently to poor food hygiene and bad sanitation.
Two vaccines are available. One is a single jab, the other is three capsules, which you swallow every other day. You can also get a combination hepatitis A / typhoid jab.
Ideally, you should take the vaccine at least a month before you go but there’s some flexibility. If you’re at risk of infection, a booster every 3 years is a good idea.
Yellow fever vaccination – This is vital if you’re going to a place where the disease is common or there’s an outbreak. Some countries demand a proof of vaccination certificate before they let you in. It’s important to have your jab at least 10 days before you leave.
It’s a good idea to have a booster every decade if you’re still at risk, but the latest research hints that this might not be necessary, with immunity lasting a lifetime, much longer than originally thought.
Expert advice from our experienced staff
We will give you expert advice on all the travel vaccinations you need, tailored to your exact situation. This level of service is vital, especially so under some circumstances: when you’re either pregnant or breastfeeding, have an immune deficiency or an allergy.
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Travel Vaccinations for Koh Samui, ThailandTravel Vaccinations for Koh Samui, Thailand Koh Samui is not only one of the loveliest and most exciting places to spend your holiday in Thailand, but, at present, it is also one of the safest in post-coup Thailand. Koh Samui...
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Travel Vaccinations for Koh Samui, Thailand
Koh Samui is not only one of the loveliest and most exciting places to spend your holiday in Thailand, but, at present, it is also one of the safest in post-coup Thailand. Koh Samui seems virtually untouched by the otherwise general unrest and protest activity that affects most regions in the country, but, in addition, it is at low risk for Malaria.
Don’t be misled, however, into thinking that you don’t need to be protected and aware of certain risks that always come with overseas travel. For, although you don’t need to worry about Malaria, you must bear in mind that you are vulnerable to certain diseases, especially, when travelling to countries with tropical climates.
As you begin preparing for your trip to Koh Samui, first on your mind should be a visit to your family Doctor for a full medical check-up, and a review of past immunisations. During your visit, remember to ask your Doctor for renewals on any prescription medication you will require for the duration of your holiday.
Make sure you book an appointment at least 6 weeks prior to your planned departure to discuss travel vaccinations. During your visit, we shall discuss with you the vaccinations that we recommend for Koh Samui, and determine whether any of these are contra-indicated, either due to medication you are taking, or other sensitivities.
1. Routine Vaccinations for Koh Samui, Thailand
Prior to any travel you need to ensure you are up-to-date with your routine vaccinations.
Diphtheria, Tetanus and Polio Vaccination
Diphtheria, Tetanus and Polio area all serious and potentially life threatening diseases. Most travellers should have been vaccinated as part of the UK national vaccination schedule. A booster every ten years is recommended by the World Health Organisation. Vaccination is given as a single dose as part of the combined DTP Vaccination.
Diphtheria, Tetanus and Polio, Revaxis, Single Dose: £28
Measles, Mumps and Rubella
Measles, Mumps and Rubella are serious and potentially life threatening diseases. Most travellers should have been vaccinated as part of the UK national vaccination schedule. Vaccination is given as a course of two as part of the combined MMR Vaccination.
Measles Mumps and Rubella, MMR, Course of Two: £45 per dose
2. Courses and Boosters advised for Travel to Koh Samui, Thailand
Most people travelling to Thailand require the following travel vaccinations.
Hepatitis A Vaccination
Hepatitis A effects the functioning of the liver. It is found in areas that have poor sanitation and is common in Africa, Asia, Middle East and South America. There are a number of options for vaccination including single and combined vaccinations.
Hepatitis A Adult, Epaxyl, Single Dose: £42
Hepatitis A Child, Epaxyl, Single Dose: £42
Hepatitis A and Typhoid, Single Dose, Viatim: £87
Hepatitis A and B Adult, Twinrix, Course of Three: £60 per dose
Hepatitis A and B Child, Twinrix, Course of Three £40 per dose
Hepatitis A and B Child, Ambrix, Course of Three, £55 per dose
Typhoid Vaccination
Typhoid is a serious bacterial infection which causes acute inflammation of the liver. Left untreated, Typhoid can be fatal. It is found throughout the world in areas that have poor sanitation including Africa, Central and South America, South Asia and India, the Middle East. There are a number of options for vaccination including single, combined and oral vaccination.
Typhoid, Typhim Vi, Single Dose: £50
Hepatitis A and Typhoid, Viatim, Single Dose: £87
Typhoid Oral, Vivotiff, Course of Three, £50 for the course
3. Additional Vaccinations for Koh Samui, Thailand
Following a risk assessment based on your itinerary, length of stay, occupational and personal risks you may be advised additional travel vaccinations for Thailand, including:
Rabies Vaccination
Rabies is a very serious disease that is spread by infected mammals such as dogs, bats and monkeys. A rabies vaccine is crucial for extended or repetitive travel anywhere in the world and is given as a course of three over 21 to 28 days.
Rabies, Rabipur, Course of three, £50 per dose
Japanese Encephalitis Vaccination
Japanese Encephalitis causes inflammation of the brain and spinal cord and can cause brain damage and can also be fatal. It is spread by infected mosquitoes across South-East Asia and Japan. Vaccination is a course of two 28 days apart.
Japanese Encephalitis, Ixiario, Course of Two: £85 per dose
Hepatitis B Vaccination
Hepatitis B affects the functioning of the liver and is spread by coming into contact with infected bodily fluids. High risk activities include sexual intercourse, sharing needles and through medical intervention using unsterile equipment. There are a number of options for vaccination including single and combined vaccinations.
Hepatitis B Adult, EnergixB, Course of Three, £35 per dose
Hepatitis B Child, EnergixB Junior, Course of Three, £35 per dose
Hepatitis A and B Adult, Twinrix, Course of Three: £60 per dose
Hepatitis A and B Child, Twinrix, Course of Three £40 per dose
Hepatitis A and B Child, Ambrix, Course of Three, £55 per dose
Cholera Vaccination
Cholera is spread by contaminated food and water found in areas with poor sanitation. It can cause severe diarrhoea which can lead to dehydration. If left untreated cholera can be fatal. The vaccination is administered orally, two doses given over one to six weeks.
Cholera, Dukorol, Course of Two: £28 per dose
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Yellow Fever Requirements for Thailand
There is no risk of Yellow Fever in Thailand. However under International Health Regulations (2005), travellers who have been to an area affected by Yellow Fever, or who have travelled via an airport of a country affected, are required to present an International Certificate of Vaccination (ICVP) before they are allowed to enter Thailand.
Yellow Fever is a serious viral illness spread by mosquitoes in the tropical regions of Africa and South America. It causes severe flu-like symptoms which can develop into a serious illness including haemorrhagic fever, which can be fatal. The Yellow Fever Vaccination is given as a single dose that you need to have at least ten days prior to travel.
Risk of Malaria in Thailand
Malaria is not considered a risk in Koh Samui or Thailand’s major cities including Bangkok, Chiang Mai, Chiang Rai or tourist resorts including Koh Phangan and Pattaya. It is however is considered a high risk in other areas of Thailand including the boarder areas with Burma, Cambodia and Laos which are rural and heavily forested. If you plan to spend time here you may need malaria prophylaxis. Chang Mai and Chang Rai in the north are considered low to no risk.
Travellers to areas where there is a risk of malaria should get advice regarding medication which can be taken to help stop the illness from developing. The type of medication required depends on your destination, itinerary, length of stay and current medical condition. Further reduce the risk of being bitten by mosquitoes by using insect repellant such as DEET 50% and covering up exposed skin by wearing long sleeves and trousers.
Malaria is a viral illness spread by mosquitoes that bite from dusk to dawn throughout the tropical world. It causes high fever and severe joint and muscle pains. In serious cases, malaria can be fatal.
Non-Vaccine Preventable Diseases for Thailand
Dengue Fever is a mosquito-borne disease common throughout the tropics of South-East Asia, including Thailand. Unlike Malaria, the mosquitoes that carry the Dengue Fever virus tend to bite mainly during the daytime. Those infected with the disease suffer from severe aches and pains in the muscles and bones and develop flu like symptoms. Travellers can reduce the risk of getting Dengue Fever by avoiding being bitten by mosquitoes including covering up areas of exposed skin with long trousers and long sleeves as well as wearing insect repellant such as DEET 50%. There is no vaccination for Dengue Fever, treatment is supportive only.
Schistosomiasis cases have been reported in Thailand but the risk to travellers is considered to be low. Schistosomiasis is a tiny flatworm which infect freshwater snails which produces a larvae which penetrates the skin of people who come into contact with infested freshwater rivers and lakes. The larvae penetrate the blood vessels and move to the liver where they develop in to worms. Schistosomiasis can be treated early with an anti parasitic drug called praziquantel. It is best however to avoid swimming or bathing in high risk areas.
General Travel Health Risks for Thailand
Medical Care in Thailand
Medical Care in Thailand is generally of a high standard, and there is a good local hospital as well as other facilities on the island. Bear in mind that the symptoms of tropical diseases could be unfamiliar, so if you feel at all ill, it is best to see a Doctor as soon as possible.
Prior to departure, contact your Insurance provider to confirm that they will continue coverage while you are visiting Thailand, since some insurance companies refuse coverage in countries under martial law. You should have comprehensive medical and travel insurance to cover any eventualities.
Travel Health Risks in Koh Samui, Thailand
Once you have taken care of the necessary travel vaccinations and preventative measures to protect your health, the only risks you will be facing in Koh Samui will be on the roads and in the bars and resorts. Be on lookout for reckless, inexperienced, or drunk drivers on scooters, petty theft, either in hotel rooms, or in public places, drink and food-spiking. Never leave your drink or meal unattended.
Scams, and hustles. Don’t let a stranger act as your ‘guide’ or in other cases, talk you into a situation that could be very costly or even dangerous. If a total stranger offers you a ‘Fantastic deal’ on gem stones, walk away. Your safety and well-being in Koh Samui, on land, and in the sea, is ultimately your responsibility, and a good helping of basic commonsense can be the most valuable tool at your disposal.
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Rabies in India: Why is it still not eradicated?Rabies in India. Our Lead Nurse Kamila Soltysik has published an article in the Journal of British Global and Travel Health Association. Read the full article below: Every year more than 59,000 people in the world die of rabies. It...
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Rabies in India.
Our Lead Nurse Kamila Soltysik has published an article in the Journal of British Global and Travel Health Association. Read the full article below:
Every year more than 59,000 people in the world die of rabies. It remains an under-reported,
neglected disease ranking the 10th biggest cause of death due to infectious diseases globally.
It is a viral zoonotic disease spread via a bite, scratch or a lick from an infected animal, present
in more than 150 countries and poses a real threat to about 2.5 billion people. Despite Pasteur’s
discovery of the rabies vaccine 131 years ago, and the post-exposure treatment available,
thousands of people still die of rabies every year. Many countries have gained an efficacious
governmental control over rabies, mainly by vaccinating a wide number of human and dog
populations, and by implementing other interventions and policies. Only a few countries have
managed to completely eradicate the disease.
Unfortunately, this is not the case with India. Here the situation has not changed for a decade.
Almost 36% of rabies deaths worldwide happen in India. According to ‘End Rabies Now
Campaign every year 20,847 rabies deaths occur in India; while only 6002 deaths were
recorded in China, a neighbouring country with a similar number of human population. The
number accounts for one third of the world’s total. Despite many international and local
governmental initiatives to control rabies, India still struggles to ameliorate the situation.
Rabies disease
Rabies is probably the oldest recorded infection affecting humans, first documented in Babylon
in 2300 B.C. Rabies virus can be found globally in domestic animals (dogs, cats) as well as in
wildlife (e.g. foxes, racoons, mongoose, skunks and bats). Humans are only accidental hosts.
They become infected when bitten or scratched by a rabid animal. After the exposure, the virus
enters the nerve or the muscle cells and thus reaches the spinal cord, where it replicates.
Subsequently the virus travels up to the brain and infects all its regions, causing death due to
the dysfunctional changes of neurons. It then runs down via the peripheral pathways to the
salivary glands, adrenals and skin. Infected patients suffer periods of uncontrollable shakes and
panic attacks, then fall into coma and eventually die of respiratory or cardiac failure.
Although fatal if not treated in time, rabies is 100% vaccine-preventable. Humans can receive
protection as a pre-exposure prophylaxis, given intramuscularly or intradermally. Animals can
also be vaccinated in a form of an injection (domestic) or orally, as bait in food (wildlife). For
previously vaccinated people who have been exposed to a rabid animal, the World Health
Organisation (WHO) recommends a post-exposure treatment that includes washing the wound
with soap and water and receiving boosters of the rabies vaccine. This is usually enough to
save the lives of victims. However, previously unvaccinated individuals that had been bitten or
scratched should be treated in a timely fashion with human rabies immunoglobulin (HRIG) and
vaccinations. This intervention can be very expensive, or even unavailable at the time in
particular region or country.
What is the problem and how big is it?
Only a few countries (Japan, United Kingdom, Australia, New Zealand, Andaman and Nicobar
Islands) have managed to completely eradicate the disease, mainly thanks to their geographical
isolation and excellent governmental initiatives to control rabies. Countries in Western Europe
and the Americas have made great progress in eliminating rabies. They have recognised it to be
a public health concern and acted upon it by improving surveillance, mass dog vaccination,
community engagement and education, pre-exposure prophylaxis for people at high risk and
long term, sustained investment.
Unfortunately, in Africa and Asia it still poses a huge public health threat. Rabies in India is still
not a notifiable disease, therefore the exact figure of rabies bites remains unknown.
Although it has the highest incidence of rabies globally, the true number is presumably grossly
underestimated. Some studies have estimated it to be as high as 17 million dog bites per year.
One of the main reasons for this is that rabies bites occur in the most deprived rural areas,
where access to medical facilities is limited. According to Hampson et al, most rabies victims die
at home (>75%), making the statistics impossible to record.
Even if dog-bite victims do reach hospitals, they can be misdiagnosed as having cerebral
malaria, Guillain-Barre syndrome or other neurological condition. Two studies carried out in New
Delhi and Jodhpur showed many disparities in the knowledge and practices of doctors in
regards to rabies. Less than half of them were unaware of the intradermal rabies prophylaxis
schedule, and only 45% of them knew about HRIG. 81% of them knew of the PEP in
unimmunized patients, but only 40% were familiar with the guidelines for previously immunized
patients. More importantly, public doctors had markedly better knowledge than private doctors in
regards to the PEP. This is very concerning, when taken into account that India has the biggest
private sector of doctors in the world, accounting for 93% of the hospitals and 85% of doctors.
Awareness of the disease among communities is also very limited. According to ‘End Rabies
Now Campaign’ only 54% of survey respondents in Indian urban slums knew that rabies can be
fatal. In another survey 70% of people in India have never even heard of rabies and only 30%
knew about the importance of washing the wounds after animal bites. The majority of the victims
happen to be young children in poor rural areas, who have no resources or knowledge of how to
seek help. With their daily income ranging between $1 to $2 they are unable to pay to be
vaccinated. Post-exposure treatment (HRIG) is simply unaffordable, costing around 30,000
rupees ($447) for an average person. Moreover, India notoriously experiences local and
national shortages of HRIG, causing the patients who are willing to pay, to wait for it, for weeks
or even months, which can eventually lead to death.
Under-reporting of rabies cases, lack of education among Indian healthcare professionals,
unawareness of the disease in the communities and irregular vaccine distribution are not the
only problems the country needs to improve in its fight against rabies. India has an uncontrolled
canine population; some estimate it to be as high as 25 million. Only 15% of dogs have been
vaccinated, but in order to eliminate canine rabies the coverage needs to reach 70%. The
immune coverage must be maintained and protected from spill over from unvaccinated animals
in neighbouring areas. Until now, little has been invested in animal vaccination and great
measures need to be taken to vaccinate such a vast number of dogs.
So what has been done?
At the end of last year WHO launched a global framework with a target to reach zero human
rabies deaths by 203019. For the first time it collaborated with animal health sector, the World
Organisation for Animal Health (OIE), Food and Agriculture Organisation of United Nations
(FAO) and the Global Alliance for Rabies Control (GARC). In its Global Framework for the
Elimination of Dog-mediated Human Rabies, five main pillars were set. They included:
– Socio-cultural aspects (awareness, responsible dog-ownership, bite prevention and
treatment, post-exposure prophylaxis, community engagement)
– Technical aspects (vaccination, logistics, diagnostics, surveillance)
– Organisational aspects (good governance, promotion of One Health approach,
coordination and monitoring)
– Resources (investment and business plans)
– Political aspects (political and international support, regional engagement, legal
frameworks and demonstrating impacts)19
The federal government of India together with the National Centre for Disease Control (NCDC)
has also developed a pilot project to eliminate rabies. In its 12th five year plan, it included
strategies for training medical students and doctors, creating awareness in communities and
minimising animal bites. The NCDC has since collaborated closely with local business
companies to establish and develop more diagnostic facilities for surveillance purposes. This
resulted in increased attendance at anti-rabies clinics and the use of HRIG. Also, thousands of
doctors and nurses have been trained in animal-bite management.
Furthermore, in 2009, the government adopted national guidelines in favour of intradermal
vaccination, which is highly immunogenic and cheaper than intramuscular vaccine. Eight out of
India’s 28 states planned to introduce this regimen that year, yet special training still had to be
implemented across the country to avoid insufficient dosing. Additionally, in 2009, India was
producing around 15 million doses of human rabies vaccine annually – quantities that met the
national requirement in that period.
Over the years India has received a huge contribution for rabies control from non- governmental
organisations, such as the Rabies in Asia Foundation, the Association for Prevention and
Control of Rabies in India, the Animal Welfare Board of India and the Association for Prevention
and Control of Rabies in India22. With their aim to end rabies in India by 2020, they slowly make
a change for the better. An example of a great success is the Rabies Day established ten years
ago by The Global Alliance for Rabies Control. It comes on the 28th of September and its
purpose is to raise global public awareness about the disease.
After only three such yearly events, GARC has estimated that over 100 million people had been
educated about rabies in over 120 countries and around three million dogs had been vaccinated
during such events. Their annual activities continue to raise awareness about rabies nationwide
including local Indian communities.
Is it enough?
It is evident that India’s main obstacle to rabies elimination is the lack of a good, comprehensive
national programme and the deficiency in coordinating it. Its neighbouring countries, such as Sri
Lanka and Thailand have made tremendous progress by taking a nationally coordinated
approach. By contrast, Bangladesh, with almost 10.000 deaths per year and less than six % dog
vaccination coverage, has adopted a very successful national strategic plan for the elimination
of rabies by 2020. Through the establishment of the District Rabies Prevention Control Centres
in almost every district, they provided facilities for mass dog vaccination, dog population
management, care of bitten patients, all of whom receive anti-rabies vaccine and
immunoglobulin for free. Funding was provided by the Ministry of Health and Family Welfare
(MoHFW) and the Ministry of Local Governance. Furthermore, local champions were appointed
to convince political leaders, policy-makers and stakeholders for political commitment and
technical leadership and partnership for this assignment. As a result, rabies deaths have
reduced by 50% between 2010 and 2013. Such an outcome contrasts with the slow progress
made in India, where rabies remains a non-notifiable disease.
Conclusion
It has been demonstrated in multiple research studies that India’s poor position in rabies
elimination is rooted in a lack of knowledge about the disease, uncontrolled canine population,
the insufficient vaccination programme, irregular supply of vaccines and inadequate training of
healthcare professionals. The government and healthcare authorities seem to know where the
problems lie and are gradually addressing them, but the process to improve the statistics
remains slow. The Indian government needs to take the rabies situation seriously, recognise it
as a real threat to its citizens and act upon it on a national level. To date, public spending on
rabies control in India has been insufficient. As Madhusudana, a rabies researcher and a
Professor of Neurovirology in Bangalore points out, a considerable amount of money in India is
being spent on raising awareness of diseases like tuberculosis, malaria, and HIV. According to
Madhusudana, India’s deaths caused by rabies would be radically reduced, if only a tenth of
that sum was spent on raising awareness about rabies. The World Health Organisation wants to
eliminate rabies from South-East Asia by the year 2020. India has seen some improvement in
its battle against rabies; however with the progress seen so far, it is a goal that India is unlikely
to meet.
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Promotional code terms and conditionsThese terms and conditions apply to those promotions where you must redeem a promotional code as part of the offer. The promotional code is valid for a limited time only. 360 Health and London Vaccination Clinic reserve the right to...
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These terms and conditions apply to those promotions where you must redeem a promotional code as part of the offer.
- The promotional code is valid for a limited time only. 360 Health and London Vaccination Clinic reserve the right to modify or cancel it at any time.
- Each promotional code can be used only once, unless otherwise specified.
- Bookings must be made before 11:59 pm, Friday 31 May in person at a London Vaccination Clinic, over the phone, or online using the code SPRINGHEALTH35 in the comments section of the booking form. The discount will be applied when payment is made.
- Each promotional code applies only to qualifying items. Details are specified in the promotion.
- Bookings must be made by Friday 31 May, 2019 and carried out by Friday 28 June, 2019.
- The promotion is subject to all restrictions set forth in the offer.
- The promotional code is not transferable, may not be resold or redeemed for cash.
- If you return items purchased using a promotional code, we will subtract the value of the promotional code from your return credit.
- Only one promotional code can be used each time and therefore cannot be combined with other offers using promotional code.
- Limit one promotional code per customer.
- 360 Health and London Vaccination Clinic reserve the right to void the transactions where prohibited.
If you violate any of the Terms and Conditions, the promotion will be invalid, and the promotional code discount will not apply.
360 Health and London Vaccination Clinic reserve the right to update these terms and conditions without prior notice.
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BRAZIL CARNIVAL VACCINESBrazil carnival vaccines : heading to Rio for the carnival this year? Make sure you have your yellow fever vaccine! Since December 2016 Brazil has been experiencing an outbreak of yellow fever that has now spread to Rio and the São...
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Brazil carnival vaccines : heading to Rio for the carnival this year? Make sure you have your yellow fever vaccine!
Since December 2016 Brazil has been experiencing an outbreak of yellow fever that has now spread to Rio and the São Paulo State. Initially covering 21 Brazilian states by July 2017 777 confirmed cases were reported with 261 deaths (case fatality rate of 34%). Since July 2017 a further 35 cases of yellow fever had been confirmed, of which 20 cases were fatal (case fatality rate 57%). Sao Paulo has been the worst-affected state, with 20 confirmed cases.
Recent spread of yellow fever into the municipality of Sao Paulo and the municipalities of Greater São Paulo suggest high risk for people who haven’t been immunised. Recent news, 9 January 2018, reports 4 deaths in Sao Paulo State.
There has been one case of yellow fever infection in a traveller. December 2017 a traveller from the Netherlands staying in in Mairipora, a municipality in the São Paulo metropolitan region became sick. He recovered fully after being hospitalised in the Netherlands on his return from Brazil. He has not had the yellow fever vaccine for Brazil
Yellow fever spreads to humans via the bite of the Aedes mosquito. These are day time biters. It is a viral infection, therefore can be difficult to diagnose and treat and is often misdiagnosed for other tropical infections or fevers. Infection can be fatal, vaccination is essential for life long immunity. The vaccine takes at least 10 days to work, so make sure you visit your travel health clinic well in advance.
Brazil carnival vaccines: The World Health Organisation http://who.int/ith/updates/20180116/en/advises all travellers heading to Rio, Brazil for carnival have the vaccine against yellow fever. Don’t forget to take a mosquito repellent with you (DEET 50% or higher) https://travelhealthpro.org.uk/disease/194/yellow-fever
In London, the vaccine is given privately, only a limited number of GP practices offer it. Clinics must be registered as the yellow fever vaccination centres in order to legally offer the vaccine. Yellow fever vaccine at the London Vaccination Clinic costs only £70 and comes with the vital yellow fever certificate. Visit the clinic here http://www.londonvaccinationclinic.co.ukfor a comprehensive consultation and yellow fever vaccine (given on the same day).
Sources: https://www.gov.uk/foreign-travel-advice/brazil
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Six reasons to visit Vietnam in 2019Vietnam is deservedly popular amongst holidaymakers. Amazing weather, divine scenery, delicious food and ancient cultural charms mix together to create a truly unforgettable destination. If you’re considering a holiday to Vietnam, 2017 is the perfect time to go. There’s good...
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Vietnam is deservedly popular amongst holidaymakers. Amazing weather, divine scenery, delicious food and ancient cultural charms mix together to create a truly unforgettable destination. If you’re considering a holiday to Vietnam, 2017 is the perfect time to go. There’s good tourist infrastructure but still plenty of sights off the beaten track to for a real Vietnamese experience. Here are six of the best reasons to visit Vietnam this year.
1 – Ha Long Bay
Vietnam’s most popular tourist attraction is still utterly spectacular in 2017. Junk boats float leisurely across this turquoise expanse and vegetation-covered limestone towers rise out of the water. It’s breath-taking – there really is no other word.
For the ultimate experience you should enjoy a cruise trip out on the bay, ideally on a boat you can sleep on. There are plenty of islands and islets across the bay that hold treasures including sandy beaches, dense forests and caves. Don’t miss Cat Ba, the largest island, half of which is covered by a National Park that is home to the endangered Cat Ba langur.
2 – Nha Trang
A pretty beach resort that has seen plenty of renovations in recent years, Nha Trang might be Southeast Asia’s most underappreciated holiday destination. Diving, snorkelling and other watersports are extremely popular thanks to the favourable conditions in the water. The arch of charming beach backs onto a lively promenade with as seemingly endless array of restaurants and boutiques. And a jaw-dropping backdrop is supplied the picturesque Co Tien Mountain, which intrepid travellers can climb. There really is something here for everyone.
3 – Mekong River
The South of Vietnam is the home of the Mekong Delta, where the Mekong River meets the sea. This is the ideal place to set off on a cruise along the Mekong. This iconic river flows through many of the important towns, including My Tho, Cai Be and Chau Doc where you can find floating markets, charming temples and more.
Cruising options range from small, basic boats to larger cruisers with amenities like air-conditioning. Be aware that as you pass through rural areas and get closer to Cambodia there is a great risk of issues such as malaria and Japanese encephalitis. It’s always best to consult a specialist clinic about the kind of vaccinations for Vietnam you may need.
4 – Cat Tien National Park
In between Ho Chi Minh City (Saigon) and Dalat, Cat Tien National Park consists of lowland tropical forests. It’s a great place to see an incredible diverse array of wildlife including Siamese crocodiles, eagles and families of the rare golden-cheeked gibbon. Hikers and birdwatchers will be in their element here, and if you’re especially lucky you might even catch a glimpse of an Asian elephant or an Asiatic black bear.
5 – Cu Chi Tunnels
Ho Chi Minh City has a range of attractions including the fascinating War Remnants Museum, Notre Dame Cathedral and a variety of pretty pagodas. But a trip to the city would not be complete without a tour of the Cu Chi Tunnels. This vast network of underground passages that served as the base for the Viet Cong during the Vietnam War. You can wander through the tunnels and visit preserved conference rooms where the resistance was planned.
6 – Hoi An
Hoi An is a beautiful city on the central coast. The city has existed for more than 2,000 years and features well-preserved examples of Vietnamese architecture. With virtually no traffic, this graceful city retains a peaceful ambiance.
Navigate the winding streets of the Old Town for a taste of the real Vietnam. This part of the city is listed as a UNESCO World Heritage Site and there are a number of famous sites including the Japanese Covered Bridge and the Quan Cong Temple, as well as museums dedicated to Folk Culture and Trade Ceramics. The city is also renowned for its range of tailors – if you’re staying for a few days and are interested in picking up a high quality tailor-made suit, the prices are fantastic.
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