Travel Health Guide

Don’t let illness ruin your travel, be prepared before you jet.

Travel is one of the most exciting and eye opening experiences, but it can also be dangerous if you are not aware. Different regions have unique germs and you want to make sure you are protecting yourself.

First, make sure you are up to date on your routine vaccines such as MMR, Polio, Meningitis, Varicella, TDAP, Hep B, and Influenza. Travel specific vaccines will be based on what region you are traveling to and often are not covered by insurance as they are considered “luxury medicine.” The CDC is a great resource to see which vaccines are recommended for what areas. https://wwwnc.cdc.gov/travel

Hep A: protects against contaminated food and water. Recommended for most regions.

· 2 doses, 6 months apart

· good for 10 years

Typhoid: protects against contaminated food and water. Typhoid comes in oral or injection form. The oral pills will last 5 years, but are a live vaccine meaning you can have side effects from them such as fever, chills, weakness. Typhoid is recommend in areas where food sanitation levels are low such as South America, Africa, Mexico, and Asia.

· Oral dose is good for 5 years

· Injection 0.5ml dose good for 2 years

Yellow Fever: protects against yellow fever, which is transmitted by insect bites. This vaccine is only needed if traveling to parts of Africa and South America. You will be required to show documentation of vaccine when entering/ leaving the country. It is a live vaccine meaning some will have flu like side effects such as fever, chills, weakness.

· 1 dose, good for life

Japanese Encephalitis: protects against JE, which is transmitted by insect bites. Only needed if you are traveling to Asia.

· 3 doses are good for 1 year

Rabivert: protects against rabies from animal bites. However, if you are bitten, you will still need 3 more doses or an immunoglobin injection within 24hours. Without the vaccine prior to an animal bite or scratch you will need 5 doses and the immunoglobin.

· prophylaxis is 3 doses, at days 0, 7, and 21 or 28

· post exposure with prophylaxis; given at 0, 3, 7, and 14

· post exposure without prophylaxis: given at 0, 3, 7, and 14 along with human rabies immune globulin (HRIG) on the first day of exposure

Travel Precautions

While these vaccines will help protect you, there are many other food, water, animal, and insect transmitted diseases that can get you sick. Proper travel safety must always be utilized also. Using DEET bug repellant, drinking bottled water, water that has been boiled for 10 mins, avoiding milk products that don’t say pasteurized, avoiding fruits with thin skin, and sticking to cooked vegetables and meats is imperative.

Travelers Stomach Sickness

If you followed these food and water safety tips, but still got sick with travelers diarrhea/ food poisoning you should take the following steps:

Step 1) Contact a medical provider to decide which medication is appropriate or if you need to be seen at a medical clinic. Medications to have on hand include; imodium, probiotic, pepto bismol, and a RX for azithromycin or cipro.

· Probiotics can be taken before and during your trip to increase the natural defense in the stomach.

· Imodium or pepto bismol should be the first drug you reach for when having moderate diarrhea (<3 bowel movements per day, for less than 2 days) and stomach ache. Pepto bismol will slow the diarrhea and works to settle an upset stomach. Imodium will stop the diarrhea most and should be taken if are loosing so much fluids dehydration may occur.

· Azithromycin (aka the Z-pack), is an antibiotic that given if you are traveling to Asia. Take if you have diarrhea plus a fever, diarrhea plus vomiting, >3 bowel movements, or if symptoms are lasting >2 days.

· Ciprofloxoin is an antibiotic given if you are traveling to South America, Europe, Africa, Australia, Middle east. Take if you have diarrhea plus a fever, diarrhea plus vomiting, >3 bowel movements, or if symptoms are lasting >2 days.

Step 2) Hydrate: try to drink at least 8 cups of water per day. Gatorade or pedialyte are helpful for restoring lost electrolytes. If unable to keep fluids down, go to medical clinic to prevent dehydration.

Step 3) Follow a bland diet such as bananas, rice, dry toast, crackers, plain chicken or fish. Avoid spicy and acidic foods, alcohol, and caffeine that can further upset your stomach.

When to seek immediate medical attention: if you feel weak, dizzy, are having >3 bowel movements per day for >2 days, have a fever, see blood in your stool or vomit, can’t keep food down, or have decreased urination.

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