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Travellers Diarrhoea

What Are the Side Effects of Ciprofloxacin?

Posted Wednesday 16 September 2020 12:00 by Harman Bhamra in Travellers Diarrhoea

Ciprofloxacin is a type of antibiotic commonly used to treat traveller’s diarrhoea. Because this is an antibiotic, Ciprofloxacin can only treat diarrhoea caused by bacteria. This is not recommended for diarrhoea caused by parasites or viral infections. Within this guide, we will be taking you through the side effects of Ciprofloxacin.

How to Use Ciprofloxacin

Using Ciprofloxacin is easy. Take one tablet of Ciprofloxacin every 12 hours. You can continue taking the medication if your symptoms have not improved. If you miss a dose, take it as soon as you remember. Do not take the missed dose if it's almost time for your next dose.

Who Can Take Ciprofloxacin?

Adults and children over a year old can take Ciprofloxacin. People who have the following are not allowed to take this medicine:

  • Diarrhoea when you take antibiotics
  • Irregular heartbeat
  • Problem with your tendons or kidneys
  • Diabetes
  • Epilepsy
  • Abdominal aortic aneurysm

The Side Effects of Ciprofloxacin

All medicines have side effects and Ciprofloxacin is no exception. Some of the common side effects of this medication include:

  • Nausea or feeling sick after taking the tablet
  • Bad taste in the mouth
  • Diarrhoea
  • Swelling
  • Pale skin
  • Sleepiness
  • Unusual tiredness
  • Heartburn
  • Vaginal itching

Usually mild, these side effects of Ciprofloxacin go away on their own after you stop taking the medication.

Serious Side Effects of Ciprofloxacin

Serious side effects of Ciprofloxacin happen in less than 1 in 100 people. Stop taking this medication and immediately inform your doctor if you developed:

Muscle pain or weakness - this side effect usually starts in your calf or ankle. It can also occur in your arms, legs, or shoulders. You may also develop swelling in your tendons or joints. This side effect is more common in children and can occur several months after stopping the medication.

Abnormal sensations - usually characterised by pins and needles or feelings of numbness, ticking, and tingling that lingers. You may also experience weakness in your legs or arms.

Severe tiredness - usually characterised by excessive tiredness, difficulty sleeping, and anxiety.

Diarrhoea - may contain blood or mucus. You may also experience muscle cramps. Consult your doctor as well if you have severe diarrhoea for more than four days even though it doesn’t have blood or mucus.

Other serious side effects of Ciprofloxacin are:

  • Tinnitus (ringing in the ears)
  • Loss of taste
  • Changes in sight or smell
  • Fast or irregular heartbeat
  • Seizure or fits

Coping With Ciprofloxacin Side Effects

Mild side effects usually don’t need medical intervention. Here are some of the things you can do to cope:

If you are feeling sick…

Avoid taking spicy food. Instead, eat simple meals. Also, take Ciprofloxacin after you have had a snack or meal.

If you have diarrhoea…

Keep yourself hydrated by drinking lots of water. It helps to replenish your lost electrolytes too. Telltale signs of dehydration include peeing less than normal and having a strong-smelling pee.

Where to Buy Ciprofloxacin

You can buy Ciprofloxacin from Express Pharmacy. Order now and we’ll get it delivered right to your doorstep.

Travellers Diarrhoea: The Symptoms and Causes

Posted Tuesday 14 July 2020 12:37 by Harman Bhamra in Travellers Diarrhoea

Amazing experiences are always around the corner when you travel to a foreign country. From the interesting people and incredible views right through to exotic foods and drinks; there’s always something remarkable to discover. However, with foreign experiences comes foreign reactions - typically in the form of travellers diarrhoea.

This guide will take you through the symptoms and causes of travellers diarrhoea so that you can feel fully prepared in the unfortunate situation of experiencing it.

What Is Travellers Diarrhoea?

If you find yourself asking: ‘is it normal to have diarrhoea when travelling?’, then we’re guessing you’ve encountered an incredibly uncomfortable situation that is stopping you from enjoying yourself. And, unfortunately, the answer is yes: it is normal to have diarrhoea when travelling. It goes by the name of Travellers Diarrhoea.

While it’s not a serious condition, travellers' diarrhoea can leave you with incredibly loose stools and, occasionally, abdominal cramps. You are likely to develop it when your body isn’t used to the change in climate or sanitisation that the country you’re visiting has to offer.

Symptoms Of Travellers Diarrhoea

The symptoms of travellers' diarrhoea are fairly obvious, making it easy to establish why you might have fallen ill. The following symptoms typically last for 1 to 2 days and will either occur while on your trip or soon after you get home:

  • Having to pass loose stools 3+ times a day
  • Abdominal cramps
  • Constant feeling of needing the toilet

In more severe cases, some people experience:

  • Vomiting
  • High fever
  • Nausea
  • Bloody stools

If you seem to be experiencing severe symptoms and they don’t ease off after a few days, it is recommended to visit your doctor for further assistance.

Causes Of Travellers Diarrhoea

As mentioned previously, travellers' diarrhoea is caused when your body isn’t used to the climate or sanitary conditions in another country. In most cases, you will develop travellers' diarrhoea when consuming contaminated food or drinking contaminated water.

While the idea of putting contaminated food and water into your body might seem like a scary thought, this is not a life or death situation and your body will recover. Travellers diarrhoea is an unpleasant experience, but not a damaging one.

How To Prevent Travellers Diarrhoea

It’s not easy to know whether you’re putting contaminated foods into your body, but luckily, there are many ways to prevent travellers' diarrhoea. The following tips are important to keep in mind so that you can enjoy your trip without any distractions.

Don’t Drink Tap Water: It’s all too easy to drink tap water when you need hydrating, but such a simple action can result in the dreaded traveller’s diarrhoea. Instead of drinking unsterilised water, drink from bottles instead. Make sure that you don’t consume any water when showering, either. If you can’t access bottled water, be sure to boil the tap water for 3 minutes before consuming. This will help to kill off any bacteria.

Say No To Ice: Ice is often made out of unsterilised water, meaning it should be avoided at all costs. Get into the habit of asking for drinks without ice when abroad.

Think About Your Food: As tempting as it may be, avoid buying food from street vendors. The food given at these vendors has often been sitting around for long periods of time, making them a feeding ground for bacteria. Instead, only eat hot foods that are served from reputable sources. If you are cooking your food yourself, stick to things that you can peel and boil.

Pack Tablets: Travellers diarrhoea can sometimes be unavoidable, making it all the more important to pack medication that will treat it as quickly as possible. The most popular travellers' diarrhoea treatments are Ciprofloxacin and Azithromycin; both as to which are available at Express Pharmacy.

Is It Normal to Have Diarrhoea When Travelling?

Posted Tuesday 17 March 2020 10:06 by Harman Bhamra in Travellers Diarrhoea

Short answer? Yes. It is perfectly normal to have traveller’s diarrhoea, especially when you are visiting high-risk areas where sanitary practices are inadequate.

What is Traveller's Diarrhoea?

Traveller’s diarrhoea (also known as “Dehli belly”) is a digestive tract illness caused by eating food or drinking water contaminated by bacteria like Salmonella, Shigella, Campylobacter and E. coli.

Viruses like the norovirus and rotavirus or parasites like Giardia, Entamoeba histolytica, and cryptosporidium can also cause diarrhoea. You can come in contact with these organisms through contaminated cups, plates, hands, etc.

Traveller’s diarrhoea is characterized by the passing of 3 or more watery/loose bowel motions in a single day. Most cases of this digestive disorder often occur in the first week of travel and are usually mild.

What Are The Symptoms of Traveller’s Diarrhoea?

Most reported instances of traveller’s diarrhoea happen during the first week of your travel or shortly after returning home. The common symptoms of this digestive disorder include:

  • Passing three or more loose stools in 24 hours
  • Urgent need to defecate
  • Nausea
  • Vomiting
  • Abdominal cramps
  • Fever

Some people also experience bloody stools, a high fever, and dehydration. Most symptoms of traveller’s diarrhoea improve after two days. And, without treatment, traveller’s diarrhoea clears up entirely after a week.

If you continue to eat or drink contaminated food or water, you may have multiple episodes of traveller's diarrhoea throughout your trip.

Classifying Traveller’s Diarrhoea

Traveller’s diarrhoea can be classified according to the degree of its severity.

  • Mild – this type of diarrhoea doesn't interfere with your activities. It's tolerable and not distressing.
  • Moderate – this type of diarrhoea interferes with your activities.
  • Severe – completely prevents you from doing your planned activities. It’s also characterized by dysentery or the presence of blood in your stools.
  • Persistent – diarrhoea that lasts for two weeks or more.

The most significant complication of traveller’s diarrhoea is dehydration – where you lose salts, minerals, and vital fluids. Severe dehydration can cause problems like coma, shock, or organ damage. It is particularly dangerous for children and older people.

Symptoms of dehydration include:

  • Sunken eyes
  • Muscle cramps
  • Light-headedness
  • Tiredness
  • Infrequent urination or passing less urine
  • Dry mouth
  • Dry tongue
  • Drowsiness
  • Cold hands or feet
  • Shallow breathing

Severe cases of dehydration may include symptoms like apathy (loss of energy and enthusiasm), confusion, and fast heart rate.

What are the High Risks Areas for Traveller’s Diarrhoea?

High-risk areas account for up to 60% of travellers’ diarrhoea cases worldwide. Usually, travellers coming from developed countries are most affected - mainly if they visit countries where sanitation and hygiene standards don't meet international standards.

Low-risk areas: Australia, New Zealand, Western Europe, and North America

Medium-risk areas: China, South Africa, the Caribbean, and Russia

High-risks areas: Central America, South America, East Africa, West Africa, North Africa, South Asia, and Southeast Asia

Although your chances of getting traveller's diarrhoea are mostly affected by your destination, people who belong to the groups below are more likely to catch the disorder in one of their trips:

  • People with compromised immune systems: People with weakened immune systems are more prone to developing infections.
  • People who take antacids: Stomach acid destroys food and bacteria. Antacids lower the acid levels in the stomach, leaving an environment that can promote more bacterial growth.
  • People with diabetes are more prone to infection as well as those who have cirrhosis of the liver and inflammatory bowel disease.
  • Young adults: Studies show that traveller's diarrhoea is more common among young adult tourists. This is most likely due to their adventurous nature and careless food choices.

How to Treat Traveller’s Diarrhoea

The aim of treating traveller's diarrhoea is to prevent dehydration. You can do this by drinking plenty of fluids and taking ciprofloxacin 500mg. We’ll discuss both below:

Diet and Fluid

Drink plenty of ‘safe’ fluids (boiled water or bottled water). For good measure, drink at least a glass of water after passing watery stool. Avoid drinking soda or alcohol as they can make your diarrhoea worse.

You can also take rehydration drinks which are readily available over the counter. Just simply pour the contents of the sachet into water. Rehydration drinks contain the right balance of salt and sugar that help your body absorb water more efficiently.

Anti-Diarrhoea Medications

Anti-Diarrhoea antibiotics like ciprofloxacin 500mg are one of the most recommended medications to treat traveller's diarrhoea. This treatment can only cure diarrhoea caused by bacteria and not the one created by parasites or viruses.

How to use ciprofloxacin 500mg

Take one tablet of ciprofloxacin 500mg twice a day. If your symptoms don’t improve, continue your medication. If you forget a dose, take the missed dose as soon as you remember it. If it’s about time for your next dose, skip the missed dose. Never take two ciprofloxacin 500mg tablets at once to compensate for the missed dosage.

What are the side effects of ciprofloxacin 500mg?

Like all medicines, ciprofloxacin 500mg may come with side effects. These include:

  • Difficulty sleeping
  • Skin rashes
  • Increased swelling
  • Headache

These side effects are usually mild and will go away as soon as the treatment is over. If they persist or if you think you’re suffering from unusual side effects from ciprofloxacin 500mg, stop taking the medicine and contact your doctor.

Where to buy ciprofloxacin 500mg

You can buy ciprofloxacin 500mg with confidence from Express Pharmacy.

In Summary

Traveller’s diarrhoea can be a nuisance, especially if you are in the middle of a much-needed vacation in the tropics. Although diarrhoea usually goes away on its own, it can prevent you from enjoying your planned activities if your symptoms are severe.

If you want to enjoy your holiday getaway to the fullest, make sure to:

  • Avoid uncooked meat, eggs, salads, and peeled fruit.
  • Don’t drink from tap water (even ice cubes!). Only drink treated or bottled water.
  • Wash your hands regularly, especially before eating or preparing your food.
  • Don’t swim in murky or dirty waters. Avoid swallowing water when you swim.
  • Carry a pack of rehydration drinks and ciprofloxacin 500mg in your first aid kit.

Do You Know How to Prevent and Treat Traveller’s Diarrhoea?

Posted Monday 29 July 2019 23:25 by Tim Deakin in Travellers Diarrhoea

food contamination

Traveller’s diarrhoea is one of the most common afflictions facing travellers, and is defined as passing three or more loose/watery bowel motions within 24 hours.[1] The condition affects as many as 20% of people travelling to high-risk destinations.[2]

But there are things you can do to reduce your chances of developing TD, and to ease the condition if you do fall victim to it.

Preventing Traveller’s Diarrhoea

High risk areas for TD include Africa, Latin America, the Middle East and many parts of Asia. Areas that carry an intermediate risk include southern Europe, Israel, South Africa and some Caribbean and Pacific Islands.[3]

When travelling to any of these areas, it’s important to take precautions in order to reduce your chances of developing TD.

Wash your hands

Washing your hands frequently is one of the simplest ways to stop the spread of germs and infection. Take the time to wash your hands thoroughly with soap and hot water, or with an alcohol-based hand sanitizer. Do this after using the bathroom and before and after eating.

Be careful what you eat and drink

Contaminated food and drink are a major factor in the spread of TD, so take care to stick to a safe diet and habits. This includes:

Eating food that is cooked and served hot

Eating fruit and vegetables you have washed and peeled yourself

Consuming only pasteurised dairy products

Avoiding food served at room temperature, as well as food from street venders and raw or undercooked meat or fish

Drinking bottled water that is sealed and avoiding tap water

This also relates to swimming, as you’re advised to take care not to ingest pool water while using the pool.[4]

Home Remedies for Traveller’s Diarrhoea

As well as producing frequent loose stools, TD can also lead to symptoms such as cramping, pain, nausea, temperature, weakness and general discomfort.[5]

Thankfully, there are ways to deal with the condition effectively, whether your TD is mild, moderate or severe.

Mild TD

Dehydration is one of the most dangerous aspects of any form of diarrhoea, so however severe your TD is, you should drink plenty of fluids. Consuming small quantities of easily digestible foods like rice and bananas can also help to aid gut recovery in those with TD.[6]

In milder cases, over the counter medication like Imodium may help.

Moderate TD

Again, drink plenty of fluids to avoid dehydration. You can also use oral rehydration salts mixed with clean water in order to reduce the discomfort caused by your TD.

Again, over the counter medications may be helpful, but you may find prescribed treatment to be necessary.

Severe TD

Try to stay as hydrated as possible, but seek medical support if you can’t stomach fluids. Oral rehydration powders can be diluted into clean drinking water and are useful for addressing the electrolyte imbalances caused by severe TD. However, if oral rehydration powders aren’t available, a salt and sugar solution (six level teaspoons of sugar and one level teaspoon of salt to a litre of water) can be used.[7]

In more severe cases of TD, prescription anti-traveller’s diarrhoea medication can help to alleviate symptoms as quickly as possible.

Medication for Traveller’s Diarrhoea

In many cases of TD, medication can help to alleviate symptoms and reduce the discomfort associated with the condition. In fact, a short course of medication can help to reduce the duration of an upset stomach by as much as 50%, reducing the severity of the symptoms at the same time.[8]

Treatments like Ciprofloxacin and Azithromycin are among the leading medications designed to treat cases of traveller’s diarrhoea. In fact, Public Health England recommends having azithromycin on stand-by when travelling to areas considered to carry high risks of TD.[9]

You can find safe and effective traveller’s diarrhoea medication right here at Express Pharmacy. And if you have any concerns about your health, don’t hesitate to contact our pharmacists by calling 0208 123 07 03 or by using our discreet online Live Chat service.

[1] Fit For Travel. Traveller’s Diarrhoea. NHS UK. 2017

[2] Travel Health Pro. Traveller’s Diarrhoea. 2019

[3] National Institute for Health and Care Excellence. Diarrhoea — prevention and advice for travellers. 2019

[4] World Health Organisation. Guidelines for safe recreational water environments: volume 2, swimming pools and similar environments. 2006

[5] Better Health Gov. Traveller’s diarrhoea. 2017

[6] DuPont, HL., Ericsson, CD., Farthing, MJG. et al. Expert review of the evidence base for self-therapy of traveller’s diarrhoea. Journal of Travel Medicine. 2009

[7] World Health Organisation. WHO position paper on Oral Rehydration Salts to reduce mortality from cholera. 2019

[8] British Medical Journal. Traveller’s diarrhoea. 2016

[9] National Institute of Health and Care Excellence, Public Health England. Summary of antimicrobial prescribing guidance — managing common infections. 2019

Your Blood Type Could Increase Your Chances of Developing Travellers’ Diarrhoea, According to New Data

Posted Friday 15 March 2019 22:45 by Tim Deakin in Travellers Diarrhoea

food market

Travellers’ diarrhoea, caused by viruses, bacteria or protozoa, is the most common infection experienced by travellers, affect over 20 percent of those who travel to high-risk destinations of the world.[1]

These high-risk areas are mostly found in South and South East Asia.[2] The condition occurs equally in male and female travellers and is more common in young adult travellers than in older ones.[3]

But now it seems that there many be other factors involved in one’s inclination towards or susceptibility to traveller’s diarrhoea – namely, blood type.

A new study[4], published in The Journal of Clinical Investigation, has found that those with Type A blood are likely to be struck down with travellers’ diarrhoea sooner and more severely. These findings are significant for UK travellers, as nearly half of Brits have type A or AB blood.[5]

Researches gave more than 100 volunteers water containing enterotoxigenic E.coli. The results found that 81% of those with type A blood required medical attention for diarrhoea as a consequence, compared to just 56% in other blood types.

The study concluded that this is due to the way E.coli releases a protein which latches onto the intestinal cells of those with blood type A.

How to avoid travellers’ diarrhoea

Travellers’ diarrhoea is defined as the passing of three or more loose/watery bowel motions within a 24-hour period. It can be accompanied by other symptoms such as stomach cramps, nausea, vomiting and fever.[6] Risk factors involved in travellers’ diarrhoea can include choice of eating place, season of travel, destination, diet, age and genetics.[7]

But despite being a common condition faced by many jet-setters, there are things you can do to significantly reduce your chances of contracting the disease.

The World Health Organisation has outlined their 5 key tips to enjoying safer food abroad, in an attempt to prevent the spread of food-borne diseases. These tips are:

  • Keep clean – wash your hands often, especially before handling food
  • Separate raw and cooked food – make sure cooked food is not contaminated with raw food
  • Cook food thoroughly – make sure food has been entirely cook and remains steaming hot
  • Keep food at safe temperatures – avoid food which has been left out such as at markets, buffers and street vendors
  • Choose safe food and water – Only drink sealed bottled water, or bring water to boil first. Peel all fruits and vegetables before consumption.[8]

The right medication can also offer a vital precautionary measure for travellers. Having access to effective travellers’ diarrhoea medication means that, should you fall victim to the infection, you are able to deal with your symptoms swiftly. Traveller’s diarrhoea treatment such as Ciprofloxacin and Azithromycin are available from Express Pharmacy.

Planning your next trip? Find effective medication at Express Pharmacy to ensure you stay safe. Get in touch today by calling 0208 123 07 03 or by using our discreet Live Chat service.

[1] Travel Health Pro. Travellers’ Diarrhoea Fact Sheet. 2019 [Accessed March 2019]

[2] British Medical Journal. Travellers’ diarrhoea clinical review. 2016 [Accessed March 2019]

[3] Connor, B.A. Traveller’s Diarrhoea.Centers for Disease Control and Prevention. 2017 [Accessed March 2019]

[4] Kumar, P. et al. Enterotoxigenic Escherichia coli-blood group A interactions intensify diarrheal severity. Journal of Clinical Investigation. 2018 [Accessed March 2019]

[5] NHS Blood and Transplant. Blood Types. 2018 [Accessed March 2019]

[6] NHS Fit For Travel. Travellers’ Diarrhoea. 2019 [Accessed March 2019]

[7] Hill, D.R., Beeching, N.J. Travellers’ Diarrhoea. Cur Opin Infect Dis. 2010 [Accessed March 2019]

[8] World Health Organisation. A Guide on Safe Food for Travellers. 2010 [Accessed March 2019]

Visiting Africa: What You Need to Know Right Now

Posted Monday 25 February 2019 16:08 by Johanna Galyen in Travellers Diarrhoea

travelling to Africa

As the weather starts to warm up and the spring flowers begin to bloom, you may be finding yourself getting ready to travel again. But before you pull out the suitcases, it’s time to make a plan. Whether you are looking forward to the majestic Mount Kilimanjaro or the plains of Kenya for a wildlife safari, spend some time making the right preparations to make sure that your vacation is extra-special and not filled with nasty surprises. In this article, we’ll be looking at a general overview of Africa and what you need to know to make this holiday the trip of a lifetime.

When and where are you visiting?

Africa is the world’s second largest continent, according to National Geographic, and given that it spans both the tropics of Cancer and Capricorn with coasts that touch many different seas and oceans, getting your packing, preparation and itinerary right can be quite a challenge. Some of the key attractions that you should consider are:

  • Savannas – these are the vast grasslands that play host to some of the world’s most captivating animal species. Kenya is one such popular destination where you may wish to head out on safari to see giraffes, elephants, and wildebeest. If you were to continue south, you would enter the Ngorongoro Crater in Tanzania. This a vast area filled with wild animals and has been called Africa’s Eden.
  • Nile River – you can take a historical trip down the Nile river (the world’s longest) and explore the area and times of the Pharaohs so many years ago. Make sure you stop and see Valley of the Kings and those epic burial pyramids.
  • Lake Victoria – this large body of water is one of seven great lakes in Africa, and is a hotspot for tourists. Choose between a thatched-roof cottage or a private villa on one of the small islands. Either way, you will get to enjoy all that the beauty and thrills that the destination can offer you.
  • Mount Kilimanjaro – if trekking up to see a dormant volcano and the highest point in Africa is your idea of a vacation, then Mount Kilimanjaro is just for you. This hike should be done with careful planning and consideration as it is not a simple day hike; it is suggested that you plan for a week to help acclimate your body to the changes in elevation and plan for weather.
  • uShaka Marine World & South African Coastline – while this is not the quintessential African destination that comes up for most people, the southern part of Africa offers many different holiday experiences. Children and adults alike will love the large marine park as well as the gorgeous views of the Indian Ocean that the South African coastline can bring.

visit mount kilimanjaroWhen visiting Africa, it is crucial to know where and when you are planning a trip because packing for a holiday in Africa is a more complicated affair than you might think, given that the climate can vary dramatically from region to region. Africa has two seasons, instead of the four we are familiar with in the temperate areas of the Northern hemisphere. They are the dry and rainy seasons. No, you probably won’t need snow boots in May & June, but visiting the northern, eastern, and western side of Africa means that you will almost certainly be rained upon every single day during certain months of the year. If you are visiting Africa in July, you can expect hot and dry weather with extreme temperatures reaching 47 degrees Celsius or 117 F with the night temperatures dipping to -4 degrees Celsius.

What you should know in advance

Rural or urban visit

Holidaying in some parts of Africa can be quite different from a city break or even a rural retreat in Europe. Due to the sheer scale of the continent and the vast unpopulated spaces in many countries, some locations - such as safari holidays - can take you to extremely remote places. If an authentic expedition or adventure holiday is what you are seeking, be prepared for periods of time without Internet, phone signal or even electricity.

In the first instance, you may wish to check with your phone’s internet provider if your contract includes coverage for the country that you’re visiting.

Clothing and culture

When you consider packing clothing for your trip, there are many considerations. It is good to know what your plans entail so you can make the right decisions. If you’re hiking up a mountain, you may want to wear something more than a t-shirt and shorts. The hot days can turn into a cool evening very quickly, so remember to pack a warm sweatshirt or jacket. A hat is very helpful to shade yourself from the hot sun and can also help prevent a nasty sunburn.

Cultural considerations are also important when visiting local areas in Africa. Women may want to pack long skirts or have a sarong ready to cover up bare shoulders depending on the region you are visiting. A head covering is also important if you’re planning to visit local mosques or areas where cultural or religious traditions may differ from your own.


Always remember that technology can take on different meanings in different countries of the world. On your packing list, make sure you get a few electrical converters for your electronic equipment. Always get the ones that have surge protectors in them; the electricity output can differ from place to place, and you might just get a nasty surprise and shock when you plug your electronics into the outlet.

Time to eat

Holidaying in a new area might conjure up visions of new delectable treats but, like many parts of the world, you should be cautious about the food that you try in Africa - particularly street food. Nothing can ruin a holiday faster than an upset stomach or food poisoning, so make sure you are extra careful about what you choose to eat.

Food suggestions

African street foodHere are some great tips when eating your next meal:

  • Only eat hot foods when they are hot. Meats should be thoroughly cooked through. Avoid rare and medium-rare cooked meats
  • If the food is served cold, make sure it is a reputable place to ensure that the food has stayed cold the entire time. Do not eat room temperature food; soft or uncooked eggs; rare meats or fish
  • Fresh fruit should only be eaten if you can peel it such as bananas and mangoes.
  • Avoid fresh salad items like lettuce, tomatoes, and celery if you cannot be confident that they have been cleaned properly. Washing salad in dirty water is a prime cause of water-borne diseases.
  • Dry packaged foods are usually safe as long as handled appropriately when opened.
  • Be very cautious about street vendors as they may not have proper food-handling and refrigeration techniques.
  • When on safari, avoid bushmeat (a wild game that is unknown to you). This also means no adventurous eating of bats, rodents or monkeys.

Water and beverages

Living in an industrialised city has many luxuries. Typically, most people in the UK don’t need to worry about the safety of the drinking water from the tap. However, this cannot be assured abroad - as the water from the tap may not be clean. The same also applies when brushing teeth and showering.

Chlorinated and filtered water rarely comes out of the tap in many remote or undeveloped regions of Africa. Freshwater lakes and streams may carry schistosomiasis, a parasitic flatworm, that can cause many stomach complaints and an itchy rash. It is worth remembering that the same rivers and lakes that is used for drinking water may also be used for bathing and laundering clothes. Where sanitation is poor, there is also a chance of waste making its way into the water.

So remember: if it goes anywhere near your mouth, it must be clean and safe for you. Here are some other extra tips to quench your thirst.

  • Bottled or canned drinks are usually considered safe. Use bottled water for drinking and brushing your teeth.
  • Avoid ice cubes in your drinks unless you have seen the water poured from a bottle before freezing.
  • Alcoholic beverages should only be served from sealed containers or well-known bartenders to ensure that you are drinking what is listed on the bottle.
  • Be careful when drinking fresh juices as the fruit and juicing equipment may have been washed with unclean water.
  • Pasteurised milk that is sealed is safe to drink. Avoid unpasteurised or fresh milk.
  • Coffee drinkers beware! While hot coffee made with clean water is fine, be very careful about adding fresh cream.
  • Try not to splash water into your mouth when showering or bathing.

Preparing for your health


After a long day’s travel, you’ll be wanting to find a relaxing bed to stretch out and get some rest. But before you get that much-needed sleep, check to see if you should be sleeping under a mosquito net. According to the Against Malaria Foundation, mosquitos that carry malaria bite most frequently between 10pm and 2am. The mosquito net should be treated with Permethrin that will kill the bugs as well as protect you from the pests.

Bug Repellant is also another way to protect yourself from mosquitoes and flies. Many travellers choose a product with DEET in it – ranging from 7% for children and all the way up to 50% for the most adventurous travellers. There are also DEET-free options using Lemon Eucalyptus oil that can be purchased. No one wants to get bitten by a bug, so using the highest level of DEET protection may seem an obvious choice. But remember, DEET is a potent and toxic chemical. It can erode plastic coatings on clothing and watches and is harmful to breathe in – you may be coughing and feel like your lungs are on fire if you inhale it in.


Your health is one of the most important priorities when planning a trip to Africa, and while you are planning your trip, it is a great time to stop and check your immunisations. The Centre for Disease Control recommends that everyone who visits other countries to have the standard childhood vaccines and ensure that no boosters are missed. These will include the DTaP, MMR & shingles, Polio, Pneumonia, Meningococcal, and HPV vaccines.

Here are the specific vaccines that are recommended for Africa:

  • Hepatitis A and B vaccines,
  • Rabies
  • Typhoid
  • Yellow Fever
  • Meningococcal
  • Cholera vaccine

Medications for your trip

He who cures a disease may be the skillfullest,

but he who prevents it is the safest physician. Thomas Fuller

As Thomas Fuller so poignantly stated back in the 1800s, preventing disease is very important to your health. Because of this, when planning your trip to Africa, you should sit down with your GP, pharmacist or travel clinician and discuss which preventive and prophylactic medications you are going to need for your trip.

Anti-malarial medications

Remember those mosquitos that the nets and the bug spray help to deter? While those are extremely important and should be used by everyone, you still may want to consider taking oral medication to help prevent malaria.

The disease of malaria is carried by mosquitoes, but only a particular type of mosquito. According to the World Health Organization, the Female Anopheles mosquito acquires the parasite Plasmodium when she bites people to get blood to feed her eggs. Then when she bites again (after being infected), the parasites are put into the person’s blood supply. Her bite is not like the annoying mosquito that is itchy and welted-up; no, her bite is a stealthy bite that doesn’t leave a mark.

Because the Female Anopheles bites in the middle of the night, most people do not even know that they have been bitten until a 10-14 days later when the first symptoms start to appear. These can include fever, headache, severe chills, and vomiting. The parasites can also be deadly as they kill red blood cells and then clog up the blood supply to the brain and vital organs (such as the liver or heart).

You should be concerned about malaria if you are visiting parts of Africa, including Chad, Cameroon, Congo, Ghana, and Kenya. Take some time and look at a malaria countries map and see if your travels intersect any of these areas. The risk in particular regions can vary over time and so consulting the WHO website is a good starting point. Some areas are worse than others, but, for example, the high prevalence of malaria in Ethiopia shows that it is one of the countries in which there is a heightened risk of catching the disease as a traveller.

It is also important to note that if you visit an endemic malaria area, some hospitals will not let you donate blood for up to three years after visiting these areas. Also, if by some terrible chance you do get malaria, you will also not be able to donate blood to those in need.

Preventative anti-malarial medications

Killing the Plasmodium parasite in the bloodstream can also be performed by anti-malarial medications. There are three specific medications that most people choose from to take for their anti-malarial needs. These are Doxycycline, Malarone (atovaquone and proguanil hydrochloride), Lariam (mefloquine).malarone malaria treatment

Some medicines are taken daily, and others are taken once a week. They all have positive and negative things that you should be aware of; so it is vital to speak with your pharmacist, travel clinician or GP about which one is best for you. Your medical history, current medications, planned activities, and specifically, where you will be going all determine which medication you should take. An easy way to help understand this information is the website Fit for Travel; it can help you look which medications may fit the best for you.


In some countries, it’s called Montezuma’s Revenge but the more common term for loose stools and stomach issues while abroad is Traveller’s Diarrhoea. But if you get it, you’ll just call it misery. A miserable time of living on the porcelain throne (toilet) and wishing your stomach would just calm down. Food and water-borne diseases can easily be obtained when travelling to different countries as foods may not be cooked as thoroughly as they should be before eating.

Also, if cups and plates that are not cleaned properly, or if the water is not purified correctly, it can cause you to be ill. The bacteria that cause this can be E-coli, Salmonella, or even parasites such a Giardia.

Traveller’s diarrhoea is different than just an upset stomach from too many spicy foods; it is three or more watery stools in 24 hours or less. You can also have nausea, vomiting, stomach cramps, and many sudden urges to have a bowel movement. Typically, these symptoms are mild-moderate and can last up to five days without treatment. If it lasts more than 5 days, or if you cannot function with the symptoms that are getting worse, then it becomes more severe.

Treatment for diarrhoea

First of all, if you find yourself in this unfortunate position, the primary treatment is treating the possible dehydration. Clear fluids, hydrating drinks (such as Gatorade or Powerade-like drinks that have electrolytes and rehydration salts in them) are the best thing for you. You do need to drink lots and lots of them. Not only with the fluids keep you from getting dehydrated, but they also help to flush out the bacteria.

Secondly, for those who are having the stomach cramping pains, some over-the-counter medications can help calm your stomach down. These would include Loperamide (Immodium) and Bismuth Subsalicylate (Pepto-Bismol).

Lastly, there are prescription medicines that your GP or pharmacist may prescribe for you in case you do have worsening symptoms. These would be Lomotil (diphenoxylate and atropine), Azithromycin, and Ciprofloxacin. Lomotil is a stronger medication that specifically helps the colon spasms to calm down; it contains atropine, which is a controlled substance in some areas, so to obtain this, your GP will need to prescribe it.

The other medications, Azithromycin and Ciprofloxacin, are antibiotics that will fight against the bacteria that causes the traveller’s diarrhoea. These medications are not taken like preventative medications, but should only be taken when your GP instructs you to – typically, this is if specific symptoms appear – so, it is important to write down the instructions and put them with the medications so if you do get sick, you will know what you should take.


Travelling to Africa can be the trip of a lifetime with the right preparations. The more you can plan in advance for your time away, the more enjoyable it can be. So get out that packing list and start checking the things off as you get them done. The mountain of Kilimanjaro and the African safari animals are waiting for you! Bon Voyage!

Where Are You Most Likely to Fall Victim to Traveller’s Diarrhoea?

Posted Tuesday 27 March 2018 15:33 by Tim Deakin in Travellers Diarrhoea

As one of the most common conditions to befall travellers, it’s important to know where you should take the most care to avoid traveller’s diarrhoea

As spring gets underway and we start looking forward to summer, many of us will be taking the time to seek out the perfect summer getaway. What with booking hotels, flights and activities, you probably won’t spend too much time considering health factors like traveller’s diarrhoea — but these are the factors which can seriously impact on your impending trip.

Traveller’s diarrhoea is one of the most common infections seen in holidaymakers and can put a real dampener on your summer trip abroad. Knowing how to spot the signs of the condition and treat it effectively is hugely important, but it’s also important to take it into consideration from the point of choosing a destination.

Where are you most likely to contract traveller’s diarrhoea?

Although the extent and severity of traveller’s diarrhoea is largely dependent on the season of travel and your own actions when abroad, heading to certain destinations can make you far more likely to develop the condition.

Low risk destinations include the USA, Canada and New Zealand, as well as most countries in Northern and Western Europe. These countries usually practice high food hygiene standards, which can significantly limit the risk of spreading the infection.

Intermediate-risk destinations include many Eastern European countries, certain Caribbean islands and South Africa. High-risk areas for contracting traveller’s diarrhoea include countries in:

- South and South East Asia

- Africa

- The Middle East

- Mexico

- Central and South America

In India, common cases of traveller’s diarrhoea are informally referred to as ‘Delhi Belly’.

How is the condition contracted?

Traveller’s diarrhoea is most commonly contracted through the consumption of faecally contaminated food and water, usually as the result of an infected person handling food after using the toilet without thoroughly washing their hands.

These actions encourage the spread of bacteria like E.Coli and Salmonella, which are common causes of the condition. These can also be spread through the use of contaminated cups and plates. Traveller’s diarrhoea is also more common in younger travellers.

What are the warning signs of traveller’s diarrhoea?

Whether you travel to an intermediate or high-risk area, you need to know the warning signs to look out for. The nature of the condition means that the initial symptoms are usually quite sudden, so it’s important to pay attention to your bathroom habits while you are away.

The condition is defined by the passing of three or more loose/watery bowel movements within a 24-hour period. It usually occurs within the first week of travel, so be extra vigilant during this time, but remember that it is possible to contract the infection more than once in a single holiday.

Other symptoms to watch out for include bloating, vomiting, fever and abdominal cramps.

How can you avoid it?

To prevent an onset of traveller’s diarrhoea, try to avoid food and drink items such as undercooked or raw meat, raw fruit and vegetables, unpasteurised milk and tap water. In the UK we drink tap water without thinking, but in higher risk areas the water may be contaminated. It is best to either boil tap water before using, or to stick to sealed bottled water.

In case you do contract traveller’s diarrhoea while away, you should be prepared with effective antibiotic treatment to speed up your recovery. Azithromycin is the recommended, highly rated treatment for bacterial traveller’s diarrhoea, and it is available from Express Pharmacy.

For further information about our services, call our team today on 0208 123 07 03 or leave a query on our discreet Live Chat.


stella rostron on Saturday 28 July 2018 16:43

I am going to the Dominican republic and I am worried travellers diarrhoea will spoil my holiday, I have had it 3 or 4 times in the past while on hoilday. I am also worried that anti biotics may reduce my gut flora making the problem worse. I have asked my GP for stand by anti biotics and if she refuses I am considering buying them before I go . Am I being over anxious.

Tags: Azithromycin Travel Health Traveller's Diarrhoea

What Does the Winter Olympics Teach Us About Traveller’s Diarrhoea?

Posted Monday 12 March 2018 11:11 by Tim Deakin in Travellers Diarrhoea

With significant numbers of people suffering prior to the Winter Olympics, it’s vital you know how to avoid this unpleasant and potentially dangerous problem.

If you were as gripped by the recent Winter Olympics as we were then you’ll now know your skeleton from your luge and your half pipe from your curling. The Games were held in Pyeongchang County, Gangwon Province in South Korea, and almost 3,000 athletes from 92 nations participated in more than 100 events. However, it wasn’t all fun and games when it came to the health of those involved.

Ahead of the events, a serious case of traveller’s diarrhoea led to dozens of members of the organization being quarantined, and the South Korean military being deployed.

In total, around 1,200 members of the security staff were quarantined and tested for norovirus. The Korea Centre for Disease Control (KCDC) stated that it suspected food and drink were to blame for the infection.

Here we have an example of just how unpleasant traveller’s diarrhoea can be. Traveller’s diarrhoea is a harmful, potentially dangerous condition which requires constant care and vigilance if it is going to be avoided and treated. So if you’re planning to go abroad this spring, here is the information you need in order to stay safe and avoid developing traveller’s diarrhoea.

What do you need to know about traveller’s diarrhoea?

Most cases of traveller’s diarrhoea occur within the first week of your travels, and thankfully the majority of cases are mild and resolve themselves within 3 to 5 days. However, sometimes additional symptoms occur which make traveller’s diarrhoea more serious, meaning treatment will be required.

Traveller’s diarrhoea can be defined as passing three or more loose bowel movements within a 24 hour period. It can be accompanied by any of the following symptoms: fever, nausea, vomiting, abdominal pain or cramps and the urgent need to pass a bowel movement.

The condition can be caused by a variety of different sources, such as bacteria like E.coli, parasites like Giardia or viruses like norovirus. All of these organisms are spread through consuming contaminated food and water, or through contact between the mouth and contaminated crockery, cutlery or hands.

Preventing the onset of traveller’s diarrhoea is largely dependent on practicing good hand hygiene and effective food and water precautions. You should wash your hands thoroughly before eating or handling food, and after using the toilet. You should also avoid ice in drinks, food that has been kept warm for an extended period of time, raw food, dairy products, unbottled water and food from street vendors. Instead, opt for consuming packaged and sealed food, sterile (pre-boiled) and sealed water from a bottle, canned food and freshly cooked food which is piping hot.

If you do contract traveller’s diarrhoea, rest and hydration are key to treating it effectively. This is particularly true for young children. Clear fluids such as sterile water, diluted fruit juices or oral rehydration solutions should be consumed regularly.

There is also effective medication available for traveller’s diarrhoea, such as Azithromycin. This is a kind of antibiotic used to treat cases of bacterial traveller’s diarrhoea, specifically for travellers who have journeyed to South Asia or South East Asia, such as India or Thailand respectively. One tablet, taken daily for a three day period, can significantly help to treat a case of traveller’s diarrhoea quickly, helping the sufferer to become well again in as little time as possible.

Azithromycin is available from Express Pharmacy.

For more guidance, support and treatment regarding a wide variety of common health concerns, contact Express Pharmacy today. Call us on 0208 123 07 03 or use our discreet online live chat service.

Tags: Azithromycin General Health Travel Health Traveller's Diarrhoea

Travellers’ Diarrhoea: How to Deal With an Unwanted Holiday Companion

Posted Wednesday 25 January 2017 13:53 by Tim Deakin in Travellers Diarrhoea

traveller's diarrhoeaWhether you are travelling to an exotic destination or holidaying on the continent, going overseas is an exciting time for all the family. Not to mention a chance to create lots of wonderful memories that you can look back on for years to come. Unfortunately, travelling abroad isn’t all fun and games, and for many people that trip to somewhere new can come with the odd health problem.

As the name suggests, travellers’ diarrhoea is one condition that is common among tourists, and it is particularly rife when visiting developing countries like Asia, Africa, the Middle East and Latin America. In fact, up to 50% of travellers spending two weeks or more in these countries are affected by the condition. As with any travel-related health issue, it is important to understand the nature of the problem, how to prevent it and the treatments to take if illness does strike. Here we offer an essential guide to travellers’ diarrhoea so you can be prepared for your upcoming trip.

What is travellers’ diarrhoea?

Travellers’ diarrhoea is the frequent passing of watery or loose stools. The condition is commonly caused by the presence of the bacteria E.coli as a result of the unsanitary handling of food and drink. E.coli is easily transmitted and is extremely contagious if an individual handling food has failed to wash their hands after using the bathroom. The infection mainly affects the stomach and intestines, leaving sufferers frequently passing loose stools and often experiencing symptoms such as fever, nausea, vomiting, bloating, discomfort, weakness, cramps, painful gas and appetite loss.

With this particular condition it is important to make sure that travellers’ diarrhoea is what you have. Diarrhoea can be a symptom of numerous travel-related illnesses – including malaria – so seeking medical assistance is important if you find that the problem persists for more than 24 hours. You should also look out for the presence of blood in your stools, as this can be an indication of something more serious.

How to prevent travellers’ diarrhoea

Taking extra care with food and drink is a vital part of preventing travellers’ diarrhoea. Maintaining a good level of personal hygiene will help to limit exposure to E.coli, so care should be taken when cleaning utensils, plates and cups. You should also take the time to wash your hands thoroughly before eating and after going to the toilet. When visiting developing countries, hand washing facilities may not be as readily available as they are at home, so make sure to keep alcohol rub and wipes to hand at all times.

Avoiding certain food and drink items can also minimise the risk of contracting travellers’ diarrhoea. It is best to stay clear of tap water (including ice in drinks), raw or uncooked foods, street food and dairy products.

Seeking treatment for travellers’ diarrhoea

Staying hydrated is an important step in treating travellers’ diarrhoea, particularly if the individual affected is a young child. Be sure that any fluids consumed are safe, and utilise these in conjunction with oral rehydration salts to re-establish the fluids lost.

Being prepared with suitable medication for the treatment of travellers’ diarrhoea is also vital to the successful management of symptoms. Stock up on medication to deal with any potential illnesses, including travellers’ diarrhoea, before you travel as the language barrier and location may make it difficult or even impossible for you to get the treatment you need whilst you are away. Here at Express Pharmacy we stock Ciprofloxacin and Azithromycin, both effective medications for the treatment of travellers’ diarrhoea.

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