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How to Avoid Travellers’ Diarrhoea Before You Travel

Travellers’ diarrhoea is the most common illness among travellers. It affects over one in five people visiting high-risk destinations. Fewer than 1% end up in hospital, but around 13% are confined to bed for a few days, and up to 46% have to change their plans. Most of that is avoidable. Here’s exactly how to cut your risk, and what to do if it catches you anyway. What Is Travellers’ Diarrhoea? Doctors define it as three or more loose, unformed stools in 24 hours, usually with at least one of fever, nausea, vomiting, cramps, or blood in your stool. It typically starts during your trip or within 10 days after you get home. Bacteria cause most cases. A strain called enterotoxigenic E. coli is the single biggest culprit, followed by Campylobacter, Shigella, and Salmonella. In up to 40% of cases, doctors can’t find a specific cause. This is why prevention is more important than trying to treat it later. Why Prevention Is Key to Enjoying Your Holiday One bad stomach bug can wipe out several days of a trip you’ve looked forward to for months. Nobody remembers the sunset if they spent day three stuck in the bathroom. Prevention isn’t complicated, and it doesn’t mean skipping the local food scene. It just means being a bit more switched on about what you eat and drink, so the rest of your holiday can go to plan. Top Ways to Avoid Travellers’ Diarrhoea Most cases trace back to something simple: unsafe water, risky food, or hands that haven’t been washed. Nail these basics, and your risk drops sharply. Stick to Bottled or Boiled Water Tap water is one of the biggest offenders in higher-risk destinations, and that includes ice cubes and the water you brush your teeth with. Stick to sealed bottled water, or water that’s been boiled or properly filtered, and check the seal hasn’t been tampered with before you buy it. Choose Street Food and Buffets Carefully Street food can be some of the best food on a trip. Choose stalls with a queue, where food is cooked fresh and served piping hot. Buffets are trickier, since food can sit out for hours at the wrong temperature, giving bacteria plenty of time to multiply. Peel It Yourself or Skip It Fresh fruit and veg are often washed in local tap water before they reach your plate. A good rule of thumb: if you can peel it yourself, it’s usually fine. Salads and pre-cut fruit are harder to judge, so treat them with a bit more caution. Be Cautious With Dairy and Seafood Unpasteurised dairy and raw or undercooked seafood often cause stomach issues. This is more common in hot climates, where food spoils quickly. If you’re unsure whether dairy has been pasteurised, it’s safer to skip it. Wash Your Hands Properly and Often Sounds obvious, but it’s one of the most effective things you can do. Wash your hands before eating and after using the toilet, and carry hand sanitiser for when soap and water aren’t around. Check Your Destination’s Risk Level Beforehand Risk isn’t the same everywhere. Parts of South Asia, Sub-Saharan Africa, and Central and South America tend to carry higher risk than Western Europe or North America. Knowing this in advance helps you decide how cautious to be once you land. Pack a Simple Travel Health Kit A small kit can save you a lot of stress. Pack oral rehydration sachets (mixed with bottled or boiled water, not tap water). Also, include hand sanitiser and any medications your pharmacist suggests before you leave. Look for rehydration sachets formulated to the standard WHO salt and sugar ratio, since these work better than water alone. It won’t take up much suitcase space, but it can make a real difference if things go wrong. Ask a Pharmacist About Standby Antibiotics Standby antibiotics require a Travel clinic consultation. They are unsuitable for under-18s, those under 45kg, pregnant/breastfeeding individuals, or if taking warfarin, digoxin, hydroxychloroquine, or rifabutin. If prescribed, take 500mg daily for three days with food, strictly for severe symptoms like blood or fever. Safe vs. Risky Foods and Drinks Overview A quick cheat sheet to keep in mind while you’re away. Category Safer Choices Higher Risk Water & drinks Sealed bottled water, hot tea/coffee Tap water, ice, unsealed bottles Food Freshly cooked, served hot Buffets, food left standing Fruit & veg Fruit you peel yourself Salads, unpeeled produce Dairy Pasteurised products Unpasteurised milk, local dairy Extras Busy stalls with high turnover Street food stalls with no queue Who Needs to Be Extra Careful Travellers’ diarrhoea hits some people harder than others. Young children dehydrate much faster than adults, so a mild bug can quickly become serious. Older travellers may struggle more with fluid loss. This is especially true if they have other health issues. Pregnant travellers have a greater risk of dehydration complications. So, it’s important to be careful with food and water. People with weak immune systems, like those on chemotherapy or immunosuppressants, are more likely to get severe or long-lasting infections. If you’re taking antacids or acid-reducing medication, be careful. Stomach acid helps protect against these bugs. Lowering it can make infections easier. What to Do If You Still Get It Even careful travellers get caught out sometimes, and that’s okay. Most cases are mild and clear up within three to four days. The main thing is staying hydrated. Oral rehydration salts work far better than plain water alone, since they replace the salts and sugars your body is losing. Anti-diarrhoeal medicines like loperamide can help if you have plans you can’t miss. They can control symptoms for a day. However, loperamide is not recommended for children under 12.  Also, avoid anti-diarrhoeal medicines if you have a fever or blood in your stool, as they might make some infections worse. Rest when you can, stick to plain foods once you feel able to eat, and avoid alcohol and caffeine until you’re feeling better. When to Seek Help

Seasonal Travel Vaccine Guide: What to Get and When

Many people focus on travel vaccines based on where they’re going. However, the time of year you travel matters, too. A trip to Kenya in March has different risks than one in October. Meningitis outbreaks in parts of Africa often follow the dry season like clockwork. This seasonal travel vaccine guide explains what changes with the seasons, helping you prepare no matter when you travel. How the Season Affects Your Vaccine Needs Disease risk isn’t fixed. It shifts with rainfall, temperature, and even religious calendars. Mosquito-borne diseases like Japanese encephalitis spike when the rains bring standing water. Meningococcal disease climbs in West Africa’s dry, dusty months. Flu season in the UK is from November to April. If you’re travelling in winter, make sure you have your own protection ready before you leave, not just what your destination offers. Getting the timing right matters as much as getting the vaccine list right. Summer and Rainy Season Travel Warm, wet months bring more mosquito activity and a higher chance of contaminated food and water. Hepatitis A and Typhoid Both diseases spread through contaminated food and water, with higher risk in hot, humid conditions. Hepatitis A vaccines (Avaxim®, Havrix®, VAQTA®) are for ages 1 and up. Typhoid can be given as an injection (Typhim Vi®, from age 2) or oral capsules (Vivotif®, from age 5). Wait at least 3 days after the last Vivotif® capsule before starting doxycycline or any other antimalarial. This helps avoid interference. Yellow Fever Yellow fever is mosquito-borne and mandatory for entry into many African and South American nations. Certificates are valid 10 days after injection and last for life, even if older cards show expiry dates. Vaccination should not be given to people with immunosuppression, thymus disorders, or a history of thymectomy.  It’s not suitable for anyone with egg, chick, or latex allergies. It also doesn’t work for those with a family history of serious reactions. Babies under nine months, pregnant people, and those planning to get pregnant within 28 days are also excluded. Travellers aged 60+ are restricted to high-risk areas where the vaccine is explicitly recommended by the WHO. Japanese Encephalitis In rural Asia, the monsoon season brings heavy rains. This creates stagnant water near rice paddies and pig farms. The standing water breeds mosquitoes, which carry the Japanese encephalitis virus. Pigs amplify the virus, allowing it to spread to humans. Even with modern vaccination programmes, remote areas still face high risks.  This is due to limited healthcare access and expensive vaccines. So, it’s important to understand how these health factors are linked. Two doses 28 days apart, licensed for 2 months. JE is the most timing-critical vaccine here and needs at least five to six weeks’ lead time. Cholera Cholera risk increases after floods and in places with broken water systems. It often spikes during the rainy season and after natural disasters. The oral vaccine (Dukoral®) is given from age 2: two doses at least a week apart for adults and children from 6, three doses for children aged 2 to 5.  Nothing to eat or drink for an hour either side of each dose. It’s mainly for aid workers, long-term travellers in remote places, and anyone going to areas with active outbreaks. Tick-Borne Encephalitis, Dengue, and Chikungunya These vector-borne diseases are distinctly seasonal. Tick-borne encephalitis risk is highest in forestry areas of Central and Eastern Europe. This happens in spring and summer when ticks are active. Dengue and chikungunya spread more during and right after the wet seasons in tropical areas. A chikungunya vaccine is available for eligible travellers. For dengue, we will discuss bite prevention and whether vaccination is right for your trip. Winter and Dry Season Travel Colder, dry months shift health risks, with respiratory illnesses becoming more prominent than mosquito-borne diseases. Cold air dries mucous membranes, weakening defences against viruses like influenza.  Flu Jab Before You Fly The UK flu season lasts from November to April. If you’re travelling during this time, especially to places with limited healthcare, get a flu vaccination before you go. Any adult can receive a private flu jab at Your Local Erdington Pharmacy and Health Clinic. You don’t need to qualify for an NHS eligibility group to get one. Meningitis Belt: Extra Precautions in Africa’s Dry Season Sub-Saharan Africa’s meningitis belt faces a serious outbreak risk that climbs every year during the dry season. During these outbreaks, case rates in the region can soar to 1,000 per 100,000 people. In contrast, Europe usually sees rates of about 0.1 to 2.4 per 100,000 each year. That’s not a small difference. Which Countries Fall in the Meningitis Belt The belt runs across the dry savannah from Senegal in the west to Ethiopia in the east, covering around 26 countries, including Mali, Burkina Faso, Niger, northern Nigeria, Chad, Sudan and northern Cameroon. Outbreak season runs roughly from December to June, ending with the rains. If your trip falls in that window and involves close contact with local communities, MenACWY is worth discussing. Why This Season Is Riskier Dry, dusty air can significantly irritate your airways. It damages the delicate lining of your throat and nose. This irritation may make it easier for meningococcal bacteria to infect the body. The risk is especially high among people in close contact. Hajj and Umrah: A Season That Moves Every Year Pilgrimage dates occur about 10 to 11 days earlier each year on the Islamic lunar calendar. So, “seasonal” means something different from a typical summer holiday. Since the dates shift annually, verifying the current Hajj or Umrah calendar well in advance is crucial. Relying on dates from previous years or a friend’s travel dates can lead to missing the opportunity to undertake this important pilgrimage. Meningitis ACWY Is Mandatory, Not Optional Saudi Arabia requires proof of meningococcal ACWY vaccination for travelers aged 1 and older to enter. It’s best to get vaccinated at least 10 days before your trip, and the certificate is valid for a maximum of 5 years.  Polio

Why Medical Supervision Matters During Weight Loss

Weight loss injections like Mounjaro and Wegovy can genuinely change someone’s health for the better. But why medical supervision matters during weight loss comes down to one simple fact: these are powerful prescription-only medicines, and without proper oversight, they can go wrong quickly. Here’s what real supervision actually involves and why skipping it is a bigger gamble than most people realise. What Medical Supervision Actually Means It’s more than just receiving a prescription. Proper supervision involves a thorough review of your health history before treatment begins. The dosage is tailored to your individual response, ensuring the treatment is effective and safe. Ongoing monitoring of side effects is crucial. Weight loss Treatment isn’t just a one-time event. If issues come up or the treatment isn’t working, a clinician who knows your medical history can quickly adjust your care plan. This ongoing support fosters a proactive approach to your health management. The Real Risk of Unregulated Weight Loss Injections in the UK In 2025, the MHRA seized nearly 20 million illegal medicine doses worth £45 million and removed over 1,200 promotional social media posts. In October 2025, the MHRA raided a site near Northampton. They found the UK’s first illegal weight loss injection lab. The team seized tens of thousands of empty pens, raw chemicals, and over 2,000 unlicensed pens. In February 2026, a second facility linked to the same criminal network was shut down. This happened in Lincolnshire and Nottinghamshire after people reported serious illnesses from fake products. In May 2026, an operation near Northampton led to two arrests. It also resulted in the seizure of around 12,000 doses. This was the MHRA’s largest seizure of unlicensed weight loss medicines ever. What’s Actually in These Fake Pens Counterfeit pens made to look like Mounjaro or Wegovy have been seized. These pens may contain bacteria due to poor manufacturing. They also have no active ingredient or use unapproved compounds like retatrutide. Some fake pens had insulin. Unmonitored doses can cause dangerous drops in blood sugar and lead to serious health problems. There is no way to verify what a pen contains unless it is sourced through a registered pharmacy. Why People End Up Buying Unsafely About 1.6 million adults in England, Wales, and Scotland used weight-loss medications from early 2024 to early 2025. Of these, around 1 in 7 were taking drugs not approved for weight loss. NHS access is quite limited.  By June 2026, the NHS will set the Mounjaro threshold at a BMI of 35 or higher, plus four or more qualifying comorbidities. Also, practice participation remains optional. Wegovy often requires a referral from a specialist. That gap between demand and access is exactly what pushes people toward cheaper, unverified sources. Why DIY Weight Loss Often Doesn’t Last Quick fixes often follow a predictable pattern: an initial rapid loss of weight, quickly followed by a regain. This rebound occurs once the plan proves unsustainable or the dose is unsuitable for individual needs. Regular monitoring helps us see if appetite changes are normal or if dose adjustments are needed. Patients often face uncomfortable side effects or plateau prematurely without professional support. What Happens at a Properly Supervised Weight Loss Consultation A thorough assessment determines your eligibility before any prescriptions are made. This usually means a BMI of 30 or more. It can also be between 27 and 29.9 if there’s a related condition like type 2 diabetes, hypertension, high cholesterol, or sleep apnoea. It also requires checking for factors that could make the medication unsafe for you. These include: If you take the oral contraceptive pill, Mounjaro can affect how well it’s absorbed. Use a barrier method as well, or switch to a non-oral contraceptive, for four weeks after starting treatment and for four weeks after every dose increase. Getting the Dose Right Isn’t Guesswork Mounjaro and Wegovy both start at the lowest dose, which is gradually increased over several weeks. This evaluation schedule is important. Raising the dose too quickly can cause nausea, vomiting, and other stomach issues. A supervised programme adjusts your dose based on your responses. This way, changes reflect your personal experience instead of a strict schedule. This personalised approach helps to enhance tolerance and effectiveness, minimising discomfort while optimising results. Identifying Side Effects Before They Become a Problem GLP-1 medications are highly effective but can occasionally cause side effects. If you have symptoms like heartburn (find out how to manage heartburn with Mounjaro) or worry about muscle loss from Mounjaro, ask for help right away. You can handle these issues with expert help. Regular check-ins with your pharmacist ensure your treatment stays safe, comfortable, and effective. Supervised vs Unsupervised Weight Loss: A Quick Comparison Comparison Factor Medically Supervised Unsupervised/Online-Only Dosing Adjusted to you, monitored Fixed, no adjustment Side effect support Ongoing check-ins None Source verification GPhC-registered pharmacy Often unverifiable Long-term success Higher, with follow-up Frequent regain Why Choose a Pharmacist-Led Weight Management Programme Booking at a registered pharmacy means you can get your assessment, prescriptions, and follow-ups all in one spot. This way, professionals who know your medical history can help you more effectively. Our weight management service features Mounjaro and Wegovy. GPhC-registered pharmacists give personalised support. This helps you understand what’s normal and what needs attention. Frequently Asked Questions Is a pharmacy selling weight loss injections legitimate? Check that they’re GPhC-registered and require a proper consultation before prescribing anything. Legitimate providers never sell these medicines without an assessment. Is a supervised programme more expensive? Prices are broadly similar to other private routes, but you’re paying for ongoing monitoring and support, not just the medication itself. Can I switch to a supervised programme? Yes. A pharmacist can assess your current treatment and bring you onto a properly monitored plan. What if I’ve been sold a fake pen? Stop using it immediately and speak to a pharmacist or GP, and report it to the MHRA’s Yellow Card scheme. Does supervision mean more appointments? It usually means a handful of check-ins rather than constant visits, enough to

Your First Week on Mounjaro: What to Expect Day by Day

This guide assumes you have been prescribed Mounjaro following a thorough clinical assessment. Your first week on Mounjaro is focused on adjustment rather than immediate results.  If the scale barely moves or you feel slight discomfort, that’s normal. It doesn’t usually mean there’s a problem. This week, your body is adjusting to the medication. You might notice changes in your appetite and energy levels. It’s essential to monitor how your body responds and note any side effects. Here’s what to expect, what signs to watch for, and tips to navigate this period comfortably. What’s Actually Happening in Your Body After the First Jab Mounjaro starts to change your appetite hormones just hours after your first shot. You might not see changes in your appetite or weight right away, but they’re happening. Typically, users experience a decrease in appetite between 24 and 72 hours after the first dose, with effects often peaking around days 3 to 5. Most people notice they’re less hungry and fuller sooner within the first few days, though some feel very little in week one. Neither tells you much about how well the medicine will work for you. Common Side Effects You Might Notice This Week These are the ones that come up most often during the first week, and most settle down as your body adjusts. Injection Site Tenderness You might see mild redness or feel itching and tenderness where you injected. This is a normal reaction and typically subsides on its own within a few days. Nausea and Upset Stomach This is the most common early side effect, affecting somewhere between 1 in 5 and 2 in 5 new users depending on the study. It tends to peak in the first two to three days and ease between days four and seven. Tiredness and Low Energy Eating less can make you feel low on energy. This reduced appetite is exactly what the medication is meant to do. It’s a knock-on effect, not a separate problem. Headaches These are often linked to lower fluid intake rather than the medication itself. Staying on top of your water intake usually helps more than you’d expect. Changes in Bowel Habits Mounjaro slows down digestion, which can mean constipation for some people and looser stools for others. Both are common and usually temporary. Will You Actually Lose Weight in Week One? Typically, weight loss in the first month averages between 1 and 2 kilograms. Most of this occurs between weeks two and four. In week one, your body is adjusting to the medication, which can temporarily mask any weight loss. Tips to Get Through Your First Week Comfortably Small, practical changes make a bigger difference than pushing through and hoping it passes. Getting the Injection Right Rotate your injection site between your stomach, thigh, and upper arm. Warm the pen to room temperature before use to reduce stinging. Store in the fridge (2–8°C) and keep at room temp (below 30°C) for up to 30 days after removal. It can return to the fridge, but the 30-day limit remains. Avoid storing with the needle attached to ensure dose accuracy. Eating Smaller Meals Helps Smaller, simpler meals are easier to digest than your usual portions. They help your stomach adjust to emptying more slowly. Don’t Skip the Water Stay hydrated to help with headaches and fatigue this week. Keep water nearby, even if you don’t feel like drinking. Alcohol can also contribute to dehydration and worsen nausea, so it’s best to avoid it during your first week. If You Take Oral Contraceptives Mounjaro can affect how well oral contraceptives are absorbed. For the first four weeks of treatment, use a barrier method as well or switch to a non-oral contraceptive. The same applies for four weeks after every dose increase. When to Contact Your Pharmacist Instead of Waiting It Out Most first-week symptoms are mild and temporary, but a few signs mean it’s time to call rather than wait. Get in touch if you notice: First Week on Mounjaro: A Quick Overview Timeframe What’s Typical Day 1-2 Little noticeable effect, injection site may feel tender Day 1-3 Appetite starts to drop, mild nausea possible Day 5-7 Fullness more noticeable, energy may still feel low Getting Ready for Week Two As you move into your second week, your body begins to adjust to the medication. Most patients find that side effects begin to subside and energy levels stabilise. In the second week, you might notice a steadier routine with your meals and appetite. This can make it feel much easier and more predictable than the first week. Have Questions? Your Pharmacist Is Here to Help Our team at Your Local Erdington Pharmacy and Health Clinic is here to support you at every step. If you have questions about side effects or dosage, ask our independent prescriber. They can also help with issues like heartburn or muscle loss. They are here to review your progress and provide personalised advice. You’re not alone on this journey. Check out our weight management service and reach out for support. Frequently Asked Questions Is it normal to feel nothing in week one? Yes. Some people notice very little in the first week, while others feel appetite changes within a couple of days. Both are normal. Should I exercise in my first week? Light activity is fine. It’s best to hold off on anything intense until side effects settle and your energy improves. Can I take painkillers for headaches? Standard paracetamol is generally fine, but speak to your pharmacist if headaches persist or feel severe. What if I miss my first dose day? You have more room than you might think. If you remember within four days of your usual injection day, take it then and carry on as normal. If it has been longer than four days, skip that dose and take the next one on your usual day. If you want to change your injection day permanently, leave at least three days between doses when you

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Contact Your Local Pharmacy

Your Local Erdington Pharmacy and Health Clinic is a family-run independent pharmacy serving Erdington, Gravelly Hill, Washwood Heath, Sutton Coldfield, Aston and surrounding Birmingham communities since 2019. We offer NHS services including Pharmacy First, Flu Vaccination, Contraception, Hypertension Case Finding, and prescription management. Private services include Travel Clinic, Hajj & Umrah Vaccinations, Microsuction Ear Wax Removal, Weight Management, Vitamin B12, Blood Testing, Cryotherapy, Aesthetics, BCG Scar Checks, Independent Prescribing and Ear Piercing. Online appointment booking available.

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