Combatting Jet Lag

Whether we travel often for business, have family on another continent, or have a big summer getaway planned, flying is something that a lot of us end up doing once or twice a year. Thankfully, modern innovations have made flying more and more convenient and comfortable over the years. But if there’s one obstacle that we always face – no matter how good those first class seats – it’s jet lag.

Jet lag is a label given to a set of symptoms that you experience after a long-haul flight. Though it might not give you much cause for concern when compared to other travel-related conditions such as malaria, jet lag is something that can seriously derail a holiday or business trip.

Luckily, there are certain things you can do to get around the worst symptoms, and if the latest research into light therapy is to be believed, even more help could be on the way. Read on to find out more.

Causes & Symptoms

Jet lag happens when your body crosses several time zones and has to readjust to the new schedule. It all comes down to your body’s circadian rhythms, which essentially provide an inner timetable for waking, eating and sleeping. When you enter a new time zone on a drastically different schedule to the one you have come from, your circadian rhythms have trouble adapting.

The main symptom is sleep disturbance, where you find yourself unable to drop off or wake up at the appropriate times. You may also find your appetite is disrupted. Resulting symptoms can include constipation, diarrhoea, anxiety, irritability, lethargy, confusion and a general feeling of being unwell. In some cases, the symptoms can last up to six days.

Preventing Jet Lag

It’s not easy to avoid jet lag, particularly if you’re travelling west to east. The good news is that there are some techniques you can use before you arrive at your destination.

Before you travel, try to adapt your sleep routine slightly to the new time zone. You should also try to get a good night’s sleep before you fly – so if you’re very concerned about jet lag, avoid booking an early flight.

Once on the plane, switch your watch to the new time zone immediately. Avoid alcohol and caffeine, and drink lots of water. Try and sleep if you can (an eye mask, ear plugs and comfy socks help), and take regular breaks from your seat to stretch your legs.

Having arrived at your destination, try your hardest to adapt to the new time zone straight away. Eat at the appropriate meal times, get used to being outside in the natural light when the sun is up, and – whatever you do – don’t take naps.

Lastly, there’s been some interesting research carried out into the effects of light therapy. Researchers at Stanford University have found that exposing your eyes to flashes of bright light while you are sleeping can help your body adjust to a new time zone before you arrive in it. Learn more here.

Treating Jet Lag

If you follow the tips above, you should find that any symptoms ease off within a few days. However, if you’re on a short trip and you need to make the most of your time, there are a couple of treatments you can try.

The first is sleeping tablets, which you may be able to obtain through a prescription from your GP, depending upon your specific needs. The second is melatonin. Melatonin is a naturally occurring hormone that your body releases in the evening to signal that it’s time to sleep. It stops being released in the morning, at which point your body wakes up.

In the UK, melatonin is prescribed to help treat insomnia. However, it can also be used off-label to combat jet lag. It comes in the form of a tablet and is taken with food a few hours before you intend to sleep. Prescribing medicines off-label (i.e. for another purpose than that for which they are licensed) is a safe and common practice in the UK when it is done through a registered medical service such as The Online Clinic.

If you would like to learn more about jet lag or order melatonin from The Online Clinic, click here.

Following the recent supply chain issue with the popular anti-malarial medication, Malarone, we are happy to say that we now have this item back in stock. Malone can be prescribed for next day delivery. If you have not yet created a consultation for a malarial prophylaxis, you can do so by clicking on the free consultation button below.

The popular anti-malarial medication, Malarone, is out of stock until the third week in January owing to a supply chain issue. This will affect all UK based pharmacies. We can recommend alternative medications as a malarial prophylaxis appropriate to the region that you will be visiting. Please be aware that some malarial medications need to be taken a week before you enter the risk area. One of the attractions of Malarone is that it can be taken 1 – 2 days before you enter the malaria area and only needs to be taken for 7 days when you have left the risk area. Some other treatments must be taken for 4 weeks after leaving. If you require any specific advice on appropriate treatment then you can contact us or consult the Fit for Travel website.

A new study has suggested that Chloroquine could be used again as a treatment for malaria in some countries. The use of Chloroquine, which was a common drug to use for malaria treatment and prevention since the 1950s, was discontinued in 2003 after an increased incidence of childhood deaths from malaria was reported. Instead, the World Health Organisation recommended the use of other treatments such as artemisinin.

The reasoning behind the decision to stop using Chloroquine came from the fact that it appeared that the extensive use of Chloroquine led to malaria parasites developing resistance to it. The malaria parasite had mutated to form this resistance. What made the mutation particularly persistent was that there were 16 polymorphisms that were associated with it. However, researchers were hoping that if individuals stopped using the medication for a period of time, the resistance developed in the parasites would decline.

This is the subject of a recent study published in American Journal of Tropical Medicine. The study, which lasted for 2 years, looked at 11 500 blood samples from children under the age of ten in two areas of Senegal. The findings indicate that there is a significant decline in the developed resistance and the researchers claim that the possibility of using Chloroquine in combination with other anti-malarial medication for treatment or prevention should be considered in the near future.

Given that there is still 30% resistance, we have to respectfully disagree with the researchers. We would need to see a much more significant decline in resistance before the use of Chloroquine could be considered again as a treatment or prevention in areas where there is still a high level of resistance.

Please note that this article does not have a bearing on the recommended preventative treatments for travellers

Researchers at the Welcome Trust- Mahosot Hospital-Oxford University Tropical Medicine Research Collaboration have published a worrying report in the Malaria Journal highlighting the factthat fraudulent anti-malarials will impact hugely on mortality rates over the next year if action is not taken soon.

These fake, and in some cases, poor quality drugs, are entering the system all over the world but the problem is especially significant on the African continent at the moment. Between criminal activity and bad manufacturing standards and practices, it is unlikely patients will continue to benefit from the first line treatments since they are developing a resistance to treatment due to the quality of drugs available.

In order to ascertain how much fake treatment and poor quality treatments were out there, researchers collected data from 11 African nations between 2002 and 2010. They discovered that counterfeit drugs contained a number of active ingredients but they only treated the symptoms of malaria and not the disease itself. It was also discovered that the ingredients used had the potential to cause harmful side effects, especially when taken with other prescription treatments. Because these drugs contain minute amounts of artemisinin, one of the most frequently used treatments in Africa, but only enough so that the manufacturers pass validity tests. Patients taking the drugs will eventually develop a resistance to the bona fide treatments if the parasite is only exposed to small quantities of the active ingredient.

The leader of this research suggests that African regulatory authorities begin to increase their investments in quality control so that only the best quality treatments are available at affordable prices.

A new study carried out on female mosquitos and mating has revealed some exciting results.  According to the study’s authors, female mosquitos do not know if their mates are infertile and furthermore, do not pursue future mates despite having not been fertilised. A particular species, known as the anopheles gambiae, were observed and are the species responsible for most of the cases of malaria transmission in Africa.

The female of this species will only mate once in her life so this means that if she has mated with an infertile partner, she will not go on to mate again and therefore miss out on her opportunity to have her eggs fertilised.

The researchers at the University of Oxford’s Department of Zoology looked at 100 males who had no sperm. In order to produce these males they injected eggs with a protein that inhibited the development of the testes. They were therefore unable to produce sperm later in life.

These male adults were coupled with females and their physiology and behaviour observed. Females that had mated with an infertile male did not search for another mate again thereafter. This is an exciting study that takes us closer to the possibility of one day controlling the mosquito population and reduce the incidence of malaria.

An increasing number of travellers around Britain are not taking ant-malarias before travelling to malaria endemic regions. The announcement comes from the UK Health Protection Agency (HPA) that says that the number of UK travellers contracting malaria has increased by 30% over a 2 year period.

Some travellers think that if they have had malaria once that they cannot have it again however this is not the case according to a HPA spokesperson. With so much research being carried out on malaria prevention and treatment it is shocking that people are not taking the necessary precautions. Malaria is potentially life threatening but easy to prevent and antimalarial drugs can be prescribed by The Online Clinic for next day delivery.

A Canadian research team and a Californian research team have made a breakthrough discovery for the future of malaria treatment.  The Canadian team discovered an easier way to harvest the chemical, artemisinin, which is notoriously difficult to obtain but which is now a key ingredient in modern anti-malaria medications. The other team discovered a new precursor to artemisinin and when both teams met, they made an invaluable discovery.

Artemisinin is usually extracted from the sweet wormwood plant in a laborious and time-consuming process. The Canadian scientists exposed the genetic information of wormwood plant that produces the protein which goes on to make artemisinin.

Simultaneously, researchers at UC, Berkley, developed a precursor to artemisinin when chemicals were mixed with yeast. The Canadian group suggested that their genes would be mixed with the compound created at Berkley and sure enough when two of the genes were mixed with the yeast compound they found that the production of artemisinin had doubled.

The companies are preparing to increase production and the Bill and Melinda Gates Foundation has provided financial backing and this will ensure that no profit will be made from the drug in developing communities. This yeast- fermentation method will ensure prices remain low and the supply plentiful as the process of making artemisinin will be much easier and much quicker than before and will not have to rely on weather conditions and soil fertility.

A subspecies of mosquito, the Goundry, has been discovered and named after the area in which it was found. The insect, which has proven itself as highly susceptible to the malaria parasite favours the outdoors and is yet another challenge facing scientists in the battle against malaria, which kills nearly one million people every year.

Unlike other mosquitoes that prefer to rest indoors, the Goundry prefers open spaces so regular methods of prevention such as nets and sprays cannot be put in place. Mosquitoes that stay outdoors are extremely difficult to catch or even trap for experimentation. The only option for scientists now is to capture the mosquito in its larval stage and observe its feeding habits in order to estimate the threat this subspecies may pose.

Nearly half of the world’s population live in malaria endemic regions.

Doctors are warning travellers to take care when travelling to malaria endemic regions and to be prepared. The warnings follow the treatment of 3 UK malaria sufferers in one week who had taken holidays in Western Africa. Each patient had arranged their holiday with the same travel website and received no medical information regarding anti-malarials or other preventative measures before they departed.

Each patient contracted falciparum malaria- the most virulent type of malaria. The UK travel trade association have been informed of the various websites promoting travel in such areas without providing the appropriate medical advice.

There are certain types of malaria tablets that need to be taken a number of weeks before departure so preparation is key. Travellers are being exploited by the agencies and websites and lured into making hasty holiday plans because of attractive last minute deals.

The recommendation is to follow Foreign and Commonwealth Office advice. Malarone and other anti-malarials are available on prescription. Malarone only needs to be taken 1 to 2 days before travelling and for seven days after one has departed from the malaria zone. Malarone is specifically convenient for these last minute trips to high risk areas.

The malaria parasite is not discriminating in who it infects as Piers Morgan tweeted earlier today; unfortunately he wasn’t entirely accurate with his facts.

Having just taken over from Larry King on CNN, Piers Morgan is difficult to escape if you’re living in the States. He is also a prolific tweeter and yesterday managed to cause a hoopla when he posted the following "BREAKING NEWS: George Clooney has contracted malaria following recent trip to Sudan”.

The trouble was that although the Hollywood A Lister had indeed contracted malaria on a trip to Africa, he had done so in January and was completely over the illness.

Clooney’s representative managed to make an important point, however, when he spoke about the actor’s recovery "This illustrates how with proper medication, the most lethal condition in Africa, can be reduced to a bad ten days instead of a death sentence."

Pier Morgan reporting inaccurate news stories- who would have thought it?

Didier Drogba, the Chelsea footballer, said yesterday that he still had not fully recovered from his bout of Malaria. He suffered with headaches and a fever for a month before he was diagnosed in September last year and although he was immediately treated he was sufficiently debilitated by the virus to still feel that he has not yet fully recovered.

This comes in the week that doctors have released new research about the malaria parasite which shows that it is not as effective at infecting its host if that host has a different body clock.

Scientists at Edinburgh University gave the parasites "jet lag" by injecting them into mice whose body clocks were different from their own 24-hour cycle.

The research allows scientists to know when the parasites are at their most infectious and will lead to improved methods of treatment to combat the debilitating, and potentially fatal, virus.

Cheryl Cole’s recent collapse and subsequent diagnosis with malaria made the headlines and projected the illness into the spotlight in a way that had never happened before in the UK.

Now, only a few weeks later, another high profile case of malaria has made the headlines. Didier Drogba, the 32-year-old Chelsea striker complained of feeling unwell at the beginning of October but was only diagnosed as having Malaria this Monday.

The Chelsea manager, Carlo Ancelotti, said that he didn’t know how his player had contracted the tropical disease but Drogba was told that he could have been carrying it for weeks. He began an intensive 48-hour course of medication yesterday.

The footballer had already been tested for malaria and other tropical diseases but the results came back negative: This is not an uncommon occurrence as the parasitic activity in the blood goes up and down on a daily basis and can be affected by anti-malarials. Drogba is soldiering on rather bravely but all the tabloid criticism of Cheryl Cole is misplaced. Any suggestion that Cheryl overplayed her illness is a complete disgrace – malaria kills around a million people in Africa every year and we even have a few deaths in the UK each year when people are not treated for the tropical disease on time.

Simon Cowell has said that X-Factor judge Cheryl Cole is recovering well from malaria. He revealed that he had received a message from the popstar, in which she said she was getting better and feeling ‘perky’.

Cole fell ill with the potentially life-threatening disease after a trip to Tanzinia three weeks ago with one of her dancers, Derek Hough, 25.

She was released from the intensive care department of University College Hospital at the start of the weekend and since has checked into a private hospital in London.  The star has been forced to pull out of a string of work commitments, including the ‘bootcamp’ stage of X-Factor and various appearances, such as at the V Festival next month.

Cowell has said he is committed to ensuring that Cole does not return to work before she is ready and has promised to have a conversation with her about it. He also revealed that she is expected to be released from hospital in the next few days.

In the meantime, a host of celebs have put themselves forward to fill Cheryl’s shoes until she returns, including Jordan, who -  despite admitting that she can’t sing  - claims that the fact that she’s ‘still got ears and can still hear things and can see looks’ makes her ideally qualified. While this could make for some fabulous TV, no doubt Simon Cowell is praying that Cole recovers from the malaria before Jordan manages to strong-arm her way onto his set!

Research by Sainsbury’s has shown that British travellers are putting their travel insurance in jeopardy by not informing their insurers of any pre-existing health conditions.

The survey for the supermarket, which sells travel insurance, revealed that more than half a million Brits last year went abroad without disclosing to their travel insurers information about a long-term medical complaint they had. Doing so could potentially invalidate any claim that they subsequently make.

245,000 holidaymakers failed to disclose that they suffered from severe back pain; 110,000 did not ensure that their cover took into account a respiratory condition and 50,000 were not honest about a heart condition.

When questioned about why they did not reveal their full medical history, various reasons cited included a fear that they would be refused cover, a belief that their condition was irrelevant or that it was an embarrassment to them.

Equally disturbing was the news that 8% of people who went abroad this year took out no travel insurance at all! Not getting proper health insurance could mean that travellers get hit with crippling costs should they fall ill abroad so it might save a few pounds before you travel but think about being hit with a $25,000 U.S. hospital bill like one of my very careless friends was last year. Not feeling so clever now Mr!

You have probably already heard the news that Cheryl Cole has contracted malaria while she was holidaying in Tanzania. We have heard that she did take some form of preventative treatment but did not start the medication prior to arriving in Tanzania.

It is necessary to take an appropriate medication for the malaria that is present in the region being visited. Malarone would have been an appropriate treatment for Tanzania and unlike most malaria treatments (which have to be started a few weeks before travel) this one can be taken a day or two before you set out on your trip but it must be continued for one week after you return.

The UK has the largest number of people who import malaria back into the UK after a holiday than anywhere else in the industrialized world. Malaria can be fatal but it usually responds to medication and there are only a few fatalities in the UK each year. Having said that, it is not a nice disease to have and it is so easy to prevent.

The Online Clinic established an anti-malaria service a few weeks ago to make it easier for people to access the sort of treatment that they need for their trip. The unfortunate incident involving the much loved Cheryl Cole simply serves to highlight the need to take precautions when travelling to malarious regions.

British travellers have been advised to speak to their own doctors before travelling, rather than relying on the advice of friends or relatives.

TV doctor Pixie McKenna has urged people to speak to their doctor 6 to 8 weeks before they travel, to make sure that they are taking the right precautions for their trip. This could ensure that travellers are protected against malaria if they travel to an area where it is present, or know how to reduce their chances of developing the dreaded stomach flu.

She warned that many travellers still believe myths and old wives tales about staying healthy abroad, such as the old colonial myth that drinking gin and tonic protects against malaria and that dogs with Rabies look unfriendly.

She spoke out as part of a new initiative called 8 Weeks to Go, which is designed to raise awareness amongst holidaymakers of the steps they need to take to protect themselves while abroad.  The campaign is funded by GlaxoSmithKline’s Travel Health and supported by the NHS’ Fit for Travel program and the Foreign and Commonwealth Office.

Organisers of the campaign say that 1 in every 2 travellers has fallen ill or hurt themselves while abroad and have warned that Brits are some of the biggest importers of malaria in the world.

The Foreign Office is also urging people to make sure they have travel insurance in place before they go abroad, as the costs of falling ill overseas can be astronomical if you are not prepared.

Andy Murray is starring in a new advert to highlight the dangers of malaria and the importance of using mosquito nets. He has agreed to help out the charity, Malaria No More UK, which campaigns to raise awareness about the potentially life-threatening disease. The charity, founded in 2009 and supported by footballer David Beckham, has a pledge that every penny donated by the public to them is spent directly on the ground in Africa to support prevention and treatment programs.

The advert will feature the tennis champ building up for a smash serve, only to stop when he realises there is no net. As he waits for someone to bring a net, he is then shown performing a few flashy moves.

He has said that he wanted to take part in the advert as, though the disease is preventable, it still claims the lives of 2,000 people each day in Africa. The dead are largely children, as they have not had time to build up immunity to the disease.

Those travelling to areas where malaria is present are particularly vulnerable to infection. Travellers are recommended to take anti-malarial medication during their trip to protect them and to always sleep under mosquito nets. However, though mosquito nets are relatively cheap for those in the West, many in Africa are forced by their price to go without.

Murray is particularly keen to raise awareness amongst travellers of the need for mosquito nets and protective medication.  In the last 10 years, there has been a 190% rise in the number of people travelling to malaria-affected regions, with 2,000 Brits contracting the disease each year.

He said that his own travels have brought him into contact with people who have been affected by malaria. He also revealed that he knew people in the UK who had lost loved ones to the disease, describing it as ‘such a tragedy’.

AIDs groups in South Africa have claimed that FIFA is stalling over making condoms available to football fans, putting at risk many travellers unaware of the AIDS epidemic ravaging the country.

South Africa has the world’s largest number of people carrying HIV, with estimates putting the number of South Africans infected at 5.7 million. Every day, there are 1,400 new infections.

The huge influx of tourists that the world cup will bring – and it is well know that tourists are more likely to drink and engage in risky sexual behaviour – means that sexual health needs to be a priority, to ensure that the supporters do not contract the disease while on holiday.

However according to a group of AIDS charities, Fifa’s tight regulations on advertising, which ensure that only official sponsors can be shown inside the stadium, mean that fans are not going to be given condoms or sufficient advice on sexual health.mThis is despite the South African government making 71 million condoms available, with a further 65million held in reserve.

The organisations, which include the AIDS Consortium and Treatment Action Campaign, say that FIFA has ignored their demands for an urgent meeting to discuss their concerns; though FIFA says that it is unaware of any such request.

FIFA has been especially criticized for welcoming advertising for alcohol, while stymying efforts to protect football fans against HIV.