Immunization in Travelling Medicine

Travelers are exposed to infectious not usually encountered at home. The risk of exposure varies upon the visiting country.

Cholera
Areas where cholera is common include Africa, the Indian sub-continent and Asia. Only limited protection is achieved up to 50% and is not considered a value in epidemic situations. Therefore no longer a legal requirement. Adequate rehydration is of most importance.

Typhoid
Killed whole vaccine and live attenuated vaccine available giving 70‐80% protection. Should be given every three years, when repeatedly exposed. In Africa, the Indian sub-continent, Asia and South America.

Hepatitis A
In Africa, the Far East, and Central and South America. Human normal immunoglobins. Offers high level of protection and should be offered to those entering high risk areas, chronic liver disease, haemophilia. Formaldehyde – inactivated HAV vaccine. Single dose persist for at least one year and immunity lasts >10 years

Meningococcal Meningitis
Especially those intending to travel to Saharan Africa, Nepal, and northern india. All travelers to Saudi Arabia for the Hajj or Umrah pilgrimages must be vaccinated.

Yellow Fever
Only in parts of Africa and South America. Avoiding mosquito is the most important measure. Immunisation is from live vaccination, also important for lab workers handling infected materials. Not recommended for children < 9 months or immunocompromised. Certificate valid for 10 years (protection lasts longer).

Rabies
Vaccine usually combined with passive immunisation with rabies specific Antibodies to those bitten by rabid animals. The rabies vaccination consists of three injections over the course of a month. Booster injections every two years are needed for continued protection after that.

Malaria
No effective vaccination, therefore important to take appropriate chemoprophylaxis.

Japanese Encephalitis
Inactivated mouse brain vaccine is effective. South East Asia and Far East

Other Vaccinations
These vaccines are given before traveling if not previously vaccinated.
 * Polio
 * DPT (Diphtheria, Pertussis, Tetanus)
 * MMR (Mumps, Measles, Rubella)
 * BCG (for TB)