- Simple Preparations
- Vaccinations
- Prophylaxis for Malaria
- Other
Malaria Prevention
*Including mosquito
bite prevention
Should You Become Sick While Traveling
Besides buying the plane tickets and booking the accommodations, planning an international trip requires certain preparations to ensure your health and happiness while traveling. Depending on the destination, you may need to receive vaccines and other medications from a physician. Other preparations you can do on your own.
- Ensure you have enough of any prescription or non-prescription medicine you are currently taking. Travelers who take prescription medications should carry an adequate supply accompanied by a signed and dated statement from a physician; the statement should indicate the major health problems and dosage of such medications, to provide information for medical authorities in case of emergency.
- The traveler should take an extra pair of glasses or lens prescription and a card, tag, or bracelet that identifies any physical condition that may require emergency care.
- Travelers with a history of motion sickness or sea sickness can attempt to avoid symptoms by taking anti-motion-sickness medication (e.g., antihistamines) before departure.
- More and more, provincial health plans are reducing coverage for out-of-country travel or imposing restrictions on the coverage provided. You should arrange for private travel health insurance to pay for any costs which are not covered by your provincial plan. Should an illness occur during travel, the costs which the uninsured traveler can be required to pay may be thousands of dollars.
Certain vaccinations exist that can reduce or eliminate your risk of catching certain illnesses. Some you may already have and others may only be required depending on the area in which you are traveling. These should be listed by country or region in the Geographical Risk section of this program. Consult your physician or local health department for information on where you can get these vaccinations. A list of travel health clinics in Canada, organized by province can be found on the CSIH website
The following vaccines you may or may not have received as part of your regular vaccinations, and some require boosters. Depending on the area you plan to travel in, some or all of these vaccines may be necessary.
Diphtheria-Tetanus (D2T5): Everyone should receive a booster injection at least every 10 years as diphtheria is common in many tropical countries. The tetanus vaccine is 100% effective.
Polio: Everyone should be immunized against polio before traveling to many tropical regions where polio is endemic. The immunization is by injection (Salk). Boosters are required every 10 years.
Typhoid: Typhoid fever may be contracted through contaminated food or water. Most people traveling in the tropics in less than first class facilities should be immunized. There are two kinds of typhoid vaccine, injectable and oral, both with the same level of effectiveness (about 60%). The injectable is a single shot and gives protection for 5 years, and the oral is 3 sachets, one to be taken every two days on an empty stomach and should not be taken on the same day as antimalaria pills or while taking an antibiotic; it gives protection for 7 years. The sachets must be kept refrigerated, but not frozen.
Cholera: Cholera is rarely acquired by travelers except during an epidemic, and the vaccine's effectiveness is limited. Accordingly, following WHO (World Health Organization) guidelines, we recommend it infrequently, according to where you are going. An oral vaccine (sachets) is available for unusual circumstances.
Yellow Fever: Yellow Fever exists in much of Africa and South America, and vaccination (just one injection every 10 years) is required for travel to these areas. It gives 100% protection. Protection from the vaccination only begins 10 days after it is given.
Hepatitis A: Hepatitis A may be contracted through contaminated food or water, and many people traveling to the tropics should be protected. Those requiring protection are those who are traveling in rural areas or staying in less than first class hotels.
Hepatitis A vaccine: A single injection of vaccine gives 90-95% protection for 6 weeks to 12 months depending on the dosage. A dose 6-12 months later will extend protection for 20 years to life.
Gamma globulin gives 70% protection for up to 6 months and at times is still recommended for reasons of cost. It has become difficult to obtain.
Smallpox: Smallpox no longer exists in the world as a wild virus and the vaccine is no longer given.
Meningococcal: Meningococcal meningitis is a serious problem in some locales. The vaccine is recommended for travel to the sub-Sahara region of Africa and is required for Saudi Arabia at certain times of year..
Japanese B Encephalitis: This occurs in parts of Asia and S.E. Asia (Pakistan to Japan), and the vaccine is given to those who will be spending an extended period (at least 1-2 months) in these regions. Three shots, over a period of one month, gives good protection. Some people receiving this vaccine will have a delayed allergic reaction (up to 10 days after the vaccination) and it is therefore recommended that the receiver not travel for 10 days after the vaccination so that they can be near a health facility.
Hepatitis B: For those spending long periods (more than two months) living in the tropics or with the potential for sexual contact in the tropics, this vaccine is recommended. Hepatitis B is transmitted by blood products or sexual contact and is a serious illness. Three shots, the first two a month apart and the third after 6 months, are necessary.
Measles: Anyone born after l956 who has not been vaccinated against measles requires a single shot. Measles is endemic in the tropics.
Miscellaneous: Under some circumstances, vaccines against rabies, plague, varicella, influenza, European spring-summer encephalitis and Lyme disease are given. Note that rabies is common in many developing nations and any traveler bitten by a dog should clean the wound carefully and visit a locally-recommended doctor within l-2 days.
Malaria is a potentially serious disease that is transmitted by mosquitoes and can be prevented by taking medications. (There is presently no vaccine.) If you are going to a malarious area, you may be prescribed one of chloroquine, Fansidar, Paludrine, doxycycline, mefloquine, Malarone, primaquine or a combination of these.
Please see Malaria for more detailed information. It is very important that you determine your risk for malaria depending on your travel itinery. Different areas of the world require different medications, and carry different risks. If you are traveling to an area of the world that has malaria, you must take the necessary precautions.
Malaria kills a small number of Canadians every year. Anti-malarials do not. Lack of malaria prophylaxis, misunderstandings about malaria prophylaxis and delays in treatment are all major causes of an increased death rate.
Permethrin-containing repellents (Permanone ® ) are recommended for use on clothing, shoes, bed nets and camping gear. Permethrin is highly effective as an insecticide/acaricide and as a repellent. Permethrin-treated clothing repels and kills ticks, mosquitoes and other arthropods and retains this effect after repeated laundering. There appears to be little potential for toxicity from permethrin-treated clothing. Permethrin treated bed nets can be obtained in various sizes from some travel health centres or from the company T.R.I.P.S. by phoning 1-800-880-8747.
DEET repels mosquitoes, ticks, and other arthropods when applied to skin or clothing. Formulations containing < 35% DEET are recommended because the additional gain in repellent effect with higher concentrations is not significant when weighed against the potential for toxicity. A microencapsulated formulation (Skedaddle ® ) may have a longer period of activity than liquid formulations. DEET is toxic when ingested. High concentrations applied to the skin may cause blistering. Rare cases of encephalopathy in children, some fatal, have been reported after application to the skin. Other neurologic side effects also have been reported. Toxicity did not appear to be dose-related in many cases and these may have been idiosyncratic reactions in predisposed individuals. However, a dose-related effect leading to irritability and impaired concentration and memory has been reported.
Covering up with pants and long-sleeves also can reduce your exposure to the mosquitoes that transmit malaria. Even if you are traveling to a warm area, bring appropriate clothes so you may cover up, particularly at dusk and during the night when malaria bearing mosquitos bite.
Source: CDC Yellow Book 1999 and LCDC http://www.hc-sc.gc.ca/pphb-dgspsp/tmp-pmv/travel/advice_e.htm 1999-2000.