CITYDOC IS AN ESTABLISHED NATIONAL PROVIDER OF VACCINATIONS
CityDoc has served over 250,000 clients since 2006. Our pre-travel consultations are with experienced staff who will assess the impact of any pre-existing medical conditions on your vaccine requirements. Our competitive pricing and easily accessible high street locations make us your first choice for all your travel needs.
We are more than travel health experts. CityDoc provides a range of speciality vaccines and private blood tests for personal and occupational health needs.
SPECIALITY SERVICES
Provided at CityDoc’s London Travel Clinic Network
TRAVEL HEALTH
Complete travel health service customised to your individual needs.
SPECIALITY VACCINES
MMR, Chickenpox, HPV Vaccine
PRIVATE BLOOD TESTS
Hepatitis B and C, Chickenpox, MMR
The most important initial step, prior to international travel, is seeing your health advisor for a travel risk assessment. Vaccinations, work by stimulating your immune system to produce antibodies without causing infection. Immunological memory, persists for life, therefore it is generally unnecessary to restart a vaccine course.
However, the levels of antibody often wane with time depending on the vaccine, so boosters will often be required, to re-stimulate your immune memory.
Some vaccinations courses, for example rabies (3 doses -Day 0, 7, 21) require multiple doses separated over a number of weeks. It is therefore prudent to arrange your initial consultation 4-6 weeks prior to travel, especially if the trip is rural in nature or to a high risk region.
We have categorised our vaccines into Highly recommended and Sometimes Considered.
Our Highly Recommended Essential Travel Vaccine Package
| Vaccine | Number of doses within course | Interval between doses | Duration of protection |
|---|---|---|---|
| Hepatitis A | 2 doses | 2nd dose administered 6-12 months later | 25 Yrs |
| Tyhoid | 1 dose | N/A | 3 Yrs |
| Diptheria/Tetanus/Polio | 1 dose (Provided childhood course has already been given) | N/A | 10 Yrs |
| Vaccine | Number Of Doses | Protection For: |
|---|---|---|
| Hepatitis A | 2 doses | 25 Yrs |
| Tyhoid | 1 dose | 3 Yrs |
| Diptheria/Tetanus/Polio | 1 dose (Provided childhood course has already been given) | 10 Yrs |
Drinking Water – Essential Tips
Important for reducing risk of traveller’s diarrhoea, as well as other water-borne infections-hepatitis A, typhoid, polio, cholera.
- We advise against drinking or brushing with tap water
- Avoid using ice cubes
- Please drink only boiled water or carbonated beverages.
- Be wary of bottled water as safety and bottling conditions may not be adequate
- Boiling water for 3 minutes followed by cooling, kills infection carrying organisms.
- Filtration devices or chemical disinfection such as chlorine tablets (may not kill all parasitic infections) are also worth considering as alternative
Food Safety
Please adhere to the following advice:
- Avoid eating unpeeled fruit
- Please refrain from eating raw vegetables
- Avoid drinking unpasteurised dairy products
- Do not eat raw or rare meat, shellfish
- Ensure that your food is always piping hot
Traveller’s Diarrhoea
Very common: 20-60% incidence depending on destination (high risk regions include: Africa, Asia, Middle East and South America).
Causes:
Bacterial – Bacterial pathogens occur in 80-90% of cases. Common agents include E.coli, Campylobacter jejuni, Shigella spp and Salmonella spp.
Viruses – Norovirus, rotavirus are common causes.
Parasites – Giardia most common, others include Entamoeba.
Symptoms
Usually includes the sudden onset of diarrhoea (can be bloody), abdominal pain/cramps, fever, vomiting. Duration typically 3-5 days in bacterial cases, 2-3 days in viral and can be weeks in untreated parasitic infections.
Treatment
Hydration – oral rehydration sachets/solutions
Antimotility drugs – provide symptomatic relief
Antibiotics – in moderate/severe cases have proven beneficial.
We advise to seek medical advice if not improving after 1-2 days, especially in the elderly/children or if symptoms of dysentery (bloody loose motions) are present.
Prevention
The cholera vaccine gives cross-protection against E. coli enterotoxin. Can be effective for traveller’s diarrhea.
Animal Bites Advice
- Avoid contact with animals especially dogs, monkeys and cats.
- If bitten wash wound thoroughly with soapy water for 10 minutes
- Do not suture or close wound
- Seek urgent medical advice
- Open water, soil and sand can harbour infection therefore
-avoid swimming in fresh water (risk schistosomiasis)
-avoid walking barefoot on sand/soil, which may be
contaminated with faeces (hookworm infection)
Insect Bite Avoidance
- Mandatory even if vaccinated or taking antimalarials
- Plan activities, so you can avoid insect/tick/mite infested areas and maximise preventive measures during peak hours to reduce exposure where possible
- Day biting mosquitoes-spread infections also including dengue and yellow fever
- Night biting mosquitoes- spread diseases including malaria and Japanese Encephalitis
- Sandflies-cause leishmaniasis and are active from dusk until dawn
- Tsetse fly-cause sleeping sickness and are found within vegetation and grasslands of Sub Saharan Africa, and exhibit day biting
- Ticks/mites-cause lyme’s disease and tick borne encephalitis, and are found meadows / woodlands / grasslands / forests
- Protective clothing-long sleeved shirts and pants, tucking in shirts / pants, closed shoes, can add permethrin to clothes for added protection
- Check skin regularly for ticks/mites during and following outdoor activities
- Apply insect repellants regularly to exposed areas
Sun Protection
- Always wear sun protection, using a minimum of SPF 15+.
- Avoid sun bathing between 12-2pm
- Wear Sun glasses
Travel Safety
- Photocopy passport and any certificates
- Email details of bank, help numbers etc to yourself
- Email photocopies of certificates etc
- Know where to get help
- Obtain Comprehensive insurance including
-Covers for all activities
-Ensure Insurance company aware of any medical problems (may not cover if decline recommended vaccines).
Travel Risk Assessment
At CityDoc you will receive a travel risk assessment, which takes into account your specific itinerary, medical history and the type of activities you likely to undertake. Your health professional will use the evidenced based travel health resource-Travax to review the latest destination specific recommendations.
Full Range of Vaccinations
Our clinics stock an extensive range of vaccinations including less commonly administered vaccines such as Japanese Encephalitis, Meningitis ACYW Vax and Cholera.
Japanese Encephalitis
This is a viral infection, which causes inflammation of the brain. It is transmitted via bites from infected mosquitos. Initially the mosquitos acquire the virus from infected animals such as pigs and then pass it onto humans. The disease is not transmitted from person to person.
It is most commonly seen in South-East Asia and the Indian subcontinent. The specific type of mosquitos which transmit this virus tend to found within rice paddy fields where they breed.
The majority of infected individuals display no symptoms. Approximately thirty percent of infected individuals will die from the disease.
| Age range | Vaccine Brand | Dose | Method of Administration | Number of doses primary course | Interval between doses primary course | First Booster dose requirements | Second Booster dose requirements |
|---|---|---|---|---|---|---|---|
| 2 months-3 years of age | Ixiaro | 0.25ml | Intramuscular injection to the thigh or deltoid muscle. | 2 doses | 2nd dose administered 28 days after 1st dose | If at ongoing risk for infection (such as travelling to live in endemic country)-First Booster at 12 months All other Travellers-First Booster at 12-24 months | Unknown |
| Children over 3 years up until 18 years | Ixiaro | 0.5ml | Intramuscular injection to the deltoid muscle | 2 doses | 2nd dose administered 28 days after 1st dose | If at ongoing risk for infection (such as travelling to live in endemic country)-First Booster at 12 months All other Travellers-First Booster at 12-24 months | Unknown |
| Adults 18 years-65 years | Ixiaro | 0.5ml | Intramuscular injection to the deltoid muscle | 2 doses | Standard Schedule=2 doses given at day 0 and day 28 Rapid Schedule-2 doses at day 0 and day 7 | If at ongoing risk for infection (such as travelling to live in endemic country)-First Booster at 12 months All other Travellers-First Booster at 12-24 months | Second Booster at 10 years if at risk. |
Cholera
Cholera is an acute severe illness characterized by very watery loose stool and vomiting. These symptoms can quickly result in dehydration and mortality can occur if rapid antibiotic treatment is not initiated.
It is caused by the bacterium Vibrio Cholerae and generally transmission is through drinking contaminated water.
| Age range | Vaccine Brand | Method of Administration | Number of doses | Interval Between doses | Booster Requirement |
|---|---|---|---|---|---|
| From 6 years of age onwards | Dukoral | Oral | 2 doses | Minimum interval 1 week Maximum interval 6 weeks | 2 years after 2nd dose if continuing risk |
| 2-6 years | Dukoral | Oral | 3 doses | Minimum interval 1 week Maximum interval 6 weeks | 6 months after 3rd dose if further risk of disease |
Meningococcal Meningitis
Meningococcal meningitis refers to a bacterial inflammation of the lining of the brain and spinal cord. It caused by various subtypes of the bacterium Neisseria Meningitidis. It can cause severe brain damage if untreated. 6 Strains of the bacterium can lead to epidemics (A,B,C,Y,W). An area known as the meningitis belt of sub-Saharan Africa has the highest incidence.
The bacterium spreads directly from person-person through respiratory or throat secretions. Those at particular risk include those living in close proximity such as university students in dormitories. Transmission occurring commonly via kissing, sneezing and coughing.
We have two vaccines available against Meningoccal Meningitis-
1.Meningitis ACYW Vaccine
Protects against strains A,C,Y,W.
| Age range | Vaccine Brand | Method of Administration | Schedule | Number of doses | Booster |
|---|---|---|---|---|---|
| From Birth to 1 year* | Menveo Only | Intramuscular injection to the thigh | First Dose Given Day O Second Dose Given One Month Later | 2 doses | Unknown |
| From 1 years of age onwards. | Menveo or Nimenrix | Intramuscular injection to the deltoid muscle | One Single Dose | 1 dose | Unknown |
- Meningitis Group B Vaccine
Protects against Group B.
| Age at first dose | Method of Administration | Number of doses | Interval Between Doses | Booster Requirement |
|---|---|---|---|---|
| 2-5 months | Intramuscular injection to the thigh | 3 doses | At least 1 month between each dose | Yes-One further dose given at 12-15 months of age |
| 6-11 months | Intramuscular injection to the thigh | 2 doses | At least 2 months between doses | Yes-One further dose given in 2nd year of life, at least 2 months after 2nd dose. |
| 12-23 months | Intramuscular injection to the thigh or deltoid muscle | 2 doses | At least 2 months between doses | Yes-One further dose given 1-2 years after the 2nd dose |
| 2-10 years of age | Intramuscular injection to the deltoid muscle | 2 doses | At least 1 month between doses | Unknown |
| Over 11 years of age | Intramuscular injection to the deltoid muscle | 2 doses | At least 1 month between doses | Unknown |
