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Hepatitis A

Hepatitis A is a viral liver disease transmitted by the fecal oral route via contaminated food or water. It can cause a mild flu-like illness, jaundice (yellow eyes and skin) and severe stomach pains that can last 2-8 weeks. Hepatitis A vaccine is recommended to all travelers going to developing counties.

Hepatitis A vaccination is a series of two injections given 6-12 months apart. Getting the first injection a minimum of two weeks before travel is recommended. Recipients of both doses of hepatitis A are considered to have long term (possibly as long as 30 years) protection.

Hepatitis B

Hepatitis B is a viral liver disease transmitted by contact with contaminated blood and body fluids. Disease can be asymptomatic or can cause illness characterized by appetite loss, tiredness, diarrhea, vomiting and jaundice. It can lead to long term chronic illness resulting in liver damage, liver cancer and/or death.

Hepatitis B vaccine is recommended especially for travelers who will be doing health care, having sexual contact with the local population or receive medical care. Because it is so easily transmissible through even casual bloody contact (such as assisting someone who is bleeding), it is recommended that all travelers consider this vaccine.

The vaccine is a series of three shots on day 0, one month and six months. Anyone who has completed the vaccine series is considered to have long term immunity (possibly lifelong).

Combination Hepatitis A and B

This combination of Hepatitis A and B vaccine is an excellent choice for travelers who need both vaccines for their travels. The schedule is Day 0, 1 month and six months.

Influenza

Influenza is a highly contagious respiratory disease that can quickly become widespread. Travelers from North America during the months of October through March should consider getting the influenza vaccine. Influenza is seasonal in the Northern Hemisphere and transmitted by airborne and droplet contact. While influenza may not be a high risk at the traveler's destination when traveling during flu season, the vaccine can provide protection against the flu virus that can be present during transit.

Measles/Mumps and Rubella (MMR)

Measles, mumps and rubella are highly contagious Infectious Diseases associated with childhood. More than 500,000 people in the world still die annually from measles. Mumps outbreaks also occur occasionally around the world, including in the US. Most people born before 1957 are considered immune because they probably had the diseases in their childhood. However, being born before 1957 is no guarantee of immunity. Travelers should consider this vaccine particularly if they are traveling to areas that are high risk for these diseases or areas undergoing outbreaks.

Younger adults may have a history of one or two MMR's depending on the laws in their state for school immunization. Travelers should have two MMR's to be considered adequately immunized.

Measles, mumps and rubella vaccines may be given individually but are most commonly given together in a vaccine referred to as MMR. Two MMR's need to be given at least 30 days apart.

Meningococcal Meningitis

Meningococcal meningitis is a bacterial disease spread by oral and respiratory secretions (coughing, sneezing, sharing drinks or eating utensils, kissing, etc.). The disease can have sudden onset of fever, headaches, nausea, vomiting and a stiff neck. It can progress rapidly to confusion, seizures, coma and death without rapid medical treatment.

Travelers should consider the meningococcal vaccine if they are planning to travel to the "meningitis belt" of sub-Saharan Africa (more information) or do the pilgrimage to Mecca. Also, college students living in campus housing have found to be at increased risk for becoming ill with meningitis. Students planning on studying abroad and living in campus housing should also consider getting this vaccine.

There are two vaccines available for protection against bacterial meningitis, Menomune® and Menactra. They both are effective for 3-5 years. Menactra® may be effective longer. Either vaccine should be given at least two weeks before travel.

Polio

Polio is a virus transmitted via the fecal oral route in contaminated food and water. It was last seen in the United States more than 20 years ago. While it has been eliminated in the United States and many countries in the world, it still exists in several developing countries in Africa and Asia (more information)

Most Americans have had the childhood series of Polio vaccine. Travelers to countries that still have polio should have one additional adult dose of Polio vaccine which is then considered good for life. Anyone who has not had the childhood series should consider getting it before traveling to any country. Many countries still use live oral polio vaccine which can be shed in the feces of vaccine recipients, infecting those who come in contact with them.

The polio vaccine is usually given to young children. Adults who receive it for the first time need three vaccines at day 0, 1 month and 6 months. For anyone who has received the initial series, a single one time adult dose is recommended for travel to high risk countries.

Rabies

Rabies is a serious viral infection transmitted in the saliva of infected animals. Most infections are caused by dog bites; however, many other animals including cats, monkeys, bats, raccoons, skunks and foxes are known to carry the disease.

Most travelers do not need to get the vaccine for travel unless they have prolonged travel to high risk areas or are engaging in high risk activities such as veterinary or wild life work.

The three dose pre-exposure vaccine is given on day 0, day 7 and day 21 or 28. All travelers, even those who've received the pre-exposure vaccine series, should seek medical assistance immediately if they are bitten by an animal or find a bat in their room (bat bites are frequently not visible).

Tetanus/Diphtheria/Pertussis

Tetanus is a serious bacterial infection that is transmitted through dirty wounds. Most Americans have had a primary series of tetanus, diphtheria and pertussis (DPT) as children. Booster vaccines of Tetanus and diphtheria (Td) are recommended every 10 years. If a person gets a dirty wound (or has a high risk occupation for getting dirty injuries) he should get a booster if it has been more than five years since his last booster.

Diphtheria is a bacterial infection of the upper respiratory tract which can be fatal. This disease still exists in some countries of the world. Booster vaccination should be done with the tetanus vaccine.

Pertussis (know as whooping cough) is a highly contagious bacterial infection that can be fatal in young (unimmunized) children. Traditionally infants and children up to the age of six years are given pertussis in a DTP vaccine and then after the age of six the booster is given with Tetanus and diphtheria only (Td). It has been found that the immunity from the childhood immunization to pertussis wanes over years and the disease has become more prevalent recently. A booster dose for tetanus and diphtheria that includes pertussis is now available and recommended for adolescents and adults ages 11 to 64. This vaccine is called Tdap and includes tetanus, diphtheria and acellular pertussis.

Typhoid

Typhoid is a bacterial illness transmitted through contaminated food and water. It causes a high fever that may or may not include diarrhea. It can be fatal but is usually treatable with antibiotics. There is growing antibiotic resistance in parts of the world which makes vaccination very important.

There are two ways to be vaccinated for typhoid, both of which provide 60-90% effectiveness. One is with an injectible vaccine (Typhim Vi®) that is effective for two years. This should be given at least a week before expected exposure to typhoid. The second vaccine is an oral vaccine given by prescription (Vivotif®). This is a series of four pills that are taken every other day for a week and should be completed at least a week before travel. Once the four pills have been taken, the vaccine is effective for five years.

Varicella (Chicken Pox)

Varicella is a highly contagious viral infection that can cause a rash in healthy children but can be more serious in adults. Varicella is a worldwide problem and travelers who do not know if they have had the disease may need to have blood work to test for immunity or the two dose vaccine series that is given 4-8 weeks apart.

Yellow Fever

Yellow Fever is a deadly viral disease occurring in regions of Africa and South America (see maps). It is transmitted by mosquitoes and causes fever, headaches, nausea and vomiting. It can produce hemorrhagic symptoms and jaundice.

For travelers, certain countries require proof of the Yellow Fever vaccine before allowing entry into their country (more information). This proof must be provided on an International Certificate of Vaccination and carried with the traveler.

The yellow fever vaccine is a live, single dose vaccine that should be given more than 10 days before travel. The vaccine is effective for 10 years after administration.

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Q: What are examples of vaccinations you should take before travelling?
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