Websters Pharmacies now have stocks of Hepatitis A vaccine - these have been unavailable or had supply problems for quite a few months but are now available as a single vaccine giving cover against Hepatitis A. A booster dose is recommended after 6-12 months which gives immunisation for at least 25 years.

Websters Pharmacies are now offering free 'Flu vaccination to healthcare workers in care homes GP & Dental surgeries and all Carers. This year we are charging £10 per vaccine to make an appointment please call 01771 637204. There have already been concerns that this years 'flu is severe as highlighted in the article below and vaccination is the most effective way of preventing it.

Websters Pharmacies now offer a FREE travel clinic where advice about all destinations. Vaccines and antimalarials are also available at VERY competitive prices. We also stock a range of travel health products including mosquito nets, DEET sprays, travel first aid kits including sterile needles and much more.

Cholera Introduction Cholera is an acute diarrhoeal illness caused by a bacteria. The disease infects the small bowel and causes painless, watery diarrhoea. It is known to infect only humans. Cholera is usually transmitted via infected water that has been contaminated by faeces and less commonly via food. The disease is found throughout the world particularly in countries where sanitation is poor, particularly parts of Africa, India and South East Asia. The Illness The disease causes rapid onset of watery diarrhoea and vomiting. Extreme dehydration can occur due to the affected individual's inability to retain fluids orally. Medical attention should be urgently sought as individuals can die quickly if they are not treated promptly. Treatment Antibiotic therapy is required in conjunction with rapid and adequate fluid replacement. Recommendations for Travellers Prevention is focused on ensuring safe food and water, particularly in countries where cholera is more common. Food and drink to be wary of include untreated water, ice, shellfish, salads, unwashed fruit and vegetables. Good personal hygiene is essential. Individuals should ensure that they wash their hands prior to eating and after visiting the bathroom. A vaccine is available to protect against cholera. Vaccination may be considered under the following circumstances: Volunteers/aid workers/medical personnel in disaster relief situations where cholera outbreaks likely. Those travelling to work in slums/refugee camps, areas affected by natural disasters, or countries experiencing cholera outbreaks.

Tick-borne Encephalitis Introduction Tick-borne encephalitis (TBE) is transmitted to humans by a bite from an infected ixodes tick. Less commonly the disease can be spread through drinking unpasteurised milk from infected animals, especially goats. The disease is maintained in the wild by birds, deer, rodents and sheep. TBE is found in the far eastern part of the former USSR and extending across into China. It is found in European Russia, Austria, Hungary, the Balkans, Czech Republic, Slovakia and Scandinavia where, it is mainly a disease of the forest. TBE occurs from late spring until early autumn and outbreaks often follow a period when voles are numerous. Most human infections are contracted during outdoor leisure pursuits such as forestry working, camping, rambling and mountain biking, during tick season (spring to early autumn). The Illness TBE produces clinical features similar to those of many other types of meningitis and/or encephalitis. The disease may be restricted to the meninges (the membranes covering the brain and spinal cord), which usually leads to full recovery, but it may also affect the brain, the upper portions of the spinal cord and even the nerve roots. Severe disease can cause permanent neurological damage and some patients require long term rehabilitation. About 1 in 100 patients will die from TBE. Treatment No specific treatment is available for TBE. Recommendations for Travellers Bite avoidance must be emphasised to all travellers e.g.protecting the skin with clothing, tucking long trousers into socks, insect repellents and keeping to designated pathways. Further information on insect bite avoidance. Travellers should consider being vaccinated against TBE if they are risk of tick bites when working walking or camping in endemic areas. The vaccine available in the UK is called TicoVac and TicoVac Junior for children.

Japanese Encephalitis Introduction Japanese encephalitis is a viral disease found in South-East Asia and the Indian subcontinent. The infection is spread by the bite of an infected mosquito. This particular type of mosquito favours breeding sites in and around rice paddies. Transmission patterns are highly specific to locations and vary year to year; in some countries transmission is seasonal and in others, disease occurs all year round. The Illness Japanese encephalitis causes headache, convulsions, encephalitis and meningitis. Severe disease can cause permanent neurological damage. About 30% of those with signs of infection will die from the disease. Treatment There is no specific treatment available for Japanese encephalitis. Recommendations for Travellers Prevention is focused on avoiding mosquito bites, especially around dusk when this mosquito is most active and feeding. Use of insect repellents, appropriate clothing and mosquito nets is recommended for those at risk. Currently two vaccines that protect against Japanese encephalitis are available in the UK: IXIARO (2 doses) and Green Cross (2-3 doses) of vaccine should be given before travel. Individuals should consider being vaccinated if they are travelling to a country where Japanese encephalitis is present and where their stay may be prolonged or they are at increased risk of exposure to the disease e.g. staying in or around rice growing areas.

Rabies is a terrifying disease that kills in the region of 60,000 people each year - at home we don't really have to worry about but as more and more of us travel to Africa, Asia, Central and South America we are exposed to the dangers of Rabies. This short video explains the risks for travellers

Rabies is a terrifying disease that kills in the region of 60,000 people each year - at home we don't really have to worry about but as more and more of us travel to Africa, Asia, Central and South America we are exposed to the dangers of Rabies. This short video explains the risks for travellers

Typhoid Introduction The disease is caused by the bacteria Salmonella Typhi and Salmonella Paratyphi A, B or C. Typhoid is transmitted by food and drink that has been contaminated with human faeces or urine (faecal-oral route). Typhoid can be found throughout the world but it is more common in countries where water or food supplies are liable to be contaminated with human excreta especially in Africa, the Indian Sub-continent, South East Asia and South America. The Illness Typhoid causes systemic infection which may present as fever, headache, confusion and vague abdominal pain. Constipation is common in adults. Salmonella Paratyphi causes a milder illness than that of Salmonella Typhi. Treatment Treatment with an antibiotic is usually required. Medical attention should be sought for any feverish illness experienced whilst travelling abroad. Recommendations for Travellers Prevention is focused on ensuring safe food and water, particularly in countries where typhoid is more common. Foods to be wary of include shellfish, salads, unwashed fruit and vegetables and raw undercooked meat products. Good personal hygiene is also very important. Individuals should ensure that they wash their hands prior to eating and after using the toilet. Various vaccines that protect against typhoid are available: Typherix, Typhim Vi and and an oral preparation (3 capsules) called Vivotif. A single dose of injectable vaccine protects for three years, but will not protect against para-typhoid fever. There are two vaccines that combine typhoid with hepatitis A for convenience: Hepatyrix and ViATIM. Individuals should consider being vaccinated if they are travelling to a country where typhoid fever is more common and where they will be unable to take sufficient care with food and drink.

Rabies Introduction Rabies is an acute viral infection that causes inflammation of the spinal cord and the brain (encephalomyelitis). 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. Very rarely, the disease has been spread through body fluids and transplant tissues. Rabies is found in all continents of the world except Antarctica. Bats in all countries are considered to be a rabies risk. Most human cases of rabies occur in Asia, Africa and South and Latin America. View rabies risk areas by region The Illness The incubation period for the disease is usually between 20-60 days but may range from 5 days to 1 year 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 rabies virus. Treatment 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. Two vaccines may be used in the UK to protect against rabies: Rabies Vaccine BP and Rabipur. 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 an 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 off with soap and water and the wound irrigated with iodine solution or alcohol. This is very effective in removing virus from the bite, providing it is prompt and thorough. Suturing of the wound should be avoided and tetanus vaccination should be considered. A thorough risk assessment should be carried out by the attending doctor where appropriate treatment should be given.

Meningococcal meningitis Introduction Meningococcal meningitis is an acute bacterial disease that can cause systemic infection. There are 13 different serogroups of meningitis of which groups B and C are most common in the UK. Serogroup A and the less common W135 can cause serious epidemics which occur predominantly in the African meningitis belt from Senegal in the west to Ethiopia in the east. These serotypes have also been responsible for outbreaks in Saudi Arabia during the Hajj pilgrimages and in the city of Moscow in Russia in the past. The disease is transmitted by sneezing, coughing or direct contact with respiratory secretions. The bacteria are found in the nasal passages of healthy individuals. Around 25% of adolescents and 5-11% of adults carry the bacteria. The Illness Symptoms of meningitis usually include one or more of the following; Sudden onset of fever Intense headache Nausea Vomiting Photophobia (intolerance of light) Stiff neck Petechial rash (blood spots under the skin) If one or more of the symptoms above occur, medical attention must be sought immediately. Treatment Antibiotic treatment is usually commenced as soon as meningococcal disease is suspected. It may also be necessary to give antibiotic treatment to close contacts of patients confirmed as having meningitis. Recommendations for Travellers Respiratory infections are often difficult to prevent but following basic personal hygiene etiquette when coughing and sneezing can help. Avoiding overcrowded areas such as busy markets and local transport may also reduce risk of exposure but may not always be practical. Vaccines to protect against multiple strains of meningococcal meningitis for travellers are available: Menveo and Nimenrix. Individuals should consider being vaccinated if they are travelling to a country where meningococcal meningitis is present and where their stay maybe prolonged or they are involved in activities which may increase the risk of exposure to the disease, for example, working in a healthcare setting and living closely with the local population. Pilgrims travelling to Saudi Arabia for Hajj are required to have a valid certificate of vaccination against the disease for visa purposes.