Travel health advice and vaccinations
Health clearance is required for
- Any trip lasting more than 3 months
- Any tropical country or country where malaria is endemic
- Any fieldwork involving work in a remote area more than 24 hours away from a medical facility
- Any work involving high risk acitivities e.g. abseiling, climbing, diving, caving
- Any dangerous work
Occupational Health provides travel health advice, immunisations and anti malaria prophylaxis to Imperial College Staff and specified Student groups travelling on College business (e.g. conferences, research or field trips). This service does not extend to holiday travel or families accompanying those on College business.
This is to ensure that those travelling to tropical countries receive recommended vaccinations, appropriate malaria prophylaxis and ensure that health problems can be effectively managed in the field. Health clearance will only be withheld in exceptional circumstances.
Please refer to the College offsite working policy for further information and to see if you are required to carry out a risk assessment.
While the OH team are operating a reduced onsite clinical service, it is essential to submit any requests in good time.
Tabs - Travel advice
Getting health clearance
Obtaining health clearance
- Evidence of departmental risk assessment signoff for all individual and group, (small team and student) fieldwork activities by the Head of Department or (delegated Departmental Operations Manager/Departmental Safety Manager) is required prior to the processing of Travel Health Clearance Questionnaires.
- Please complete and return the Travel Health Questionnaire to Occupational Health. The form will be screened and you will receive your travel health clearance by email along with any recommended vaccines and malaria advice if applicable. The Principal Investigator/Fieldwork Leader will also be copied into the health clearance if applicable. Please note Health clearance is only withheld in exceptional circumstances.
- You will be asked to book an appointment if you require any vaccines and/or malaria tablets, please wait for your travel health clearance e-mail before calling Occupational Health.
- Repeat malarial prescriptions may be requested by email. You will need to confirm that there is no change to your health or significant adverse reaction to the tablets used.
Tropical & malarious countries requiring health clearance
The following webpage displays all countries and territories where there is either limited risk of malaria transmission or where malaria transmission occurs. You may also require additional vaccinations where there is a risk of other diseases. If you are travelling outside the UK please visit NaTHNaC Travel Health Pro for vaccination recommendations and arrange a travel appointment with Occupational Health if necessary.
Managing group travel
The trip organiser must inform the OH Service of their travel plans with the planned itinerary and details of activities being undertaken. OH will make recommendations based on this information as to which vaccines and malaria prophylaxis are necessary.
- As soon as a trip is confirmed, check the College Travel Health Policy to see if health clearance is required. Health clearance at present is required for:
- Any trip lasting more than 3 months
- Any tropical country or country where malaria is endemic
- Any fieldwork involving work in a remote area, more than 24hrs away from a medical facility
- Any work involving high risk activity eg climbing, abseiling, diving, caving
- Any dangerous work
Occupational Health will advise you on specific travel vaccinations that you require for your trip. Recommendation for vaccination will depend on where you are staying, how long you are away for and the activities you will be doing in line with the College vaccination policy.
You should also ensure that you are fully immunised with vaccines such as Measles, Mumps & Rubella and TB. Consider Meningitis ACWY vaccine if you are working in endemic areas. You can use the websites listed under 'Useful Information' to find out out which vaccines are recommended for the country you are visiting.
Please complete the travel health questionnaire with as much vaccine history as you can as this allows accurate recommendations to be made .
Diphtheria, Tetanus and Polio are 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.
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.
Hepatitis A effects the functioning of the liver. Present worldwide but there is greater risk in areas that have poor sanitation and is common in Africa, Asia, Middle East and South America. Vaccination is course of two vaccines 6-12 months apart which will provide 20 year protection.
Typhoid is a serious bacterial infection which causes acute inflammation of the liver. Transmission is mainly faecal-oral and is found throughout the world in areas that have poor sanitation including Africa, Central and South America, South Asia and India, the Middle East. Booster vaccines recommended every 3 years.
Rabies is a very serious disease that is spread by infected saliva of mammals such as dogs, bats and monkeys. Vaccination is offered if you are travelling to a high risk country for longer than 4 weeks, if you are in remote areas where medical care is not readily available or if you are undertaking higher risk activities or at occupational risk. Rabies vaccination is given as a course of three over 21 to 28 days. Booster vaccines recommended every 5 years if at continuous risk.
Japanese Encephalitis causes inflammation of the brain and spinal cord . It is spread by infected mosquitoes across South-East Asia and Japan. Vaccination is a course of two 28 days apart with a booster recommended at one year.
Hepatitis B affects the functioning of the liver and is transmitted by coming into contact with infected blood or body fluids. High risk activities include sexual intercourse, sharing needles and through medical intervention using unsterile equipment. There are a number of course options for vaccination consisting of 3 vaccines.
Cholera is spread by contaminated food and water found in areas with poor sanitation. It can cause severe diarrhoea which can lead to dehydration. The vaccination is administered orally, two doses given over one to six weeks.
Meningitis is a serious bacterial infection that causes inflammation of the brain and spine and can be fatal. It is found throughout the world but most common is the meningitis belt in Sub Saharan Africa. Proof of Meningitis ACWY vaccination is needed for pilgrims visiting the Haj in Saudi Arabia. Vaccination is given as a single dose lasting 5 years.
Tick-borne Encephalitis is a viral infection spread by ticks across eastern, northern and central Europe. In serious cases it can damage the spinal cord and brain. Vaccination is given as a course of three injections.
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. Vaccination is mandatory for travel to certain countries and also if transiting through endemic countries. Vaccination is given as a single dose that you need to have at least ten days prior to travel. Yellow fever certificates currently last for 10 years. Yellow Fever immunity is now considered to be life-long, so repeating vaccination is only necessary for immigration purposes.
Malaria and bite avoidance
Prevention of Malaria
Malaria is a major health problem throughout the tropics and all travellers are at risk of developing malaria if visiting malaria endemic areas. Malaria is a serious, sometimes fatal, tropical disease spread by mosquito bites. Malaria is transmitted via the bite of an infected Anopheles mosquito that feeds predominately during the hours from dusk to dawn. Preventing bites is the best protection against malaria as well as a variety of other serious diseases transmitted by mosquitoes in tropical and sub-tropical areas.
A: Awareness of the risk
- Check NaTHNaC Travel Health Pro to see if malaria is a risk in the country you are visiting
- If it is and malaria prophylaxis is advised, arrange an appointment with the College OH service to obtain a prescription
- Risk varies according to the season, geographic location, altitude, accommodation, length of visit, medication, pregnancy, activities and bite avoidance measures
B: Bite Avoidance
- Use insect repellent containing 50% DEET on exposed skin. Re-apply regularly after application of sunscreen
- Wear light coloured clothing, long-sleeved trousers, socks and covered shoes to reduce area exposed
- Wear insect repellent impregnated wrist and ankle bands, particularly between dusk and dawn
- Spray room with an insecticide spray before sleeping
- If camping or in an unscreened room sleep under a mosquito net (impregnated with permethrin), check nets for holes and repair them also tuck net edges under mattress before dusk
- If you are not sure about the availability of nets, take your own
- Preventing bites is the best protection against malaria
- As well as a variety of other serious diseases transmitted by mosquitoes in tropical and sub-tropical areas
- There are a number of different options for the type of malaria medication that you may require for your trip. Your travel nurse can advise you on the most appropriate medication based on your destination, itinerary, length of stay and current medical condition
- No regime is 100% effective in preventing malaria, but the combination of bite avoidance and malaria tablets will provide you with significant protection against malaria
- Take the recommended tablets as instructed, if you miss a dose take it as soon as you remember
- Establish a routine, continue taking the tablets for the recommended period after leaving the risk area
- Occupational Health will provide you with a prescription, alternatively you can see your GP or Travel Clinic. You are also able to purchase malaria tablets with an online doctor or from reputable sources such as LloydsPharmacy and TravelPharm
|Anti-malarials||Dosage||Start||While in Malarious area take||Continue taking anti-malarials after leaving malarious region for|
|Chloroquine||2 tablets weekly||1 week before travel||2 tablets weekly||4 weeks|
|Paludrine||2 tablets daily||1 week before travel||2 tablets daily||4 weeks|
|Mefloquine (Larium)||1 tablet weekly|| 3 weeks before travel
|1 tablet weekly||4 weeks|
|Doxycycline||1 tablet daily||2 days before travel||1 tablet daily||4 weeks|
|Atovaquone/Proguanil (Malarone)||1 tablet daily||1-2 days before travel||1 tablet daily||1 week|
|Please note all anti-malarials are obtained by prescription only with the exception of Paludrine|
D. Diagnosis & Treatment
Malaria can be treated but early diagnosis is essential. Most people become ill within one month of leaving the malarious area but if you develop flu like symptoms up to one year after return you must inform your doctor that you were in a malarious area.
From 1 August 2017, the College travel insurer for all business trips will be Royal Sun Alliance (RSA). The College travel insurance policy provides cover for medical expenses, loss of baggage etc for any member of staff or student travelling abroad on College business or authorised study. This policy also includes insurance cover for personal holiday time in the same country where the business activities have taken place – the number of days being dependent on the number of business days taken.
To ensure that you are insured by the College:
- Register your travel by completing the Insurance Travel Registration Form
- Download the Travel Certificate and carry it with you which includes the policy number etc.
- Use the Insurers mobile app Healix Travel Oracle to access travel alerts and up to date travel information
The European Health Insurance Card
The European Health Insurance Card (EHIC) allows UK residents to receive free or reduced cost medical care when travelling or staying temporarily in an EU country or Switzerland. The card is valid for five years and covers medical care if you become ill or have an accident during your trip.
If the UK leaves the EU, access to healthcare when visiting an EU country is likely to change. Please check updates on the government website.
You can also download the EHIC card to a smartphone, just use the relevant link for your device.
Outbreaks and alerts
Zika fever is a mosquito-borne viral disease caused by the Zika virus. There has been an virulent outbreak of this virus and it is spreading. It has already been found in 21 countries in the Caribbean, North and South America.
One in four people may develop symptoms that are similar in nature to dengue fever, two to seven days after the mosquito bite. There have been many reported cases in South America of newborns with microcephaly (a condition that causes abnormal brain development), associated with Zika virus infection during the first trimester of pregnancy.
Cases of sexual transmission of the virus have been documented and although the risk of this appears to be low, ZIKV has been found in the semen of symptomatic males up to 6 months after the infection has resolved. Although to date, sexual transmission has not been recorded beyond 2 months after infection. ZIKV has not been found to persist in the female genital tract beyond 3 weeks. The majority of cases of sexual transmission of ZIKV have occurred from men with symptomatic infection. However, sexual transmission of ZIKV from an asymptomatic man to his female partner has been documented twice. There is a very low risk of female to male sexual transmission. After careful consideration the UK has now adopted the WHO guidance for men.
Travellers to a Country/territory/area with High or Moderate risk of ZIKV transmission
- Women (asymptomatic/symptomatic/pregnant/non-pregnant)
Use contraception and condoms during travel and for 8 weeks afterwards to avoid the risk of ZIKV in an unplanned pregnancy and prevent sexual transmission.
- Men (asymptomatic or symptomatic)
Use condoms during travel and for 3 months afterwards to avoid the risk of sexual transmission of ZIKV, particularly during conception or pregnancy.
Travel to the region is not prohibited. The Zika Virus is only transmitted by a mosquito bite. While travelling in the region, bite avoidance strategies will reduce the risk of infection. Use a good repellent containing N, N-diethyl-meta-toluamide (DEET 50%) on exposed skin, together with light cover-up clothing. If you need sunscreen, apply repellent after sunscreen.
As infection with the virus is suspected to cause birth deformities, women who are pregnant or planning to become pregnant should seek advice prior to travelling to this region.