It is important to consult with a travel health specialist concerning immunizations that may be recommended for your destination and specific itinerary. It is critical to realize that the health and sanitation conditions for the country you are visiting are not the same as here in the U.S. Thanks to decades of public health initiatives in the United States, many contagious diseases have been eliminated. But when a traveler goes to a country that is not similarly protected, a person can be at dangerous risk of contracting a disease. The principle behind a vaccine or immunization is to expose your body's system to the disease after it has been rendered harmless. By doing so, the body can build up its own natural protection so that if it encounters the virus, the body will be "immune" to its effects. This immunization effect takes time, so it is a good idea to give your body at least a month head start to condition itself before traveling.
Routine Immunizations for travel
The Immunization Practices Advisory Committee of the Centers for Disease Control and Prevention (CDC) recommends that all persons be up-to-date on routine immunizations, regardless of travel plans. Outbreaks of measles, polio, and pertussis have occurred in developing countries where populations were inadequately immunized, and susceptible visitors have been stricken with travel-acquired measles and poliovirus infections. There have now even been outbreaks of measles and pertussis in the U.S.
The primary series of tetanus, diphtheria, pertussis, MMR and polio vaccines is customarily given in childhood. Surveillance data suggests that a significant percentage of North Americans over the age of 20 do not update their tetanus/diphtheria immunizations at the recommended 10-year interval. Although polio boosters are not routinely given in North America, they are recommended before travel to known polio endemic and developing areas.
What is Tetanus and Diphtheria? Tetanus is an acute and serious infection of the central nervous system caused by bacterial infection of open wounds. Diphtheria is a very serious and contagious illness that significantly affects breathing.
Who is at risk? Anyone
How can I protect myself? A Tetanus/Diphtheria vaccine is the best protection against these illnesses. After receiving recommended childhood doses, booster is recommended at 10-year intervals.
What is measles? Measles is a highly contagious virus causing rash, cough, runny nose, eye irritation, and fever. It can lead to ear infection, pneumonia, seizures, brain damage, and death.
What is mumps? Mumps is a contagious viral disease characterized by fever and swelling in the salivary glands. It can lead to deafness, meningitis, painful swelling of the testicles or ovaries, and rarely, death.
What is Rubella? Often called the German measles, rubella is mild viral disease characterized by an eruptive rash which starts on the face and spreads along the rest of the body.
Who is at risk for these viruses? Generally, anyone 18 years of age or older who was born after 1956.
How can I protect myself? The best protection against these diseases is the MMR vaccine. This triple vaccine for these viral diseases is usually given in childhood at 15 months of age, with a second dose between 4-6 years of age. It is likely that individuals born before 1957 acquired immunity to measles, mumps, and rubella through natural infection with the viruses and do not need vaccination.Persons born after 1957 who received their initial MMR vaccination before 1980 should be revaccinated before international travel.
What is polio? Polio is an acute viral disease that can damage the nervous system and cause paralysis. It was a crippling disease in the 1950s. Thanks to a national immunization effort, polio was all but eradicated in the United States over the next three decades.
Who is at risk? Three groups of adults are at higher risk and should consider polio vaccination, even if they were vaccinated as children. 1) people traveling to areas of the world where polio is common, 2) laboratory workers who might handle polio virus, and 3) health care workers treating patients who could have polio.
How can I protect myself? Polio vaccine.
What is Influenza ? The influenza virus is a contagious respiratory illness that produces cough, congestion, muscle pain, headache, fever, and sore throat. It can lead to hospitalization and even death. Beginning in 2009, a new flu virus called “2009 H1N1” spread worldwide, causing the first flu pandemic in more than 40 years. Although the flu is unpredictable, the CDC expects the 2009 H1N1 virus to spread again this upcoming season along with other seasonal flu viruses.
Who is at risk? The CDC is now recommending that everyone 6 months and older receive the flu vaccine. The elderly and very young, as well as those with certain health conditions, are at a high risk for serious flu complications.
How can I protect myself? The best way to prevent the flu is to get a flu vaccine each year.
Required Travel Vaccines
According to World Health Organization (WHO) requirements, the yellow fever vaccine is the only immunization that may be required for entry into certain countries. Even when it is not required, yellow fever vaccine may be highly recommended for persons traveling to countries within endemic zones. The vaccine is highly effective at preventing the disease. After primary immunization with a single injected dose, booster doses are needed at 10-year intervals. Vaccination with the yellow fever vaccine is valid 10 days after the primary dose and immediately after booster doses.
Cholera vaccine is no longer administered in the U.S. However, contrary to WHO regulations, proof of cholera vaccination may occasionally be required as a condition of entry into some countries. Some countries with cholera-infected areas may still require evidence of a full primary series and a current booster dose. Thus, travelers to cholera endemic areas should be advised to check with the appropriate embassies or consulates before departure, particularly if they anticipate travel between two countries with active cholera outbreaks.
To avoid cholera vaccination at a border (or even quarantine in some countries), travelers may need a physician's signed statement (on letterhead) that cholera vaccine is contraindicated because of underlying health conditions.
Your immunizations should be documented in an International Certificate of Vaccination (Yellow Card). It is a good idea to keep this Certificate with your passport so you don't misplace it. It is recognized internationally and may be required before entry to certain countries.
Other travel-related vaccines
The following vaccines are not covered by WHO regulations and are not required for entry into any country. However, they are highly recommended for travel to parts of the world where the diseases exist. Decisions regarding their use are based on geographic area, the purpose and duration of travel, and the anticipated level of contact with the local population.
What is meningococcal disease? Meningococcal is caused by a bacterium that enters the body through the respiratory system. It is the leading cause of bacterial meningitis in young adults. Meningitis is an infection of the fluid surrounding the brain and spinal cord. Meningococcal is active in several countries throughout the world.
Who is at risk? The vaccine against meningococcal is now routinely recommended for children and adolescents 11 through 18 years of age. To determine if you are at particular risk while traveling outside the U.S., contact a travel health professional.
How can I protect myself? Protection is obtained through vaccination. There are two kinds of meningococcal vaccine available in the U.S. One is the preferred vaccine for people 2 through 55 years of age. The other is generally recommended for those older than 55. A meningococcal vaccine is required who those who travel to the annual pilgrimage to Mecca (Hajj). Those travelers must be vaccinated at least 10 days before arriving to Saudi Arabia.
What is Yellow Fever? Yellow fever is a serious disease caused by the yellow fever virus. it is spread through the bite of an infected mosquito and cannot be spread directly from person to person. It is found in certain parts of Africa and South America.
Who is at risk? Those traveling to yellow fever-endemic areas are at risk.
How can I protect myself? As with any disease transmitted by mosquitoes, precautions and insect repellent are recommended to prevent exposure to yellow fever virus. Precautions include remaining in well-screened areas, wearing clothing that covers most of the body, and using effective insect repellent containing DEET. If traveling to endemic area, you should receive the yellow fever vaccine.
What is Typhoid Fever? Typhoid fever is a serious disease caused by a bacteria. If not treated, it can kill up to 30% of people who get it. Generally, people get typhoid from contaminated food or water, although some people who get typhoid become "carriers," who can spread the disease to others.
Who is at risk? Most at risk are those traveling to parts of the world where typhoid is common and those in close contact with a typhoid carrier.
How can I protect mysefl? Take precautions about what you eat or drink and receive the typhoid fever vaccine.
What is Japanese Encephalitis? Japanese Encephalitis is a serious viral infection spread by infected mosquitoes in many areas of Southeast Asia and the Indian subcontinent. It is not spread directly from person to person. Since infection is spread by mosquitoes, it is important to protect yourself from insect bites. For those traveling to high-risk areas, vaccination is recommended. Protection requires a two dose series, 28 days apart.
Who is at risk? The risk is low for most travelers, but it is higher for people living or traveling for long periods in areas where the disease is common and for those traveling for short periods of time but plan to visit rural areas or engage in outdoor activities.
How can I protect myself? Avoid mosquito bites by remaining in well-screened areas, wear clothing that covers most of the body, and use an effective insect repellent containing DEET. The Japanese Encephalitis vaccine is recommended for travelers to high-risk areas.
What is Hepatitis A? Hepatitis A is an acute viral infection which produces loss of appetite, nausea, vomiting, fatigue, weakness, muscle pain, sore throat, jaundice and cough often lasting one to two weeks or more. It is spread by contaminated food, water, milk, shellfish and contact with persons who have the infection. No specific treatment is available.
Who is at risk? Anyone. International travelers are most at risk.
How can I protect myself? Protection from Hepatitis A infection requires a series of two doses of the Hepatitis A vaccine, six months apart.
What is Hepatitis B? Hepatitis B is a serious disease that affects the liver. Some people go on to develop chronic infection which can lead to cirrhosis, liver cancer, and death. It is spread by contact with blood or bodily fluids.
Who is at risk? As with Hepatitis A, the vaccine to protect against Hepatitis B is now routinely given to the general population. The first dose is given at birth. Foreign travelers are most at risk.
How can I protect myself? The Hepatitis B vaccine can prevent the disease and is recommended for all international travelers. The standard dosing regimen consists of three injections at 0, 1, and 6 months.