The following immunisations are generally recommended to travellers.

•Malaria

It is vital that you undertake a course of immunisation against malaria. It is also important to realise that the tablets you should take may vary according to the country in which you are traveling. This is because in some parts of the world, the malaria parasite is resistant to certain drugs.

Remember though that antimalarial tablets do not provide complete protection and you should always try to avoid mosquito bites.

If at any point during your trip you get a measured fever of 38°C (use a thermometer) or higher, 7 days or more after arriving in a malarial area it is possible that you could have malaria and immediate medical help should be sought. If you cannot reach help that day and your condition deteriorates you should take emergency self-treatment.

Self-treatment should be considered to be a first-aid measure only and you should still endeavour to get to medical attention. Suitable standby kit (adult) For malarious areas with no chloroquine resistance. Treat with 3 tablets of Fansidar as a single dose and seek medical attention. For malarious areas with chloroquine resistance. Treat with 600mg of quinine sulphate taken three times daily for three days followed by a single dose of 3 tablets of Fansidar after the course of quinine is finished.

Polio: This vaccine is given orally, often on a lump of sugar, and is a simple and safe protection against poliomyelitis which is still prevalent in tropical and developing countries. A booster is needed every 10 years.

Tetanus: All travellers should be in date for tetanus immunisation as the disease is spread throughout the world and is potentially fatal. A booster dose is given as a single injection and lasts for 10 years.

Typhoid: Contracted from contaminated food and water which leads to high fever and septicaemia. Immunisation can be either by a new injected single-dose vaccine or a live oral vaccine. Immunisation is usually advised for those going to areas where the standards of food and water hygiene are lower than the UK.

Hepatitis: A Short term protection against this water-borne viral disease is offered by a single injection. A vaccine is now available which provides protection for ten years and is suitable for the frequent traveler. Immunisation is usually advised for those going to areas where the standards of food and water hygiene are lower than the UK.

Yellow Fever: A single injection provides protection against yellow fever for ten years. An International Certificate of Vaccination against Yellow Fever is valid ten days after the injection or immediately upon re-vaccination, and is a mandatory requirement for entry into certain countries.

Cholera: Cholera is an uncommon disease in travellers Immunisation against cholera is not appropriate for most travellers, although, it has been known that border officials may demand a cholera certificate, so it might be best to have one prior to departure.

The following vaccines are occasionally suggested to travellers at particular risk or those who may be staying for long periods of time..

Rabies: Pre-immunisation against rabies should be considered by travellers going to areas where rabies is endemic, who are staying for considerable periods of time or are at particular risk.

TB: The majority of travellers from the UK will have had a BCG vaccination in childhood and do not need to be boosted. Unimmunised adults and children going to endemic areas for prolonged periods should consider immunisation. The vaccine is given as a single injection.

Hepatitis B: Hepatitis B is a viral disease of the liver that is endemic in many tropical countries. It is transmitted by sexual activity and through contaminated needles and syringes. travellers at particular risk should consider being in date for this immunisation. The course comprises two injections separated by one month and a further injection at six months. An accelerated schedule is available for those who do not have time to complete the recommended course.

Japanese Encephalitis: Japanese encephalitis is a serious viral disease transmitted by mosquitoes in certain rural parts of India, Asia and south east Asia. A vaccine is available which should be reserved for those going to risk areas for periods of a month or more.

Tick Borne Encephalitis: Tick borne encephalitis is a viral disease transmitted by ticks. It is prevalent in certain European countries where the ticks are found in the long grass at the edge of forests. The vaccine is recommended for those who will be staying in such areas for prolonged periods of time.

Diphtheria: Most travellers from the UK will have been immunised against diphtheria in childhood. A booster of low-dose vaccine would be advised every 10 years for those intending to make long-stay trips to developing countries. travellers requiring a booster for tetanus should be given the new combined diphtheria/tetanus vaccine.

Meningococcal meningitis: A single dose vaccine is available which protects against the A and C strains of the disease. The vaccine would be advised for travellers to areas where there are outbreaks of these strains of meningococcal meningitis. Long-stay travellers to areas where the disease is endemic (e.g. the "meningitis belt" in northern sub-Saharan Africa in the dry season) should also be offered the vaccine. A booster is required every 3-5 years.