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Advice & Information

Self Help Guides

NHS self-help guides are for anyone looking for tailored guidance on common ailments and treatments. They’re not intended to replace the advice of a medical professional.

Help from your Pharmacy Team

Your local pharmacy is the place to go to get any prescription medicines and clinical advice for minor health concerns. But they do a lot more than that.

Common Illnesses & Conditions

Asthma is a common lung condition that causes occasional breathing difficulties.

It affects people of all ages and often starts in childhood, although it can also develop for the first time in adults.

There’s currently no cure, but there are simple treatments that can help keep the symptoms under control so it doesn’t have a big impact on your life.

Symptoms

The main symptoms of asthma are:

  • wheezing (a whistling sound when breathing)
  • breathlessness
  • a tight chest, which may feel like a band is tightening around it
  • coughing

The symptoms can sometimes get temporarily worse. This is known as an asthma attack.

Read more about the symptoms of asthma.

When to see a GP

See your GP if you think you or your child may have asthma.

Several conditions can cause similar symptoms, so it’s important to get a proper diagnosis and correct treatment.

Your GP will usually be able to diagnose asthma by asking about symptoms and carrying out some simple tests.

Read more about how asthma is diagnosed

Treatments

Asthma is usually treated by using an inhaler, a small device that lets you breathe in medicines.

The main types are:

  • reliever inhalers – used when needed to quickly relieve asthma symptoms for a short time
  • preventer inhalers – used every day to prevent asthma symptoms occurring

Some people also need to take tablets.

Read more about how asthma is treated and living with asthma

Causes and triggers

Asthma is caused by swelling (inflammation) of the breathing tubes that carry air in and out of the lungs. This makes the tubes highly sensitive, so they temporarily narrow.

It may occur randomly or after exposure to a trigger. Common asthma triggers include:

  • allergies – to house dust mites, animal fur or pollen, for example
  • smoke, pollution and cold air
  • exercise
  • infections like colds or flu

Identifying and avoiding your asthma triggers can help you keep your symptoms under control.

Read more about the causes of asthma

How long does it last?

Asthma is a long-term condition for many people, particularly if it first develops when you’re an adult.

In children, it sometimes disappears or improves during the teenage years, but it can come back later in life.

The symptoms can usually be controlled with treatment. Most people will have normal, active lives, although some with more severe asthma may have ongoing problems.

Complications

Although asthma can normally be kept under control, it’s still a serious condition that can cause a number of problems.

This is why it’s so important to follow your treatment plan and not ignore your symptoms if they’re getting worse.

Badly controlled asthma can cause problems such as:

  • feeling tired all the time
  • underperformance at or absence from work or school
  • stress, anxiety or depression
  • disruption of your work and leisure because of unplanned visits to your GP or hospital
  • lung infections (pneumonia)
  • delays in growth or puberty in children

There’s also a risk of severe asthma attacks, which can be life-threatening

Bowel cancer is a general term for cancer that begins in the large bowel. Depending on where the cancer starts, bowel cancer is sometimes called colon or rectal cancer.

Bowel cancer is one of the most common types of cancer diagnosed in the UK. Most people diagnosed with it are over the age of 60. 

Symptoms of bowel cancer

The three main symptoms of bowel cancer are:

  •  persistent blood in the stools – that occurs for no obvious reason or is associated with a change in bowel habit
  •  a persistent change in your bowel habit – which usually means going more often, with looser stools
  •  persistent lower abdominal (tummy) pain, bloating or discomfort – that’s always caused by eating and may be associated with loss of appetite or significant unintentional weight loss

The symptoms of bowel cancer can be subtle and don’t necessarily make you feel ill.

However, it’s worth waiting for a short time to see if they get better as the symptoms of bowel cancer are persistent.

If you’re unsure whether to see your GP, try the bowel cancer symptom checker.

Bowel cancer symptoms are also very common, and most people with them don’t have cancer.

For example:

  • blood in the stools when associated with pain or soreness is more often caused by piles (haemorrhoids)
  • a change in bowel habit or abdominal pain is usually the result of something you’ve eaten
  • a change in bowel habit to going less often, with harder stools, is not usually caused by any serious condition – it may be worth trying laxatives before seeing your GP

These symptoms should be taken more seriously as you get older and when they persist despite simple treatments.

Read about the symptoms of bowel cancer

When to seek medical advice

Try the bowel cancer symptom checker for advice on what you can try to see if your symptoms get better, and when you should see your GP to discuss whether tests are necessary.

Your doctor may decide to:

  • carry out a simple examination of your tummy and bottom to make sure you have no lumps
  • arrange for a simple blood test to check for iron deficiency anaemia – this can indicate whether there’s any bleeding from your bowel that you haven’t been aware of
  • arrange for you to have a simple test in hospital to make sure there’s no serious cause of your symptoms

Make sure you see your doctor if your symptoms persist or keep coming back after stopping treatment, regardless of their severity or your age. You’ll probably be referred to hospital.

Read about diagnosing bowel cancer.

Causes of bowel cancer

It’s not known exactly what causes bowel cancer, but there are a number of things that can increase your risk.

These include:

  •  age – almost 9 in 10 cases of bowel cancer occur in people aged 60 or over
  •  diet – a diet high in red or processed meats and low in fibre can increase your risk
  •  weight – bowel cancer is more common in people who are overweight or obese
  •  exercise – being inactive increases your risk of getting bowel cancer
  •  alcohol and smoking – a high alcohol intake and smoking may increase your chances of getting bowel cancer
  •  family history – having a close relative (mother or father, brother or sister) who developed bowel cancer under the age of 50 puts you at a greater lifetime risk of developing the condition; screening is offered to people in this situation, and you should discuss this with your GP

Some people also have an increased risk of bowel cancer because they have another condition, such as extensive ulcerative colitis or Crohn’s disease in the colon for more than 10 years.

Although there are some risks you can’t change, such as your family history or your age, there are several ways you can lower your chances of developing the condition.

Read about:

Red meat and bowel cancer risk

Eating good food and a healthy diet

Losing weight

Health and fitness

Stopping smoking

Tips on cutting down on alcohol

Read more about the causes of bowel cancer

Bowel cancer screening

To detect cases of bowel cancer sooner, the NHS offers two types of bowel cancer screening to adults registered with a GP in England:

  •  All men and women aged 60 to 74 are invited to carry out a faecal occult blood (FOB) test. Every two years, they’re sent a home test kit, which is used to collect a stool sample. If you’re 75 or over, you can ask for this test by calling the freephone helpline on 0800 707 60 60.
  •  An additional one-off test called bowel scope screening is gradually being introduced in England. This is offered to men and women at the age of 55. It involves a doctor or nurse using a thin, flexible instrument to look inside the lower part of the bowel.

Taking part in bowel cancer screening reduces your chances of dying from bowel cancer. Removing any polyps found in bowel scope screening can prevent cancer.

However, all screening involves a balance of potential harms, as well as benefits. It’s up to you to decide if you want to have it.

To help you decide, read our pages on bowel cancer screening, which explain what the two tests involve, what the different possible results mean, and the potential risks for you to weigh up.

Read more about screening for bowel cancer

Treatment for bowel cancer

Bowel cancer can be treated using a combination of different treatments, depending on where the cancer is in your bowel and how far it has spread.

The main treatments are:

  •  surgery – the cancerous section of bowel is removed; it’s the most effective way of curing bowel cancer and in many cases is all you need
  •  chemotherapy – where medication is used to kill cancer cells 
  •  radiotherapy – where radiation is used to kill cancer cells
  •  biological treatments – a newer type of medication that increases the effectiveness of chemotherapy and prevents the cancer spreading

As with most types of cancer, the chance of a complete cure depends on how far it has advanced by the time it’s diagnosed. If the cancer is confined to the bowel, surgery is usually able to completely remove it.

Keyhole or robotic surgery is being used more often, which allows surgery to be performed with less pain and a quicker recovery.

Read more about how bowel cancer is treated.

Living with bowel cancer

Bowel cancer can affect your daily life in different ways, depending on what stage it’s at and the treatment you’re having.

How people cope with their diagnosis and treatment varies from person to person. There are several forms of support available if you need it:

  • talk to your friends and family – they can be a powerful support system
  • communicate with other people in the same situation – for example, through bowel cancer support groups
  • find out as much as possible about your condition
  • don’t try to do too much or overexert yourself
  • make time for yourself

You may also want advice on recovering from surgery, including diet and living with a stoma, and any financial concerns you have.

If you’re told there’s nothing more that can be done to treat your bowel cancer, there’s still support available from your GP. This is known as palliative care.

Read about living with bowel cancer.

A cervical screening test (previously known as a smear test) is a method of detecting abnormal cells on the cervix. The cervix is the entrance to the womb from the vagina.

Detecting and removing abnormal cervical cells can prevent cervical cancer.

These pages should tell you everything you need to know about cervical screening.

You can also watch a video that explains what you can expect to happen during cervical screening. 

Testing for abnormal cells

Cervical screening isn’t a test for cancer, it’s a test to check the health of the cells of the cervix.

Most women’s test results show that everything is normal, but for around 1 in 20 women the test shows some abnormal changes in the cells of the cervix.

Most of these changes won’t lead to cervical cancer and the cells may go back to normal on their own.

But in some cases, the abnormal cells need to be removed so they can’t become cancerous.

About 3,000 cases of cervical cancer are diagnosed each year in the UK.

It’s possible for women of all ages to develop cervical cancer, although the condition mainly affects sexually active women aged 30 to 45. The condition is very rare in women under 25. 

The cervical screening programme

The aim of the NHS Cervical Screening Programme is to reduce the number of women who develop cervical cancer and the number of women who die from the condition.

Since the screening programme was introduced in the 1980s, the number of cervical cancer cases has decreased by about 7% each year.

All women who are registered with a GP are invited for cervical screening:

  •  aged 25 to 49 – every 3 years
  •  aged 50 to 64 – every 5 years
  •  over 65 – only women who haven’t been screened since age 50 or those who have recently had abnormal tests

Being screened regularly means any abnormal changes in the cells of the cervix can be identified at an early stage and, if necessary, treated to stop cancer developing.

But cervical screening isn’t 100% accurate and doesn’t prevent all cases of cervical cancer.

Screening is a personal choice and you have the right to choose not to attend.

Read about:

What happens when you go for cervical screening?

Booking your test

You’ll receive a letter through the post asking you to make an appointment for a cervical screening test. The letter should contain the details of the place you need to contact for the appointment.

Screening is usually carried out by the practice nurse at your GP clinic. You can ask to have a female doctor or nurse.

If possible, try to book an appointment during the middle of your menstrual cycle (usually 14 days from the start of your last period), as this can ensure a better sample of cells is taken. 

It’s best to make your appointment for when you don’t have your period.

If you use a spermicide, a barrier method of contraception or a lubricant jelly, you shouldn’t use these for 24 hours before the test, as the chemicals they contain may affect the test.

Your screening appointment

The cervical screening test usually takes around 5 minutes to carry out.

You’ll be asked to undress from the waist down and lie on a couch, although you can usually remain fully dressed if you’re wearing a loose skirt.

The doctor or nurse will gently put an instrument called a speculum into your vagina. This holds the walls of the vagina open so the cervix can be seen.

A small soft brush will be used to gently collect some cells from the surface of your cervix.

Some women find the procedure a bit uncomfortable or embarrassing, but for most women it’s not painful.

If you find the test painful, tell the doctor or nurse as they may be able to reduce your discomfort.

Try to relax as much as possible as being tense makes the test more difficult to carry out. Taking slow, deep breaths will help.

The cell sample is then sent off to a laboratory for analysis and you should receive the result within 2 weeks. 

HPV testing

Changes in the cells of the cervix are often caused by the human papilloma virus (HPV).

There are more than 100 different types of HPV. Some types are high risk and some types are low risk. HPV-16 and HPV-18 are considered to be highest risk for cervical cancer.

After successful trials, HPV testing has been incorporated into the NHS Cervical Screening Programme.

If a sample taken during the cervical screening test shows low-grade or borderline cell abnormalities, the sample should automatically be tested for HPV.

If HPV is found in your sample, you should be referred for a colposcopy for further investigation and, if necessary, treatment.

If no HPV is found, you’ll carry on being routinely screened as normal. If your sample shows more significant cell changes, you’ll be referred for colposcopy without HPV testing.

In some areas, a test for HPV is the first test on the screening sample. In these cases, the sample is only checked for abnormal cells if HPV is found.

If HPV isn’t found, you’ll be offered a screening test again in 3 to 5 years (depending on your age).

Read about the results of cervical screening tests

More information about cervical screening

For more information, the Cervical Screening Programme has guides about:

The GOV.UK website also has cervical screening leaflets in other languages.

When to vaccinate your child

There’s a recommended timetable for routine childhood vaccinations. This timetable has been worked out to give children the best chance of developing immunity against common, but potentially deadly, diseases.

 

When to start childhood vaccinations

Routine childhood vaccinations start when a baby is 8 weeks old.

This is a good age to start vaccinations, because the natural immunity to illness that newborn babies get from their mother is beginning to wear off. If a vaccine is given before 8 weeks of age, the baby’s natural immunity to disease may stop it from working.

That’s why you should ideally have your child vaccinated at the recommended time. Any delay can leave your baby unprotected against illnesses that are often more common and worse as a child gets older.

 

Vaccinations for premature babies

Babies who are born early can have a greater risk of catching infections than babies born on time. This is because their immune systems are less developed and they don’t receive as much natural immunity from their mothers.

It’s especially important that premature babies get their vaccines on time, from 8 weeks after birth, no matter how premature they are.

It may seem very early to give a vaccination to such a tiny baby, but many scientific studies have shown that it’s a good time to give them vaccines. Postponing vaccination until they’re older leaves them vulnerable to diseases.

If your baby was born very prematurely (before 26 weeks of pregnancy), they may still be in hospital when their first vaccinations are due. In this case, your baby will receive their first vaccines in hospital.

Read this NHS leaflet on vaccinations for premature babies (PDF, 221kb).

 

Booster jabs

Some vaccines are given more than once. A gap is left between these vaccine doses to make sure that each one has time to work properly.

However, the recommended gap is only a minimum. If the gap is longer – because you missed an appointment, for example – you don’t have to start the course again.

 

Vaccination timings

The NHS childhood vaccination schedule tells you when each routine vaccination should be given. It normally starts when your baby is 8 weeks old and is completed by the time they’re 18.

You can also create a personalised vaccination calendar for your baby.

Other non-routine vaccines may be needed throughout childhood, such as travel vaccines or vaccines for children with certain medical conditions.

Deciding which method suits you

Which method works best for you depends on a number of factors, including your age, whether you smoke, your medical and family history, and any medicines you’re taking.

Find out more in Which method suits me?

 

Where you can get contraception and emergency contraception

Contraception is free on the NHS. Find out where to get contraception and search by postcode to find:

You can also find out where to get emergency contraception – the “morning after pill” or the IUD (coil).

 

Common questions about contraception

Get answers to some common questions about getting and using contraception, including:

 

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties.

It includes:

  •  emphysema – damage to the air sacs in the lungs
  •  chronic bronchitis – long-term inflammation of the airways

COPD is a common condition that mainly affects middle-aged or older adults who smoke. Many people don’t realise they have it.

The breathing problems tend to get gradually worse over time and can limit your normal activities, although treatment can help keep the condition under control.

 

Symptoms of COPD

The main symptoms of COPD are:

  • increasing breathlessness, particularly when you’re active
  • a persistent chesty cough with phlegm – some people may dismiss this as just a “smoker’s cough”
  • frequent chest infections
  • persistent wheezing

Without treatment, the symptoms usually get slowly worse. There may also be periods when they get suddenly worse, known as a flare-up or exacerbation.

Read more about the symptoms of COPD.

 

When to get medical advice

See your GP if you have persistent symptoms of COPD, particularly if you’re over 35 and smoke or used to smoke.

Don’t ignore the symptoms. If they’re caused by COPD, it’s best to start treatment as soon as possible, before your lungs become significantly damaged.

Your GP will ask about your symptoms and whether you smoke or have smoked in the past. They can organise a breathing test to help diagnose COPD and rule out other lung conditions, such as asthma.

Read more about how COPD is diagnosed.

 

Causes of COPD

COPD occurs when the lungs become inflamed, damaged and narrowed. The main cause is smoking, although the condition can sometimes affect people who have never smoked.

The likelihood of developing COPD increases the more you smoke and the longer you’ve smoked.

Some cases of COPD are caused by long-term exposure to harmful fumes or dust, or occur as a result of a rare genetic problem that means the lungs are more vulnerable to damage.

Read more about the causes of COPD.

 

Treatments for COPD

The damage to the lungs caused by COPD is permanent, but treatment can help slow down the progression of the condition.

Treatments include:

  •  stopping smoking – if you have COPD and you smoke, this is the most important thing you can do
  •  inhalers and medications – to help make breathing easier
  •  pulmonary rehabilitation – a specialised programme of exercise and education
  •  surgery or a lung transplant – although this is only an option for a very small number of people

Read more about how COPD is treated and living with COPD.

 

Outlook for COPD

The outlook for COPD varies from person to person. The condition can’t be cured or reversed, but for many people treatment can help keep it under control so it doesn’t severely limit their daily activities.

But in some people COPD may continue to get worse despite treatment, eventually having a significant impact on their quality of life and leading to life-threatening problems.

 

Preventing COPD

COPD is largely a preventable condition. You can significantly reduce your chances of developing it if you avoid smoking.

If you already smoke, stopping can help prevent further damage to your lungs before it starts to cause troublesome symptoms.

If you think you need help to stop smoking, you can contact NHS Smokefree for free advice and support. You may also want to talk to your GP about the stop smoking medications available.

Read more about advice about stopping smoking or find a stop smoking service near you.

Depression is more than simply feeling unhappy or fed up for a few days.

Most people go through periods of feeling down, but when you’re depressed you feel persistently sad for weeks or months, rather than just a few days.

Some people think depression is trivial and not a genuine health condition. They’re wrong – it is a real illness with real symptoms. Depression isn’t a sign of weakness or something you can “snap out of” by “pulling yourself together”.

The good news is that with the right treatment and support, most people with depression can make a full recovery.

 

How to tell if you have depression

Depression affects people in different ways and can cause a wide variety of symptoms.

They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety.

There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains.

The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal, that life is no longer worth living.

Most people experience feelings of stress, unhappiness or anxiety during difficult times. A low mood may improve after a short period of time, rather than being a sign of depression. Read more about low mood and depression.

If you’ve been feeling low for more than a few days, take this short test to find out if you’re depressed.

 

When to see a doctor

It’s important to seek help from your GP if you think you may be depressed.

Many people wait a long time before seeking help for depression, but it’s best not to delay. The sooner you see a doctor, the sooner you can be on the way to recovery.

 

What causes depression?

Sometimes there’s a trigger for depression. Life-changing events, such as bereavement, losing your job or even having a baby, can bring it on.

People with a family history of depression are more likely to experience it themselves. But you can also become depressed for no obvious reason.

Read more about the causes of depression.

Depression is fairly common, affecting about one in 10 people at some point during their life. It affects men and women, young and old.

Studies have shown that about 4% of children aged five to 16 in the UK are anxious or depressed.

 

Treating depression

Treatment for depression can involve a combination of lifestyle changes, talking therapies and medication. Your recommended treatment will be based on whether you have mild, moderate or severe depression.

If you have mild depression, your doctor may suggest waiting to see whether it improves on its own, while monitoring your progress. This is known as “watchful waiting”. They may also suggest lifestyle measures such as exercise and self-help groups.

Talking therapies, such as cognitive behavioural therapy (CBT), are often used for mild depression that isn’t improving or moderate depression. Antidepressants are also sometimes prescribed.

For moderate to severe depression, a combination of talking therapy and antidepressants is often recommended. If you have severe depression, you may be referred to a specialist mental health team for intensive specialist talking treatments and prescribed medication.

Read more about treating depression.

 

Living with depression

Many people with depression benefit by making lifestyle changes, such as getting more exercise, cutting down on alcoholgiving up smoking and eating healthily.

Reading a self-help book or joining a support group are also worthwhile. They can help you gain a better understanding about what causes you to feel depressed. Sharing your experiences with others in a similar situation can also be very supportive.

Read more about the lifestyle changes you can make to help you beat depression.

Your baby’s health and development reviews

You will be offered regular health and development reviews (health visitor checks) for your baby until they are two. These are to support you and your baby, and make sure their development is on track.

The reviews are usually done by your health visitor or a member of their team. They may be done in your home or at the GP surgery, baby clinic or children’s centre.

It’s helpful, where possible, for both parents to attend. This gives you both a chance to ask questions and talk about any concerns you have.

 

The personal child health record (red book)

Shortly before or after your baby is born, you’ll be given a personal child health record (PCHR). This usually has a red cover and is known as the “red book”.

It’s a good idea to take your baby’s red book with you every time you visit the baby clinic or GP.

They will use it to record your child’s weight and heightvaccinations and other important information.

You can also add information to the red book yourself. You may want to record any illnesses or accidents your baby has, or any medicines they take.

You’ll find it helpful to keep the developmental milestones section of the red book up-to-date, too.

 

What happens at your baby’s reviews

During your baby’s reviews your health visitor will discuss your baby’s health and development, and ask if you have any concerns.

If your baby is gaining weight and you and your health visitor have no concerns, they should only be weighed once a month. This gives a clear idea of your baby’s weight gain over a period of time.

See how your baby’s weight is monitored.

If your baby was born prematurely, their developmental age will be calculated from your original due date, not from the actual date they were born, until they are two years old.

The Ages and Stages Questionnaire (ASQ-3)

Your health visiting team will send you a questionnaire, known as the Ages and Stages Questionnaire or ASQ-3, to fill in before your child’s nine-month and two-year development reviews.

This allows you to try out some of the activities covered by the questionnaire with your baby at home, where they are comfortable and in familiar surroundings.

 

When your baby will have their reviews

Your baby will usually have reviews at the ages listed below. If you have any concerns at other times, you can contact your health visitor or GP, or go to your local baby clinic.

Shortly after birth

Your baby will be weighed at birth and again during their first week. They will also have a thorough physical examination within 72 hours of being born. A health professional will usually check your baby’s eyes, heart, hips and – for baby boys – testicles.

Read more about the newborn physical examination.

At five to eight days your baby will have a blood spot (heel prick) test that screens for a number of rare diseases, including cystic fibrosis and sickle cell disease. This is usually done by the midwife.

See more about the blood spot (heel prick) test.

Your baby will have a hearing test soon after birth. If you have your baby in hospital, this may happen before you leave. Otherwise, it will be done some time in the first few weeks in your home, at an outpatient clinic, or at your local health centre.

See what the newborn hearing test involves.

Your midwife and health visitor will also support you with breastfeeding, caring for your new baby, and adjusting to life as new parents.

One to two weeks

Your health visitor will carry out a new baby review within 10-14 days of the birth. 

They can give you advice on:

Six to eight weeks

Your baby will be invited for a thorough physical examination. This is usually done by your GP.

Your baby’s eyes, heart, hips and – for boys – testicles will be checked. They’ll also have their weight, length and head circumference measured.

Your GP or health visitor will discuss your baby’s vaccinations with you. These are offered at 8 weeks, 12 weeks, 16 weeks and one year old, and before your child starts school.

They’ll also ask you how you’ve been feeling emotionally and physically since the birth of your baby.

Nine months to one year

During this time, your baby should be offered another review looking at, among other things, language and learning, safety, diet and behaviour.

This is usually done by a member of your health visiting team. It’s an opportunity for you to discuss any concerns you may have.

Your health visiting team will send you an ASQ-3 questionnaire to fill in before the review. This helps you and your health visitor understand how your baby is developing.

Don’t worry if you can’t fill in the whole questionnaire – your health visitor will help you complete it.

Two to two-and-a-half years

At two to two-and-a-half years your child will have another health and development review. It’s best if you and your partner can both be there.

This is usually done by a nursery nurse or health visitor, and may happen at your home, baby clinic or the children’s centre.

If your child has started going to nursery, playgroup or a childminder, the review may be done there. You, your health visitor, your child’s early years keyworker or childminder will all do the review together.

You’ll be sent an ASQ-3 questionnaire about your baby’s development to fill in before the review. Your health visitor or your child’s keyworker or childminder can help you with this.

This review will cover:

Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high.

There are two main types of diabetes:

  • type 1 diabetes – where the body’s immune system attacks and destroys the cells that produce insulin
  • type 2 diabetes – where the body doesn’t produce enough insulin, or the body’s cells don’t react to insulin

Type 2 diabetes is far more common than type 1. In the UK, around 90% of all adults with diabetes have type 2.

During pregnancy, some women have such high levels of blood glucose that their body is unable to produce enough insulin to absorb it all. This is known as gestational diabetes.

 

Pre-diabetes

Many more people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes.

This is sometimes known as pre-diabetes. If your blood sugar level is above the normal range, your risk of developing full-blown diabetes is increased.

It’s very important for diabetes to be diagnosed as early as possible because it will get progressively worse if left untreated.

 

When to see a doctor

Visit your GP as soon as possible if you experience the main symptoms of diabetes, which include:

  • feeling very thirsty
  • urinating more frequently than usual, particularly at night
  • feeling very tired
  • weight loss and loss of muscle bulk
  • itching around the penis or vagina, or frequent episodes of thrush
  • cuts or wounds that heal slowly
  • blurred vision

Type 1 diabetes can develop quickly over weeks or even days.

Many people have type 2 diabetes for years without realising because the early symptoms tend to be general.

 

Causes of diabetes

The amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach).

When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where it’s broken down to produce energy.

However, if you have diabetes, your body is unable to break down glucose into energy. This is because there’s either not enough insulin to move the glucose, or the insulin produced doesn’t work properly.

Although there are no lifestyle changes you can make to lower your risk of type 1 diabetes, type 2 diabetes is often linked to being overweight.

Read about how to reduce your diabetes risk.

 

Living with diabetes

If you’re diagnosed with diabetes, you’ll need to eat healthily, take regular exercise and carry out regular blood tests to ensure your blood glucose levels stay balanced.

You can use the BMI healthy weight calculator to check whether you’re a healthy weight.

People diagnosed with type 1 diabetes also require regular insulin injections for the rest of their life.

As type 2 diabetes is a progressive condition, medication may eventually be required, usually in the form of tablets.

Read about: 

 

Diabetic eye screening

Everyone with diabetes aged 12 or over should be invited to have their eyes screened once a year.

If you have diabetes, your eyes are at risk from diabetic retinopathy, a condition that can lead to sight loss if it’s not treated.

Screening, which involves a half-hour check to examine the back of the eyes, is a way of detecting the condition early so it can be treated more effectively.

Read more about diabetic eye screening.

Emergency contraception can prevent pregnancy after unprotected sex or if the contraception you have used has failed – for example, a condom has split or you have missed a pill.

There are 2 types of emergency contraception:

  • the emergency contraceptive pill – Levonelle or ellaOne (the “morning after” pill)
  • the intrauterine device (IUD or coil)
 

At a glance: facts about emergency contraception

  • You need to take the emergency contraceptive pill within 3 days (Levonelle) or 5 days (ellaOne) of unprotected sex for it to be effective – the sooner you take it, the more effective it’ll be.
  • The IUD can be fitted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated, for it to be effective.
  • The IUD is more effective than the contraceptive pill at preventing pregnancy – less than 1% of women who use the IUD get pregnant.
  • Taking the emergency contraceptive pills Levonelle or ellaOne can give you a headache or tummy pain and make you feel or be sick.
  • The emergency contraceptive pill can make your next period earlier, later or more painful than usual.
  • If you’re sick (vomit) within 2 hours of taking Levonelle or 3 hours of taking ellaOne, go to your GP, pharmacist or genitourinary medicine (GUM) clinic, as you’ll need to take another dose or have an IUD fitted.
  • If you use the IUD as emergency contraception, it can be left in and used as your regular contraceptive method.
  • If you use the IUD as a regular method of contraception, it can make your periods longer, heavier or more painful.
  • You may feel some discomfort when the IUD is put in, but painkillers can help.
  • There are no serious side effects of using emergency contraception.
  • Emergency contraception doesn’t cause an abortion.
 

How the emergency pill works

Levonelle

Levonelle contains levonorgestrel, a synthetic (man-made) version of the natural hormone progesterone produced by the ovaries.

Taking it’s thought to stop or delay the release of an egg (ovulation).

Levonelle has to be taken within 72 hours (3 days) of sex to prevent pregnancy. It doesn’t interfere with your regular method of contraception.

ellaOne

ellaOne contains ulipristal acetate, which stops progesterone working normally. This also works by stopping or delaying the release of an egg.

ellaOne has to be taken within 120 hours (5 days) of sex to prevent pregnancy.

If you take Levonelle or ellaOne

Levonelle and ellaOne don’t continue to protect you against pregnancy – if you have unprotected sex at any time after taking the emergency pill, you can become pregnant.

They aren’t intended to be used as a regular form of contraception. But you can use emergency contraception more than once in a menstrual cycle if you need to.

 

Who can use the emergency pill?

Most women can use the emergency contraceptive pill. This includes women who can’t use hormonal contraception, such as the combined pill and contraceptive patch. Girls under 16 years old can also use it.

But you may not be able to take the emergency contraceptive pill if you’re allergic to anything in it, have severe asthma or take any medicines that may interact with it, such as:

  • the herbal medicine St John’s Wort
  • some medicines used to treat epilepsyHIV or tuberculosis (TB)
  • medicine to make your stomach less acidic, such as omeprazole
  • some less commonly used antibiotics (rifampicin and rifabutin)

ellaOne can’t be used if you’re already taking one of these medicines, as it may not work. Levonelle may still be used, but the dose may need to be increased.

Tell a GP, nurse or pharmacist what medicines you’re taking, and they can advise you if they’re safe to take with the emergency contraceptive pill.

You can also read the patient information leaflet that comes with your medicine for more information.

Breastfeeding

Levonelle is safe to take while breastfeeding. Although small amounts of the hormones in the pill may pass into your breast milk, it’s not thought to be harmful to your baby.

The safety of ellaOne during breastfeeding isn’t yet known. The manufacturer recommends that you don’t breastfeed for one week after taking this pill.

 

If you’re already using regular contraception

You may need to take the emergency pill if you:

If you have taken Levonelle, you should:

  • take your next contraceptive pill, apply a new patch or insert a new ring within 12 hours of taking the emergency pill
  • continue taking your regular contraceptive pill as normal

Use additional contraception, such as condoms, for:

  • 7 days if you use the patch, ring, combined pill (except Qlaira), implant or injection
  • 9 days for the combined pill Qlaira
  • 2 days if you use the progestogen-only pill

If you have taken ellaOne:

  • wait at least 5 days before taking your next contraceptive pill, applying a new patch or inserting a new ring

Use additional contraception, such as condoms, until you restart your contraception and for an additional:

  • 7 days if you use the patch, ring, combined pill (except Qlaira), implant or injection
  • 9 days for the combined pill Qlaira
  • 2 days if you use the progestogen-only pill

A GP or nurse can advise further on when you can start taking regular contraception and how long you should use additional contraception.

 

Side effects of using the emergency pill

There are no serious or long-term side effects from taking the emergency contraceptive pill.

But it can cause:

  • headaches
  • tummy pain
  • changes to your next period – it can be earlier, later or more painful than usual
  • feeling or being sick – get medical attention if you’re sick within 2 hours of taking Levonelle or 3 hours of taking ellaOne, as you’ll need to take another dose or have an IUD fitted

See a GP or nurse if your symptoms don’t go away after a few days or if:

  • you think you might be pregnant
  • your next period is more than 7 days late
  • your period is shorter or lighter than usual
  • you have sudden pain in your lower tummy – in rare cases, a fertilised egg may have implanted outside the womb (ectopic pregnancy)
 

Can I get the emergency contraceptive pill in advance?

You can get the emergency contraceptive pill in advance of having unprotected sex if:

  • you’re worried about your contraceptive method failing
  • you’re going on holiday
  • you can’t get hold of emergency contraception easily

See a GP or nurse for further advice on getting advance emergency contraception. You can also talk to them about your options for regular methods of contraception.

 

How the IUD works as emergency contraception

The intrauterine device (IUD) is a small, T-shaped plastic and copper device that’s put into your womb (uterus) by a doctor or nurse.

It releases copper to stop the egg implanting in your womb or being fertilised.

The IUD can be inserted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated (released an egg), to prevent pregnancy.

You can also choose to have the IUD left in as an ongoing method of contraception.

How effective is the IUD at preventing pregnancy?

The emergency IUD is the most effective method of emergency contraception – less than 1% of women who use the IUD get pregnant.

It’s more effective than the emergency pill at preventing pregnancy after unprotected sex.

 

Who can use the IUD?

Most women can use an IUD, including those who are HIV positive. A GP or nurse will ask about your medical history to check if an IUD is suitable for you.

The IUD might not be suitable if you have:

  • an untreated sexually transmitted infection (STI) or a pelvic infection
  • problems with your womb or cervix
  • unexplained bleeding between periods or after sex

The emergency IUD won’t react with any other medicines you’re taking.

Pregnancy and breastfeeding

The IUD shouldn’t be inserted if there’s a risk that you may already be pregnant.

It’s safe to use when you’re breastfeeding and it won’t affect your milk supply.

 

Side effects of the IUD

Complications after having an IUD fitted are rare, but can include:

  • pain
  • infection
  • damage to the womb
  • the IUD coming out of your womb
  • heavier, longer or more painful periods if you continue to use it as a regular method of contraception
 

Where can I get emergency contraception?

Getting it for free

You can get emergency contraception for free, even if you’re under 16, from these places, but they may not all fit the IUD:

  • contraception clinics
  • sexual health or genitourinary medicine (GUM) clinics
  • some GP surgeries
  • some young people’s clinics
  • most NHS walk-in centres and minor injuries units
  • most pharmacies
  • some accident and emergency (A&E) departments (phone first to check)

Find your nearest sexual health clinic

Find your nearest pharmacy

Buying it

If you’re aged 16 or over, you can buy the emergency contraceptive pill from most pharmacies, in person or online, and from some organisations, such as the British Pregnancy Advisory Service (BPAS)or Marie Stopes. The cost varies, but it will be around £25 to £35.

 

Contraception for the future

If you’re not using a regular method of contraception, you might consider doing so to protect yourself from an unintended pregnancy.

There are several methods of contraception that protect you for a long period, so you don’t have to think about them once they’re in place, or remember to use or take them every day or every time you have sex.

These methods include the:

See a GP, nurse or visit your nearest sexual health clinic to discuss the options available.

 

If you’re under 16 years old

Contraception services are free and confidential, including for people under the age of 16.

If you’re under 16 and want contraception, the doctor, nurse or pharmacist won’t tell your parents (or carer) as long as they believe you fully understand the information you’re given, and the decisions you’re making.

Doctors and nurses work under strict guidelines when dealing with people under 16. They’ll encourage you to consider telling your parents, but they won’t make you.

The only time a professional might want to tell someone else is if they believe you’re at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first.

 

Flu vaccination is available every year on the NHS to help protect adults and children at risk of flu and its complications.

Flu can be unpleasant, but if you are otherwise healthy it will usually clear up on its own within a week.

However, flu can be more severe in certain people, such as:

  • anyone aged 65 and over
  • pregnant women
  • children and adults with an underlying health condition (such as long-term heart or respiratory disease)
  • children and adults with weakened immune systems

Anyone in these risk groups is more likely to develop potentially serious complications of flu, such as pneumonia (a lung infection), so it’s recommended that they have a flu vaccine every year to protect them.

The injected flu vaccine is offered free on the NHS annually to:

  • adults over the age of 18 at risk of flu (including everyone aged 65 and over)
  • pregnant women 
  • children aged 6 months to 2 years at risk of flu

Find out more about who should have the flu jab.

 

Flu nasal spray vaccination

The flu vaccine is routinely given on the NHS as an annual nasal spray to:

  • children aged 2 and 3 plus children in reception class and school years 1, 2, 3 and 4 
  • children aged 2 to 17 years at a particular risk of flu

Read more about the flu nasal spray for children.

 

65 and overs and the flu jab

You are eligible for the flu vaccine this year (2017/18) if you will be aged 65 and over on March 31 2018 – that is, you were born on or before March 31 1953. So, if you are currently 64 but will be 65 on March 31 2018, you do qualify.

 

Where to get the flu jab

You can have your NHS flu jab at:

  • your GP surgery
  • a local pharmacy offering the service
  • your midwifery service if they offer it for pregnant women

Some community pharmacies now offer flu vaccination to adults (but not children) at risk of flu including pregnant women, people aged 65 and over, people with long-term health conditions and carers.

If you have your flu jab at a pharmacy, you don’t have to inform your GP – it is up to the pharmacist to do that.

 

How effective is the flu jab?

Flu vaccine is the best protection we have against an unpredictable virus that can cause unpleasant illness in children and severe illness and death among at-risk groups, including older people, pregnant women and those with an underlying medical health condition.

Studies have shown that the flu jab will help prevent you getting the flu. It won’t stop all flu viruses and the level of protection may vary, so it’s not a 100% guarantee that you’ll be flu-free, but if you do get flu after vaccination it’s likely to be milder and shorter-lived than it would otherwise have been.

There is also evidence to suggest that the flu jab can reduce your risk of having a stroke.

Over time, protection from the injected flu vaccine gradually decreases and flu strains often change. So new flu vaccines are produced each year which is why people advised to have the flu jab need it every year too.

Read more about how the flu jab works.

 

Flu jab side effects

Serious side effects of the injected flu vaccine are very rare. You may have a mild fever and aching muscles for a couple of days after having the jab, and your arm may be a bit sore where you were injected.

Read more about the side effects of the flu jab.

 

When to have a flu jab

The best time to have a flu vaccine is in the autumn, from the beginning of October to early November, but don’t worry if you’ve missed it, you can have the vaccine later in winter. Ask your GP or pharmacist.

 

The flu jab for 2017/18

Each year, the viruses that are most likely to cause flu are identified in advance and vaccines are made to match them as closely as possible. The vaccines are recommended by the World Health Organization (WHO).

Most injected flu vaccines protect against 3 types of flu virus:

  • A/H1N1 – the strain of flu that caused the swine flu pandemic in 2009
  • A/H3N2 – a strain of flu that mainly affects the elderly and people with risk factors like a long-term health condition. In 2017/18 the vaccine will contain an A/Hong Kong/4801/2014 H3N2-like virus
  • Influenza B  – a strain of flu that particularly affects children. In 2017/18 the vaccine will contain B/Brisbane/60/2008-like virus

The nasal spray flu vaccine and some injected vaccines also offer protection against a fourth B strain of virus, which in 2017/18 is the B/Phuket/3073/2013-like virus.

 

Is there anyone who shouldn’t have the flu jab?

Most adults can have the injected flu vaccine, but you should avoid it if you have had a serious allergic reaction to a flu jab in the past.

Read more about who shouldn’t have the flu vaccine.

You can find out more by reading the answers to the most common questions that people have about the flu vaccine.

You’re more prone to foot problems like corns, blisters and foot infections in later life as the skin becomes thinner and less elastic.  But painful or uncomfortable feet aren’t a natural part of ageing, and can be alleviated.

If you’re having trouble looking after your feet, you’re not alone. Age UK reports that nearly one in three older people can’t cut their own toenails.

Foot care problems tend to happen if you’re less mobile than you used to be, particularly if you have difficulty bending down. Poor eyesight, can also make it harder for you to look after your feet.

How to look after your feet

Your feet will remain in better condition if you have a regular foot routine. This includes:

  • cutting and filing toenails and keeping them at a comfortable length
  • smoothing and moisturising dry and rough skin
  • checking for cracks and breaks in the skin and inflammation such as blisters
  • looking for signs of infection like nail fungus or other obvious early problems, and seeking professional advice
  • wearing suitable socks and footwear
  • keeping your feet clean, dry, mobile, comfortable and warm. Bedsocks are a good idea

If it’s difficult for you to follow this routine yourself, see a professional chiropodist/podiatrist for help.

Foot care on the NHS

Depending on where you live, it may be possible for you to have routine chiropody/podiatry on the NHS but this is not the general rule.

NICE guidance recommends that footcare services related to long term conditions such as diabetesperipheral arterial disease and rheumatoid arthritis should be available on the NHS.

It’s less likely that you will be eligible for footcare on the NHS if you do not have a long-term condition or a specific foot problem, such as a bunion, that is hindering your mobility.

If you don’t qualify for NHS treatment or you would prefer to pay privately for treatment, contact the Institute of Chiropodists and Podiatrists or the Society of Chiropodists and Podiatrists to find a registered podiatrist in your area. Make sure you ask about the cost before you agree to go ahead with treatment.

Find out how a podiatrist can help.

Medical foot problems

If you have a specific problem with your feet, see your GP. You don’t have to put up with pain and discomfort in your feet simply because you’re getting older.

Most foot problems can be treated, which means you will be in less pain and able to move around better.

Find out more about how to look after your feet.

Cholesterol is a fatty substance known as a lipid and is vital for the normal functioning of the body. It’s mainly made by the liver, but can also be found in some foods.

Having an excessively high level of lipids in your blood (hyperlipidemia) can have an effect on your health.

High cholesterol itself doesn’t usually cause any symptoms, but it increases your risk of serious health conditions.

 

About cholesterol

Cholesterol is carried in your blood by proteins. When the two combine, they’re called lipoproteins.

The two main types of lipoprotein are: 

  • high-density lipoprotein (HDL) – carries cholesterol away from the cells and back to the liver, where it’s either broken down or passed out of the body as a waste product; for this reason, HDL is referred to as “good cholesterol”, and higher levels are better
  • low-density lipoprotein (LDL) – carries cholesterol to the cells that need it, but if there’s too much cholesterol for the cells to use, it can build up in the artery walls, leading to disease of the arteries; for this reason, LDL is known as “bad cholesterol”

The amount of cholesterol in the blood – both HDL and LDL – can be measured with a blood test.

The recommended cholesterol levels in the blood vary between those with a higher or lower risk of developing arterial disease.

 

Why should I lower my cholesterol?

Evidence strongly indicates that high cholesterol can increase the risk of:

This is because cholesterol can build up in the artery wall, restricting the blood flow to your heart, brain and the rest of your body. It also increases the risk of a blood clot developing somewhere in your body.

Your risk of developing coronary heart disease also rises as your blood’s cholesterol level increases. This can cause pain in your chest or arm during stress or physical activity (angina).

 

What causes high cholesterol?

Many factors can increase your chances of having heart problems or a stroke if you have high cholesterol.

These include:

  • an unhealthy diet – in particular, eating high levels of saturated fat
  • smoking – a chemical found in cigarettes called acrolein stops HDL transporting cholesterol from fatty deposits to the liver, leading to narrowing of the arteries (atherosclerosis)
  • having diabetes or high blood pressure (hypertension)
  • having a family history of stroke or heart disease

There’s also an inherited condition called familial hypercholesterolaemia, which can cause high cholesterol even in someone who eats healthily.

Read more about the causes of high cholesterol.

 

When should my cholesterol levels be tested?

Your GP may recommend that you have your blood cholesterol levels tested if you:

  • have been diagnosed with coronary heart disease, stroke or mini stroke (TIA), or peripheral arterial disease (PAD)
  • have a family history of early cardiovascular disease
  • have a close family member who has a cholesterol-related condition
  • are overweight
  • have high blood pressure, diabetes, or a health condition that can increase cholesterol levels

Read more about how cholesterol is tested.

 

What should my cholesterol levels be?

Blood cholesterol is measured in units called millimoles per litre of blood, often shortened to mmol/L.

As a general guide, total cholesterol levels should be:

  • 5mmol/L or less for healthy adults
  • 4mmol/L or less for those at high risk

As a general guide, LDL levels should be:

  • 3mmol/L or less for healthy adults
  • 2mmol/L or less for those at high risk

An ideal level of HDL is above 1mmol/L. A lower level of HDL can increase your risk of heart disease.

Your ratio of total cholesterol to HDL may also be calculated. This is your total cholesterol level divided by your HDL level. Generally, this ratio should be below four, as a higher ratio increases your risk of heart disease.

However, cholesterol is only one risk factor and the level at which specific treatment is required will depend on whether other risk factors, such as smoking and high blood pressure, are also present.

 

How can I lower my cholesterol level?

The first step in reducing your cholesterol is to maintain a healthy, balanced diet. It’s important to keep your diet low in fatty food.

You can swap food containing saturated fat for fruit, vegetables and wholegrain cereals. This will also help prevent high cholesterolreturning.

Other lifestyle changes, such as taking regular exercise and giving up smoking (if you smoke), can also make a big difference in helping to lower your cholesterol.

If these measures don’t reduce your cholesterol and you continue to have a high risk of developing heart disease, your GP may prescribe a cholesterol-lowering medication, such as statins.

Your GP will take into account the risk of any side effects from statins, and the benefit of lowering your cholesterol must outweigh any risks.

Read more about how high cholesterol is treated.

High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes.

More than one in four adults in the UK have high blood pressure, although many won’t realise it.

The only way to find out if your blood pressure is high is to have your blood pressure checked. 

 

What is high blood pressure?

Blood pressure is recorded with two numbers. The systolic pressure (higher number) is the force at which your heart pumps blood around your body.

The diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels. They’re both measured in millimetres of mercury (mmHg).

As a general guide:

  • high blood pressure is considered to be 140/90mmHg or higher
  • ideal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
  • low blood pressure is considered to be 90/60mmHg or lower

A blood pressure reading between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you don’t take steps to keep your blood pressure under control.

Find out more about what your blood pressure result means.

 

Risks of high blood pressure

If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes.

Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening conditions, such as:

If you have high blood pressure, reducing it even a small amount can help lower your risk of these conditions.

 

Check your blood pressure

The only way of knowing whether you have high blood pressure is to have a blood pressure test.

All adults over 40 are advised to have their blood pressure checked at least every five years. Getting this done is easy and could save your life.

You can get your blood pressure tested at a number of places, including:

  • at your GP surgery
  • at some pharmacies
  • as part of your NHS Health Check
  • in some workplaces

You can also check your blood pressure yourself with a home blood pressure monitor.

Read more about getting a blood pressure test.

 

Causes of high blood pressure

It’s not always clear what causes high blood pressure, but certain things can increase your risk.

You’re at an increased risk of high blood pressure if you:

  • are over the age of 65
  • are overweight or obese
  • are of African or Caribbean descent
  • have a relative with high blood pressure
  • eat too much salt and don’t eat enough fruit and vegetables
  • don’t do enough exercise
  • drink too much alcohol or coffee (or other caffeine-based drinks)
  • smoke
  • don’t get much sleep or have disturbed sleep

Making healthy lifestyle changes can help reduce your chances of getting high blood pressure and help lower your blood pressure if it’s already high.

Read more about the causes of high blood pressure.

 

Reduce your blood pressure

The following lifestyle changes can help prevent and lower high blood pressure:

Some people with high blood pressure may also need to take one or more medicines to stop their blood pressure getting too high.

Read more about how to keep your blood pressure healthy.

 

Medicines for high blood pressure

If you’re diagnosed with high blood pressure, your doctor may recommend taking one or more medicines to keep it under control.

These usually need to be taken once a day.

Common blood pressure medications include:

  • ACE inhibitors – such as enalapril, lisinopril, perindopril and ramipril
  • angiotensin-2 receptor blockers (ARBs) – such as candesartan, irbesartan, losartan, valsartan and olmesartan
  • calcium channel blockers – such as amlodipine, felodipine and nifedipine or diltiazem and verapamil.
  • diuretics – such as indapamide and bendroflumethiazide
  • beta-blockers – such as atenolol and bisoprolol
  • alpha-blockers – such as doxazosin
  • renin inhibitors – such as aliskiren
  • other diuretics – such as amiloride and spironolactone

The medication recommended for you will depend on things like how high your blood pressure is and your age.

Read more about how blood pressure is treated.

HIV (human immunodeficiency virus) is a virus that damages the cells in your immune system and weakens your ability to fight everyday infections and disease.

AIDS (acquired immune deficiency syndrome) is the name used to describe a number of potentially life-threatening infections and illnesses that happen when your immune system has been severely damaged by the HIV virus.

While AIDS can’t be transmitted from one person to another, the HIV virus can.

There’s currently no cure for HIV, but there are very effective drug treatments that enable most people with the virus to live a long and healthy life. 

With an early diagnosis and effective treatments, most people with HIV won’t develop any AIDS-related illnesses and will live a near-normal lifespan.

 

Symptoms of HIV infection

Most people experience a short, flu-like illness 2-6 weeks after HIV infection, which lasts for a week or two.

After these symptoms disappear, HIV may not cause any symptoms for many years, although the virus continues to damage your immune system. This means many people with HIV don’t know they’re infected.

Anyone who thinks they could have HIV should get tested. Certain groups of people are advised to have regular tests as they’re at particularly high risk, including:

  • men who have sex with men
  • Black African heterosexuals
  • people who share needles, syringes or other injecting equipment

Read about symptoms of HIV.

 

Causes of HIV infection

HIV is found in the body fluids of an infected person. This includes semen, vaginal and anal fluids, blood, and breast milk.

It’s a fragile virus and doesn’t survive outside the body for long. HIV can’t be transmitted through sweat, urine or saliva.

The most common way of getting HIV in the UK is through having anal or vaginal sex without a condom.

Other ways of getting HIV include:

  • sharing needles, syringes or other injecting equipment
  • transmission from mother to baby during pregnancy, birth or breastfeeding

The chance of getting HIV through oral sex is very low and will be dependent on many things, such as whether you receive or give oral sex and the oral hygiene of the person giving the oral sex.

Read about what causes HIV.

 

Diagnosing HIV

Seek medical advice as soon as possible if you think you might have been exposed to HIV. 

You can get tested in a number of places, including at your GP surgery, sexual health clinics, and clinics run by charities.

Find HIV testing services near you 

The only way to find out if you have HIV is to have an HIV test. This involves testing a sample of your blood or saliva for signs of the infection.

It’s important to be aware that:

  • emergency anti-HIV medication called post-exposure prophylaxis (PEP) may stop you becoming infected if started within three days of possible exposure to the virus; starting it as soon as possible is recommended
  • an early diagnosis means you can start treatment sooner, which can improve your chances of controlling the virus and reduce the chance of passing the virus on to others
  • HIV tests may need to be repeated 1-3 months after potential exposure to HIV infection (this is known as the window period), but you shouldn’t wait this long to seek help
  • clinics may offer a finger prick blood test, which can give you a result in minutes, but it may take up to a few days to get the results of a more detailed HIV test
  • home testing or home sampling kits are available to buy online or from pharmacies – depending on the type of test you use, your result will be available in a few minutes or a few days

If your first test suggests you have HIV, a further blood test will need to be carried out to confirm the result.

If this is positive, you’ll be referred to a specialist HIV clinic for some more tests and a discussion about your treatment options.

Read about diagnosing HIV.

 

Treatment for HIV

Antiretroviral medications are used to treat HIV. They work by stopping the virus replicating in the body, allowing the immune system to repair itself and preventing further damage.

These come in the form of tablets, which need to be taken every day.

HIV is able to develop resistance to a single HIV drug very easily, but taking a combination of different drugs makes this much less likely.

Most people with HIV take a combination of drugs – it’s vital these are taken every day as recommended by your doctor.

The goal of HIV treatment is to have an undetectable viral load. This means the level of HIV virus in your body is low enough to not be detected by a test.

Read about treating HIV

 

Living with HIV

If you’re living with HIV, taking effective HIV treatment and being undetectable significantly reduces your risk of passing HIV on to others.

You’ll also be encouraged to:

  • take regular exercise
  • eat a healthy diet
  • stop smoking
  • have yearly flu jabs to minimise the risk of getting serious illnesses

Without treatment, the immune system will become severely damaged, and life-threatening illnesses such as cancer and severe infections can occur.

It’s rare for a pregnant woman living with HIV to transmit it to her baby, provided she receives timely and effective HIV treatment and medical care.

Read about living with HIV.

 

Preventing HIV

Anyone who has sex without a condom or shares needles is at risk of HIV infection.

The best way to prevent HIV is to use a condom for sex and never share needles or other injecting equipment, including syringes, spoons and swabs.

Knowing your HIV status and that of your partner is also important.

For people with HIV, taking effective HIV treatment and being undetectable significantly reduces the risk of passing HIV on to others.

Read about preventing HIV.

  1. About hydrocortisone injections

    Hydrocortisone injections – or ‘steroid injections’ – are a type of medicine known as a corticosteroid. Corticosteroids are not the same as anabolic steroids.

    Hydrocortisone injections are used to treat swollen or painful joints, such as after an injury or in arthritis.

    The hydrocortisone is injected directly into the painful joint. This is also called an intra-articular injection. The joints most often injected are the shoulder, elbow, knee, hand/wrist and hip.

    Hydrocortisone injections are also used to treat painful tendonsand bursitis (when a small bag of fluid which cushions a joint gets inflamed). They’re sometimes used to treat muscle pain when it’s in a particular area.

    The injections usually help relieve pain and swelling, and make movement easier. The benefits can last for several months.

    Hydrocortisone injections are only available on prescription. They’re usually given by a specially trained doctor in a GP surgery or hospital clinic.

    In an emergency, medical staff may give higher dose hydrocortisone injections to treat severe asthma, allergic reactions, severe shock due to injury or infection, or failure of the adrenal glands.

    Other types of hydrocortisone

    There are different types of hydrocortisone, including skin creams, foam and tablets.

    Find out more about other ways you can use hydrocortisone to treat different health problems.

  2. Key facts

    • Hydrocortisone injections for joint pain work by releasing the medicine slowly into the joint. This reduces pain and swelling. 
    • After an injection, your joint may feel better for several months – sometimes as long as a year.
    • Some people get increased pain and swelling in the joint where the injection was given. This pain tends to go away after a few days.
    • Hydrocortisone injections into the same place can be repeated up to 4 times a year – more often can cause long-term joint damage.
    • Hydrocortisone injections can sometimes damp down your immune system so you’re more likely to get infections. Tell your doctor if you come into contact with chickenpoxshingles or measles. If your immune system is damped down, these infections could make you very ill.
  3. Who can and can’t have hydrocortisone injections

    Adults and children can have hydrocortisone injections.

    Hydrocortisone injections aren’t suitable for some people. Tell your doctor before starting the medicine if you:

    • have ever had an allergic reaction to hydrocortisone or any other medicine
    • have ever had depression or manic-depression (bipolar disorder) or if any of your close family has had these illnesses
    • have an infection (including an eye infection)
    • are trying to get pregnant, are already pregnant or you are breastfeeding
    • have recently been in contact with someone with shingleschickenpox or measles (unless you’re sure you are immune to these infections)
    • have recently had, or will soon have, any vaccinations

    Hydrocortisone can make some health problems worse so it’s important that your doctor monitors you.

    Make sure your doctor knows if you have:

    If you have diabetes and monitor your own blood sugar, you will need to do this more often. Hydrocortisone injections can affect your blood sugar control.

  4. How and when to have them

    A specially trained doctor usually gives the injection. If the injection is for pain, it may contain a local anaesthetic. You may also have a local anaesthetic by spray or injection to numb the skin before the hydrocortisone injection.

    You can go home after the injection but you may need to rest the area that was treated for a few days.

    You can have a hydrocortisone injection into the same joint up to 4 times in a year. 

    If you have arthritis, this type of treatment is only used when just a few joints are affected. Usually, no more than 3 joints are injected at a time.

    The dose of hydrocortisone injected depends on the size of the joint. It can vary between 5mg and 50mg of hydrocortisone.

    Will the dose I have go up or down?

    The amount of hydrocortisone in the injection could go up or down in future. It depends on how well the previous injection worked, how long the benefits lasted and whether you had any side effects.

  5. Side effects

    Most people don’t have any side effects after a hydrocortisone injection. Side effects are less likely if only one part of the body is injected.

    Common side effects

    The most common side effect is intense pain and swelling in the joint where the injection was given. This usually gets better after a day or two.

    You may also get some bruising where the injection was given. This should go away after a few days.

    Serious side effects

    With hydrocortisone injections, the medicine is placed directly into the painful or swollen joint. It doesn’t travel through the rest of your body. That means, it’s less likely to cause side effects.

    Sometimes, though, hydrocortisone from a joint injection can get into the bloodstream. This is more likely to happen if you’ve had several injections.

    If hydrocortisone gets into your bloodstream, it can travel around your body and there’s a very small chance that you may have a serious side effect.

    Tell a doctor straight away if you get:

    • depressed (including having suicidal thoughts), feeling high, mood swings, feeling anxious, seeing or hearing things that aren’t there or having strange or frightening thoughts – these can be signs of mental health problems
    • a fever (temperature above 38C), chills, a very sore throat, ear or sinus pain, a cough, pain when you pee, mouth sores or a wound that won’t heal – these can be signs of an infection
    • sleepy or confused, feeling very thirsty or hungry, peeing more often than usual, flushing, breathing quickly or having breath that smells like fruit – these can be signs of high blood sugar
    • weight gain in the upper back or belly, a moon face, a very bad headache and slow wound healing – these can be signs of Cushing’s syndrome

    You should also tell a doctor straight away if you get:

    • breathless
    • swelling in your arms or legs
    • changes in your eyesight

    Some of these side effects, such as mood changes, can happen after a few days. Others, such as getting a rounder face, can happen weeks or months after treatment.

    Children and teenagers

    In rare cases, if your child or teenager has hydrocortisone injections over many months or years, it can slow down their normal growth.

    Your child’s doctor will watch their growth carefully while they are having hydrocortisone injections. That way they will be able to see quickly if your child is growing more slowly and can change their treatment if necessary.

    Talk to your doctor if you are worried about your child having hydrocortisone injections.

    Serious allergic reaction

    It’s extremely rare to have an allergic reaction to a hydrocortisone injection but if this happens to you, contact a doctor straight away. 

    A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

    The warning signs of a serious allergic reaction are:

    • getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
    • wheezing
    • tightness in the chest or throat
    • having trouble breathing or talking
    • swelling of the mouth, face, lips, tongue, or throat

    You can report any suspected side effect to the UK safety scheme.

  6. How to cope with side effects

    What to do about:

    Pain in the joint after the injection: this gets better after a day or two. Rest the joint for 24 hours after the injection and don’t do any heavy exercise. It’s safe to take everyday painkillers such as paracetamol and ibuprofen.

  7. Pregnancy and breastfeeding

    It’s usually ok to have a hydrocortisone injection while you’re pregnant or breastfeeding.

    However, hydrocortisone has occasionally been known to cause problems in the first 12 weeks of pregnancy. 

    For safety, tell your doctor if you’re trying to get pregnant or if you’re already pregnant before having a hydrocortisone injection.

    Hydrocortisone injections and breastfeeding

    It’s safe to have hydrocortisone injections while you’re breastfeeding. Only very small amounts of hydrocortisone get into breast milk so it’s unlikely to be harmful.

    Tell your doctor if you’re trying to get pregnant, are already pregnant or if you’re breastfeeding.

  8. Cautions with other medicines

    There are many medicines that can interfere with the way hydrocortisone injections work.

    It’s very important to check with your doctor or pharmacist that a medicine is safe to mix with hydrocortisone injections before you start taking it. This includes prescription medicines and ones that you buy over the counter like aspirin, paracetamol and ibuprofen. It also includes herbal remedies and supplements.

    Tell your doctor or pharmacist before stopping or starting any other medicines and before taking any herbal remedies, vitamins or supplements.

Whooping cough, also called pertussis, is a highly contagious bacterial infection of the lungs and airways.

It causes repeated coughing bouts that can last for two to three months or more, and can make babies and young children in particular very ill.

Whooping cough is spread in the droplets of the coughs or sneezes of someone with the infection.

 

Symptoms of whooping cough

The first symptoms of whooping cough are similar to those of a cold, such as a runny nose, red and watery eyes, a sore throat, and a slightly raised temperature.

Intense coughing bouts start about a week later.

  • The bouts usually last a few minutes at a time and tend to be more common at night.
  • Coughing usually brings up thick mucus and may be followed by vomiting.
  • Between coughs, you or your child may gasp for breath – this may cause a “whoop” sound, although not everyone has this.
  • The strain of coughing can cause the face to become very red, and there may be some slight bleeding under the skin or in the eyes.
  • Young children can sometimes briefly turn blue (cyanosis) if they have trouble breathing – this often looks worse than it is and their breathing should start again quickly.
  • In very young babies, the cough may not be particularly noticeable, but there may be brief periods where they stop breathing.

The bouts will eventually start to become less severe and less frequent over time, but it may be a few months before they stop completely.

 

Who’s at risk of whooping cough

Whooping cough can affect people of any age, including:

  • babies and young children – young babies under six months of age are at a particularly increased risk of complications of whooping cough
  • older children and adults – it tends to be less serious in these cases, but can still be unpleasant and frustrating
  • people who’ve had whooping cough before – you’re not immune to whooping cough if you’ve had it before, although it tends to be less severe the second time around
  • people vaccinated against whooping cough as a child – protection from the whooping cough vaccine tends to wear off after a few years

You can get whooping cough if you come into close contact with someone with the infection.

A person with whooping cough is infectious from about six days after they were infected – when they just have cold-like symptoms – until three weeks after the coughing bouts start.

Antibiotic treatment can reduce the length of time someone is infectious.

 

When to get medical advice

See your GP or call NHS 111 if you or your child:

  • have symptoms of whooping cough
  • have had a cough for more than three weeks
  • have a cough that is particularly severe or is getting worse

Call 999 or go to your nearest accident and emergency (A&E) department if you or your child:

  • have significant breathing difficulties, such as long periods of breathlessness or choking, shallow breathing, periods where breathing stops, or dusky, blue skin 
  • develop signs of serious complications of whooping cough, such as fits (seizures) or pneumonia
 

Treatment for whooping cough

Treatment for whooping cough depends on your age and how long you’ve had the infection.

  • Children under six months who are very ill and people with severe symptoms will usually be admitted to hospital for treatment.
  • People diagnosed during the first three weeks of infection may be prescribed antibiotics to take at home – these will help stop the infection spreading to others, but may not reduce the symptoms.
  • People who’ve had whooping cough for more than three weeks won’t normally need any specific treatment, as they’re no longer contagious and antibiotics are unlikely to help.

While you’re recovering at home, it can help to get plenty of rest, drink lots of fluids, clean away mucus and sick from your or your child’s mouth, and take painkillers such as paracetamolor ibuprofen for a fever.

Avoid using cough medicines, as they’re not suitable for young children and are unlikely to be of much help.

 

Stopping the infection spreading

If you or your child are taking antibiotics for whooping cough, you need to be careful not to spread the infection to others.

  • Stay away from nursery, school or work until 48 hours from the start of antibiotic treatment or three weeks after the coughing bouts started (whichever is sooner).
  • Cover your or your child’s mouth and nose with a tissue when coughing and sneezing.
  • Dispose of used tissues immediately.
  • Wash your and your child’s hands regularly with soap and water.

Other members of your household may also be given antibiotics and a dose of the whooping cough vaccine to stop them becoming infected.

 

Vaccinations for whooping cough

There are three routine vaccinations that can protect babies and children from whooping cough:

These vaccines don’t offer lifelong protection from whooping cough, but they can help stop children getting it when they’re young and more vulnerable to the effects of the infection.

Older children and adults aren’t routinely vaccinated, except during pregnancy or a whooping cough outbreak.

 

Complications of whooping cough

Babies and young children under six months are usually most severely affected by whooping cough.

They’re at an increased risk of:

  • dehydration
  • breathing difficulties
  • weight loss
  • pneumonia – an infection of the lungs
  • fits (seizures)
  • kidney problems
  • brain damage caused by a lack of oxygen reaching the brain
  • death – although this is very rare

Older children and adults tend to be less severely affected, although they may experience problems caused by repeated coughing, such as nosebleeds, bruised ribs or a hernia.

If you want to stop smoking, several different treatments are available from shops, pharmacies and on prescription to help you beat your addiction and reduce withdrawal symptoms.

The best treatment for you will depend on your personal preference, your age, whether you’re pregnant or breastfeeding and any medical conditions you have. Speak to your GP or an NHS stop smoking adviser for advice.

Research has shown that all these methods can be effective. Importantly, evidence shows that they are most effective if used alongside support from an NHS stop smoking service.

The treatments available are outlined below.

 

Nicotine replacement therapy (NRT)

The main reason that people smoke is because they are addicted to nicotine.

NRT is a medication that provides you with a low level of nicotine, without the tar, carbon monoxide and other poisonous chemicals present in tobacco smoke.

It can help reduce unpleasant withdrawal effects, such as bad moods and cravings, which may occur when you stop smoking.

Where to get it and how to use it

NRT can be bought from pharmacies and some shops. It’s also available on prescription from a doctor or NHS stop smoking service.

It’s available as:

  • skin patches
  • chewing gum
  • inhalators (which look like plastic cigarettes)
  • tablets, oral strips and lozenges
  • nasal and mouth spray

Patches release nicotine slowly. Some are worn all the time and some should be taken off at night. Inhalators, gum and sprays act more quickly and may be better for alleviating cravings.

There’s no evidence that any single type of NRT is more effective than another. But there is good evidence to show that using a combination of NRT is more effective than using a single product.

Often the best way to use NRT is to combine a patch with a faster acting form such as gum, inhalator or nasal spray.

Treatment with NRT usually lasts 8-12 weeks, before you gradually reduce the dose and eventually stop.

Who can use it

Most people are able to use NRT, including:

  • adults and children over 12 years of age – although children under 18 shouldn’t use the lozenges without getting medical advice first
  • pregnant women – your doctor may suggest NRT if they think it would help you quit; read more about stopping smoking in pregnancy
  • breastfeeding women – your doctor can advise you how to do this safely

Always read the packet or leaflet before using NRT to check whether it’s suitable for you.

Sometimes it may be advisable to get medical advice first, for example if you have kidney or liver problems,  or you’ve recently had a heart attack or stroke.

Possible side effects

Side effects of NRT can include:

  • skin irritation when using patches
  • irritation of nose, throat or eyes when using a nasal spray
  • difficulty sleeping (insomnia), sometimes with vivid dreams
  • an upset stomach
  • dizziness
  • headaches

Any side effects are usually mild. But if they’re particularly troublesome, contact your GP as the dose or type of NRT may need to be changed.

 

Varenicline (Champix)

Varenicline (brand name Champix) is a medication that works in two ways. It reduces cravings for nicotine like NRT, but it also blocks the rewarding and reinforcing effects of smoking.

Evidence suggests it’s the most effective medication for helping people stop smoking.

Where to get it and how to use it

Varenicline is only available on prescription, so you’ll usually need to see your GP or contact an NHS stop smoking service to get it.

It’s taken as one to two tablets a day. You should start taking it a week or two before you try to quit.

A course of treatment usually lasts around 12 weeks, but it can be continued for longer if necessary.

Who can use it

Varenicline is safe for most people to take, although there are some situations when it’s not recommended.

For example, it’s not suitable for:

  • children under 18 years of age
  • women who are pregnant or breastfeeding
  • people with severe kidney problems

Possible side effects

Side effects of varenicline can include:

  • feeling and being sick
  • difficulty sleeping (insomnia), sometimes with vivid dreams
  • dry mouth
  • constipation or diarrhoea
  • headaches
  • drowsiness
  • dizziness

Speak to your GP if you experience any troublesome side effects.

 

Bupropion (Zyban)

Bupropion (brand name Zyban) is a medication originally used to treat depression, but it has since been found to help people quit smoking.

It’s not clear exactly how it works, but it’s thought to have an effect on the parts of the brain involved in addictive behaviour.

Where to get it and how to use it

Bupropion is only available on prescription, so you’ll usually need to see your GP or contact an NHS stop smoking service to get it.

It’s taken as one to two tablets a day. You should start taking it a week or two before you try to quit.

A course of treatment usually lasts around seven to nine weeks.

Who can use it

Bupropion is safe for most people to take, although there are some situations when it’s not recommended.

For example, it’s not suitable for:

Possible side effects 

Side effects of bupropion can include:

  • dry mouth 
  • difficulty sleeping (insomnia)
  • headaches
  • feeling and being sick
  • constipation
  • difficulty concentrating
  • dizziness

Speak to your GP if you experience any troublesome side effects.

 

E-cigarettes

An e-cigarette is an electronic device that delivers nicotine in a vapour. This allows you to inhale nicotine without most of the harmful effects of smoking, as the vapour contains no tar or carbon monoxide.

Research has found that e-cigarettes can help you give up smoking, so you may want to try them rather than the medications listed above. As with other approaches, they’re most effective if used with support from an NHS stop smoking service.

There are no e-cigarettes currently available on prescription. But once medicinally licensed e-cigarette products become available, GPs and stop smoking services will be able to prescribe them.

For now, if you want to use an e-cigarette to help you quit, you’ll have to buy one. Costs of e-cigarettes can vary, but generally they’re much cheaper than cigarettes.

Read more about e-cigarettes.

If you’re planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world.

Vaccinations are available to protect you against infections such as yellow fevertyphoid and hepatitis A.

In the UK, the childhood vaccination programme protects you against a number of diseases, but doesn’t cover most of the infectious diseases found overseas.

 

Which jabs do I need?

You can find out which vaccinations are necessary or recommended for the areas you’ll be visiting on these two websites:

Some countries require you to have an International Certificate of Vaccination or Prophylaxis (ICVP) before you enter. For example, Saudi Arabia requires proof of vaccination against certain types of meningitis for visitors arriving for the Hajj and Umrah pilgrimages.

Many tropical countries in Africa and South America won’t accept travellers from an area where there’s yellow fever unless they can prove they’ve been vaccinated against it.

Read more about the vaccines available for travellers abroad.

 

Where do I get my jabs?

You should get advice at least eight weeks before you’re due to travel, as some jabs need to be given well in advance.

First, phone or visit your GP or practice nurse to find out whether your existing UK jabs are up-to-date (they can tell from your notes). Your GP or practice nurse may also be able to give you general advice about travel vaccinations and travel health, such as protecting yourself from malaria.

Your GP or practice nurse can give you a booster of your UK jabs if you need one. They may be able to give you the travel jabs you need, either free on the NHS or for a charge.

Alternatively, you can visit a local private travel vaccination clinic for your UK boosters and other travel jabs.

Not all vaccinations are available free on the NHS, even if they’re recommended for travel to a certain area.

Free travel vaccinations

The following travel vaccinations are usually available free on the NHS:

These vaccines are usually free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.

Private travel vaccinations

You’re likely to have to pay for travel vaccinations against:

Yellow fever vaccines are only available from designated centres.

The cost of travel vaccines at private clinics will vary, but could be around £50 for each dose of a vaccine. It’s worth considering this when budgeting for your trip.

 

Things to consider

There are several things to consider when planning your travel vaccinations, including:

  • the country or countries you’re visiting – some diseases are more common in certain parts of the world and less common in others 
  • when you’re travelling – some diseases are more common at certain times of the year; for example, during the rainy season
  • where you’re staying – in general, you’ll be more at risk of disease in rural areas than in urban areas, and if you’re backpacking and staying in hostels or camping, you may be more at risk than if you were on a package holiday and staying in a hotel
  • how long you’ll be staying – the longer your stay, the greater your risk of being exposed to diseases
  • your age and health – some people may be more vulnerable to infection than others, while some vaccinations can’t be given to people with certain medical conditions
  • what you’ll be doing during your stay – for example, whether you’ll be spending a lot of time outdoors, such as trekking or working in rural areas
  • if you’re working as an aid worker – you may come into contact with more diseases if you’re working in a refugee camp or helping after a natural disaster
  • if you’re working in a medical setting – for example, a doctor or nurse may require additional vaccinations
  • if you are in contact with animals – in this case, you may be more at risk of getting diseases spread by animals, such as rabies

If you’re only travelling to countries in northern and central Europe, North America or Australia, you’re unlikely to need any vaccinations.

If possible, see your GP at least eight weeks before you’re due to travel. Some vaccinations need to be given well in advance to allow your body to develop immunity. Some also involve multiple doses spread over several weeks.

 

Pregnancy and breastfeeding

Speak to your GP before having any vaccinations if:

  • you’re pregnant
  • you think you might be pregnant
  • you’re breastfeeding

In many cases, it’s unlikely a vaccine given while pregnant or breastfeeding will cause problems for the baby. However, your GP will be able to give you further advice about this.

 

People with immune deficiencies

For some people travelling overseas, vaccination against certain diseases may not be advised. This may be the case if:

  • you have a condition that affects your body’s immune system, such as HIV or AIDS
  • you’re receiving treatment that affects your immune system, such as chemotherapy
  • you’ve recently had a bone marrow or organ transplant

Your GP can give you further advice about this.

 

Non-travel vaccines

As well as getting any travel vaccinations you need, it’s also a good opportunity to make sure your other vaccinations are up-to-date and have booster jabs if necessary. Your GP surgery can check your existing vaccination records.

People in certain risk groups may be offered extra vaccines. These include vaccinations against diseases such as hepatitis Btuberculosis (TB)flu and chickenpox.

Read more information on NHS vaccines for adults and children to find out whether you should have any.

Tuberculosis (TB) is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person.

It mainly affects the lungs, but it can affect any part of the body, including the tummy (abdomen) glands, bones and nervous system.

TB is a serious condition, but it can be cured if it’s treated with the right antibiotics.

 

Symptoms of TB

Typical symptoms of TB include:

  • a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody
  • weight loss
  • night sweats
  • high temperature (fever)
  • tiredness and fatigue
  • loss of appetite
  • swellings in the neck

You should see a GP if you have a cough that lasts more than three weeks or you cough up blood.

Read more about the symptoms of TB and diagnosing TB.

 

What causes TB?

TB is a bacterial infection. TB that affects the lungs (pulmonary TB) is the most contagious type, but it usually only spreads after prolonged exposure to someone with the illness. 

In most healthy people, the body’s natural defence against infection and illness (the immune system) kills the bacteria and there are no symptoms.

Sometimes the immune system can’t kill the bacteria, but manages to prevent it spreading in the body.

You won’t have any symptoms, but the bacteria will remain in your body. This is known as latent TB. People with latent TB aren’t infectious to others.

If the immune system fails to kill or contain the infection, it can spread within the lungs or other parts of the body and symptoms will develop within a few weeks or months. This is known as active TB.

Latent TB could develop into an active TB disease at a later date, particularly if your immune system becomes weakened.

Read more about the causes of TB.

 

Treating TB

With treatment, TB can almost always be cured. A course of antibiotics will usually need to be taken for six months.

Several different antibiotics are used because some forms of TB are resistant to certain antibiotics.

If you’re infected with a drug-resistant form of TB, treatment with six or more different medications may be needed.

If you’re diagnosed with pulmonary TB, you’ll be contagious for about two to three weeks into your course of treatment.

You won’t usually need to be isolated during this time, but it’s important to take some basic precautions to stop the infection spreading to your family and friends.

You should:

  • stay away from work, school or college until your TB treatment team advises you it’s safe to return
  • always cover your mouth when coughing, sneezing or laughing
  • carefully dispose of any used tissues in a sealed plastic bag
  • open windows when possible to ensure a good supply of fresh air in the areas where you spend time
  • avoid sleeping in the same room as other people 

If you’re in close contact with someone who has TB, you may have tests to see whether you’re also infected. These can include a chest X-rayblood tests, and a skin test called the Mantoux test.

Read more about treating TB.

 

Vaccination for TB

The BCG vaccine offers protection against TB, and is recommended on the NHS for babies, children and adults under the age of 35 who are considered to be at risk of catching TB.

The BCG vaccine isn’t routinely given to anyone over the age of 35 as there’s no evidence that it works for people in this age group.

At-risk groups include:

  • children living in areas with high rates of TB
  • people with close family members from countries with high TB rates
  • people going to live and work with local people for more than three months in an area with high rates of TB

If you’re a healthcare worker or NHS employee and you come into contact with patients or clinical specimens, you should also have a TB vaccination, irrespective of age, if:

Read more about who should have the BCG vaccine.

 

Countries with high TB rates

Parts of the world with high rates of TB include:

  • Africa – particularly sub-Saharan Africa (all the African countries south of the Sahara desert) and west Africa
  • southeast Asia – including India, Pakistan, Indonesia and Bangladesh
  • Russia
  • China
  • South America
  • the western Pacific region (to the west of the Pacific Ocean) – including Vietnam, Cambodia and the Philippines 

The World Health Organization (WHO) has produced a world map showing countries with high rates of TB.

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