Sun, Sea and my GP
It’s another Monday morning here today in The Grove Medical Centre in Ballincollig. Our first patients of the day are Helen and her 17 year old daughter Louise. They are off on holiday to Australia in July for 3 weeks. They are spending a week in Bangkok, Thailand sightseeing on their stopover flight. They have a few questions for us about safe travel before they head off.
Helen: So doctor, I am just wondering about which vaccinations myself and Louise will need
before we go away?
Doctor: Well I am very happy you came in to discuss this as it’s very important you are
properly vaccinated when you go away on holiday, especially when heading to the
destinations you are visiting. Did you bring your immunisation cards with you?
Helen: Yes I have both with me.
Doctor: Perfect, let me have a look at those.
Louise: I’ve been to Spain and France before and I didn’t need any special injections, why do
I need them now?
Doctor: Well Louise, vaccines protect you against serious diseases, like the MMR you got
when you were small, which protected you against measles, mumps and rubella. In
other parts of the world there are different diseases that we don’t have here in
Ireland or in Europe and we are not immune to them, so you have to get new
vaccines before going to these places to protect yourself.
Helen: So what vaccines will we need for Thailand and Australia?
Doctor: There are no specific vaccines you need for going to Australia especially as you will
be in an urban area. However, for Thailand there are a few you will require to stay
safe.
Helen: Okay how many will we need?
Doctor: So firstly, you both will need boosters for tetanus, diphtheria and polio. A booster is
an extra dose of the vaccine to keep your immune system up, and for these 3
diseases a booster is recommended every 10 years in adults.
Helen: That’s perfect, aren’t they the 4 in 1 and 6 in 1 vaccines Louise got when she was
little?
Doctor: Yes that’s them! You are also advised to get a combined vaccine for Hepatitis A and
Typhoid and it is also advised to get the rabies vaccine, which has three doses over a
one month period.
Louise: Eww I thought you can only get that from stray dogs, I wouldn’t touch them! Why do
we need the rabies vaccine?
Doctor: Well every mammal has the potential to carry rabies, even domestic pets. In
developing countries it can be quite hard to get the vaccine if you become infected.
Helen: I suppose it is better to have it and not need it than to need it and not have it!
Doctor: Exactly. Also, it is really important to protect yourself against mosquito bites as they
are a carrier for many diseases such as malaria and dengue fever. You can do this by
wearing insect repellent spray that you can get in a chemist, just be sure to ask the
pharmacist for a suitable type. You can also use a mosquito net if you’re sleeping in
an unscreened area. As you will be staying in Bangkok, this is a low to no risk area for malaria, so there is no need for antimalarial tablets.
Helen: Perfect. Actually doctor my friend’s daughter had a terrible upset stomach and all
that goes with it when she went to India as a volunteer, how do I stop myself from
getting the same thing?
Doctor: It sounds like she was suffering from traveller’s diarrhoea. The most important thing
here is hygiene and avoiding contaminated water and food. You can do this by
always washing your hands before eating, avoiding raw uncooked food and
vegetables, peeling fruit and only having pasteurised dairy products. You need to
keep up your fluid intake in the heat but only drink pure bottled water or boiled
water, and also avoid ice if it is made from tapwater. Make sure to use pure water
when brushing your teeth and keep your mouth closed in the shower!
Helen: I never would have thought about ice! I know Louise wants to get a nice tan but I’m
afraid about her burning as she’s very fair, have you any words of advice for her?
Sure she won’t listen to me!
Doctor: No problem. So Louise, you can’t underestimate how strong the sun is and the
damage it can do to your skin which can lead to very serious conditions like skin
cancer. It’s important to always wear good quality sunscreen with a high factor like
factor 30 if you are prone to burning. Make sure to put factor 50 on any moles you
have as well for extra protection and don’t forgot to stay hydrated. Have you any
more questions?
Helen: No I think that’s everything, thank you for your help!
Doctor: My pleasure, now let me just go fetch the vaccines….
By UCC Medical Students Alex Brickley and David Doherty, with Dr Suzanne Kelly and Dr Joe Hartnett