When one thinks of a travel clinic or an exotic destination overseas, the next anxiety-provoking thought is often one involving the unpleasant task of receiving multiple injections in an effort to prevent certain diseases when abroad. While a travel consultation involves much more than merely recommending various needles, they certainly play an important role in travel medicine. The following summary is intended as general information to describe the various immunizations available at our clinic and their intended purpose.
It is important to remember that the choice of immunizations are made according to risk of exposure and not merely by country visited. There are many variables which will determine whether a vaccine is reasonable or recommended. Once these are carefully reviewed then a prudent selection of vaccines can be made. Ultimately the choice of injections is, of course, solely at the discretion of the traveler.
Hepatitis A
the most common illness in travelers that we can prevent with a needle
food and water-borne (enteric)
it attacks the liver causing jaundice, anorexia and weight loss
immunization is good for life once completion of the 2 shot series
shots are usually 6-18 months apart but booster can be anytime
never too late for second Hepatitis A shot and no need to restart series
first shot takes effect within one week so can be last-minute
Hepatitis B
a blood and body fluid-borne illness
100x more contagious than HIV/AIDS
can occur from accidental or inadvertent exposure to blood or body fluid (e.g. needle-sticks, contaminated manicure or barbershop instruments)
can be severe and persist as a chronic carrier state leading to cirrhosis (liver scarring) and even liver cancer
series of 3 shots but once completed is good for life
good idea to check blood levels after the shots to confirm immunity
currently given in Grade 7 to Ontario school kids
Typhoid Fever
a food and water-borne illness (enteric disease)
causes fever and severe systemic illness often requiring hospitalization
most common in South Asia and Southeast Asia
the shot is recommended for children and adults travelling to those areas especially for longer trips or those visiting friends and relatives
vaccine good for 2-3 years
Dukoral®
an oral vaccine to reduce the likelihood of traveler’s diarrhea (and cholera)
2 doses ≥ one week apart to be completed at least one week before departure
effective at reducing the risk of traveler’s diarrhea for 3 months
recommended for those who have a tendency to diarrhea on trips and those with chronic medical conditions
Yellow Fever
a severe viral disease transmitted by daytime-biting mosquitoes
only occurs in tropical Africa and South America
immunization is effective for 10 years
only available at Designated Yellow Fever Centres registered with the Public Health Agency of Canada
‘yellow card’ proof of immunization provided with the vaccine
may be required for visitors entering certain countries in South America and Africa (i.e. crossing borders or for obtaining a visa)
Meningococcal Meningitis
a serious bacterial disease which attacks the lining around the brain (meninges) and can be fatal
the causative organism is often carried in the nose and throat
the disease is spread by droplet/contact (e.g. coughing and sneezing)
most common in the sub-Saharan region of Africa (“the meningitis belt”)
there are 4 strains in the current travel vaccines (A,C Y, W-135)
vaccine is required for Saudi Arabian visa for the Hajj pilgrimage to Mecca
Zostavax®
a vaccine to reduce the chance of shingles and its associated severe pain
recommended for all those ≥ 60 years of age
only contraindication is active immunosuppression (i.e. cancer, HIV, steroids)
reduces risk of shingles by ~ 50% and risk of post-herpetic neuralgia by 66%
Rabies
a deadly viral disease spread from infected animals to humans
usually from a bite or scratch
most commonly spread to humans by dogs or bats but can be other animals such as monkeys
vaccine requires 3 doses but then confers lifetime immunity
expensive but avoids need for other immunization (Rabies immune globulin) if exposed overseas
Japanese Encephalitis
an uncommon but serious viral disease transmitted by night- time biting mosquitoes primarily in South and Southeast Asia
while many do not get sick if infected some can have severe neurological complications or even die
the vaccine course is 2 doses preferably 1 month apart
the immunity lasts for 2-3 years
Tick-borne Encephalitis
a viral disease transmitted by hard ticks in Europe and Asia
relatively common in the forests and mountains during summer
hikers, backpackers and others working outdoors are at highest risk
vaccine course is 2 doses at least one month apart
vaccine good for 2-3 years
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