1. iamat.org – International Association for Medical Assistance to Travellers. Provides contact information for English-speaking doctors with recognized training in 125 countries.
2. mdtravelhealth.com – Free, comprehensive, up-to-date travel health recommendations for every country.
3. who.int/publications. International Travel Health. WHO book last edition 2012 with new edition in preparation. Many updates. Can be downloaded for US$12.
4. cdc.gov/travel – Centres For Disease Control and Prevention. Has tips on immunizations and updates on health conditions by destination.
5. travel.state.gov/travel/warnings.html – US Department of State. Lists travel warnings and basic information on world conditions worldwide, from weather to the political climate.
6. fitfortravel.scot.nhs.uk – good travel info, malaria prophylaxis advice.
INFANTS AND CHILDREN: Follow the recommended age-appropriate immunization schedule for Diphtheria, Tetanus, Pertussis, Polio, Measles, Mumps, Rubella, Haemophilus B, Meningitis, Pneumococcal, Varicella, Rotavirus, Hepatitis A and B, Human Papillomavirus.
MEASLES-MUMPS-RUBELLA: Travellers of all ages should ensure that they are up-to-date. All three viruses are highly contagious and tend to spread in places of mass gatherings, including sports events and university campuses. Many countries, once believed to have eliminated the diseases, are seeing a resurgence as a result of lower herd immunity levels due to lack of or under vaccination.
Adults born before 1957 (USA) and 1970 (Canada) are generally considered to be immune to Measles and Mumps as a result of previous illness or having had a clinically asymptomatic infection when the virus circu- lated freely before the vaccine was introduced.Women of childbearing age should ensure that they are immune to Rubella, but are advised not to get pregnant for 4 weeks following vaccination.
TETANUS-DIPHTHERIA and PERTUSSIS: Travellers of all ages should ensure that they are up-to- date. A single injection booster containing Tetanus-Diph- theria toxoids is recommended for adults every 10 years, regardless if travelling or not. A primary series (which also protects against Pertussis –Tdap) is recommended for previously unvaccinated adults.
POLIO: A primary vaccination series is necessary for those not previously or only partially vaccinated. Adults who have been fully vaccinated as children should receive a Polio booster once only. If travellers have not received a Polio booster as adults, vaccination is recommended for countries where Polio is not yet eradicated: Afghanistan, Nigeria and Pakistan.
Some countries in Africa, the Middle East and Central Asia are susceptible to re-introduction of Polio. Check www.iamat.org for the latest information and make sure you are fully vaccinated.
PNEUMOCOCCAL: Vaccination is recommended for persons over 65, smokers, or those with chronic health conditions such as emphysema, asthma, lung disease, heart disease, renal disorders, immune-suppressive disorders, and organ transplant recipients, including cochlear implants. Pneumonia and ear infections can be more severe for these travellers.
INFLUENZA: Vaccination is recommended for all travellers over 6 months of age, especially children, pregnant women, persons over 65 and those with chronic health conditions such as asthma, diabetes, lung disease, heart disease, immune-suppressive disorders, and organ transplant recipients.
Influenza viruses typically circulate from November to April in the northern hemisphere, from May to October in the southern hemisphere, and year-round in the tropics. If the flu vaccine is not available at the time of departure, contact your healthcare provider regarding influenza anti-viral protection.
HEPATITIS A: Vaccination is recommended for all travellers over one year of age. This viral infection occurs worldwide and is transmitted through contaminated food or water. This vaccine is often combined with Hepatitis B and provides long term protection for both viral diseases. An HAV antibody test may be advised for persons over 40 or those born in developing countries to determine immunity. Immune globulin may be recommended for some last-minute travellers.
HEPATITIS B: Vaccination is now given routinely as a childhood vaccination. The virus is transmitted through infected blood products, sexual contact, or infected items such as needles or razor blades.
Vaccination is recommended for persons on working assignments in the healthcare field (dentists, physicians, nurses, laboratory technicians), for those working in close contact with the local population (teachers, aid workers, missionaries), or for travellers having sexual contact with locals. This vaccine is often combined with Hepatitis A and provides long term protection for both viral diseases.