VICTORIA ROAD SURGERY
50 VICTORIA ROAD WORTHING BN11 1XE
Telephone: (01903) 230656 Fax: (01903) 520094
Dr Birgit Woolley. Dr Jonathan Price.
Dr Navdeep Sandhu. Dr Madeleine Babicki. Dr Mohammed Haque.
Dr Rachel Butler. Dr Eugenie McCreanor.
TRAVEL VACCINATIONS
Vaccines are currently available for many infectious diseases. The immunity from vaccines
is never immediate or total. As the vaccines may need several trips to the Practice you
must plan your vaccinations well in advance of the trip, 4-6 weeks if possible.
Please complete and return the attached travel vaccination form (complete one for each
patient) to the Surgery at least THREE DAYS before your appointment with the Practice
Nurse so they can check your requirements and order the vaccines needed.
Unfortunately the NHS does not fund vaccinations for holidaymakers travelling abroad and
they must be classed as part of the cost of the holiday, something people do not realise. At
this Practice, we charge the fees that are recommended by the British Medical Association.
The following vaccinations are available to patients of this Practice:
VACCINE
FEE
Diphtheria/Tetanus/Polio (booster 10 years)
Typhoid (booster 3 years)
Hepatitis A (booster 6-12 months, then 20 years)
free
free
free
Rabies (course of 3 injections)
Rabies booster (after 2 – 3 years)
Hepatitis B (Course of 3 injections)
Hepatitis B booster
Yellow fever
Meningitis ACWY (booster 5 years)
Japanese Encephalitis (Course of 2 injections)
(Ixiaro for over 18 years only)
Japanese Encephalitis booster (after 1-3 years)
Tick-Borne Encephalitis (course of 2 injections)
Tick-Borne Encephalitis booster (after 3 years)
Private Prescription for Malaria tablets for travel
Price on application
Price on application
£77.00
£36.00
£75.00
Price on application
Price on application
Price on application
Price on application
Price on application
£15
Payment for vaccinations must be made at the reception desk before seeing the Nurse and
you will be given a receipt for payment, which must be in cash following the discontinuation
of the cheque card guarantee system by banks in the UK.
Vaccinations are also available at private travel clinics.
The Sussex Travel Clinic: 01273 749100 www.sussextravelclinic.com
OFFICE USE ONLY
TRAVEL APPOINTMENT DATE & TIME:
TRAVEL IMMUNISATION QUESTIONNAIRE
PERSONAL INFORMATION
Name:
DOB:
Address:
Tel Number:
Mobile Number:
Email:
What vaccinations have you had in the past? (Please fill in date if known)
Yes/No
Date last
had
NURSES USE ONLY
Recommended Given
Booster
(date)
due
Tetanus
Diphtheria
Polio
Typhoid
Cholera
Hepatitis A
Yellow Fever
Meningitis
Rabies
Hepatitis B
BCG
Tick Borne
Encephalitis
Japanese
Encephalitis
MMR
Influenza
Pneumococcal
Other
Anti Malarials
TRAVEL INFORMATION
When are you leaving:
How long are you away for:
Country to be Visited Exact Location or Region City or Rural Length of Stay
TYPE OF TRAVEL AND PURPOSE OF TRIP – TICK ALL THAT APPLY
Holiday
Business
Expatriate
Volunteer Work
Healthcare
Worker
Pilgrimage
Medical
Tourism
Adventure
Diving
Visiting family /
friends
Hotel Stay
Cruise Ship
Safari
Backpacking
Camping /
Hostels
Are there any specific hazards associated with this holiday: …………………………
……………………………………………………………………………………………….
MEDICAL INFORMATION
Yes
Are you fit and well today
Any allergies including food, latex,
medication
Severe reaction to a vaccine before
Tendency to faint with injections
Any surgical operations in the past,
including e.g. your spleen or thymus
gland removed
Recent chemotherapy / radiotherapy
/ organ transplant
Anaemia
Bleeding / clotting disorder (including
history of DVT)
Heart disease (e.g. angina, high
blood pressure)
Diabetes
Epilepsy / seizures
Gastrointestinal (stomach)
complaints
Liver or kidney problems
HIV / Aids
Immune system conditions
Mental Health issues (including
anxiety / depression)
Neurological (nervous system )
illness
Respiratory (lung)disease
Rheumatology (joint) condition
Spleen problems
Any other conditions
WOMEN ONLY
Are you pregnant
Are you breast feeding
Are you planning pregnancy while
away
No
Details
MEDICATION
Are you currently taking any medication (including prescribed, purchased or a contraceptive
pill
ADDITIONAL INFORMATION
Have you taken out travel insurance for this trip?
Do you plan to travel abroad again in the future?
Any additional information
Signature:
Date:
CONSENT: There may be occasions when the Surgery needs to get in touch with you. It
may be that the quickest form of contact is to phone you. By signing this consent you will
be agreeing to us:

leaving a message with a third party or on your voice mail

sending you a text message to your mobile phone.
No medical information will be left or disclosed.
I the undersigned agree that messages may be left with a third party or my voice mail
requesting that I make contact with the Surgery and that we can send you text
messages:
Signature: …………………………………………………………………………………………..
Print Name: ……………………………………………………………………………………….
ESSENTIAL INFORMATION FOR TRAVELLERS
FOOD, DRINK AND HYGIENE
There are many diseases that are caught by eating contaminated food or by drink. These
include travellers’ diarrhoea, hepatitis A, salmonella, typhoid and cholera. You can help
avoid catching them by paying strict attention to food, drink and general hygiene.










If in doubt about the water available for drinking, washing food or cleaning teeth boil it, sterilise it with disinfectant tablets, or use bottled water in sealed containers.
Avoid both ice cubes and ice cream unless you are sure they are made from clean
water.
Avoid food which has been reheated, kept warm or exposed to flies.
Avoid uncooked food – unless you peel it or shell it yourself.
Eating shellfish – even cooked can be suspect.
Remember that salads will be washed with untreated water.
Avoid unpasteurised milk or boil it before use.
Avoid fruit juice (if sold by a street vendor).
Avoid eggs, mayonnaise and sauces.
Avoid peeled fruit.
Food and drink that are generally safe to eat include:
 sealed bottled water that is produced by a recognised international manufacturer
 cooked food, such as soup or stir-fry
 canned food or food in sealed packs
 fresh bread
 unpeeled fruit
 tea and coffee
TRAVELLERS’ DIARRHOEA
Dehydration following fluid loss from sweating, diarrhoea and fever if left untreated can kill.
Any diarrhoea must be treated with liberal quantities of re-hydration fluid made up of the
cleanest water available. Sachets of re-hydration salts are available without a prescription
and should always be carried, especially with children. Seek medical advice if you have a
temperature, on-going symptoms or blood is passed.
MALARIA
Many countries have insects and animals that pose potential threat to travellers. To avoid
insect bites use insect repellent preparations and cover arms and legs. Malaria is a blood
disease caused by a parasite which is caught from the bite of an infected mosquito. Whilst
anti-malarial tablets can reduce the risk of catching malaria they are not 100% effective so
it is essential that you take steps to avoid being bitten.





Cover arms and legs, especially between dusk and dawn as malaria mosquitoes are
most active at night.
Use an insect repellent containing 50% DEET (Diethyltoluamide) they are very
effective.
Impregnated ankle and wristbands are also effective
If your accommodation does not have insect screens or windows which close sleep
under a mosquito net. If possible stay in air-conditioned accommodation.
Use an insecticide to clear a room and a vaporiser to keep it clear.



Mosquito nets are more effective if impregnated with insecticide such as permethrin.
Take malaria tablets as instructed and you must finish the course.
If you are pregnant or planning pregnancy or taking young children please ask the
doctor or practice nurse for advice.
Protection against malaria cannot be guaranteed and some strains of the disease have
become resistant to medication. Tell your GP as soon as possible if you develop a
fever or an unexplained illness while you are away or up a year later after your return.
HEPATITIS B AND AIDS (HIV INFECTION)
These can be caught by contact with infected body fluid (blood, saliva etc.) and from
unprotected sex or drug abuse. These infections are world wide. Always practice safe sex,
use a condom (in some parts of the world locally produced condoms may not be as reliable
as the ones available in the UK ), and never share needles. You may be at risk in places
where screening of blood products and sterilisation of medical equipment is inadequate. If
unsure take a sterile medical kit with you.
SUNBURN AND HEATSTROKE
Ultraviolet light (UVA and UVB rays) is radiated by the sun. The ozone layer filters out most
of the harmful UVA and UVB rays before they reach earth, but some rays are still able to
get through and can cause skin damage. It is very important to take precautions when
travelling to hot climates. Try not to get burnt – repeated sunburn can cause various skin
diseases including cancer. Particularly take care of children and babies. A particular risk of
overexposure to the sun is sunstroke or heatstroke caused by overheating. Avoid
strenuous activity during the hottest hours and drink plenty of non-alcoholic drinks.
Some useful tips for avoiding sunburn are listed below:
 Do not wait until your skin feels uncomfortable before taking preventative action.
Defence is the best form of protection. Once your skin is burnt, the damage has
already been done, so cover up with loose-fitting clothes. Make sure your legs and
arms are covered. Tightly woven fabrics provide the best protection from the sun.
 Avoid direct exposure to sunlight when the sun is at its strongest. Remember that
the sun can be strong during the early and late part of the day, so you still need to
take adequate precautions if you go out in the sun in the morning or evening. Cover
your arms and legs with clothes, wear a wide-brimmed hat and a pair of good-quality
sunglasses, and apply plenty of sun lotion with the right skin protection factor (SPF)
for your skin type.
 Always use a sun protection lotion with an SPF of at least 15. If you have very fair
skin, use lotions with an SPF of up to 40. This is also the case for children, whose
skin is very sensitive. Most skin damage caused by the sun occurs before the age of
18.
 Make sure that your entire body is covered by sun protection lotion. This includes
your face, hands, feet and neck. The most vulnerable parts of your body are those
that are not usually exposed to sunlight.
 Apply sun lotion at least 30 minutes before you go out in the sun. Reapply it every
couple of hours because sweat and contact with clothing and towels will cause it to
wear off. Reapply sun lotion immediately after swimming, even if your lotion is
waterproof. Use waterproof sun lotion while swimming because UVA and UVB rays
can penetrate through about a metre of water.
 Cloud and fog do not protect skin from ultraviolet rays. Cover up with clothing and
use SPF 15 sun lotion, even on cloudy days.
 Wear a hat, and sunglasses that have UVA and UVB filters when you are in the sun.
Ultraviolet rays can damage the retinas in your eyes, causing cataracts.

Drink plenty of fluids, particularly after exercise. Isotonic drinks that replace the salt
lost through sweating are ideal, but water is also sufficient. Avoid drinking alcoholic
drinks when you are out in the sun.
Keep a careful eye on any moles on your body and visit your GP if you notice any
changes in their appearance. Signs to look out for are darkening of the mole, an
increase in size, ragged edges, multiple colours within the mole, itchiness, redness
and swelling or bleeding.
INSURANCE AND ACCIDENTS
Do not travel without insurance. Try to assess the potential risks of some of the more
adventurous holiday activities before trying them. Remember that some activities will not be
covered by standard holiday insurance. Be aware that your insurance will not be valid if you
knowingly do not declare an existing medical condition. Accidents are the most common
cause of holiday disasters.
A European Health Insurance Card (EHIC) entitles you to free or reduced-cost medical
treatment in a European Economic Area (EEA) country or Switzerland. The EEA includes
all European Union countries as well as Iceland, Liechtenstein and Norway. The EHIC is
usually valid for five years and covers any medical treatment necessary as a result of an
accident or illness. The card entitles you to state-run medical services only, and you will be
treated on the same basis as an 'insured citizen’ of the country you are visiting. This may
not cover all the treatment and services you would usually get free of charge from the NHS,
and you may have to contribute to the cost of your care. The EHIC is not a substitute for
travel insurance and you should take out a private travel insurance policy before you travel.
AIR TRAVEL
There is some evidence that long haul flights, especially when passengers have little or no
exercise, may increase the risk of developing DVT (Deep Vein Thrombosis). While it is
difficult to be certain what the exact causes of travel-related DVT are, experts agree that
lack of exercise or immobility are major underlying risks. The signs of a DVT are that you
may get swelling, pain, tenderness and redness especially at the back of the leg below the
knee. This is different from the ankle swelling that many people get during long-haul flights,
and DVT usually, though not always, affects only one leg. These complaints may develop
during the journey but more commonly hours or even days later. If you get any signs please
seek medical opinion. You can minimise the risk by doing the following:
 Wear flight socks
 Get comfortable in you seat and reline as much as possible. Bend and straighten
your legs, feet and toes while seated every half-hour or so during the flight
 Press the balls of your feet down and hard against the floor or foot-rest to increase
the blood flow in you legs and reduce clotting
 Do upper body breathing exercises to further improve circulation
 Take occasional short walks around the cabin whilst cruising at altitude
 Where possible during refuelling stopovers get off the plane and walk about
 Drink plenty of water and avoid alcohol which in excess leads to dehydration and
immobility
 Avoid taking sleeping pills
Travel health information is available from:
The Travel Health Section of the nhs web site www.nhs.uk
www.masta-travel-health.com
www.fitfortravel.nhs.uk
www.malariahotspots.co.uk
www.nathnac.org