Holiday and Travel Information

If you are planning to travel abroad, check well in advance which vaccinations are required. Immunosuppressed patients should not receive live vaccines .

Listed below are some of the vaccines that transplant patients can and cannot have. Only a few have been covered. If you are in any doubt about which vaccines are suitable, please check with the transplant co-ordinator who will be able to advise you.

Before planning to go to a country where there is malaria, discuss this with your transplant doctor. Some anti-malarial treatment can affect the levels of immunosuppression in your blood. In addition, if you do contract malaria whilst immunosuppressed this can be very dangerous.

Don't book your holiday until you take out holiday insurance which covers you for a pre-existing medical condition . Most standard policies do not and if your travel agent states that you will be covered under their insurance policy, ask to see a copy of their full policy. The cost of treatment for a person with kidney failure can be extremely expensive abroad, especially beyond Europe.

The important message for all transplant patients going on holiday to sunny destinations is - "Avoid the sun and you can avoid skin cancer". Transplant patients are three times more likely than other people to get skin cancers after a transplant because of the immuno-suppressant drugs they need to take. However, skin cancer can be avoided and, if detected early, can be easily treated.

Using sunblocks - The effectiveness of a sunblock is rated by an SPF (sun protective factor) number. The number indicates how long you can stay in the sun before your skin burns. For example, if your skin would normally burn after 10 minutes out in the sun, an SPF of 15 means that you can stay in the sun fifteen times longer before burning than if you were wearing no sunscreen; in this case that would be 150 minutes. However, this information is supplied for the general public and because some transplant medication makes the skin extra sensitive to the sun, all transplant patients are advised to use an SPF factor of 25 or higher.

Please be aware that you cannot "add" SPF numbers. If an SPF 25 sunblock will protect you for two hours, you will need to apply a stronger SPF if you want to stay in the sun for more than two hours, rather than just applying more SPF 25.

Protect your skin with suitable clothing. Clothing offers the advantages of even, non-sticky protection that you don't have to remember to reapply. However, many summer-weight fabrics don't give enough protection and fibres like cotton offer even less protection when wet. As the incidence of skin cancer is increasing globally it is now possible to buy protective clothing. Ask your pharmacist or high street chemist for information.
Wear a wide-brimmed hat to protect your eyes, ears, face, and the back of your neck.
Wear sunglasses that block 99 to 100 percent of UV radiation. Check the label.
Avoid the midday sun - 10 am to 2 pm when UV radiation is strongest.
Remember that the sun's rays can be reflected by snow, sand, water and even concrete.
Avoid using sun lamps.
Skin cancer and mole watch - Examine your skin regularly. If you find any unusual blemish, moles, or other marking on the skin, especially one that changes in size, shape or colour, see your doctor.

Transplant immuno-suppressant drugs also reduce a patient's ability to fight infections. Simple precautions include:

Avoid contact with people who have a cold, flu or any infectious disease such as chickenpox.
Buy bottled water abroad or use boiled water (especially in far eastern countries).
Avoid salads unless you have washed them and/or made them yourself, and avoid ice cubes unless you have made them from bottled water.
Avoid ice cream from street vendors.
Make sure you have been appropriately vaccinated.
Avoid travelling to countries where the risk of catching an infection is high - MASTA and British Airways Clinics can help advise you on this in this section.
Vaccinations - Transplant patients should never be given 'live' vaccines. See your renal unit for advice on live vaccines and also make sure your GP is informed. Vaccinations and advice can be obtained at your local GP clinic or at any of the British Airways Travel Clinics.

Organise assistance at ports, airports, etc - If you tire easily, or have problems with mobility, most airports now offer wheelchairs and/or chauffeured "buggies", which will whisk you through check-in, the departure procedures and passport control in minutes. Ferry ports, railway stations and many special attractions also offer this type of assistance. You will need to book this in advance.

Holiday Insurance Companies

FREE SPIRIT
Address: Hamilton Barr House
Bridge Mews, Bridge Street.
Godalming
Surrey GU7 1HZ.

Telephone: 01483 255888 Fax: 01483 255888
Website: http://www.free-spirit.com
Profile: Free Spirit provide comprehensive holiday insurance cover for renal patients. Their Medical team (who are familiar with renal problems) will discuss your medical condition and needs with you in order to provide a quotation.

LEADING EDGE TRAVEL INSURANCE SERVICES LTD.
Address: The Business Centre
1-7 Commercial Road
Paddock Wood
Tonbridge, Kent
TN12 6YT

Telephone: 01892 836622 Fax: 01892 836622 Email: sales@leadedge.co.uk
Website: http://www.leadedge.co.uk

Profile: Offer travel insurance to UK residents up to 40 years of age. Do not charge extra to cover passengers with a pre-existing medical condition, although restrictions to cover may apply.

LEISURECARE INSURANCE SERVICES LTD.
Shaftesbury Centre,
Percy Street,
Swindon,
Wiltshire,
SN2 2AZ

Telephone: 01793 750661 Fax: 01793 750661 Email: leisurecare@it-adviser.co.uk

Profile: Cover from UK to EU countries only for people aged 59 ears or younger, and who reside in the UK on a permanent basis.
Can include extra cancellation cover if on transplant waiting list.

OUR WAY TRAVEL INSURANCE
Address: Foxbury House
Foxbury Road
Bromley
Kent

Telephone: 020 8313 3353 or 0208 313 3900 Fax: 020 8313 3353 or 0208 313 3900 Email: admin@ourway.co.uk
Profile: Cover for medically or physically disadvantaged UK residents up to 60 years or age. All accompanying family and friends must be insured under the same policy. Link to their site or contact them for further details of terms and conditions.

MEDI-COVER TRAVEL INSURANCE
Lumbry Park
Alton
Hampshire
GU34 3HF

Telephone: 0870 735 3600
Website: http://www.medi-cover.co.uk

CITYBOND TRAVEL CONSULTANTS
Citybond House
21 Station Road
London
SE25 5AH

Telephone: 0208 771 6431

TRAVELCARE LTD
68 High Street,
Chislehurst,
Kent,
BR7 5AQ

Telephone: 0800 181532

Form E111

The UK has reciprocal health service agreements with other EC member countries(as well as some countries outside the EC). You need to take an E111 form with you if you are to benefit from these reciprocal health service agreements. Possession of the E111 form will entitle you to free or reduced cost emergency medical treatment in specified countries.

The E111 form can be obtained from your local Post Office. In order to be valid the form needs to be filled in and signed by you and stamped at the Post Office (you will need your passport with you). Do not forget to take the form with you when you travel. The form is valid indefinitely, unless a claim is made on it or you are no longer ordinarily resident in the UK.

E111 does not provide cover should you or any members of your family need to fly home urgently, nor if you need to return from holiday because a transplant kidney becomes available.
Keep your E111 in a safe place, eg, with your passport.
Always keep a photocopy of your E111 form with the original - especially important for France, Germany, Italy, the Netherlands and Spain.
You can use the same E111 for as long as you remain resident in the UK (but you will need to apply for a new one if any dependent children leave school).

Please note : because the reciprocal health service agreements do not always cover the full cost of treatment, it is always advisable to have insurance even when travelling around the EC.

Information on diseases abroad can also be supplied by MASTA (Medical Advisory Service to Travellers Abroad), who can also provide an individual health brief (recommended immunisations, together with up to date health news and travel advice from the Foreign Office).

MASTA
Address: MASTA
UK Wide

Telephone: 0908 8 224100 (calls charged at 60p per minute) Fax: 0908 8 224100 (calls charged at 60p per minute) For more information visit Website: http://www.masta.org

They provide up to date health and travel news and can supply an individual health brief according to your itinerary, including details of recommended vaccinations, etc.

BRITISH AIRWAYS CLINICS
Address: British Airways
UK Wide

Telephone: 01276 685040 Fax: 01276 685040 For more information visit Website : http://www.britishairways.com/travelclinics

Offers travel advice whether travelling by land, sea or air. Receives up-to-date information on 84 different health hazards in more than 250 countries, which means advice can be tailored to your individual itineraries. Immunisation advice and vaccinations are available.There are branches throughout UK - call or visit their website for details of individual branches

Emergencies - Make sure you and your travelling companion(s) have with you at all times emergency contact numbers. These should include your medical contact at destination (nearest unit or equivalent will be provided by your UK renal unit - make sure you know whether it is open 24 hours, and if not, what your alternative contact number is), numbers of your UK renal unit, travel agent and insurance company.

Further reading
Health Advice for Travellers, a booklet published by the Department of Health contains comprehensive information on the E111, as well as the E111 application form (also available from Post Offices). It also details what is covered by reciprocal arrangements for healthcare abroad, tips on avoiding health risks and information on vaccinations required for visits to certain countries. Available, free of charge, by calling 0800 555 777, or got to the Department of Health Website.

MEDICATION - always divide your supply of tablets. Keep half with you in your hand luggage, and pack the other half in the luggage you check in, or give it to a travelling companion to carry.

Take a letter from your doctor stating that the drugs you are carrying are prescription drugs.

Make sure you have written down the prescription names (as written on the label) of the medication you are on, so that if your supply is lost, you can advise doctors accordingly.
If you need to take medication with you that must be kept cool, pack it in a small cool bag (the type sold for school lunches and picnics) or jiffy bag with ice packs, or use a wide necked thermos flask, which has been chilled.
EPO does not need refrigeration for journeys of up to 6 hours, but make sure you allow time for transfers and delays when calculating the length of your journey.
On your return trip, make sure you declare to customs any drugs you were given or prescribed.
First aid kit - take an emergency supply of plaster, painkillers, insect bite ointment and tablets for diarrhoea. As always, check with your renal unit regarding any over-the-counter drugs you are taking.

Please be aware that while we have made all effort to ensure that this brief information is accurate, we cannot guarantee that there are no mistakes. Also that the best management for individual patients may differ from that outlined here. Only the doctors caring for the patient will be able to advise on this.