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If you can’t produce evidence that you’ve been vaccinated, or remember if this happened some time back, the doctor will insist that you receive all the standard childhood vaccines, and likely add hepatitis A for good measure. There’s no harm in this – boosting pre-existing immune memory can only be beneficial and you will be better protected. Where is Hayward? Vaccine-induced protection against water-borne diseases like typhoid and cholera, for example, falls off pretty quickly. Many of the paediatric infections, particularly rubella and mumps, can be much worse if you encounter them for the first time as an adult – males might suffer permanent sterility. And, if you’re travelling to somewhere like West Africa, it is mandatory that you receive the yellow fever vaccine – this terrible disease kills, on average, more than 25,000 Africans a year, and you don’t want to join that list!

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Your doctor will also assess if you need to start taking antimalarial drugs. Be aware, though, multi-drug resistant forms of malaria are active through much of the tropics, though there is no endemic malaria in northern Hayward Map or in the southern United States. Malaria, like dengue and Zika viruses, is carried by mosquitoes, so you should also purchase and use a good-quality insect repellent, as there are many mosquito-borne infections. Some, like Zika, have only recently come to the fore, while others that probably cause occasional human disease, lumped together as PUOs (pyrexias, fevers, of unknown origin) with (often) odd brain symptoms, are poorly understood. The only protection you have is to wear long trousers, a long-sleeved and light-coloured shirt, use a mosquito repellent and sleep in a screened room or under a bed net.

The travel clinic may also offer to sell you a ‘gastro’ pack. Buy it! We’re not talking about gastronomy, but gastrointestinal disease, particularly low- grade Escherichia coli infections characterised by throwing up and diarrhoea – think Delhi belly, Montezuma’s revenge. Included will be some broad-spectrum antibiotics and packets of physiological salts that can be dissolved in clean (boiled or bottled) water to counter dehydration. Be careful, though: self-medication is always risky. If you have a high fever it could be something much worse (malaria), so consult a doctor immediately if your symptoms are very severe. Usually your hotel or travel director can arrange for you to be seen by a professional.

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