Category Archives: English (UK)

Do you have mental health problems and are you going on a trip? On this page you will find information to consider before and during your trip.

TRAVELLING AND YOUR MENTAL HEALTH

Travelling can have a lot of impact on your mental health, for instance because you end up in a new environment, a different rhythm, a different culture or because you suffer from homesickness. When there is already a history of mental illness, symptoms may intensify or return. Therefore, it is important to travel well prepared and take into account as many scenarios as possible.

Good preparation makes the trip more predictable and less stressful. Here are some tips to get started:

• Make sure you have good travel insurance, if something happens while travelling, good insurance can save you a lot of money;
• Take the time to prepare the trip well and apply for any visas on time;
• Take your vaccination passport and/or medication passport with you when you travel;
• Some medications prescribed for mental disorders fall under the Opium Act. These medications may only be brought on your trip with a valid doctor’s certificate. Which declaration is needed depends on the country you are travelling to and the type of medication. During a consultation, the vaccinatiecentrum.nl nurse will check with you for contraindications of certain medicines and whether the medication you are taking with you falls under the Opium Act;
• For serious psychiatric problems, bring your practitioner’s phone number and an English letter telling them what to do if things don’t go well and who they can reach for help.

MENTAL DISORDERS AND VACCINATIONS

Fear of needles can get in the way of getting travel vaccinations. It is still important to get the necessary vaccinations for travel. Feel free to discuss this with the nurse during the consultation.

MENTAL DISORDERS AND MALARIA

Some mental health problems have a contraindication for Lariam (Mefloquine). These include depression, schizophrenia, psychosis or epilepsy. If any of the above applies to you, please let us know during the consultation or on the intake form.

MENTAL DISORDERS AND ANTIBIOTICS

When taking lithium, it is wise to take antibiotics for self-treatment of diarrhoea. Mention this on the intake form or to the nurse during the consultation and consult with your doctor.

PERSONALISED ADVICE FOR TRAVELLING WITH MENTAL HEALTH PROBLEMS

Some medications prescribed for mental disorders fall under the Opium Act. These medications may only be brought on your trip with a valid doctor’s certificate. Which statement is needed depends on the country of travel and the medication.

During the consultation, we look at contraindications of certain medications and check whether the medication you take with you on your trip falls under the Opium Act.

Do you have any questions or would you like to book an appointment?

If you have any questions or would like to book an appointment for personal (travel) advice, you can use the button below, email via info@vaccinatiecentrum.nl or call 085-9020303.

Has your spleen been removed and are you going on a trip? On this page you will find information to consider before and during your trip.

TRAVELLING WITHOUT A SPLEEN

The spleen is an organ that plays a role in the functioning of the immune system. It acts as a kind of filter that traps micro-organisms from the blood. When that function fails, some diseases can become much more severe or cause serious complications, such as blood poisoning.

There are several reasons why the spleen may not work properly or at all. The spleen may have been surgically removed completely or partially, for example after an accident or because of illness. If the spleen has been surgically removed, it is important to know at what age the spleen was removed, how long ago it was removed, what the reason for the spleen removal was, and whether the spleen was completely or partially removed.

In addition, the spleen may also not function or function not as well due to certain medical conditions. It is often difficult to determine the extent to which the spleen is still functioning properly. There are a number of causes that can lead to reduced spleen function, for example:

• Spleen injury due to trauma;
• Congenital asplenia;
• Sickle cell disease;
• Spleen infarction;
• Radiation of the spleen.

There are also other causes that increase the risk of reduced spleen function, for example:

• Stem cell transplantation;
• Severe forms of celiac disease;
• Severe forms of inflammatory bowel disease;
• Liver cirrhosis;
• Systemic lupus erythematosus or discoid lupus erythematosus;
• Haemolytic anaemias with extreme bleeding.

IMPAIRED SPLEEN FUNCTION AND VACCINATIONS

When travelling to areas with a high risk of meningococcal ACWY, vaccinations should be up-to-date.

There are also a number of diseases against which additional vaccination may be recommended:

• Pneumococci;
• Meningococcal disease (ACWY and B);
• Haemophilus Influenzae type B. (Hib);
• Annual flu shot.

IMPAIRED SPLEEN FUNCTION AND ANTIBIOTICS

In some cases, it is recommended to have antibiotics with you. If you get a fever or if you are bitten by a dog or cat, you can start the antibiotics right away. If this applies to your situation, you should always have the first dose on you at all times. In addition, you should visit a doctor for further treatment within eight hours of starting antibiotic treatment.

These vaccinations and antibiotics ‘on demand’ are normally prescribed and given by your specialist or GP. This is because most of these pathogens are also common in the Netherlands and the vaccinations and antibiotics are therefore not only needed during travel. 

REDUCED SPLEEN FUNCTION AND MALARIA

When travelling to areas where malaria is prevalent, people with impaired function of the spleen are always advised to take malaria pills preventively. This advice is in addition to the regular advice to take proper precautions to prevent mosquito bites.

PERSONALISED ADVICE IN CASE OF REDUCED SPLEEN FUNCTION

Are you planning a trip? If so, make sure you are well prepared. Vaccinatiecentrum.nl helps you with personalised advice. Book an appointment well in advance, preferably at least six weeks before departure.

Do you have any questions or would you like to book an appointment?

If you have any questions or would like to book an appointment for personal (travel) advice, you can use the button below, email via info@vaccinatiecentrum.nl or call 085-9020303.

Do you have heart and/or vascular diseases and are you going on a trip? On this page you will find information to consider before and during your trip.

TRAVELLING WITH CARDIOVASCULAR DISEASE

Cardiovascular disease is a collective term for various diseases of the heart or blood vessels. In cardiovascular diseases, your heart does not work as it should or your vessels are narrowed, so oxygen is not transported properly to all parts of the body.

Some tips for travelling with cardiovascular disease:

• Consider using supplemental oxygen when flying. Discuss this with your doctor/specialist;
• Consult your doctor/specialist if you want to travel to high altitudes. You may be prescribed medication for extra support;
• Do you have heart and/or vascular diseases and are you travelling to a (sub)tropical area? Then being well prepared is extra important. Vaccinatiecentrum.nl can help you with this;
• Preferably book an appointment at vaccinatiecentrum.nl at least six weeks before departure.

CARDIOVASCULAR DISEASES AND VACCINATIONS

Besides the standard vaccinations recommended for your destination, we also recommend getting the flu vaccination annually.

CARDIOVASCULAR DISEASES AND MALARIA

Are you taking medication for cardiovascular disease? Malaria tablets may interact with other medication. In case you need malaria tablets during your trip, it is advisable to check with your doctor or a traveller’s nurse/doctor first.

CARDIOVASCULAR DISEASES AND TRAVELLER’S DIARRHOEA

If you suffer from traveller’s diarrhoea, the body loses more fluids than normal and there is a risk of dehydration. The use of diuretics, ACE inhibitors or angiotensin receptor antagonists and NSAIDs increases the risk of kidney damage in dehydration, especially if these drugs are used in combination.

If you have had watery stools more than three times within eight hours, the dosage of these drugs should be reduced or use should be discontinued. We recommend consulting a doctor at your travel destination. It is also advisable to discuss this with your doctor before travelling.

CARDIOVASCULAR DISEASES AND TYPHOID FEVER

Typhoid fever is a serious bacterial infection caused by Salmonella Typhi that spreads through contaminated food and water, especially in areas with poor sanitation. The risk of infection is increased in people with heart or vascular prostheses, as they are more susceptible to infection and may develop complications if they become infected. For example, it can lead to inflammation of the heart valves. It is therefore wise to get vaccinated against typhoid fever before departure to reduce the risk of infection and prevent any complications.

CARDIOVASCULAR DISEASES AND ALTITUDE SICKNESS

If you have cardiovascular disease, you may develop heart problems faster and more often at high altitude even if the same level of exercise at sea level would not cause problems. Before travelling at high altitude, consult your doctor first. Do you have obstructive sleep apnoea syndrome (OSAS)? If so, we recommend using medication throughout your stay above 1600m. If you use a CPAP (Continuous Positive Airway Pressure) mask at home, we advise against travelling to high-altitude areas. If you do want to stay at high altitude, always take your CPAP device with you.

CARDIOVASCULAR DISEASE AND ANTIBIOTICS IN CASE OF TRAVELLER’S DIARRHOEA

Are you taking digoxin? If so, consult with your doctor about the use of antibiotics for traveller’s diarrhoea.

Any questions or want to book an appointment?

If you have any questions or would like to book an appointment for personal (travel) advice, you can use the button below, email via  info@vaccinatiecentrum.nl or call 085-9020303.

Do you have epilepsy and are you going on a trip? On this page you will find information to consider before and during your trip.

TRAVELLING WITH EPILEPSY

Epilepsy is a disorder of the central nervous system in which you have repeated and spontaneous epileptic seizures. During an epileptic seizure, brain cells start sending all kinds of signals very quickly. There are different types of seizures. An important difference is where exactly the seizure starts: in one part of the brain, or in both hemispheres at the same time.

EPILEPSY AND VACCINATIONS

Vaccinations do not usually cause problems for people with epilepsy.

EPILEPSY AND MALARIA

Malaria is prevalent in some countries. In these countries, it is sometimes necessary to take malaria tablets preventively or as emergency treatment. The use of the malaria prophylaxis ”Mefloquine” or Lariam in people with epilepsy increases the risk of seizures. It should only be used curatively or if there is a strictly necessary medical reason for this. In addition, there may be interaction when using some anti-epileptic drugs in combination with Lariam or Doxycycline. This means that the drug may be less effective. Also, the drug chloroquine can cause seizures. It is better not to use this drug.

EPILEPSY AND TRAVELLER’S DIARRHOEA

Many travellers get traveller’s diarrhoea. It usually goes away after a few days. If you take medication for epilepsy, its effects may be reduced. Diarrhoea can cause the medicine to leave your body too quickly, so it is not absorbed properly. The advice is to use loperamide. Loperamide can stop the diarrhoea for a while. However, long-term use of this is not recommended because of the risk of constipation. It is also advisable to take ORS with you. This will keep you from dehydrating.

EPILEPSY AND ANTIBIOTICS

Are you taking medication for epilepsy? If so, be careful when taking antibiotics. This is because some medicines cannot be combined with medicines against epilepsy. Should you get medication in a (sub)tropical country, for example against diarrhoea, be careful that this is not an antibiotic!

TAILORED ADVICE FOR EPILEPSY

If you have any questions or would like to book an appointment for personal (travel) advice, you can use the button below, email via  info@vaccinatiecentrum.nl or call 085-9020303.

Do you have diabetes and are you going on a trip? On this page you will find information to consider before and during your trip.

TRAVELLING WITH DIABETES

Travelling with diabetes is a lot easier these days due to developments in diabetes care. These include better medication, better sensor-based monitoring, better insulin administration methods and better education in self-treatment and self-titration for insulin-dependent patients. However, there are risks to consider during travel. While travelling, there are certain things that can cause your blood glucose level to become dysregulated. Take this into account beforehand. Dysregulated blood glucose levels can be caused by:

• Change of daily routine and activities;
• Change of diet and consumption of alcohol;
• (dropping or increasing) Stress;
• Change of climate; Skin temperature affects insulin uptake;
• Travel sickness (vomiting, not eating or diarrhoea);
• Passing time zones;
• Infections, especially intestinal infections, malaria and other febrile illnesses.

When travelling as a diabetes patient, it is important to prepare well. Make sure you have enough insulin and other supplies with you and carry them in your carry-on luggage. Check-in luggage may get lost and the temperature in the hold may be too low. It is wise to bring a medical certificate stating that you are transporting your insulin and other materials in your carry-on luggage for these reasons.

Insulin should be stored between 2 and 8 degrees. It is therefore best to transport insulin in a special cooler bag.

You may also need to adjust your insulin schedule due to different time zones. You discuss this with your diabetes nurse.

DIABETES AND VACCINATIONS

No additional travel vaccinations are advised for people with diabetes. However, the risk of complicated influenza when travelling in the (sub)tropics is just as high as in the Netherlands. An influenza vaccine is advised for everyone with diabetes, whether you travel or stay at home.

If you are staying in the southern hemisphere for an extended period, the advice is to get an influenza vaccine there. Flu epidemics do not run concurrently in the northern and southern hemispheres. Therefore, the vaccine available with us does not match the flu viruses in the southern hemisphere.

DIABETES AND MALARIA

There is no evidence that malaria is more severe or progresses differently in travellers with diabetes. Therefore, the same advice applies to travellers with diabetes as for all other travellers.

Some symptoms of malaria, such as fever and vomiting, can have a disruptive effect on your blood glucose levels. This also applies to treatment with quinine. For these reasons, it is important for travellers with diabetes to carefully follow the advice on preventing a malaria infection.

DIABETES AND TRAVELLER’S DIARRHOEA

To prevent traveller’s diarrhoea, always pay attention to what you eat and drink.

Travellers with diabetes are not at greater risk of contracting traveller’s diarrhoea. Traveller’s diarrhoea does have a greater effect on a traveller with diabetes. The loss of fluids and possible fever or vomiting can disrupt blood glucose levels.

For this reason, it is wise for travellers with diabetes who use insulin to take antibiotics with them. You start taking these the first time you have watery diarrhoea or diarrhoea accompanied by fever or vomiting.

For travellers with diabetes who are not insulin-dependent but use tablets, it may be wise to take antibiotics with you when travelling to an area where it is difficult to get to a doctor.

Furthermore, it is wise for travellers with diabetes to take ORS in case of diarrhoea. ORS stands for oral rehydration salts. These contain salts, sugars and minerals. These make the body retain more fluids, which helps against dehydration. It is not a problem that this contains glucose. 

DIABETES AND ANTIBIOTICS

Besides antibiotics for self-treatment of traveller’s diarrhoea, it is sometimes wise to take other antibiotics with you.

In travellers with diabetes who have polyneuropathy, there is an increased risk of skin infections on the feet. For them, it is important to include a course of flucloxacillin as emergency treatment in case of incipient infections. 

TAILORED ADVICE FOR DIABETES

The advice for travellers with diabetes depends on what medication you take, whether you have polyneuropathy and how you take your medication. The traveller’s nurse at vaccinatiecentrum.nl will help you with this.

Would you like advice specific to your personal health situation? Use the button below, email us at info@vaccinatiecentrum.nl or call 085-9020303.

Do you have an immune disorder and are you going on a trip? On this page you will find information to consider before and during your trip.

Travelling with an immune disorder

A well-functioning immune system protects the body against pathogens, such as viruses, bacteria, fungi and parasites. If you have an immune disorder (immune deficiency), the immune system does not work properly. This makes you more susceptible to infections. An immune disorder can be congenital or develop later in life.

People with immune disorders are especially vulnerable and have an increased risk of contracting certain diseases and infections. Some diseases can also become more severe. It is therefore especially important to prepare a (distant) journey well in advance. Very rarely, you may even have to change your travel destination.

Your immune system may be weakened by a disease, such as cancer or HIV. Certain medications can also lower the functioning of the immune system. These medicines are called ‘immunosuppressants’. Drugs that lower the function of your immune system are often given for autoimmune diseases, such as rheumatoid arthritis or chronic intestinal inflammation. Examples of immunosuppressants are prednisone, methotrexate or azathioprine. When you have (had) chemotherapy for cancer, your immune system is often also temporarily weakened.

There are different types of immune disorders and the severity of the immune disorder can also vary widely. The type and severity of the immune disorder determine the level of risk and the measures that should be taken.

Do you have any of the following chronic conditions? Or have you recently been treated for one of these? If so, you are more likely to get a serious infection when travelling abroad:

• Crohn’s disease or ulcerative colitis
• HIV / AIDS
• Cancer, Kahler disease (multiple myeloma), chronic lymphatic leukaemia (CLL) or (non)Hodgkin lymphoma
• Diabetes
• No spleen or impaired spleen function
• Rheumatoid arthritis, SLE or other rheumatic diseases
• Chronic liver disease
• Chronic kidney disease
• Organ transplantation

IMMUNE DISORDERS IN COMBINATION WITH VACCINATIONS

If you have an immune disorder, the effect of vaccinations is sometimes less certain. An additional blood test is therefore sometimes recommended. You also run a higher risk of complications with some vaccines.

In addition, you cannot get all vaccinations, including live attenuated vaccines. The benefits and dangers of vaccination must be weighed against each other by you and your doctor. Sometimes additional vaccinations are also advised and you may need to be referred to the tuberculosis control department because of an increased risk of tuberculosis.

Sometimes vaccinatiecentrum.nl refers you back to your doctor for additional vaccinations. These are not vaccinations that you need for your trip, but to which you are entitled because of your condition, even if you were not travelling. These include the vaccines against influenza (flu), meningococcal, pneumococcal and Hib.

Do you have current or future travel plans and have yet to start immunosuppressant drugs? If so, get vaccinated before starting the immunosuppressive drugs.

IMMUNE DISORDERS AND MALARIA

In areas with malaria where anti-mosquito measures or emergency treatment are adequate for healthy travellers, a different advice applies for some travellers with chronic medical conditions. The advice in these cases is to always use the most effective malaria prophylaxis and anti-mosquito measures. The traveller’s nurse at vaccinatiecentrum will assess which measures apply to you.

IMMUNE DISORDERS AND ANTIBIOTICS

When travelling with a chronic condition, it is sometimes necessary to bring a course of antibiotics to treat diarrhoea. Always carry the antibiotics with you, so first in your hand luggage and then in your backpack or handbag. It is also wise to take a medical passport with you, which will ensure that you receive appropriate treatment if necessary.

For travellers with chronic illnesses, it is extra important to book an appointment on time (six weeks before departure). The traveller’s nurse will assess with you whether it is wise to take antibiotics with you.

TAILORED ADVICE FOR IMMUNE DISORDERS

For people with immune disorders, thorough travel preparation is especially important. Sometimes additional vaccinations, medications or precautions are highly recommended or even necessary.

Preferably book an appointment for the traveller’s consultation at least six weeks before departure. Sometimes consultation with your specialist or with a specialist centre is necessary.

Do you have any questions or would you like to book an appointment?

If you have any questions or would like to book an appointment for personal (travel) advice, you can use the button below, email via info@vaccinatiecentrum.nl  or call 085-9020303.

Do you have a coagulation disorder and are you going on a trip? On this page you will find information to consider before and during your trip.

TRAVELLING WITH A COAGULATION DISORDER

A coagulation disorder can be congenital or the result of certain medications that make the blood clot faster/slower. As a result, when vaccinating, bruising sometimes occurs more quickly at the injection site or injections have to be given somewhere other than in the muscle of the upper arm. 

COAGULATION DISORDER AND VACCINATIONS

If you use blood thinners, it is usually no problem to administer the vaccinations into the muscle of the upper arm as normal. Always inform us during the consultation if you use blood thinners or have a congenital coagulation disorder. With (congenital) coagulation disorders, the vaccination may have to be administered in a different way. Discuss this with your doctor before the consultation.

COAGULATION DISORDER AND MALARIA

Vitamin K antagonists (VKAs) sometimes interact with certain malaria tablets. If you take this type of medication please mention this to the nurse during the consultation or in the intake. 

COAGULATION DISORDER AND TRAVELLER’S DIARRHOEA

If you experience diarrhoea, fever or vomiting during your trip, your INR value may become disrupted. In that case, try to check your INR value extra for dysregulations. 

COAGULATION DISORDER AND ANTIBIOTICS

Vitamin K antagonists (VKAs) sometimes interact with certain malaria tablets. If you take this type of medication please mention this to the nurse during the consultation or in the intake. Furthermore, the antibiotic Cotrimoxazole should not be prescribed to you in combination with certain blood thinners. Cotrimoxazole may also be in some diarrhoea inhibitors sold abroad, so be extra alert to this. 

TAILORED ADVICE FOR COAGULATION DISORDERS

Prior to the consultation and your trip, consult with your practitioner/specialist about the dosage of blood thinners you are taking. Depending on the dosage, we will determine which vaccinations can and cannot be administered into the muscle. Vaccinations administered into the muscle often offer more guarantee of good protection. Travelling and getting vaccinated with a coagulation disorder or on blood thinners is perfectly possible. During the consultation, inform the nurse about your coagulation disorder and/or use of blood thinners. Consult with your practitioner about getting vaccinations and adjusting the dosage of blood thinners if necessary.

Do you have any questions or would you like to book an appointment?

If you have any questions or would like to book an appointment for personal (travel) advice, you can use the button below, email via info@vaccinatiecentrum.nl or call 085-9020303.