MEDICAL
The following is presented as an overview and not as an official
guide. Make sure you consult a physician or specialist for
requirements. Carry your medicines on the plane so they are with you
during the flight and with you if your luggage is lost.
The Basics - Inoculations aren't required for travel in many
locations, such as Europe or North
America. However, it's a good idea for everyone to inoculate
against:
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Tetanus - Inoculation is good for 10 years, but a
booster at 5 years is recommended if you've had dirty wound or cut
exposed to animal waste. Tetanus is a bacteria carried in dirt
and waste.
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Diphtheria
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Polio - If you had a polio vaccination more than 10
years ago, the booster is good for life and is provided at no charge
as part of the provincial Medical Services plan. It just makes
good sense to cover this one off.
-
Measles
General Advice for Traveller's Diarrhea
Consider Dukoral by Sanofi Pasteur for your trip, if you are heading to an area where local foods
typically cause traveller's diarrhea. Doctors frequently
recommend it and use it themselves when travelling. It's a raspberry
flavored vaccine that you drink before your trip. It provides
protection from E coli for 3 months and from cholera for 2 years. It does not prevent all
types of traveller's diarrhea, so it's important to take steps to avoid
contaminated food and drink.
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Don't drink unsealed bottled water or take ice in your
drinks.
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Avoid salads as these may have been washed in unsafe
water.
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Wash your hands or use sanitizer before touching any
food.
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Eat cooked foods immediately and avoid reheated food.
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Don't eat raw seafood.
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Avoid tap water for brushing your teeth.
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Consider using ElectroLyte Gastro, a non prescription
powder added to water and used to balance electrolytes and keep you
healthy. It comes in small travel packets.
If you still get sick, fluid intake and imodium for those
over 12 is recommended. If you are still having trouble a good
multi-spectrum drug such as a cipro prescription can provide rapid relief.
Required Inoculation for Specific Countries:
-
Yellow fever - Yellow fever is a virus transmitted by the bite female yellow fever mosquitoes
(Aedes aegypti) in tropical South America and tropical Africa. These
mosquitoes bite during the day. Many countries in or near the tropics require an International Certificate of Vaccination against yellow fever.
Some countries require the certificate based on the country you have
come from. For example, you do not need a yellow fever certificate to enter Tanzania from Amsterdam, but you will need one on your return trip if your flight stops in Kenya.
The most confusing part is that the World Health Organization
designates Tanzania as a yellow fever zone. So, it's easier to
get the injection than it is to confirm you need it. The immunization is effective 10 days after injection and is valid for 10 years.
-
Meningococcal disease - This is transmitted by
bacteria and affects a narrow band of countries in tropical Africa
where inoculation is required.
Other Worthwhile Vaccinations
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Hepatitis A - Given in 3 doses with the second dose at
1 month and the third at 6 months. The efficacy 2 - 4 weeks
after the inoculation is 94%, 99% and 100% for Twinrix, which also
covers Hep B in the same inoculation. An inoculation for Hep A
is good for about 20 years. Hep A is found in the feces of people with
Hepatitis A and is usually spread by close personal contact (including sex or sharing a household).
It can also be spread by eating food or drinking water contaminated with
Hepatitis A.
-
Hepatitis B - Given in 3 doses with the second dose at
1 month and the third at 6 months. The efficacy 2 - 4 weeks
after the inoculation is 31%, 78% and 98% for Twinrix, which also
covers Hep A in the same inoculation. The inoculation can also
be done in an accelerated method at 0, 7 and 21 days, plus a fourth
inoculation at 12 months. The accelerated method isn't
frequently recommended, but it can be useful protection for Hep B when you don't have much time in
advance of your travel, as you reach
a higher efficacy much more quickly. An inoculation for Hep B is
good for about 15 years. Hepatisis B is found in blood and certain body fluids. Exposure to infected blood in
any situation can be a risk for transmission.
-
Malaria - carried by female anopheles mosquitoes in tropical
countries such as Africa. These mosquitoes are very large and
transmission only occurs within 20 minutes of having bitten someone
who already has malaria. The prevention includes the drug
Malarone, staying inside at dusk and dawn, wearing protective
clothing, sleeping under a treated insect net and using a DEET
repellent.
-
Typhoid fever - Typhoid fever or typhoid is transmitted by the ingestion of food or water contaminated with the feces
from an infected person. It is only transmitted between people and does not affect animals.
The two recommended vaccines for typhoid are the live, oral Ty21a vaccine
(Vivotif Berna) and injected Typhoid polysaccharide vaccine (Typhim Vi by Sanofi Pasteur
or Typherix). Both the oral and the injected version are roughly 50% to 80%
effective. Typhoid immunization is good for about 2 years by
injection and 5 years if taken orally. The oral method is a bit
more challenging as it's taken in 4 doses taken every other day and you can't
eat two hours before or one hour after it's ingested. You also
have to keep the serum refrigerated..
-
Cholera - an intestinal infection brought on by
fecal matter contaminating food and water due to poor
sanitation. It primarily occurs in refuge camps. Dukoral
provides oral protection against cholera for a couple of years.
General Advice on Protection from Mosquitoes
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Use mosquito nets while sleeping.
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Outside use insect repellants and light colored
clothing that covers as much of your skin surface as possible.
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Use 30% DEET on exposed skin surfaces and apply this
after your sun screen has been applied and had 10 - 30 minutes to
absorb and dry.
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Don't use scents and perfumes.
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For malaria, take pills like Malarone as well.
Wondering what's recommended for a specific country?
We think the Net
Doctor - Country Guide is a great resource for answering this
question.
The
best site for information on the above diseases is the Centers
for Disease Control and Prevention.
Want to go over your vaccination needs with a professional
and obtain an International Vaccination Certificate? We recommend the
The Travel Medicine and Vaccination Centre.
The Centre offers recommendations for specific countries and arranges for inoculation and supporting documentation for those vaccines that require a certificate. The most common example
of an inoculation requiring an International Certificate is yellow fever.
The Centre will provide a proper document, signed by the administrator of
the vaccine and stamped with an internationally approved seal. The
certificate can then be carried with your passport. Many other vaccinations such as Hep A, Hep B and tetanus can also be arranged through
the Centre, through your family doctor or a walk in clinic. Here are
the Travel Medicine and Vaccination Centre locations in BC:
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Victoria
Gateway Village
206-771 Vernon Avenue
Victoria , BC Canada V8X 5A7
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Vancouver
314-1030 West Georgia Street
Vancouver , BC Canada V6E 2Y3
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Surrey
304-13798 94A Avenue
Surrey , BC Canada V3V 1N1
EMERGENCIES
The Government of Canada offers information for
international travellers at voyage.gc.ca
At the top of the web page you can select a country
from the drop down box and get the latest Travel Report and Warnings.
Section 4 is the one I use the most, but I also look for travel warnings above the second level (insurance won't cover anything past that...ie http://www.voyage.gc.ca/countries_pays/report_rapport-eng.asp?id=79000 for Egypt is at level 3. That means RBC won't even cover death of a family member prior to departure if this warning is on before they buy insurance).
The Government of Canada also offers a registration service for all Canadians
traveling or living abroad. This service is provided so that they can contact and assist you in an emergency in a foreign country, such as a natural disaster or civil unrest, or inform you of a family emergency at home.
Canadian
Citizens Traveling Abroad - Register Here:
