Travel Reference
In-Depth Information
days after a long flight. Anyone who thinks that they might have a DVT needs to see
a doctor immediately.
PREVENTION OF DVT
• Keep mobile before and during the flight; move around every couple of hours
• Drink plenty of fluids during the flight
• Avoid taking sleeping pills and excessive tea, coffee and alcohol
• Consider wearing flight socks or support stockings (see
www.legshealth.com
)
If you think you are at increased risk of a clot, ask your doctor if it is safe to travel.
Some travellers like to carry tablets for the emergency treatment of malaria; if you choose
to do this make sure you understand when and how to take them, and carry a digital ther-
mometer.
Take plenty of
insectrepellent;
50% DEET-based repellents are best. Loose-fitting out-
fits with long-sleeved shirts and long trousers will allow you to cover up at dusk; for addi-
tional protection you can spray your evening clothes with permethrin (eg: Bug Proof from
Nomad). Consider carrying a
mosquito net
(see
Click Here
). Bed-nets are most effective
iftreated with permethrin orasimilar contact insecticide. Suchtreatment remains effective
for six months; kits are sold at many travel clinics.
IMMUNISATIONS
PreparationstoensureahealthytriptoMadagascarrequirecheckson
your immunisation status: it is wise to be up to date on tetanus, polio and diphtheria (now
givenasanall-in-onevaccine,Revaxis,thatlastsfortenyears),andhepatitisA.Immunisa-
tions against rabies may also be recommended. Proof of vaccination against yellow fever
is required from travellers coming from yellow fever areas, but there is no risk from this
disease in Madagascar itself. Immunisation against cholera is no longer required for Mad-
agscar but it may be suggested if there has been a recent outbreak.
HepatitisAvaccine(HavrixMonodoseorAvaxim)comprisestwoinjectionsgivenabout
a year apart. The course costs about £100, but may be available on the NHS; it protects for
25 years and can be administered even close to the time of departure. Hepatitis B vaccina-
tion should be considered for longer trips (two months or more) or for those working with
children or in situations where contact with blood is likely. Three injections are needed for
thebestprotectionandcanbegivenoverathree-weekperiodiftimeisshortforthoseaged
16 or over. Longer schedules give more sustained protection and are therefore preferred if
time allows. Hepatitis A vaccine can also be given as a combination with hepatitis B as
'Twinrix',thoughtwodosesareneededatleastsevendaysaparttobeeffectiveforthehep-
atitis A component, and three doses are needed for the hepatitis B. Again this schedule is
only suitable for those aged 16 or over.
