Dr Robin Hollands (University Medical Officer) Advice to All Students in relation to A/H1N1 Influenza (commonly known as Swine Flu) Latest advice can be found on the main university site via the following link: http://resources.glos.ac.uk/currentstudents/news/swine.cfm GENERAL VACCINATIONS WHICH YOU SHOULD HAVE HAD BEFORE STARTING AT UNIVERSITY MUMPS EPIDEMIC An epidemic of mumps continues to occur across the country. The highest number of cases reported is in the 20 - 22 year age range; Universities including The University of Gloucestershire are especially affected. The Health Protection Agency is advising all young people whether students or not who are under the age of 25 years at the University to have had two MMR vaccines. Some students will have had only one MMR vaccine and an additional MR vaccine (no mumps) and believe that they are covered. Other students believe that they had mumps as a child. Both the latter groups are at risk of contacting mumps and if there is any doubt it is safe to have a third MMR vaccine. All students  under 25 years registered with the Medical Centre should contact the Centre  by phone or in person if  they haven't had two MMR vaccinations. Students and Staff under 25 years not registered with the Medical Centre should contact their own Surgeries. If you think that you have previously had mumps (e.g. mum says that I have had mumps in the past )then the advice is that you should still be vaccinated as evidence is that many of these supposed mumps cases were not mumps. The MMR vaccine protects against measles, mumps and rubella and is the only way to be immunised against mumps as there is no single mumps vaccine. MMR was introduced into the routine childhood immunisation programme in 1988, so it is unlikely that you will have received it if you were born before this date. If you're at all unsure if you have had mumps or MMR then we recommend that you have the vaccine. This will not do you any harm in the event that it comes to light later that you did have the vaccine or the illness. You can read about MMR by visiting www.mmrthefacts.nhs.uk These precautions are essential to ensure that you are properly protected from potentially serious illness and we strongly recommend that you visit your GP to check that your immunisations are all up to date. Winter Vomiting Disease There continue to be outbreaks in Gloucestershire. It was caused by Norovirus which is the most common cause of infectious gastroenteritis in England and Wales. Although relatively mild, Norovirus illness can occur at any age because immunity to it is not long-lasting. The disease was historically known as 'winter vomiting disease' due to its seasonality and typical symptoms. Outbreaks of Norovirus gastroenteritis are common in semi-closed environments such as halls of residence. Numbers of Norovirus fluctuate each year with laboratory reported cases representing only a small fraction of the number of cases that actually occur. The self-limiting infection usually only lasts a few days hence the majority of cases are not reported to the clinician. Norovirus is highly contagious, however, one of the ways to protect against the infection or to help prevent yourself or others becoming infected, is by practising good hygiene. This includes thorough hand washing especially after using the toilet, and any contaminated surface should be thoroughly disinfected after an episode of illness. Food preparation should also be avoided until three days after symptoms have disappeared. Unfortunately there is no specific treatment for Norovirus apart from letting the illness run its course; therefore it is important to drink plenty of fluids to prevent dehydration especially in the very young or elderly. What are the symptoms of gastroenteritis? The main symptom is diarrhoea, often with vomiting as well. Crampy pains in the abdomen (tummy) are common. Pains may ease for a while each time some diarrhoea is passed. High temperatures (fever) and headaches are common. If vomiting occurs, it typically lasts only a day or so. Diarrhoea often lasts for several days or more and often continues after the vomiting stops. Loose stools (loose faeces) can persist for a week or so before a normal pattern returns. Sometimes the symptoms last longer. Treatment The aim is to prevent dehydration (low body fluid), or to treat dehydration if it has developed. As a rough guide, drink at least 200 ml after each bout of diarrhoea (after each watery stool). This extra fluid is in addition to what you would normally drink. For example, an adult will normally drink about two litres a day, but more in hot countries. The above '200 ml after each bout of diarrhoea' is in addition to this usual amount that you would drink. If you vomit, wait 5-10 minutes and then start drinking again, but more slowly. For example, a sip every 2-3 minutes, but making sure that your total intake is as described above. You will need to drink even more if you are dehydrated. A doctor will advise on how much to drink if you are dehydrated. For example, this may be to drink 1-2 litres over 6 -12 hours if you are mild to moderately dehydrated. Rehydration drinks are the ideal drink to have. They are made from sachets that you can buy from pharmacies. (The sachets are also available on prescription.) You add the contents of the sachet to water. Rehydration drinks provide a perfect balance of water, salts, and sugar. They are better than just drinking water alone. The small amount of sugar and salt helps the water to be absorbed better from the gut into the body. They do not stop or reduce diarrhoea, but are the best drinks to prevent or treat dehydration. Do not use homemade salt/sugar drinks as the quantity of salt and sugar has to be exact. If rehydration drinks are not available, then have water as your main drink. Also, have some diluted fruit juice now and then as this contains a little bit of sugar. It is best not to have drinks that contain a lot of sugar such as cola, pop or undiluted juice. Eat as normally as possible It used to be advised to 'starve' for a while, but this is now known to be wrong. However, you may not feel like food and most adults can do without food for a few days (but don't stop drinking). Eat as soon as you are able. Medication Anti-diarrhoea drugs are not usually necessary. However, you may wish to reduce the number of trips to the toilet. You can buy anti-diarrhoea drugs from pharmacies. The safest and most effective is loperamide. The adult dose of this is two capsules at first. This is followed by one capsule after each time you pass some diarrhoea up to a maximum of eight capsules in 24 hours. It works by slowing down the gut's activity. Note: do not give anti-diarrhoea drugs to children under 12 years. Also, do not use anti-diarrhoea drugs if you pass blood with the diarrhoea. Paracetamol or ibuprofen are useful to ease a high temperature or headache. If symptoms are severe, or persist, a doctor may ask for a sample of the diarrhoea. This is sent to the lab to look for infecting germs (bacteria, parasites, etc). Sometimes an antibiotic or other treatments are needed, depending on the cause of the infection. Meningitis C You should ensure, before coming to University, that you have had Meningitis C Vaccine. Most UK-based school children should have received it. Many countries in the world however do not offer this vaccine. The vaccine is safe and will, effectively, protect an individual against the C-type meningitis bacteria (although other strains of meningitis may also cause infections so all students should be aware of the symptoms and signs of bacterial meningitis). Measles, Mumps and Rubella (MMR) Again in the UK, this vaccine is given to small children and also at school. Please check that you have received this vaccine twice in your life before coming to university. (SEE ABOVE FOR INFORMATION ON MUMPS EPIDEMIC) Diphtheria / Tetanus / Polio In the UK (and the majority of countries in the world) these are routinely offered to all people when they are children. Please check that you have received these vaccines when you were small. REMEMBER THAT ALL THESE VACCINES WILL REDUCE THE CHANCES OF CONTRACTING AN INFECTIOUS DISEASE IN THE UK ( AND ELSEWHERE ). THEY ARE AVAILABLE FREE OF CHARGE FROM THE MEDICAL CENTRE. WE WOULD STRONGLY ADVISE ALL STUDENTS TO ENSURE THAT THEY HAVE BEEN ADEQUATELY VACCINATED BEFORE THEY ARRIVE. PLEASE CONTACT THE MEDICAL CENTRE AS SOON AS POSSIBLE AFTER ARRIVAL IN THE UK IF YOU REQUIRE ANY FURTHER ADVICE OR HELP WITH VACCINATIONS.

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