Travel Health Tips

Post Travel Concerns

Have you returned from your exotic trip and brought home more than just memories and photos?  Here are some guidelines on what to do if you have post travel health concerns.

  • If you experience a fever and have traveled in a Malaria zone, we recommend you seek medical attention.  Be sure to inform your health care provider that you have travelled in a Malaria zone.
  • If you have been in contact (saliva, scratched) or been bitten by an animal it is important you seek post exposure follow up for Rabies as soon as possible.  In BC, post exposure follow-up is done though the BC Centre for Disease Control.  Please contact them at 604-675-3916 or 604-675-3900.
  • If you have non emergency concerns regarding your health after returning from your trip, please contact your family physician.  Depending on your symptoms, you might get a referral to a Tropical Disease specialist.

 

Recommendations for Specific Regions

In addition to the basic immunizations recommended above there are some additional recommended or required vaccinations for specific regions depending upon destination, length of stay, accommodation, urban vs. rural travel, etc.

CENTRAL AMERICA AND THE CARIBBEAN *

Yellow fever is present in parts of Panama. Malaria exists throughout rural areas of Central America, Haiti and the Dominican Republic.

SOUTH AMERICA *

Yellow fever vaccine is highly recommended for travellers venturing outside urban areas of tropical South America . A certificate of vaccination against yellow fever is required for travel between countries in this region. Malaria risk is high in rural areas throughout the tropical region.

NORTH AFRICA AND THE MIDDLE EAST*

Meningococcal meningitis vaccine is recommended for travel to Saudi Arabia (during the Hajj). Malaria exists in some rural areas.

SUB-SAHARAN AFRICA *

Yellow fever vaccine is highly recommended for all travellers to the central tropical part of this region. A certificate of vaccination against yellow fever is required for travel between countries in this region.

Meningococcal meningitis vaccine is recommended for travel throughout sub-Saharan Africa. Malaria risk is high in most rural areas and present in some urban areas. Malaria also occurs in rural areas of southern Africa.

INDIAN SUBCONTINENT AND NEPAL *

Japanese B encephalitis vaccine may be recommended for extended travel in rural areas where the disease is endemic or epidemic. Malaria risk is high in rural areas and present in some urban areas. Yellow fever is not a risk within this region.

EAST AND SOUTHEAST ASIA *

Japanese B encephalitis vaccine may be recommended for extended travel in rural areas where the disease is endemic or epidemic. Malaria occurs in some regions of southern interior China and throughout Southeast Asia. Yellow fever is not a risk within this region.

THROUGHOUT THE TROPICS*

Influenza is prevalent in the Tropics year round. In other areas risk is seasonal. Vaccinations should be updated annually.

*Basic immunizations are recommended for travel to all the above regions. Cholera and Rabies vaccines are recommended for high-risk individuals. Recommendations are subject to change. Check with your physician or Travel Clinic prior to departure. For further information check the Public Health Agency of Canada web site: Information For Travellers
Permalink for travel vaccination information

Travel advisories and other useful links

Frequently Asked Questions

Q: I am just going to visit friends and relatives abroad. Do I still need pre travel advice?

A: Even though you may have lived overseas in the past, you may no longer be immune to many diseases such as malaria and traveller’s diarrhea. It is always a good idea to receive expert pre-travel advice.

Q: What should I bring with me for the pre-travel visit?

A: Please bring any immunization records that you may have, a list of any medications you are taking and your Care Card.

Q: Does MSP cover the cost of pre-travel advice and vaccines?

A: Travel medicine is not an insured service of MSP, but some routine shots such as tetanus boosters may be covered by MSP. In addition, some extended health plans may cover travel vaccines and consultations so please check your extended health plan prior to your visit. Detailed receipts are provided for you to submit if this is the case.

Q: I just found out that I have to travel on short notice. Is there time to have a pre-travel visit?

A: We try to fit last-minute travellers in where possible. It is never too late to get pre-travel advice and some immunizations provide rapid protection.

Q: How far ahead should I book my pre travel visit?

A: If time permits, book an appointment 4-6 weeks ahead of your trip. If you are making a lengthy or complicated trip, or need vaccinations like hepatitis B, two months lead time is preferable. If you have a chronic disease you may want to book your appointment well in advance of your trip.

Q: I am travelling with small children. Do they need any special advice?

A: Our doctors and nurses will check that your child’s routine vaccinations are up to date and will give you additional information specific to your destination. Children weighing over 5 kg should receive anti-malarial medication if they are at risk.

Q: I have a cold but no fever. Can I still receive immunizations?

A: In most cases, yes, but a final determination will be made after consulting with a clinic physician or nurse.

Q: I am pregnant or trying to become pregnant. Can I still receive immunizations?

A: Pregnancy carries particular risk during travel. A thorough pre-travel consultation is recommended. Certain vaccines and medications are safe during pregnancy.

Q: I would like to carry my own needle kit to protect against blood-borne diseases. Where can I get a kit?

A: TMVC carries needle kits in varying sizes that include a physician’s authorization note. Please ask our physicians/nurses for further information.

Q: My child has come down with chickenpox. I do not know if I am immune. What shall I do?

A: For anyone over 13 years of age it is worthwhile to test their blood to see if they are immune. Healthy contacts may be offered chickenpox vaccine within 3-5 days of exposure to chickenpox to reduce their risk of serious disease.

Q: Do I need a flu shot for travel?

A: Flu season is all year round in the tropics, and from May to October in the southern hemisphere. For many reasons it may be a good idea to think about receiving a flu shot prior to travel. This may be discussed with the physician or nurse.

Q: I would like to find out about meningitis immunizations. Do you carry these?

A: TMVC carries the meningitis vaccine used for local outbreaks and also the vaccine recommended for special destinations such as the meningitis belt of sub-Saharan Africa, and the Hajj and Umra pilgrimages in Saudi Arabia .

Q: I lost my TMVC vaccination booklet. What should I do?

A: TMVC keeps a permanent record of your vaccinations and will replace it for a small fee. For some countries it may be necessary to show your vaccine booklet to gain entry. This is generally the case for yellow fever endemic countries. If you are travelling and have lost this information, please contact us and we will provide a replacement. Always keep your vaccine booklet in a safe place, along with your passport.

Q: I lost my travel prescriptions. What should I do?

A: Most travel physicians advise you to obtain your prescriptions prior to travel to avoid the uncertainty of obtaining medications overseas. If you have misplaced your prescription please call our office.

Q: I am going on a new trip. Do I need to come in again?

A: Yes. You will need to update the travel physician about your destination and your current health status. A consultation fee of $35 is charged for new trips.

Q: What should I do if I am bitten by a dog or other animal overseas?

A: Always think rabies, as this is preventable if attended to quickly, and fatal if left untreated. The cut should be washed well, and every effort should be made to obtain reliable post exposure rabies immune globulin and vaccinations. If you are having difficulty obtaining these products, try your embassy, call your nearest IAMAT clinic (see www.iamat.org), the British Columbia Centre for Disease Control (BCCDC) or call any TMVC office and speak to one of our physicians or nurses.

Q: I have had diarrhea since I got back from my trip. What should I do?

A: Check with your primary care physician to see whether you may need further follow up or call TMVC if you need assistance in locating post-travel medical advice.

Q: I just returned from a holiday and I feel feverish and unwell. What should I do?

A: If you have been travelling in a tropical country where malaria is present, you should rule this out first. Malaria is a medical emergency and requires blood testing to make a diagnosis. This should be done immediately, with results usually available within several hours. Please proceed to the nearest medical centre and explain that you have recently been in a malarious region. (see the Public Health Agency of Canada’s malaria link).

Permalink: Travel Vaccine FAQ

While travelling

Limit Your Sun Exposure
Sun intensity is usually greater in the tropics. In order to limit your exposure to damaging ultraviolet rays, use sunscreen (SPF >15) and wear approved sunglasses. A wide brimmed hat along with light coloured, loose cotton clothing is also appropriate. Remember that UV radiation is strongest between 11:00 am and 2:00 pm.

Watch What You Are Drinking
Water supplies in many developing countries are contaminated because of inadequate sewage disposal. To avoid such diseases as hepatitis A, typhoid fever, cholera and polio, note the following: bottled water, beer, carbonated beverages, boiled water, hot tea and coffee are generally safe – don’t forget to wipe bottle and can tops or bring your own straw; avoid ice in desserts and drinks and use safe water to brush teeth. Safe water may be bought in sealed bottles, or prepared either by boiling or by treatment with iodine or chlorine. Water filtration devices vary widely in efficacy and may not be effective against viruses.

Watch What and Where You Eat
Contaminated food can transmit typhoid fever, cholera, hepatitis A and gastroenteritis. Your likelihood of contracting these diseases is related to the level of hygiene practiced by food preparers. Raw or poorly cooked foods (including salads), unpasteurized dairy products (including yogurt and ice cream) and untreated water should be avoided unless prepared in a reputable establishment. All fruit should be washed and peeled before consumption. If you are particularly susceptible to Traveller’s Diarrhea, it may help to chew Pepto-Bismol tablets shortly before each meal. Moreover, you may wish to have some antibiotics or antidiarrheal medication on hand – these may be obtained from the Travel Medicine & Vaccination Centre when you receive your immunizations.

Avoid Mosquito Bites
Most mosquito bites are harmless. However, in tropical countries certain mosquitos may carry malaria, yellow fever or Japanese encephalitis as well as a number of other diseases for which vaccines are not available such as dengue fever. Mosquitos generally bite from dusk to dawn, although some are daytime biters. When outside, especially evenings or overnight, wear light-coloured long-sleeved shirts and trousers and apply mosquito repellent to all exposed areas (recommended active ingredient DEET). For overnight stays, permethrin-treated mosquito netting is highly recommended. Permethrin may also be sprayed on clothing to protect against ticks and mites which crawl on the skin.

Sexually Transmitted Diseases
Gonorrhea, chlamydia, herpes, hepatitis B, HIV and syphilis are widespread in developing countries and are all transmitted through sexual contact. Latex condoms are absolutely necessary if one is contemplating sex with strangers although abstinence is the only true “safe sex”.

The above are general guidelines and are not intended to be a substitute for a consultation with a knowledgeable travel medicine physician.

Prior to travel

Basic Immunizations

Tetanus/Diphtheria
Most Canadians have received their primary series in childhood and their last booster in high school. Boosters should be received every 10 years thereafter.

Polio
The polio vaccine series is also routinely administered in childhood and a one-time booster should be received if 10 years have elapsed since the last dose.

Typhoid
Typhoid is a bacterial infection caused by exposure to contaminated food or water. Two vaccines of equal efficacy are available, one injectable and one oral. Boosters should be received every three or seven years respectively.

Hepatitis A
Hepatitis A is a viral infection transmitted through contaminated food or water. Long-term immunity (at least 10 years) is possible with new vaccines.

Hepatitis B
Hepatitis B is a serious blood and body fluids transmitted viral disease which causes liver damage. It is transmitted in much the same way as AIDS. Persons at high risk are those who are sexually active, live and work with local people where the disease is endemic, share needles, health care workers, have an immune deficiency or have blood transfusions. Vaccines which provide long term immunity are available.

Malaria Prevention
Malaria, a serious and often fatal disease present in many parts of the developing world, is transmitted by the bites of infected mosquitoes. No vaccine is available yet, but with proper precautions risks can be minimized, though not eliminated. Anti-malaria tablets which are taken before, during and after travel to malarious areas can help prevent illness should bites occur. Many different types of malaria medication are prescribed depending on availability, region of travel, and individual tolerance – check with your physician or a Travel Clinic before departure.

Other Considerations
Remember to pack a personal medical kit in your carry-on bag containing first-aid supplies, adequate amounts of prescription medication in original containers, spare eyeglasses and contact lens equipment. Avoid walking barefoot – bring a pair of rubber thongs for use at community showers and beaches – and swim only in bilharzia-free fresh water. And bring your common sense abroad – practice good personal hygiene, avoid any questionable activities and always use seatbelts.