Louise Chang, MD
Do you dream about the white sands and aquamarine waters of the Caribbean? Have you ever wanted to go on an African safari? Don't let concerns about "Montezuma's revenge" or a more serious illness like typhoid fever stop you from pursuing your wanderlust.
While it's true that visiting new countries can expose you to illnesses rarely seen in the U.S., there are several ways to protect yourself from foreign invaders, starting with travel vaccines.
Travel vaccines, also called travel immunizations, are shots travelers can get before visiting certain areas of the world that help protect them from serious illnesses. Vaccinations work by exposing the body to a germs or parts of germs of the disease it will protect against. You can't get the disease from the vaccine because the viruses or bacteria are dead or severely weakened. The body responds to the vaccination by making antibodies that will protect you if you are exposed to the disease in the future.
Travel vaccines are safe, effective ways to help protect travelers from bringing home more than they bargained for.
"In almost all circumstances, it's very rare for someone not to need vaccines," says Jeffrey Goad, PharmD, MPH. He explains that travel vaccines are broken down into three types.
Routine vaccines are the standard child and adult immunizations recommended for the general U.S. population.
"Every time we see a patient, we check general routine vaccines," says Goad, who is the director of USC International Travel Health Services. According to Goad, many people are not up to date on their adult immunizations, such as the tetanus, diphtheria, pertussis vaccination, and this is a great time to catch them up.
"Because vaccines for diseases that are routine here, for instance measles, which breaks out every now and then, can be extremely common in other countries, routine vaccines sometimes become very important when traveling abroad," says Goad.
Recommended vaccines are travel vaccinations that can protect you in areas where there is an intermediate or high risk for contracting certain illnesses. They also help prevent the spread of diseases from one country to another.
Required vaccines. The yellow fever vaccine may be required for travel to certain parts of Africa and South America. According to Goad, Saudi Arabia also has a meningococcal vaccine requirement during the hajj, the annual pilgrimage to Mecca.
Below is a list of vaccine-preventable travel-related diseases that are not covered by routine adult vaccinations:
Whether or not you may need one or more of these vaccines depends on any number of variables.
"People assume it's one-size-fits-all -- OK, I'm going to Thailand, what do I need," says Phyllis Kozarsky, MD, professor of medicine and infectious diseases at Emory University. But according to Kozarsky, who is an expert consultant for the Division of Global Migration and Quarantine with the CDC, that's not enough. A business executive staying in Bangkok at a 5–star hotel has a completely different risk profile from a college student who's going to backpack in rural Thailand, says Kozarsky. So the vaccinations recommended for these two people would be different, even though they are going to the same country.
"That's why we encourage people to see a travel health specialist," says Kozarsky. "Not only is your itinerary important, your medical history is important, too."
Of course, it's a good idea to let your doctor know that you'll be traveling, especially if you have a chronic health condition. However, your doctor isn't likely to have all the vaccines you might need. "It doesn't pay for them to hold a vaccine like typhoid that they would only use once a year," says Kozarsky.
Many travel immunizations need to be given in a series of shots given over a period of days or weeks. Plus, vaccines take time to work. So travel health experts recommend giving yourself 4 to 6 weeks to meet with a travel health provider about how to plan for your travel and to get any needed travel vaccinations.
To find a travel clinic near you, you can go to the travel clinic locator on the Traveler's Health section of the CDC web site. When you meet with a travel specialist, he or she can provide you with recommendations based on the following:
Your current healthIf you are taking medications for a condition like diabetes, there may be certain drug interactions you need to be aware of. For example, some drugs may reduce the effectiveness of travel vaccinations.
Knowing what past immunizations you have had and when will help the doctor know what routine vaccines you may need to have updated.
Because the risk for certain diseases can vary greatly from one city or town to another even within one country, it's important to know as much about your itinerary as possible. This is true whether you are traveling with a guided tour or planning your own visit. When you review your itinerary, be sure to consider:
Ultimately, it's up to you to decide whether or not to see a doctor about recommended vaccinations. Some people may not be able to receive certain vaccines due to allergy to a vaccine component or medical condition. Remember that, in general, you are much more at risk from the diseases that they protect you against than the vaccines.
"I think basic hygiene and common sense is very helpful," says Kozarsky. "Washing hands before you eat, and not putting your fingers to your face or in your mouth, that kind of thing. There's so much that we pick up on our fingers that can cause diarrheal disease or food-borne illness. So basic sanitation or hand washing is extremely helpful." Kozarsky recommends carrying around one of the alcohol-based hand gels. She also emphasizes understanding which foods are safe to eat and making sure that you're drinking water that is bottled or boiled to get rid of organisms, or other bottled, carbonated drinks.
Both Kozarsky and Goad stress using insect repellent and looking at other ways to protect yourself from insect bites in countries where malaria and other insect-borne diseases are present. Specific drugs are used to prevent malaria and should be used by travelers to certain regions. The medicines used for prevention can vary by country, so its important to discuss your itinerary with your doctor.
The important thing is to educate yourself as much as possible and follow any precautions carefully. "The educated traveler will be a healthy and happy traveler and will travel again, and that's what we try to encourage and enable," says Kozarsky.
The traveler's health section of the CDC web site has extensive information about which vaccines are recommended or required for each country, special travel alerts, a travel clinic locator, and much more.
SOURCES:Phyllis Kozarsky, MD, expert consultant, Division of Global Migration and Quarantine, Traveler's Health, CDC; professor of medicine and infectious diseases, Emory University.Jeffery Goad, PharmD, MPH,director, USC International Travel Health Services.CDC: "How Vaccines Prevent Disease."CDC: "What You Need to Know about Vaccinations and Travel: A Checklist."CDC Traveler's Health Yellow Book: "Chapter 2: Yellow Fever."CDC Traveler's Health Yellow Book: "Chapter 2: Yellow Fever Vaccine Requirements and Recommendations by Country."CDC Traveler's Health Yellow Book: "Chapter 1: Planning for Healthy Travel: Responsibilities of the Traveler, Clinician, and Travel Industry."CDC Traveler's Health Yellow Book: "Chapter 8: Traveling With Chronic Medical Illnesses."CDC Traveler's Health Yellow Book: "Chapter 2: Pre-Travel Consultation."
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