A very common mosquito spread illness which can be deadly – you should take medicine as a precaution when travelling to endemic areas. Also protect yourself against bites as much as possible.

There are 3 alternatives to take. They can only be issued as a private prescription so you pay the actual cost of the medication – this also applies for children and people who would normally not pay for prescriptions. You can go directly to a pharmacy in some cases if you only need malaria treatment:

1. Doxycycline – to be taken starting one day before the holiday, everyday while you’re there and four weeks when you come back.  For a two week stay that works out as 43 capsules and costs about £10. Can’t be given to children under 12.
2. Mefloquine (Lariam) – start two weeks before going away but only needs to be taken once a week. Continue for four weeks after coming home. Costs about £2/tablet, So a two-week holiday would be 8 tablets costing about £16. This is a good choice for children under 12 (and cheaper as they will be taking half or quarter tablets depending on weight)
3. Atovaquone/Proguanil (Malarone) – good for a short trip as you only need to take it from one day before travel, daily while you’re away and for one week when you return. It is the most expensive at about £2.00 a tablet. So enough for two weeks away would be 22 tablets – about £50.

The following immunisations are available from the NHS. They cover the most common diseases you need to consider:

• Hepatitis A – spread through contaminated food and drink – present in lots of countries outside Europe – particularly where sanitation is poor. One jab lasts for a year but if you get a booster between 6 and 12 months later – you’re covered for 25 years.
• Typhoid – again from contaminated water – less common than Hepatitis A – but still a risk in some countries. One jab lasts 3 years and then needs to be repeated.
• Diphtheria/Tetanus/Polio – a combination jab to cover these diseases – one jab covers you for 10 years.

The following immunisations are not covered by the NHS and therefore you will charged a fee payable during the consultation:

• Yellow Fever – spread by mosquitoes (like malaria) – present in sub-Saharan Africa and also South America. The Travel Health Pro website is particularly good when looking at which countries and areas carry a risk of yellow fever. The immunisation is ‘one for life’ and currently costs £60 at Paxton Green, as we are an accredited Yellow Fever Vaccination Centre. We take card or cash. You get a ‘Yellow Book’ which you may need to show when you travel, so always keep it with your passport. The vaccination has some risks of side effects so you need to go through a check list before we can give you the jab. A replacement Yellow Book can be issued for £10 if we have clear documentation on a previous immunisation.
• MenACWY – this jab against Meningitis is needed for all Hajj and Umrah pilgrims to Saudi Arabia. It lasts 5 years before a booster is needed. It costs £60.

• Rabies – spread through bites from animals carrying the disease – seek medical attention immediately if you’re bitten by an animal abroad
• Japanese Encephalitis – spread by mosquito bites from affected animals (particularly pigs) – should be considered if traveling to rural destinations in Asia or are staying for a long time.
• Tick borne encephalitis – a viral disease spread by tick bites in Eastern Europe and Northern Asia.