Travel Reference
In-Depth Information
theUKhasbeenextendedforuptothreemonths'useandapaediatricformoftabletisalso
available, prescribed on a weight basis.
Another alternative is the antibiotic doxycycline (100mg daily). Like Malarone it can be
started one day before arrival. Unlike mefloquine, it may also be used in travellers with
epilepsy, although certain anti-epileptic medication may make it less effective. In perhaps
1-3%ofpeople there isthepossibility ofallergicskinreactions developing insunlight; the
drug should be stopped if this happens. Women using the oral contraceptive should use an
additional method of protection for the first four weeks when using doxycycline. It is also
unsuitable in pregnancy or for children under 12 years.
Chloroquine and proguanil are no longer considered to be effective enough for Mada-
gascar but may be considered as a last resort if nothing else is deemed suitable.
All tablets should be taken with or after the evening meal, washed down with plenty of
fluid and, with the exception of Malarone (see above), continued for four weeks after leav-
ing.
LONG-HAUL FLIGHTS, CLOTS AND DVT
Any prolonged immobility including travel by land or air can result in deep vein
thrombosis (DVT) with the risk of embolus to the lungs. Certain factors can increase
the risk and these include:
• Previous clot or close relative with a history
• People over 40 but greater risk for those aged over 80
• Recent major operation or varicose veins surgery
• Cancer
• Stroke
• Heart disease
• Obesity
• Pregnancy
• Hormone therapy
• Heavy smokers
• Severe varicose veins
• People who are very tall (over 6ft/1.8m) or short (under 5ft/1.5m)
A deep vein thrombosis (DVT) causes painful swelling and redness of the calf or
sometimes the thigh. It is only dangerous if a clot travels to the lungs (pulmonary em-
bolus). Symptoms of a pulmonary embolus include chest pain, shortness of breath,
and sometimes coughing up small amounts of blood and commonly start three to ten
