This is the first article in a series on Travel Health
Some people are scared by the idea of traveling somewhere where immunizations are advised; others are oblivious, and don’t even read about recommended health precautions for the places they plan to visit. You don’t need to be scared – or oblivious. You need to be informed.
Vaccines
When people read about health precautions for visiting other countries, they often forget that we all take health precautions at home. There are routine vaccines given to both children and adults that have cut the rates of infectious disease dramatically. DPT (diphtheria, pertussis, tetanus) has been the way most people in the US get their first tetanus immunization.
Tetanus is an organism that is ubiquitous in the soil around the world. An often fatal and always agonizing disease, the fact that it is rarely encountered in the developed world is a testament to the power of immunization. Check with your doctor to see if you need a booster.
Childhood Diseases
Childhood diseases (measles, mumps, rubella and chicken pox) are rarely seen in the US now except for small pockets of unimmunized children. A recent rise in US parents opting not to have their children vaccinated has yielded mini-epidemics of a number of childhood illnesses, some with very serious consequences. People often think of these as fairly benign illnesses, but in fact, they can have serious sequelae in children including brain damage from very high fevers, and there are some deaths from these illnesses.
In adults, these illnesses are much more serious, with a greater risk of serious complications or even death. These illnesses are encountered in places where these inoculations are not common, so as a traveler, you might have contact with them in any third world country and in other countries where children are not routinely inoculated.
If you did not have these illnesses as a child (which is believed to confer life-long immunity) or if you had the inoculations as a child but have not as an adult, check with your doctor about the advisability of a booster shot.
Polio
Polio, which has been nearly eradicated, does still exist in India and parts of Africa. Periodically, there are reports of cases elsewhere, typically from an infected traveler. If you have not had a polio inoculation as an adult, check with your doctor to determine if you are still protected.
Hepatitis A
Few people pause to think about what inoculations they would be wise to have to visit say France or Canada or Brussels or London. But Hepatitis A is a vaccine it would be wise to have even if you are staying at home. As with many other diseases, Hepatitis A is a disease of sanitation breakdown. There are outbreaks of Hepatitis A in the US, Canada and Western Europe from time to time. Two shots six months apart confer at least 20 years of immunity. Some health care professionals believe we may find that the two shots confer life-long immunity.
Hepatitis B
Hepatitis B is a blood-borne illness. It is spread by contact with blood and other bodily fluids. Contact with blood via injury, unsterilized needles or medical equipment, blood transfusions with infected blood, or sexual contact with someone who carries Hepatitis B are all routes to contracting this serious illness.
There is a vaccine for Hepatitis B, often given in combination with the Hepatitis A vaccine. It takes a series of three shots over an 18-month period to confer full immunity. Many day care centers in the US require children in their care to be immunized, as children may have inadvertent contact with the blood of other children in a day care environment.
Travel Medicine Resources
There are a number of good travel medicine websites. In the US, the standard of care is the Center for Disease Control website: wwwn.cdc.gov/travel
While the information in this article can be helpful in thinking about immunizations prior to travel, it is no substitute for a visit with a travel medicine professional.
Next in this series: Immunizations for travelers
