Top five immunizations for adventure travelers

immunizationsSpending a lot of money to get poked with a needle may not be at the top of your pre-trip to-do list, but it should be. While some countries require proof of certain immunizations before they theoretically permit entry (details later in this post), there are a couple of vaccinations all travelers should get, barring any prohibitive allergies.

Getting vaccinated greatly reduces or virtually eliminates the odds of contracting certain serious illnesses or travel-related diseases, and helps prevent the spread of contagions. This is especially critical in developing countries, where there is generally little in the way of preventative or active health care, and lack of sanitation provides a fertile breeding ground for disease. As is true at home, infants, children, the elderly, and immuno-compromised are at greatest risk.

I consulted with Dr. John Szumowski, Clinical Fellow of the University of Washington Medical Center’s Division of Allergy and Infectious Disease, for expert advice before compiling the following list. As he pointed out, it’s tricky to generalize which immunizations are most important, since it depends upon where you’re going, and what you’re doing there.

That said, all of the immunizations on this list are a good idea if you travel frequently to developing nations, even if it’s for business or budget travel. They are especially important to have if you eat street food or visit rural areas.

The top five, after the jump.

[Photo credit: Flickr user johnnyalive]immunizations1. Flu
With flu epidemics making annual headlines, there’s no reason not to get a flu shot. This is especially true if you fly frequently or use other forms of public transit. Think of an airplane as a flying petri dish; why risk ruining your trip, or exposing others if you’re coming down with something? If you have an underlying health condition such as asthma, diabetes, or other lung or heart disease, it’s of particular importance to get immunized.

2. Tetanus
I grew up on a ranch, so tetanus shots have always been a part of my life. Many people don’t think about getting a tetanus vaccine, however, and as Dr. Szumowski points out, “It’s under-appreciated, and worth getting prior to travel given challenges of obtaining adequate, timely wound care.” Beats lockjaw, any day.

3. Hepatitis A
“Hepatitis A is common and can occasionally be quite serious,” cautions Dr. Szumowski. “For anyone with underlying liver disease (e.g. chronic hepatitis B or C) this is an especially important vaccination.”

4. Polio
Polio hasn’t been fully eradicated in parts of the developing world, so an inactivated poliovirus booster is important when traveling to areas where it’s still a problem, such as Nigeria and India.
immunizations
5. Typhoid
This vaccine can be taken either orally or by injection. Be aware that you must avoid mefloquine (an anti-malarial) or antibiotics within 24 hours of the vaccine doses.

Additional vaccines
Depending upon your destination, you may also require, by law, a Yellow Fever (tropical South America and sub-Saharan Africa), or Japanese Encephalitis/JE vaccination (parts of Asia and the Western Pacific). Dr. Szumowski recommends JE vaccine if you’re traveling for an extended (over one month) period in rural areas of affected countries.

Rabies vaccine isn’t usually recommended, but if you travel extensively in developing nations or have/expect frequent contact with animals, it’s a good idea. I’ve had a couple of canine-related experiences that have sold me on the idea. Dr. Szumowski notes that “excellent wound care and post-bite medical evaluation are still needed,” even if you’ve had a rabies pre-exposure vaccination.

Tips
It’s critical to allow ample time before your trip to allow the protective effects of the vaccines to establish themselves. Go to the Centers for Disease Control and Prevention’s vaccinations page for more information on what’s required and epidemic updates, if applicable. Often, your GP, internist, or local drugstore can provide some of these vaccinations; others require a specialist. For locations of a travel medicine clinic near you, click here.

Carry your immunization card with you as proof of vaccination, and email yourself a scanned copy, as well. The same goes for copies of your medical insurance cards.

Practice good hygiene and get enough rest, inasmuch as possible, while traveling, to maintain a healthy immune system. Airborne and Emergen-C are great immunoboosters to carry with you.

Consider travel insurance if you’ll be in a remote or sketchy area, or engaging in high-risk outdoor pursuits.

[Photo credits: swine flu, Flickr user ALTO CONTRASTE Edgar AVG. (away); polio, Flickr user Cambodia Trust;

Airlines not taking any swine flu risks – bumping sick passengers

It was only a matter of time, but H1N1 fear has finally spread to the airlines.

Yesterday, United Airlines passenger Mitra Mostoufi was kicked off her plane when the flight crew suspected she may have swine flu.

The 50 year old from Hawaii was questioned in front of her fellow passengers, and pulled from the plane.

United Airlines said that they do allow their staff to determine whether someone is too ill to fly, and this is obviously done to protect the other passengers and crew on the plane. Especially on a plane, the air circulation system can spread germs to everyone on board in a matter of minutes.

According to Mostoufi, she had thrown up in the airplane bathroom due to a reaction to a restless leg syndrome medication. When she asked for an air sickness bag, a United Airlines staffer ordered her to gather her belongings and leave the plane.

Even though the airline bumped her, they refused to rebook her on a different flight that day, so she had to spend the night with relatives.

I’m torn on this issue – obviously, airline staff are not trained physicians, so they have no way of making a 100% accurate judgment on our health. However, if they notice someone with flu-like symptoms, I’d be quite happy if they asked that passenger some more questions. Throwing someone off a flight just because they are puking does not seem very fair though.

What do you think? Should airlines abandon passengers with (swine) flu like symptoms?

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Dying to Travel

Don’t despair, paranoid traveler! You’re no longer limited to checking the CDC website to see what diseases you can catch while traveling. Now, there’s a handy, colorful, and interactive map based on the Maplecroft Avian Influenza Risk Index. The map interactively ranks countries, shows you the threat level (the Avian Influenza Risk Index, or “AIRI,” of course), and can provide hours of hypochondriac pleasure. You can find it here. What it will tell you is that you’re safest in Australia, out of 179 surveyed countries.

When you’re done with avian flu map, pull down their menu to bring up other interactive maps, including HIV/AIDS, land mine risks, TB risk, and malaria risk, among other goodies. (They also include a host of other rankings, with respect to climate, politics, and disaster risks. They’ve got an index for everything: for example, the US is listed as having an “extreme” (2.488!) “debt index” score–too bad they didn’t break out Manhattan separately.)

When you’re satiated (that is, once you feel the fever coming on, and after you’ve canceled your next vacation) click over to Euro Assistance, and sign up for your weekly World Pandemic Monitor newsletter. I’m waiting for my free copy to arrive. It sounds gripping and informative: “Hundreds of international articles and reports are being carefully scrutinized and summarized in the form of a weekly newsletter keeping pace with events such as: new countries affected, confirmed cases, actions and remedies introduced by authorities of concerned countries. This information comes with graphs and maps, in-depth articles selected for the relevance of their analyses.” So, travel with confidence! As Jeff Mills of the Financial Times joyfully, and helpfully, put it yesterday: “traversing the world need not be a death sentence.”