IMMUNIZATIONS FOR INTERNATIONAL TRAVEL
Section snippets
ROUTINE IMMUNIZATIONS
Adults should have protective immunity with regard to the routine vaccine-preventable diseases: tetanus, diphtheria, pertussis, measles, mumps, rubella, chicken pox (varicella), polio, Haemophilus influenzae b and hepatitis B. Although these vaccines now form the nucleus of childhood immunization programs, many adults will require booster doses, and a few may even need the primary series before travel.12, 15, 22, 36 A detailed discussion of the routine immunizations of childhood is beyond the
REQUIRED TRAVEL IMMUNIZATIONS
Member countries belonging to the World Health Organization (WHO) periodically review worldwide health conditions with regard to communicable diseases and agree to regulations governing vaccines required for international travel. At the present time, only yellow fever vaccine is required as a condition of entry into certain countries by WHO regulations.4, 39
Hepatitis A
The risk of hepatitis A is present worldwide wherever conditions of hygiene and sanitation allow fecal contamination of food and water supplies. In highly endemic areas, most of the population is exposed to the infection in childhood, and infections tend to be relatively mild and unrecognized in such settings. Symptomatic hepatitis A infections are acquired by adult travelers going from highly sanitary industrialized areas to less hygienic areas.
In addition, hepatitis is transmitted in areas
Anthrax
Anthrax is a serious bacterial infection seen in certain occupational settings around the world, especially in developing countries in which livestock are raised under poor conditions for food and hides and in countries in which wool textiles are made from imported materials without special disinfection. Tourists are at risk for acquiring cutaneous anthrax through contact with contaminated wool and fur articles, especially items made from goat skins. Gastrointestinal infection from eating
SUMMARY
Immunization recommendations for international travelers is a complex subject that takes into consideration the geographic destination, planned activities during travel, health conditions at destination, length of trip, and underlying health status of the traveler. The final immunization program is also determined by how much time is available before departure and the worldwide availability of vaccines and their cost. In some cases, preventive behaviors and chemoprophylaxis may protect against
References (41)
- et al.
Risks of cholera immunisation at port of entry
Lancet
(1991) Immunizations for international travelers
Med Clin North Am
(1992)Travel medicine prevention based on epidemiologic data
Trans R Soc Trop Med Hyg
(1991)Rabies 1996
Int J Infect Dis
(1997)- et al.
Accelerated schedule for hepatitis B immunization
J Travel Med
(1995) - Berna Products, Corporation. Swiss Serum Institute, Berne,...
From the World Health Organization: Development of dengue and Japanese encephalitis vaccines
J Infect Dis
(1990)Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. Recommendations of the Immunization Practices Advisory Committee (ACIP)
MMWR
(1991)Health Information for International Travel, 1996–97
Hepatitis B virus: A comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: Recommendations of the Immunization Practices Advisory Committee (ACIP)
MMWR
(1991)
Inactivated Japanese encephalitis virus vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR
Outbreak of leptospirosis among white-water rafters—Costa Rica, 1996
MMWR
Pertussis vaccination: Acellular pertussis vaccine for reinforcing and booster use (supplementary ACIP statement) Recommendations of the Immunization Practices Advisory Committee (ACIP)
MMWR
Prevention of plague
Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR
Prevention of varicella. Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR
Rabies prevention—United States, 1991
Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR
Recommended childhood immunization schedule—United States, 1997. Approved by the Immunization Practices Advisory Committee (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP)
MMWR
Typhoid immunization
Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR
Update: Cholera—Western hemisphere, 1991
MMWR
Update on adult immunization
Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR
Cited by (14)
Vaccines administered simultaneously: Directions for new combination vaccines based on an historical review of the literature
2004, International Journal of Infectious DiseasesTravel-related vaccines
2001, Infectious Disease Clinics of North AmericaMedical advice for international travelers
2001, Mayo Clinic ProceedingsCitation Excerpt :Travel to Mexico, Haiti, North Africa, and Iran is considered intermediate risk. Protective efficacy of the typhoid vaccines ranges from 46% to 96%.18 The oral typhoid vaccine is not currently available in the United States.
Emergency department presentations of typhoid fever
2000, Journal of Emergency MedicineCitation Excerpt :Vaccines are available for travelers to endemic areas but controversy surrounds their use. Efficacy ranges from 43% to 96%, and the protective effect can be overcome by ingestion of a large inoculum of organisms (5). Most cases of typhoid fever diagnosed in the United States are imported.
A case of pyrexia from abroad
2006, European Journal of Emergency Medicine
Address reprint requests to Elaine C. Jong, MD, Hall Health Primary Care Center, University of Washington Box 354410, East Stevens Circle, Seattle, WA 98195
- *
Department of Medicine, University of Washington Travel and Tropical Medicine Service and Hall Health Travel Clinic, University of Washington, Seattle, Washington