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Rabies remains a deadly disease that can be overlooked, but with pretty much 100% fatality once symptoms develop and nearly 100% prevention with vaccines, it deserves our attention. Our guest Alys, a Travel Health Nurse Specialist and Immunisation Trainer, explains why every traveller should be aware of rabies risks regardless of destination.

• Rabies can be transmitted through minor contact with animal saliva – even a small scratch can be fatal
• The virus hides from the immune system while travelling to the brain, making it undetectable until it's often too late for treatment
• Pre-exposure vaccination requires three doses but simplifies treatment if bitten and eliminates the need for hard-to-source immunoglobulins
• All mammals can carry rabies – not just dogs but cats, monkeys, bats, pigs and even seals
• Children, long-stay travellers, and those visiting rural areas are at highest risk
• Immediate wound washing and prompt medical attention is crucial if bitten or scratched by an animal
• Post-exposure treatment in the UK is an NHS service that should be provided free of charge
• There is no time limit on when post-exposure treatment can begin – even exposures from years ago should be reported

If you're traveling abroad, especially with children or to rural areas, consider rabies pre-exposure vaccination and always avoid contact with animals, however cute and friendly they may seem.

Here are some helpful links

Alys' website - Comprehensive Immunisation & Travel Health Training | Sharp Scratch Training

The Green Book - Rabies green book chapter 27

Rabies Post Exposure Treatment Guidelines - Rabies post-exposure treatment: management guidelines - GOV.UK

Rabies and Immunoglobulin Service (RIgS) - Rabies and Immunoglobulin Service (RIgS) - GOV.UK

Rabies Information for Travellers - Rabies – Information for travellers

Rabies Risk By Country - Rabies risks in terrestrial animals by country - GOV.UK

Robert Steffen’s ‘Steffenogram’ Research - https://academic.oup.com/jtm/article/30/7/taad085/7204327 

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I share my personal experience with imposter syndrome after launching this podcast and how it led me to temporarily delete the show despite positive reception. My anxiety flared when I saw people downloading the podcast worldwide, making me question and worry about being judged.


Check the episode description for links to resources about imposter syndrome that I've found helpful in my journey.

Imposter syndrome: Seven steps to overcome it | RCN Magazine | Royal College of Nursing

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Recent social media claims about contraception and health risks require careful examination, as medical headlines often lack crucial context that healthcare professionals need to provide to patients.

• The claim that "contraceptive injections increase brain tumour risk" refers specifically to benign intracranial meningiomas, with risk increasing from 0.01% to 0.04%
• Average age of women in the depo-contraceptive/meningioma study was 57.6 years, when guidelines already recommend switching from depo around age 50
• GLP-1 medications (like Ozempic and Mounjaro) require reliable contraception during use and for two months after discontinuation
• Mounjaro specifically decreases oral contraceptive effectiveness, requiring either non-oral contraception or barrier methods during titration periods
• UK cervical screening now moves to 5-yearly for HPV-negative results due to HPV vaccination success reducing cervical cancer by 90%
• Scotland reports zero cervical cancer cases in women vaccinated since the 2008 HPV vaccination programme began
• Any concerning symptoms warrant immediate investigation rather than waiting for routine screening appointments
• Self-testing options for cervical screening are being piloted to improve the current 64-65% uptake rate

I'll link all resources mentioned in the description. Feedback and suggestions are welcome through the anonymous message function above the description.

BMJ Study Depo - Use of progestogens and the risk of intracranial meningioma: national case-control study | The BMJ

FSRH Statement Depo - FSRH CEU Statement: Response to new study by Roland et al (2024) | FSRH

Pfizer Statement Depo - Medroxyprogesterone_acetate_-_Risk_of_meningioma_and_measures_to_minimise_this_risk_-_to_publish.pdf

FSRH Statement GLP-1 and oral contraception - CEU-statement-GLP-1-agonists-and-contraception.pdf

FSRH Patient info leaflet GLP-1 - Patient-information-GLP-1-agonists-and-contraception.pdf

UK Gov info GLP-1 - GLP-1 medicines for weight loss and diabetes: what you need to know - GOV.UK

BMJ Extention to Cervical Screening - Extension of cervical screening intervals with primary human papillomavirus testing: observational study of English screening pilot data | The BMJ

Eve Appeal Info Smears - Cervical screening moving to every five years in England  - The Eve Appeal

HPV Self testing study info - HPValidate cervical screening self-sampling study publishes final results – UK National Screening Committee

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UPDATE - this was recorded before the UKHSA announced that if Menitorix stocks depleted and a child born on or before 30/6/24 presents for one year immunisations we should offer an additional dose of 6:1 therefore that isn't covered in this podcase but is in the UKHSA slides and is what we should do for those who present late and no further Menitorix is available.

The UK child immunisation schedule is undergoing major changes starting 1st July 2025, with Meningitis B vaccinations moving from 16 weeks to 12 weeks and additional modifications to the one-year immunisations. These changes respond to shifts in disease patterns, with Men B infections now peaking earlier in infancy and the discontinuation of Menitorix requiring programme restructuring.

• Changes to 12-week immunisations: Men B moved forward from 16 weeks to 12 weeks from 1st July 2025
• Changes apply based on appointment date, not birth date
• Careful checking needed for 16-week appointments to determine correct schedule
• One-year immunisations: No more Menitorix for babies born after 1st July 2024
• Children who turned one before 1st July 2025 should still receive Menitorix while stocks last
• New 18-month immunisation appointments coming January 2026
• Red books will not reflect these changes for some time
• Health Publications' immunisation calculator can help determine correct schedules
• Patient communication is key - explain schedule changes clearly to parents

I'd love to hear suggestions for future episode topics, including women's health, contraception, and long-term conditions. Please use the link in the description to send in your ideas.

Link to letter outlining changes - Changes to the routine childhood vaccination schedule from 1 July 2025 and 1 January 2026 letter - GOV.UK

UKHSA Slide Set detailing changes - Changes to the routine childhood immunisation programme in 2025 and 2026

Childhood Immunisations Calculator (you will need an Excel compatible device) - Childhood immunisation eligibilty calculator - Health Publications

Updated with a really helpful visual guide - Immunisation-appointment-aide-memoire-NHSE-London.pdf

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Introducing a new podcast specifically for nurses working in General Practice, filling a gap in the podcast landscape where there isn't currently dedicated content for this nursing specialty.

• Created by a UK-based General Practice Nurse who values podcasts as an easy way to stay updated while commuting or walking the dog
• Plans to release episodes fortnightly or monthly covering important updates to nursing guidance and practice
• Will spotlight trending topics in general practice nursing and condense complex information into digestible content
• Aims to include multidisciplinary team members and other practice nurses as collaborators
• First full episode will focus on upcoming changes to the UK immunisation schedule
• Invites listeners to text suggestions for future content topics

Text any suggestions for content or topics you're interested in using the link in the description. Happy practising.