by Kristin Gagnon, RN Kristin Gagnon, RN No Comments

Tuberculosis Skin Testing – What you need to know!

Congratulations! You’ve been accepted to that school program or perhaps you got that new job. But before you can start you’ve been asked to complete a TB skin test by your school or employer. No idea what a TB skin test is? Here’s what you need to know.

What is TB?

TB, or tuberculosis, is a bacteria spread through the air when a contagious person coughs, sneezes, sings or talks. TB usually occurs in the lungs but can affect any organ. Medication is available to treat TB.

What is a TB skin test?

The TB skin test is used to detect infection with TB bacteria. The TB test consists of two appointments:

Appointment #1: A small amount (0.1mL) of test substance is injected under the first layer of skin on your forearm. If you have been exposed to TB bacteria your skin will react to form a firm red bump.

Appointment #2: You must return to the clinic 48 to 72hrs later to have your forearm looked at by the nurse. If it is not looked at within 72 hours the result becomes invalid and the test must be repeated. Make sure to arrive on time for your second appointment!

What is a two-step TB skin test?

If you have been asked for a two-step TB test then you need to repeat the exact same procedure 1-3 weeks after the first test. A two-step TB test is used to establish a baseline for people who need regular TB skin testing.

Is there anything I need to do to get ready for the test?

  • Be sure you don’t receive any live vaccines in the 28 days before your TB test as they can interfere with the test (MMR, chicken pox, oral typhoid, shingles, or yellow fever vaccines). These vaccines can be given on the same day as the TB test or anytime after the test is completed. Td, Tdap, polio, hepatitis A and B are all inactivated vaccines and can be given anytime before or after the TB test.
  • If you need other vaccines please bring your list for the nurse to review and any forms you may need signed.
  • Please bring a list of your current medications.

Is there anything I can’t do after the TB test?

DO everything as you normally would. Eat and drink as normal. Shower and swim as much as you like.

DON’T scratch it or put a bandage on it (in case the bandage irritates your skin). If it becomes itchy you can put a cool cloth on it. Do not put any creams on it.

I’ve had the BCG vaccine – Can I still get a TB test?

Yes you can! The BCG vaccine, or Bacille Calmette Guerin, is routinely given in many countries to protect against TB disease. Although there is a chance the BCG vaccine may cause a false-positive TB skin test, this is not likely if you received the vaccine more than 10 years ago.

My TB skin test is positive – does this mean I have TB?

Not necessarily! The TB test can be positive if you have been infected with TB bacteria, had a previous BCG vaccine, or have had an infection with non-TB bacteria from the same family of bacteria. The test cannot determine how long you may have been infected with TB or whether the bacteria is active or latent (sleeping). The next step is to review your health history with the nurse and complete a chest x-ray to see if TB bacteria are growing in your lungs.

What’s the difference between active and latent TB?

  • Latent TB infection occurs when you have breathed in the TB bacteria but your immune system stops the bacteria from multiplying so you don’t get sick. If you have latent TB you don’t have any symptoms and cannot spread TB to other people.
  • Active TB disease occurs when you have breathed in the TB bacteria but your immune system does not stop the bacteria from multiplying. These multiplying bacteria can make you very sick.

Where can I get the x-ray done?

You can go to any hospital in the Lower Mainland for your x-ray (eg. St Paul’s Hospital, Vancouver General Hospital, Royal Columbian Hospital, Burnaby General Hospital). Take your requisition to the radiology department. The x-ray is free when you have a BC care card.

How do I get the results?

A doctor at TB Control will review your health history and look at your x-ray. An x-ray report will be mailed to your home address if no further follow-up is required. It can take 4-6 weeks to receive your x-ray results in the mail. If you have still not received your results after this time please call TB control (TravelSafe clinic does not receive any x-ray results).


TB Control Vancouver Clinic
655 West 12th Avenue
Vancouver, BC V5Z 4R4
Phone: 604-707-2692

TB Control New Westminster Clinic
100-237 Columbia Street E
New Westminster, BC V3L 3W4
Phone: 604-707-2698


Please see the following links for further information on Tuberculosis in Chinese, Korean, Punjabi and French.


Be sure to get your TB test as soon as you find out you are accepted into your school program or got your new job. Whenever possible don’t leave it to the last minute!

Any other questions you may have can be answered by the nurse at the TravelSafeTM clinic when you come in for your TB test. See you soon!

by TravelSafe Clinic TravelSafe Clinic No Comments

Love, Exciting and New: Tips for Cruising

Anyone who is old enough to remember watching The Love Boat in the early 80’s (we are) knows that taking a cruise can be entertaining, exciting and even romantic!

Indeed, that quirky show did much to popularize the cruising industry, which is now grander and more fun than ever–even though, today, you may not run into random 80’s B-list celebrities like Charo and Zsa Zsa Gabor.

In any case, cruising can be wonderful, but before you embark on the high seas for some tropical locale, it’s wise to consider your health status.


Are You Ship-Shape to Cruise?

Cruising has many benefits over traditional travel, as you don’t have to worry about driving in scary traffic, dealing with car rentals, hotel bookings, confusing GPS directions, and a multiplicity of other stressors and anxiety-inducing scenarios. It’s a delight to be able to board a cruise ship knowing that almost everything is taken care of and all-inclusive!


Cruising is generally a low-risk mode of traveling but it isn’t recommended for travellers who have a history of serious unstable chronic cardiovascular disease or pulmonary disorders. Women diagnosed with high-risk pregnancy requiring regular monitoring should also avoid traveling on cruise ships, as adequate medical care or staff may not be available under these conditions. Whatever your health status, it’s always a good idea to check with your cruise line company and check what type of medical services and staff are available during your cruise.


If you’re healthy and well, traveling by cruise ship is a safe and fun way to visit new destinations and meet new people. Heck, you may even fall in love! And if you don’t, you’re basically on a floating buffet–so it’s a win-win!


What to Bring on the Boat

Before you embark on your ocean adventure, have a look at the suggestions below for what to pack in your bag:


  • Sun Hat (Being on deck and surrounded by water can increase exposure and intensity of the sun. Be sure to bring a hat that will adequately shade your face and neck)
  • Sunglasses
  • Sun protection (SPF 30 or higher)
  • Hand Sanitizer (Take advantage of using hand sanitizer to decrease risk of gastrointestinal and respiratory infections, such as influenza)
  • Gravol or similar product (Over the counter medication to combat sea-sickness may be useful if you experience motion-sickness)
  • Malaria prophylaxis, and Vaccines (Depending on your destination and port stop activities. Consult TravelSafe for further information.)



Now you’re ready to slip on your white loafers, sharpen your shuffleboard skills and start your pre-cruise diet! Remember there are gym facilities on cruise ships and fitness classes which are worth taking advantage of so that you can maintain your health regime even on the water.

And, if you’re lucky, you may even run into Marie Osmond or David Hasselhoff…but that may just happen on 80’s television.

by Penny Gleave RN, BScN Penny Gleave RN, BScN No Comments

Minimizing Jet Lag


Jet lag occurs when travelling over one or more time zones.  When flying eastbound, it causes problems falling asleep and difficulty waking up in the morning.  When we fly west, we have difficulty staying awake in the evening and will wake early.  Eastbound travel can take longer to adjust to than flying westbound.  Jet lag affects people of all ages, fitness and those who travel frequently.

Travelling through more than one time zone can throw off our body’s inner clock (circadian rhythm) decreasing our mental capabilities and causing digestive disturbances.  Headache, loss of appetite, constipation or diarrhea and sleeping difficulties are common.  It takes time for our bodies to adjust to the new time zone.  Thankfully, jet lag is temporary and only lasts three to four days.


Tips to minimize jet lag


Before you depart

  • When flying eastbound, go to bed one hour earlier each night a few days before departure.
  • For westbound destinations go to bed one hour later for a few nights before departure.
  • Choosing a flight that arrives at your final destination in late afternoon or early evening can also be helpful as you will only need to stay awake for a few hours after arrival.
  • wear comfortable clothing with footwear you can remove easily


When you’re flying

  • Change your watch to the local time of your destination
  • If it is nighttime at your destination sleep on the plane or read, listen to quiet music
  • Try to stay awake if it is daytime at your destination
  • avoid caffeine, and alcohol
  • drink water to thirst


When you arrive

DO NOT NAP!  While this may be tempting it is best to adapt to the new time zone as soon as possible.  If you must have a rest, sleep in the early afternoon for 20-30 minutes and set an alarm to ensure you wake up.  Sleeping during the day for long periods will prolong jet lag.

  • Go to bed at the same time as you would at home and get up at your usual time
  • use ear plugs to sleep and try to make the room dark and comfortable
  • Eat small meals at local meal times
  • avoid caffeine after mid-day and drinking alcohol
  • expose yourself to natural light or sunshine during the day


Sleep aids

For adults, over the counter sleep aids can assist with jet lag.  Melatonin is a hormone naturally produced by the body that regulates our sleep and waking cycles.  It is also available in pill form at your local pharmacy or health food shop.

According to Bernice Li, Bsc. (Pharm), RPh Pharmacist at The Pharmacy Kitsilano, taking 3-5 mg of melatonin one day before you depart and continuing for 3-5 days after you arrive is a possible safe option for reducing jet lag.  Currently studies are inconclusive on the effectiveness of melatonin but is a viable option for adults.  Bernice continues, ‘melatonin will not work immediately but it is a safe alternative to try.’

Although there are prescription and other over the counter sleep aids available we recommend you discuss these options with your family doctor.

Travellers taking insulin may need to adjust their insulin schedule during travel and when you arrive at your destination.

Jet Lag can be distracting but it will resolve.  The excitement of travelling to a new destination for pleasure can make jet lag much easier to endure.



by TravelSafe Clinic TravelSafe Clinic No Comments

(Some) Sage Sartorial Advice for Visiting Sacred Places


Perhaps the Queen of Soul, Aretha Franklin, said it best when she sang those iconic lyrics: ​“R-E-S-P-E-C-T, find out what it means to me!”​ Indeed, as travellers, we are continually trying to find out what is considered respectful–​ mindful not to put our proverbial foot in our mouths or inadvertently offend locals when galavanting around the globe.


Is it Rude If I…? 

We know it can be a daunting experience when travelling to countries whose cultural etiquette is different from our own. We often find ourselves burdened with questions like:​ ​Is it polite to shake hands? Should I bow, and if so, how low? Is it considered rude to tip? 

Clearly, most of us want to be respectful when visiting a foreign country, and some of the most frequent questions from travellers concern proper and appropriate attire when visiting places of worship. ​With that in mind, here are some helpful tips for your next trip to places of worship in Southeast Asia! 


 What Not to Wear when Visiting Temples

  • Tank tops
  • See-through clothes
  • Shorts
  • Short skirts
  • Backless dresses
  • Strapless dresses
  • Revealing clothes (crop tops/low cut tops)


Skip the Bare Essentials! 

The most important thing to remember is that ​bare shoulders and knees are not allowed ​in most temples. Be sure to bring clothes that will adequately cover these areas of your body.


What to Bring when Visiting Temples For Men: 

  • Long pants
  • Long-sleeve shirts
  • Socks

For Women: 

  • Ankle-length skirts
  • Tops that cover shoulders
  • Long pants
  • Bras
  • Dresses that cover shoulders and knees
  • Long scarf to use to cover shoulders
  • Sarong to cover over shorts/skirts


Helpful Temple Hacks!

If you come upon a temple or place of worship and are not properly dressed, it’s a great idea to keep a long scarf or two in your bag or purse, so you can wrap it around your legs (like a sarong) or cover your shoulders. Some temples will allow you to rent these coverings for a small fee but, like the Boy Scouts say, it’s always better to be prepared! 


 Modesty is Key 

Amazing view down from Angkor Tom on late evening.

When visiting temples in Southeast Asia, the key word is modesty. A recent article in the Telegraph notes that ​Apsara Authority​, which manages the Angkor Wat site, explains that, ​Wearing revealing clothes disrespects the temple’s sanctity…we will not allow [tourists] to buy a temple pass if they wear revealing clothes. Our officials will inform them what they should wear to be able to visit our ancient temples, so they can come back to buy a ticket later after they change their clothes.” 


Some further Code of Conduct information

Certain temples, such as Angkor Wat, have a strict code of conduct. Before venturing out, it’s worth taking note of the following rules:

  • No littering
  • No smoking
  • No touching of artifacts and Temple reliefs
  • No taking pictures with monks without asking permission




Watch the Video! 

For more information on Angkor Wat’s code of conduct, please click here for an informative and entertaining video!


Read the Code of Conduct!

Please see this handy chart for further code of conduct instructions when Travelling to Angkor Wat:
























Through the act of travelling we come to the profound realization that we are more alike than unalike, but we also come to appreciate our diversity in meaningful ways. ​One of the most wonderful aspects of travel is that it allows us to gain a deeper understanding and appreciation of these diverse cultures and their respective customs​. We hope this information will be useful to you as you plan your next adventure. As always, have fun and travel safe!



Before you travel, protect your health.

TravelSafely with TravelSafe Immunization Clinic