The European Card of Insurance upon illnesses has substituted travel paper E111.

On December, 31st 2005, E111 has stopped to be correct. Since January, 1st 2006, you require the European Card of Insurance upon illnesses (EHIC) to receive public health services which becomes necessary during your visiting of country EEA or Switzerland.

In the majority of the countries round the world you should pay for processing, thus to travellers strictly advise to take out private insurance upon illnesses. The Great Britain has mutual agreements on public health services with some countries which gives the chance to travellers to receive free or cheap extreme care.

EHIC - a plateau which grants the right to the clamper on free, or reduced the density costs processing of the first help somewhere in the European Economic Area (EEA).

If you are ill or have an accident during trip to Europe, only represent the EHIC to hospital or the doctor who handles you. EHIC grants the right to you on the same processing as inhabitants of the country which you visit. Only the processing given according to the state circuit, is substituted.

Mark: EHIC not replacement for all-round insurance of travel.

Who has the right on EHIC?

Any character who usually is the inhabitant in the Great Britain, has the right on EHIC. However, you should be more than 16 years of age to be applied. Inhabitants of Channel Islands and Isle of Man have not the right.

All EEA (the European Economic Area) the countries should release the European Card of Insurance upon illnesses (EHIC) as replacement for form E111.

The tetanus vaccine protects against a tetanus also known as a tetanus.

It is recommended, that adults have received a booster vaccine each ten years.

The standard care in many hospitals should give a booster to any patient with a wound of a puncture which is doubtful from this when it or it was last inoculated or if for the patient was less than 3 lifelong doses of a vaccine. The booster cannot prevent potentially fatal case of a tetanus from a current wound, as can take about two weeks for tetanus antibodies to be generated.

In children seven are younger, a tetanus vaccine often control as an incorporated vaccine, TDap or DTaP which also switches on vaccines against a diphtheria and pertussis.

For adults and children is higher seven, vaccine Td (a tetanus and a diphtheria) is usually used.

What is Shingles?

Shingles (herpes zoster) is an outbreak of rash or blisters on the skin that is caused by the same virus that causes chicken pox - the varicella-zoster virus.

The first sign of shingles is often burning or tingling pain, or sometimes numbness, in or under the skin. You may also feel ill with fever, chills, headache, or upset stomach.

After several days, a rash of small fluid-filled blisters, reminiscent of chickenpox, appears on reddened skin.

The pain associated with shingles can be intense and is often described as “unrelenting.”

Anyone who has had chickenpox is at risk for shingles. Scientists think that in the original battle with varicella-zoster, some of the virus particles leave the skin blisters and move into the nervous system. When the varicella-zoster virus reactivates, the virus moves back down the long nerve fibers that extend from the sensory cell bodies to the skin and cause the characteristic blisters of shingles .

Is there any treatment?

The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with antiviral drugs, which include acyclovir, valcyclovir, or famcyclovir.

Antiviral drugs may also help stave off the painful after-effects of shingles known as postherpetic neuralgia.

Other treatments for postherpetic neuralgia include steroids, antidepressants, anticonvulsants, and topical agents.

What is the prognosis?

For most people, the lesions heal, the pain subsides within 3 to 5 weeks, and the blisters leave no scars.

However, shingles is a serious threat in immunosuppressed individuals — for example, those with HIV infection or who are receiving cancer treatments that can weaken their immune systems. People who receive organ transplants are also vulnerable to shingles because they are given drugs that suppress the immune system.

Mouth ulcer - an open wound in an oral cavity. Two common types of an ulcer of a mouth - ящурные ulcers (an ulcer wound) and herpes (called by a virus of herpes simple).

Types of oral ulcers are various, with set of the associated reasons, switching on: a physical or chemical trauma, an infection from microorganisms or viruses, medical conditions or medicines, malignant and sometimes indefinite processes. After generated, the ulcer can be supported an inflammation and-or a secondary infection.

Symptoms

The symptoms previous an ulcer, can vary according to the reason of ulcerative process.

A few oral ulcers can start with a sharp venomous or shining sensation on a site of the future ulcer of a mouth. In some days they progress often to generate red maculae or the blow accompanied by an open ulcer. Sometimes it is a beret little bit more longly, depending on the ulcer reason.

The oral ulcer appears as a white or yellow oval with the inflamed red boundary. Sometimes the white circle or an aura round a lesion can be observed. Grey, white, or the yellow colour area within red boundary occurs because of creation of levels of fibrin, the fiber involved in coagulation of blood. To an ulcer which immediately is often extremely painful, especially when worries, the painful swelling of lymph nodes below a jaw which can be accepted for a dentagra can accompany.

The reasons

There are many processes which can lead to an ulceration of oral tissues. In some cases they are called by excessive response by own immune system of a body.

Factors which, apparently, call mouth ulcers, switch on power, weariness, illness, a wound from infringement of accidentals, hormonal changes, a menses, sudden loss in weight, allergies of nutrition and inaccuracies in vitamin B12, iron and Acidum folicum.

Treatment

The treatment grounded on antibiotics and steroids, is intended for serious cases, and should be used only under a medical supervision.

Some doctors can order also local sedative, such as lidocaine, for cases of multiple or serious oral ulcers.

Some people benefit from usage внебиржевого actual gel Bonjela which contains an Aether of Acidum salicylicum of a choline - an Aether of Acidum salicylicum of a choline - a local analgesic resource which helps to reduce a pain and an inflammation linked to oral ulcers.

What is otitis externa?

Otitis externa (Swimmer’s ear) is an infection of the ear and/or outer ear canal. It can cause the ear to itch or become red and inflamed so that head movement or touching of the ear is very painful. There may also be pus that drains from the ear.

What causes otitis externa?

Otitis externa is often caused by infection with a germ called Pseudomonas aeruginosa. This germ is common in the environment (soil, water) and is microscopic so that it can’t be seen with the naked eye. Although all age groups are affected by Otitis externa, it is more common in children and young adults and can be extremely painful.

How is otitis externa spread?

Having contaminated water get in the ear can give people Otitis externa. Otitis externa usually occurs within a few days of getting contaminated water or placing contaminated objects in the ear.

Is there a difference between a childhood middle ear infection and otitis externa?

Yes. Otitis externa is not the same as the common childhood middle ear infection. If you can wiggle the outer ear without pain or discomfort then your ear infection is probably not Otitis externa.

Can otitis externa be prevented?

Yes. Here are four Healthy Swimming tips for protection against Otitis externa:
Dry your ears after swimming. If it is difficult to get water out of your ear, apply a few drops of an alcohol-based ear product into the ear. Ask a pharmacist at your local drug store for this product.
Ask your pool manager about the chlorine and pH testing programme at your pool. Pools and hot tubs with good chlorine and pH control are unlikely to spread Otitis externa.
Pay attention to signage and avoid swimming in locations that have been closed because of pollution.
Avoid putting objects in the ear (e.g. fingers, cotton swabs) that may scratch the ear canal and provide a site for infection.

If you think you have otitis externa, consult your healthcare provider. Otitis externa can be treated with antibiotic ear drops.

The fetid breath also named by an unpleasant smell from a mouth, is typically called by bacteria which grow in your mouth. Bacteriemic putrefication small plays of nutrition has left in your chartreuse structures of release of a mouth which is that does your smell of breath.

Short-term fetid breath can be linked to a tonsillitis, a gastroenteritis, diabetic кетоацидозом, or синусовой an infection.

The chronic unpleasant smell from a mouth can be called weak oral hygiene, an ulitis (an inflammation of gums) and/or a tooth abscess.

How fetid breath can be handled?

The majority of cases of an unpleasant smell of a mouth is called by a problem in a mouth. Therefore, if your fetid breath does not leave, see the dentist for check.

If no oral reason is found, it can be necessary to see your therapist, to eliminate the medical reason.

Simple convalescences to oral hygiene will usually help an unpleasant smell from a mouth. They switch on:

- To clean a teeth (and tongue) at least two times a day.

- Usage of an oral liquid for a mouth gargle, especially during a dream.

- A smoking stopping.

- Drink of a considerable quantity of liquids to avoid a xerostomia.

- Chewing of sugarless rubber if your mouth is dry.

A hydrocoele is a collection of fluid around the testicle (testis), in the tunica vaginalis (the space surrounding the testis).

Hydrocoeles only occur in males.

Typically presents as a painless swelling of the scrotum.

Most hydrocoeles are congenital (ie. present at birth) - these are usually seen in boys aged 1-2 years of age. Most congenital hydrocoeles resolve by the end of the first year of life. Persistent congenital hydrocoele is readily corrected surgically.

Secondary hydrocoeles can affect males of any age, but usually occur in men older than 40 years.

May affect one side of the scrotum or both sides.

Causes of hydrocoeles in adults:

In many cases, no cause is found. Possible causes include:

* Trauma - traumatic hydrocoeles are common.

* Infection (eg. epididymo-orchitis)

* Testicular Tumour

* Torsion of the testes - reactive hydocoeles occur in up to 20% of cases of testicular torsion.

Symptoms of a hydrocoele:

Painless, enlarged scrotum.

There may be a sensation of heaviness or dragging.

Hydrocoele is not usually painful (pain may be an indication of an accompanying infection).

Investigations:

A light shined through the scrotum will cause the hydrocoele to illuminate (transillumination).

Investigation is not usually required in children.

For adults, an ultrasound of the testis may be required.

Since testicular lumps could potentially be missed on physical examination (due to the collection of fluid preventing full examination of the testis), an ultrasound is often advised. An ultrasound of the scrotum will confirm the diagnosis of hydrocoele & also identify any abnormal testicular lumps.

Treatment of hydrocoeles:

If the hydrocoele is small, no treatment is usually required.

For larger hydrocoeles, drawing off of the fluid using a needle & syringe may be indicated. However, such needle aspiration is not therapeutic because the fluid generally reaccumulates quickly & is associated with a risk of infection.

For larger hydrocoeles, or where there is a suspected underlying tumour, surgery may be required.

Hydrocoeles can usually be cured with a relatively simple surgical operation.

Note: Most hydrocoeles occur with normal testes. However, always see your doctor if you notice any change in the size and/or shape of your scrotum or testes.

Yellow fever (so called because one of the early symptoms of infection is jaundice) occurs only in Africa and South America. In South America sporadic infections occur almost exclusively in forestry and agricultural workers from occupational exposure in or near forests.

In Africa the virus is transmitted in three geographic regions:
principally and foremost, in the moist savanna zones of West and Central Africa during the rainy season,
secondly, outbreaks occur occasionally in urban locations and villages in Africa,
and finally, to a lesser extent, in jungle regions.

Yellow fever is a viral disease transmitted between humans by a mosquito. Yellow fever is a very rare cause of illness in travelers, but most countries have regulations and requirements for yellow fever vaccination that must be met prior to entering the country. General precautions to avoid mosquito bites should be followed. These include the use of insect repellent, protective clothing, and mosquito netting. Yellow fever vaccine is a live virus vaccine which has been used for several decades. A single dose confers immunity lasting 10 years or more. If a person is at continued risk of yellow fever infection, a booster dose is needed every 10 years. Adults and children over 9 months can take this vaccine. Administration of immune globulin does not interfere with the antibody response to yellow fever vaccine.

Motion sickness, a common problem in travellers by automobile, train, air, and particularly sea, usually causes mild to moderate discomfort but in severe cases can be incapacitating.

It affects up to half of children travelling in automobiles or airplanes and almost 100% of boat passengers in very rough seas.

Motion sickness is more common in women, especially during pregnancy or menstruation, children age 2-12, and in persons who have migraine headaches, but little is known about individual susceptibility.

Symptoms of motion sickness

Sensation of head position and movement is generated in the semicircular canals (angular acceleration or rotation) and otolith organs (vertical acceleration) in the inner ears and carried to the central nervous system via cranial nerve VIII.

The signs and symptoms of motion sickness occur when sensory information about the body’s position in or movement through space is contradictory or contrary to prior experience. Resulting signs and symptoms include dizziness, nausea, vomiting, pallor, and cold sweats.

Travellers who are susceptible to motion sickness can minimize symptoms by choosing seats with the smoothest ride (front seat of a car, forward cars of a train, and the seats over the wings in an airplane), focusing on distant objects rather than trying to read or look at something inside the vehicle, minimizing head movement, and if necessary lying supine.

Treatment of motion sickness with medication

Medications that may ameliorate symptoms of motion sickness include scopolamine (available in both patch and oral form), oral meclizine, dimenhydrinate, diphenhydramine, and promethazine.

Choice of medication is based on trip duration, underlying medical conditions, and concerns about sedation. Scopolamine patches are appropriate for longer voyages and should be applied 4 hours before departure and changed every 3 days if needed. Oral scopolamine is effective for 6-8 hours and can be used for short journeys or for the interval between application of the patch and onset of effectiveness.

Other oral medications are efficacious for several hours and can also be used for shorter journeys.

Oral medications should be started 1 hour before departure.

All these medications can impair alertness and must be used with caution by persons operating vehicles or heavy machinery. This effect is additive with alcohol and is least severe with scopolamine.

In addition, because these drugs all have anticholinergic properties, they should be avoided in travellers with narrow-angle glaucoma, pyloric obstruction, or prostatic hypertrophy and should be used with caution in those with asthma and cardiovascular disease.

Side effects include dry mouth, blurred vision (especially for persons with hyperopia), and bradycardia. Promethazine primarily decreases nausea and has been combined with ephedrine (25-50 mg) to decrease sedation. Only dimenhydrinate and diphenhydramine are recommended for use in children. They may cause paradoxical excitation and should not be used in children <2 years of age.

Non-pharmacologic treatment of motion sickness

Nonpharmacologic methods for motion sickness may benefit some persons but have not been proven consistently effective.

High levels of ginger have been helpful in some people.

Pressure on the P6 acupuncture point of the wrist provides relief of nausea in pregnancy and after chemotherapy, but evidence for efficacy in motion sickness is contradictory.

Chemoprophylaxis is the strategy that uses medications before, during, and after the exposure period to prevent the disease caused by malaria parasites. The aim of prophylaxis is to prevent or suppress symptoms caused by blood-stage parasites.

In addition, presumptive anti-relapse therapy (also known as terminal prophylaxis) uses medications towards the end of the exposure period (or immediately thereafter) to prevent relapses or delayed-onset clinical presentations of malaria caused by hypnozoites (dormant liver stages) of P. vivax or P. ovale.

General Recommendations for Prophylaxis

Chemoprophylaxis should continue during travel in the malarious areas and after leaving the malarious areas (4 weeks after travel for chloroquine, mefloquine, and doxycycline, and 7 days after travel for atovaquone/proguanil and primaquine).

In comparison with drugs with short half-lives, which are taken daily, drugs with longer half-lives, which are taken weekly, offer the advantage of a wider margin of error if the traveller is late with a dose. For example, if a traveller is 1-2 days late with a weekly drug, prophylactic blood levels can remain adequate; if the traveller is 1-2 days late with a daily drug, protective blood levels are less likely to be maintained.