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Vaccination Requirements
Immunization against a number of diseases is recommended before travel to certain countries or regions. The "YELLOW BOOK" is considered the best source for determining which vaccinations are required in particular geographical areas. In most cases, multiple vaccines should be given simultaneously or separated by 4 weeks.
CHOLERA
Cholera is a bacterial infection caused by Vibrio cholerae found in contaminated water supplies.
Recommended for: Travelers to endemic areas, more common in the Far East.
DIARRHEA PREVENTION
Recommended for : All developing and under developed countries.
Dose : Prophylaxis include (Pepto-Bismol) 2 tablets four times a day and antibiotics.
For treatment of traveler’s diarrhea:
- Imodium 2 mg after each loose stool to a maximum of 16 mg per day
- Ciprofloxacin 500 mg twice a day; or norfloxacin 400 mg twice a day; or ofloxacin 300 mg twice a day for adults; Bactrim DS twice a day, may be used in children as a substitute, but resistance has emerged in many areas.
- Fluid and electrolyte replenishment are an essential part of treatment
Travelers are advised to obtain adequate insurance coverage for foreign travel ,along with medical evacuation coverage.
DIPHTHERIA & TETANUS
Recommended for : In all developing & under developed countries, for travelers interested in active outdooor or wild expeditions.
Dose: Tetanus and diphtheria toxoid(DT) is recommended every 10 years, but 5 year interval should be considered for travelers who will be in higher risk situations.
HEPATITIS A
Recommended for : All developing and under developed countries.
Vaccine : Havrix.
Dose: Single dose to adults and as two doses one month apart to children, followed by a booster does 6 to 12 months later. Antibody levels (that are protective) are detectable in adults 15 days after the first dose. Immune globulin may be given for immediate protection. Both may be given at the same time at different sites.
HEPATITIS B
Recommended for : Travelers traveling for more than a month or who may have sexual contact with persons in high risk groups(drug abusers, prostitutes).
Dose: Three injections on days 0,30, and 60.
INFLUENZA
Influenza is a viral infection, is easily spread from casual person to person contact..
Vaccine : Fluimmune.
Recommended for :Travelers to the Southern Hemisphere should be immunized in the spring and early summer.
JAPANESE B ENCEPHALITIS
Japanese B encephalitis is a viral infection caused by the bite of an infected mosquito
Recommended for: The Far East, including the Philippines, Korea, Vietnam, China, Nepal, Burma, Pakistan, Singapore, Cambodia, Indonesia, Malaysia, Thailand, Taiwan, India, and eastern areas of Russia. Dose :Primary series of three doses is given over 2 to 4 weeks. A booster is given in 3 years.
MALARIA PREVENTION
Recommended for : All endemic regions, especially all tropical countries.
Dose Tablet Chloroquine 300 mg once a week one week before travel to endemic areas and to continue for four weeks after departure. Mefloquine hydrochloride is probably one of the most commonly used prophylactic agents for travel to chloroquine-resistant areas. One 250 mg. Tablet is taken on the same day each week.. In all areas the use of room sprays, netting, pants, long-sleeve clothing, and windows screens and nighttime. Spraying clothing with permethrin (Duranon) and using permethrin-impregnated mosquito nets are also helpful.
MEASLES
Measles is a viral infection.
Recommended for: In all developing & under developed countries.
Dose: Most people born after 1956 should receive a one-time measles booster (Attenuvax) or an MMR, at least two weeks before or three months after immune globulin. Women who are not planning to become pregnant within 3 months of vaccination should also receive the rubella (German measles) virus vaccine (Meruvax II).
MENINGOCOCCAL MENINGITS
Recommended for: Travelers to endemic areas. Also for regions like India, Nepal, Saudi Arabia, Kenya, Tanzania, the Sao Paulo region of Brazil, and sub-Saharan Africa.
Dose: The vaccine is a single-doses vial with a duration of immunity of 3 years.
PNEUMOCOCCUS
Recommended for: For all trans-oceanic travelers, more than 65 years old, immunocompromised, chronic obstructive pulmonary disease
Vaccine: Pneumovax.
POLIO
Poliomyelitis is a viral infection that results in paralysis.
Recommended for : In all developing & under developed countries, polio is still quite prevalent.
Dose: A repeat oral booster (OPV) will be advisable for those adults who have already completed the primary series of oral polio vaccine. Those who have not completed the primary series will have to undergo a series with either injectable inactivated virus or oral (live) vaccine (protection within 1 month). The risk of vaccine related paralysis is estimated to be 1/520,000 cases.
RABIES
Recommended for : All
Dose: Generally pre-exposure prophylaxis is recommended. Each should receive three injections of rabies vaccine over 3 or 4 weeks.
TYPHOID
Recommended for: All
Typhoid is a bacterial infection caused by Salmonella typhi.
Etiology: This is usually caused by the ingestion of contaminated food, milk, or water supplies. Average incubation period (from time of exposure to onset of symptoms) is 10-14 days. Onset is heralded by a fever progressing to diarrhea (often bloody). A rash may appear on the trunk in the first week of illness. Recovery is usually seen after 3 weeks.
Dose: Oral (live) typhoid vaccine (Ty21a). One tablet is taken on an empty stomach on alternate days, for a total of 4 doses. At least a 2 week interval is required before or after administration of the oral polio vaccine. The oral typhoid vaccine should be completed 1 week before starting prophylaxis for malaria. An injectable form is also available .
YELLOW FEVER
Yellow fever is a viral infection caused by the infected bite of mosquito.
Recommended for: Travelers to endemic areas which include much of tropical South America and most of Africa.
Dose: Vaccine is recommended 10 days before travel to endemic areas. Boosters are given every 10 years.
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