Travel Medicine FAQs
Why do I need a travel clinic?
Different countries in the world have different threats to health; including infectious diseases, sanitation issues, safety of food and water supplies and also threats with taking part in certain activities like climbing to high altitudes. Although QuickDoc usually reviews your request within 24 hours, you should aim to have your online consultation with QuickDoc at least 4 weeks before your departure date to ensure you receive your prescription travel medication in time.
How common are travel-related diseases?
The most common illness affecting travellers is that of travellers’ diarrhoea, it usually occurs when visiting countries with a different level of sanitation to which you are used to. International travellers going to areas with local malaria transmission are at higher risk of malaria infection due to their lack of immunity, although the risk can be drastically reduced by taking malaria prophylaxis (prevention) medication and following protection guidelines such as using insect repellent, covering exposed skin and sleeping inside a mosquito net.
Between 43 - 79% of international travellers report developing a travel-related illness.
What medications do you offer in the travel clinic?
QuickDoc offers a variety of prescriptions for travel medications. These include various types of anti-malarials, antibiotics for travellers’ diarrhoea, Dukoral®, (a drinkable vaccine for cholera and E.Coli), antibiotics for other infections such as respiratory tract, ear infections and skin infections and medications for altitude sickness (for those tackling those high peaks on expeditions).
Why do you not provide a face-to-face consultation?
QuickDoc only offers 100% online consultations. Our triage process has gone through rigorous design and testing and is an approved process within our company. If our Doctors need to question a request then we will contact you via telephone or email (with the details you provided upon registration). Being an online service, we are able to keep consultation fees down and we aim to offer the best value for online clinic in Canada for our clients.
Why do you not provide prescription for Travel Vaccines?
Travel vaccines need to be administered professionally by a trained professional. Due to the nature of the shipping process from our partner pharmacies to your door and the need for the vaccine to travel to a trained professional to administer it; we cannot guarantee the pharmacological cold-chain to ensure the efficacy of the vaccine when administered.
What is Malaria?
Malaria is a life-threating disease caused by parasites which are spread to humans through the bites of infected mosquitos and the release of malaria sporozites. The sporozite then travels to the liver invading liver cells. Once matured in the liver, the mature hepatic schizont ruptures and releases red blood cell invading merozoites into the blood stream. Malaria is mainly found in tropical countries. It is preventable and curable. The most common early malaria symptoms are fever, chills and headache. These usually start within 10-15 days of being bitten by an infected mosquito.
How Common is Malaria?
While the disease is uncommon in temperate climates, malaria is still common in tropical and subtropical countries. Each year nearly 290 million people are infected with malaria, and more than 400,000 people die of the disease.
The greatest risk factor for developing malaria is to live in or to visit areas where the disease is common. These include the tropical and subtropical regions of:
- Sub-Saharan Africa
- South and Southeast Asia
- Pacific Islands
- Central America and northern South America
The degree of risk depends on local malaria control, seasonal changes in malaria rates and the precautions you take to prevent mosquito bites.
Risks of more-severe disease
People at increased risk of serious disease include:
- Young children and infants
- Older adults
- Travelers coming from areas with no malaria
- Pregnant women and their unborn children
What are the Symptoms of Malaria?
Signs and symptoms of malaria may include:
- Fever
- Chills
- General feeling of discomfort
- Headache
- Nausea and vomiting
- Diarrhoea
- Abdominal pain
- Muscle or joint pain
- Fatigue
- Rapid breathing
- Rapid heart rate
- Cough
Some people who have malaria experience cycles of malaria "attacks." An attack usually starts with shivering and chills, followed by a high fever, followed by sweating and a return to normal temperature.
Malaria signs and symptoms typically begin within a few weeks after being bitten by an infected mosquito. However, some types of malaria parasites can lie dormant in your body for up to a year.
How Can I Prevent Malaria?
If you are traveling to an area where malaria is common, take steps to avoid mosquito bites. Mosquitoes are most active between dusk and dawn. To protect yourself from mosquito bites, you should:
- Cover your skin. Wear pants and long-sleeved shirts. Tuck in your shirt, and tuck pant legs into socks.
- Apply insect repellent to skin. Use an insect repellent registered on any exposed skin.
- Apply repellent to clothing. Sprays containing permethrin are safe to apply to clothing.
- Sleep under a net. Bed nets, particularly those treated with insecticides, such as permethrin, help prevent mosquito bites while you are sleeping.
- Sleep in an air-conditioned room if possible.
- Take Preventative Medicine Prescribed by QuickDoc
What are Anti-Malarials?
Anti-malarial medications are used for the treatment and prevention of malarial infection. Each anti-malarial medication differs in its structure, working uniquely to kill the parasite. Malaria medication isn’t 100% effective in preventing the disease and the medication should be used with other preventative methods such as wearing insect repellent, wearing long clothing, having accommodation with air conditioning and sleeping in an area with a net and bed treatments.
When Should I See a Doctor?
Talk to your doctor if you experience a fever while living in or after traveling to a high-risk malaria region. If you have severe symptoms, seek emergency medical attention.
What is Malarone?
Malarone contains two medicines, Atovaquone and Proguanil. It is used to prevent and treat malaria.
How do Malarone tablets work?
Malarone works by interfering with the growth of parasites in the red blood cells of the human body. As all malaria symptoms are caused by blood stage parasites, malarone targets this stage of the parasite lifecycle.
What is my dose of Malarone?
The usual dose that our Doctors recommend of malarone is to take one 250mg tablet a day orally, starting two days before you are due to travel, then once a day during travel. You must continue taking the same dose for 7 days after leaving the malaria area.
Take malarone with food and at the same time each day. If you vomit within one hour of taking your dose, repeat the dose. Ensure to store malarone in its original packaging at room temperature and keep out of reach of children
What are the side effects of Malarone?
Lots of medications can cause side effects, which is an unwanted response to a medication when taken as a normal dose. Not all people experience side effects. This medication has been prescribed by our Doctors as they have judged that the benefit to you outweighs the risk of any side effects. The following side effects have been reported by at least 1% of people when using Malarone.
- Nausea and Vomiting
- Abdominal Pain
- Headache
- Diarrhoea
- Loss of Appetite
- Dizziness
- Weakness
Check with your Doctor (and discontinue medication) as soon as possible if any of the following less common side effects occur:
- Signs of serious liver problems such as (Nausea and Vomiting that is severe and doesn’t stop, dark urine or yellowing of the eyes or skin)
- Signs of anaemia such as (worsening tiredness, rapid breathing, pale skin, lips and nail beds and fast heart rate while resting)
- Signs of severe infection such as (high fever, severe chills, body aches or a sore throat)
SEEK IMMEDIATE MEDICAL ATTENTION IF ANY OF THE FOLLOWING SIDE EFFECTS OCCUR AND DISCONTINUE TAKING THE MEDATION
- Chest pains, irregular heartbeat, shortness of breath
- Shortness of breath associated with a blue colouring of the lips and peripheries (hands and feet)
- Severe Allergic reaction or anaphylaxis (swelling, facial swelling, swelling of lips, tongue, throat, shortness of breath, wheeze, rash, itching)
- Severe skin reaction (blistering, skin peeling, an extensive rash or rash accompanied by fever or pain)
This is not a complete list of side effects and others may occur.
PLEASE ENSURE YOU READ THE PATIENT INFORMATION LEAFLET THOROUGHLY WHICH WILL BE DELIVERED WITH YOUR MEDICATION BEFORE TAKING ANY MEDICATION PRESCRIBED BY US
What is Doxycycline?
DOXYCYCLINE is an antibiotic from a family called tetracyclines. It can be used to prevent contracting malaria. It is thought to kill malaria plasmodium parasites by blocking protein translation in the essential apicoplast organelle (in the Liver phase).
What is my dose of Doxycycline?
The usual dose of Doxycycline that our Doctors recommend is 100mg capsules taken orally once daily, starting two days before you are due to travel, then once a day during travel. You must continue taking the same dose for 28 days after leaving the malaria area.
Take Doxycycline at the same time each day. If you vomit within one hour of taking your dose, repeat the dose. Ensure to store Doxycycline in its original packaging at room temperature and keep out of reach of children.
What are the side effects of Doxycycline?
Lots of medications can cause side effects, which is an unwanted response to a medication when taken as a normal dose. Not all people experience side effects. The following side effects have been reported by at least 1% of people when using Doxycycline.
- Angioedema (swelling)
- Nausea and vomiting
- Diarrhoea
- Headache
- Dizziness
- Photosensitivity reaction (increased risk of sunburn)
- Skin reactions
- Hypotension (low blood pressure)
- Tachycardia (fast heart rate)
Check with your Doctor (and discontinue medication) as soon as possible if any of the following less common side effects occur:
- Abdominal Discomfort
- Agitation, confusion, hallucinations or excessively drowsy.
- Blood in urine
- Signs of bleeding (e.g., unusual bruising or bleeding, unexplained nosebleeds)
- Kidney pains (pain in the side between lower ribs and hip)
- Tremors
- Low white blood cells (Leucopoenia) or Low platelet levels (thrombocytopenia)
- Sign of decreased kidney function (e.g., decreased urine output, nausea, reduced appetite).
SEEK IMMEDIATE MEDICAL ATTENTION IF ANY OF THE FOLLOWING SIDE EFFECTS OCCUR AND DISCONTINUE TAKING THE MEDATION
- Chest pains, irregular heartbeat, shortness of breath
- Shortness of breath associated with a blue colouring of the lips and peripheries (hands and feet)
- Severe Allergic reaction or anaphylaxis (swelling, facial swelling, swelling of lips, tongue, throat, shortness of breath, wheeze, rash, itching)
- Severe skin reaction (blistering, skin peeling, an extensive rash or rash accompanied by fever or pain)
- Signs of bowel inflammation (e.g., Fever that appears after starting the medication, watery and severe diarrhoea [may also be bloody])
- Sinus infection
- Discolouration of skin, scars, teeth or gums
- Increased blood pressure
This is not a complete list of side effects and others may occur.
PLEASE ENSURE YOU READ THE PATIENT INFORMATION LEAFLET THOROUGHLY WHICH WILL BE DELIVERED WITH YOUR MEDICATION BEFORE TAKING ANY MEDICATION PRESCRIBED BY US
What is Altitude Sickness?
Altitude sickness is a general term for a group of medical conditions that can happen when you move to a higher altitude too quickly for your body to adjust. The higher elevations result in a thinner atmosphere and lower oxygen levels in the air, which means you are breathing in less oxygen than you would get at lower altitudes. When your body struggles to adjust to the oxygen difference, it causes the symptoms of altitude sickness. The three distinct conditions of altitude sickness are:
- Acute Mountain Sickness (AMS), the most common and mildest form.
- High Altitude Pulmonary Oedema, when altitude sickness affects your lungs, causing them to fill with fluid.
- High Altitude Cerebral Oedema, when altitude sickness causes your brain to swell.
How Common is Altitude Sickness?
Altitude sickness is most common amongst people who aren’t acclimatised and not used to breathing at high altitudes. It is rare below 2438 metres (8,000 feet) above sea level. Most people who ascend quickly to 3352 metres (11,000 feet) will develop some form of Acute Mountain Sickness.
What the Symptoms of Altitude Sickness?
The symptoms of Acute Mountain Sickness usually appear within the first 24 hours of reaching a high altitude and include:
- Headache (the most common symptom)
- Nausea and Vomiting
- Fatigue and malaise (even when resting)
- Reduced Appetite
- Restless Sleeping
- Dizzy or Lightheaded
- Vision changes (a rarer symptom, but an indicator or more severe altitude sickness, usually due to blood vessel ruptures in the retina)
Can Altitude Sickness be Prevented?
Altitude sickness is easily prevented with good planning and preparation.
- Limit the speed of ascent (altitude sickness is more likely when you ascend too fast). Once you have reached 2500 metres (8202 feet), it is only recommended to ascend between 300-500 metres per day.
- Take rest days! Once you reach 2500 metres, have an initial rest day, then every third day as you continue to ascend.
- Sleep at a lower altitude (if you can, ascend during the day and rest at a lower altitude).
- Preventative Medications such as Acetazolamide (Diamox) can prevent and treat altitude sickness.
What is Acetazolamide (Diamox)?
Acetazolamide (Diamox) is a diuretic, it helps you lose salt and excess water from your body. It is used in the prevention and treatment of altitude sickness. It is a potent carbonic anhydrase inhibitor causing diuresis and renal bicarbonate loss, this in turn increases minute ventilations and oxygenation by enhanced central chemoreceptor outputs. By using Acetazolamide (Diamox), high-elevation acclimatisation that normally takes between 3 and 5 days can potentially be achieved in just one.
What is my dose of Acetazolamide (Diamox)?
The usual dose that our Doctors recommend of Acetazolamide (Diamox), is to take one 125mg tablet twice a day (at the same times each day). Begin taking this medication 24 hours before arriving at high altitude and continue for 48 hours while at high altitude. If symptoms persist, you may take Acetazolamide (Diamox) for an additional 48 hours. If you vomit within one hour of taking your dose, repeat the dose. Ensure to store Acetazolamide (Diamox) in its original packaging at room temperature and keep out of reach of children.
What are the side effects of Acetazolamide (Diamox)?
Lots of medications can cause side effects, which is an unwanted response to a medication when taken as a normal dose. Not all people experience side effects. This medication has been prescribed by our Doctors as they have judged that the benefit to you outweighs the risk of any side effects. The following side effects have been reported by at least 1% of people when using Acetazolamide (Diamox).
- Nausea and vomiting
- Diarrhoea
- Loss of appetite
- Drowsiness or confusion
- Reduced hearing or ringing in the ears
- Increased urination
- Altered sense of taste
Check with your Doctor (and discontinue medication) as soon as possible if any of the following less common side effects occur:
- Signs of serious liver problems such as (Nausea and Vomiting that is severe and doesn’t stop, dark urine or yellowing of the eyes or skin)
- Blood in the urine or stools
- Signs of blood cell disorders such as (high fever, severe chills, body aches, sore throat, nosebleeds, bleeding gums)
- Specific weakness in one area of your body
- Signs of metabolic acidosis (confusion, vomiting, lack of energy, irregular heartbeat)
- Signs of kidney stones (pain in the flank area or lower back, blood in the urine, painful or difficult urination)
SEEK IMMEDIATE MEDICAL ATTENTION IF ANY OF THE FOLLOWING SIDE EFFECTS OCCUR AND DISCONTINUE TAKING THE MEDATION
- Chest pains, irregular heartbeat, shortness of breath
- Shortness of breath associated with a blue colouring of the lips and peripheries (hands and feet)
- Severe Allergic reaction or anaphylaxis (swelling, facial swelling, swelling of lips, tongue, throat, shortness of breath, wheeze, rash, itching)
- Severe skin reaction (blistering, skin peeling, an extensive rash or rash accompanied by fever or pain)
This is not a complete list of side effects and others may occur.
PLEASE ENSURE YOU READ THE PATIENT INFORMATION LEAFLET THOROUGHLY WHICH WILL BE DELIVERED WITH YOUR MEDICATION BEFORE TAKING ANY MEDICATION PRESCRIBED BY US
What is Travellers’ Diarrhoea?
Travellers’ diarrhoea is spread through food and water mainly, but it can also spread from person to person. It is the most common health problem experienced during travel. Most cases usually get better within 3-5 days, are mild and do not need specific treatment.
It can be caused by many different germs like bacteria (E.coli, Salmonella), viruses (norovirus) and parasites (Giardia). All these germs are spread through eating and drinking contaminated food and water, or using contaminated dishes and cutlery.
We do not routinely recommend antibiotics to prevent travellers’ diarrhoea; however, if you are travelling somewhere remote or with limited medical access or to a place with different hygiene standards to your country of origin, we can prescribe antibiotics for travel for if symptoms of travellers’ diarrhoea occurs. It is especially important for those individuals who have travellers’ diarrhoea to avoid dehydration.
How Common is Travellers’ Diarrhoea?
Travellers’ Diarrhoea is the most predictable travel-related illness. Reported rates are between 30-70% of travellers during a two-week period (depending on the destination and season of travel).
What the Symptoms of Travellers’ Diarrhoea?
The symptoms of Travellers’ Diarrhoea usually appear within the first 24 hours of eating or drinking contaminated food and can consist of:
- Loose, watery stools
- Nausea
- Vomiting
- Bloating
- Abdominal pain or cramps
- Blood in the stool
- Urgency to have a bowel movement
- Feeling tired
- Fever
Can Travellers’ Diarrhoea be Prevented?
Travellers’ Diarrhoea can be prevented with good planning and good hygiene.
- Wash your hands
Wash your hands often with soap and water, especially after using the bathroom and before eating. If soap and water aren’t available, use an alcohol-based hand sanitizer. Keep your hands away from your mouth as much as possible. - Choose food and drinks carefully.
Eat only foods that are cooked and served hot and avoid food that has been sitting on a buffet. Wash and peel raw fruits and vegetables in clean water. Only drink beverages from factory-sealed containers, and avoid ice because it may have been made from unclean water.
What is Azithromycin?
Azithromycin is an antibiotic that fights various bacteria. It is the preferred first-line treatment antibiotic for acute watery diarrhoea (travellers’ diarrhoea) as it has the broadest activity against the bacterial pathogens causing travellers’ diarrhoea.
It is also used for respiratory infections, skin infection, ear and eye infections and some sexually transmitted infections.
What is my dose of Azithromycin?
The usual dose that our Doctors recommend of Azithromycin, is to take one 500mg tablet once daily on an empty stomach. Take one 500mg tablet every day after symptoms start for 3 days.
If you vomit within one hour of taking your dose, repeat the dose. Ensure to store Azithromycin in its original packaging at room temperature and keep out of reach of children.
What are the side effects of Azithromycin?
Lots of medications can cause side effects, which is an unwanted response to a medication when taken as a normal dose. Not all people experience side effects. This medication has been prescribed by our Doctors as they have judged that the benefit to you outweighs the risk of any side effects. The following side effects have been reported by at least 1% of people when using Azithromycin.
- Nausea and vomiting
- Diarrhoea
- Loss of appetite
- Headache
- Feeling Dizzy or tired
- Altered sense of taste
Check with your Doctor (and discontinue medication) as soon as possible if any of the following less common side effects occur:
- Signs of serious liver problems such as (Nausea and Vomiting that is severe and doesn’t stop, dark urine or yellowing of the eyes or skin)
- Ringing in your ears (tinnitus) or temporary hearing loss
- Severe stomach or back pain that could be indicative of Pancreatitis
- Fast or irregular heart beat
SEEK IMMEDIATE MEDICAL ATTENTION IF ANY OF THE FOLLOWING SIDE EFFECTS OCCUR AND DISCONTINUE TAKING THE MEDATION
- Chest pains, irregular heartbeat, shortness of breath
- Shortness of breath associated with a blue colouring of the lips and peripheries (hands and feet)
- Severe Allergic reaction or anaphylaxis (swelling, facial swelling, swelling of lips, tongue, throat, shortness of breath, wheeze, rash, itching)
- Severe skin reaction (blistering, skin peeling, an extensive rash or rash accompanied by fever or pain)
This is not a complete list of side effects and others may occur.
PLEASE ENSURE YOU READ THE PATIENT INFORMATION LEAFLET THOROUGHLY WHICH WILL BE DELIVERED WITH YOUR MEDICATION BEFORE TAKING ANY MEDICATION PRESCRIBED BY US
What is Cholera?
Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio Cholerae (V. cholerae). Cholera can cause severe acute watery diarrhoea and the severe forms of the disease can kill within hours if left untreated.
How Common is Cholera?
Researchers have estimated that each year there are 1.3 to 4.0 million cases of cholera, and 21 000 to 143 000 deaths worldwide due to cholera. Most of those infected have no or mild symptoms and can be successfully treated with oral rehydration solution.
What the Symptoms of Cholera?
Most people infected with V. cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1–10 days after infection and are shed back into the environment, potentially infecting other people.
Among people who develop symptoms, the majority have mild or moderate symptoms. It takes between 12 hours and 5 days for a person to show symptoms. A minority of patients develop acute watery diarrhoea with severe dehydration. This can lead to death if left untreated.
What is LT-producing ETEC Diarrhoea?
Enterotoxigenic Escherichia coli (ETEC) is transmitted by eating food or drinking water that is contaminated with enterotoxin strains of E. coli from human or animal faeces. Infection with LT-producing ETEC can cause profuse watery diarrhoea. Exposure to heat‐labile toxin (LT) produces a high rate of seroconversion.
How Common is LT-producing ETEC Diarrhoea?
Enterotoxigenic Escherichia coli (ETEC) is the most common major enteric pathogen accounting for diarrhoea occurring in global travellers. ETEC infection is caused by ingestion of contaminated food and water. It enters through the gastrointestinal tract and colonises in the small intestine.
What the Symptoms of LT-producing ETEC Diarrhoea?
The diarrhoeal disease caused by ETEC is characterized by a rapid onset of watery, non-bloody diarrhoea of considerable volume, accompanied by little or no fever, leading to rapid dehydration. Other common symptoms are abdominal pain, malaise, nausea, and vomiting.
Can Cholera and LT-producing ETEC Diarrhoea be prevented?
A multifaceted approach is key to control cholera and LT-producing ETEC Diarrhoea, and to reduce deaths. A combination of surveillance, water, sanitation and hygiene, treatment, and oral vaccines are used.
At QuickDoc we offer prescriptions for the oral vaccine Dukoral ®.
What is Dukoral ®?
DUKORAL® (Oral, Inactivated Cholera and LT-producing ETEC Diarrhea Vaccine) is indicated for the prevention of and protection against cholera and diarrhoea caused by heat-labile toxin producing enterotoxigenic Escherichia coli (LT-producing ETEC).
What is my dose of Dukoral ®?
The usual dose that our Doctors recommend of Dukoral® to achieve sufficient immunisation are two oral doses. The first dose needs to be at least 2 weeks before departure. The second dose should be at least one week after the first dose and at least one week before departure. Protection against Cholera and LT-producing ETEC Diarrhoea starts approximately one week after the second dose and will last for approximately 2 years for Cholera and 3 months for LT-producing ETEC Diarrhoea.
Avoid food and drink for 1 hour before and 1 hour after drinking the vaccine. Food and drink taken during this time may inactivate the vaccine.
Note: If more than 6 weeks elapse between the 1st and 2nd dose, the primary immunization should be restarted.
Booster Doses of Dukoral®
BOOSTER DOSES:
For an adult who has taken Dukoral® before and is travelling again:
- If it has been between 3 months and 5 years since the patient received the last dose, one booster dose will be sufficient to renew the protection.
- If it has been more than 5 years since the patient received the last dose, a complete primary immunization (2 doses) is recommended to renew the protection
What are the side effects of Dukoral ®?
Lots of medications can cause side effects, which is an unwanted response to a medication when taken as a normal dose. Not all people experience side effects. This medication has been prescribed by our Doctors as they have judged that the benefit to you outweighs the risk of any side effects. The following side effects have been reported by at least 1% of people when using Dukoral ®.
- Diarrhoea and loose stools
- Stomach discomfort
- Nausea and vomiting
- Headache
- Cough
- Blocked or runny nose
- Loss of appetite
Check with your Doctor (and discontinue medication) as soon as possible if any of the following less common side effects occur:
- Severe diarrhoea
- Fainting
SEEK IMMEDIATE MEDICAL ATTENTION IF ANY OF THE FOLLOWING SIDE EFFECTS OCCUR AND DISCONTINUE TAKING THE MEDATION
- Chest pains, irregular heartbeat, shortness of breath
- Shortness of breath associated with a blue colouring of the lips and peripheries (hands and feet)
- Severe Allergic reaction or anaphylaxis (swelling, facial swelling, swelling of lips, tongue, throat, shortness of breath, wheeze, rash, itching)
- Severe skin reaction (blistering, skin peeling, an extensive rash or rash accompanied by fever or pain)
This is not a complete list of side effects and others may occur.
PLEASE ENSURE YOU READ THE PATIENT INFORMATION LEAFLET THOROUGHLY WHICH WILL BE DELIVERED WITH YOUR MEDICATION BEFORE TAKING ANY MEDICATION PRESCRIBED BY US
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