Which Travel Vaccinations Do You Need?

When telling your parents your next travel destination is in an exotic region, the first thing they talk about how many dangerous diseases there are, you must be crazy for choosing this as travel destination, why can’t you go to a safer destination?!

In the meanwhile, I learned how to handle this situation. I check the recommended vaccinations for that region or country and even make an appointment with a doctor specialised in travel vaccination before I tell them where I’m going.

Every traveller should inform him/herself about the possible diseases in the chosen destination and undertake preventive actions to avoid getting sick. Luckily I never got sick while or after traveling (I hope it remains that way) and the discussions with the parents don’t last that long anymore.

I thought I share the information I have about the diseases which are common in developing countries and which travel vaccinations or medicaments you need when you travel to countries in Asia, Africa, and Latin America. I hope it is easier for you at least to get the first idea before you go to your doctor.

Diphtheria

Diphtheria is a bacterial infection affecting the nose and throat, spread by coughs and sneezes.

Symptoms: Increased fever, chills, tiredness, sore throat, headache, pale, blue skin.

WARNING! Most of the symptoms off all the disease in this post might be similar which is why you always should visit a doctor as soon as you feel any unusual symptoms no matter which disease you think you have. 

Pertussis – Whooping cough

Pertussis is a bacterial infection of the lungs and airways

Symptoms: Dry cough, runny or blocked nose, sneezing, watering eye, slightly raised temperature.

Polio

Polio is a viral infection which causes temporary or permanent paralysis, loss of the ability to move one or more muscles.

Symptoms: Increased fever, sore throat , headaches, aching muscles.

Tetanus

Tetanus is caused by bacteria getting into a wound such as cuts and burns in the skin.

Symptoms: Having difficulties by opening your jaw, muscle spasms which make swallowing and breathing difficult, increased fever, rapid heartbeat.

Vaccination: For the above 4 diseases there is usually a combined dose.
Effective 1 month after vaccination
Protection lasts 10 years
Where: Regular doctor

Typhoid

Typhoid is a bacterial infection caused by food and water contaminated with a bacterium called Salmonella typhi.

Symptoms: High temperature, stomach pain, headache, constipation, diarrhoea.

Hepatitis A

Hepatitis A is a liver disease caused by contaminated food and water and can be spread through an infected person.

Symptoms: slightly increased fever, feeling sick or being sick, sore throat, loss of appetite, tiredness, muscle pain, tummy pain.

Vaccination: For the Hepatitis A and Typhoid there is usually a combined dose.
Effective 14 days after vaccination. 
Protection: 
Against Typhoid 3 years.
Against Hepatitis A you get a booster 6-12 months after the first dose so that the protection last for 10 years.
Where: Regular doctor

Hepatitis B

Hepatitis B is also a liver disease which spreads through blood and body fluids (semen, vaginal fluids, etc.). Therefore it is recommended only for people who inject drugs, people who change sexual partners frequently and people working in medical facilities who might be in contact with Hepatitis B infected people.

Symptoms: tiredness, headaches,  high temperature, loss of appetite, diarrhoea

Vaccination: 3 doses in total. 2. dose 4-6 weeks after the first and 3. dose 6-12 months later. 
Effective Right after the 2. dose
Protection: 10 years after the 3. dose.
Where: Regular doctor

Rabies

Rabies is a viral infection that targets the brain and nerve system. Rabies is usually transmitted to people from bites or scratches from infected animals such as dogs, bats, raccoons, monkeys, etc.

Symptoms: It starts with fever, headache, feeling scared or anxious. Advanced symptoms are aggressive behaviour, hallucinations, agitation and producing lots of saliva.

Don’t wait for the symptoms and seek medical attention immediately to get a post-exposure treatment, directly after an animal bites, even if you have received the full vaccination previously.

Vaccination: 3 doses at days 0, 7 and 21 or 28.
Effective 10 days after the last dose. 
Protection: 2-5 years
Where: Regular doctor

Cholera

Cholera is a bacterial infection caused by consuming contaminated food or water.

Symptoms: Severe diarrhoea, feeling and being sick, stomach cramps

Vaccination: The cholera vaccine is given as a drink mixed with water in 2 doses 1 week apart. Don't eat or drink for 2 hours before and after having the vaccination.
Effective 2 weeks after the second dose. 
Protection: 2 years 
Where: Regular doctor
Bonus: It will reduce the risk of getting infected by diarrhoea in general.

Meningococcal disease

Meningitis is an infection of the protective membranes that surround the brain and spinal cord. The inflamed membranes can damage the nerves and brain.

The meningococcal vaccine is recommended for Africa, especially during dry season. Saudi Arabia requires from pilgrims to Mecca a proof of a vaccination not older than 3 years.

Symptoms: High fever, with cold hands and feet, vomiting, drowsiness, confusion, severe muscle pain, pale skin, stiff neck, sensitivity to light.

Vaccination: 1 dose
Effective 10 days after the vaccination. 
Protection: 3 years
Where: Regular doctor

Japanese encephalitis

Japanese encephalitis is a type of viral brain infection spread through mosquito which bite infected animals, mostly pigs and birds. So be extra careful near to pig farms and rice fields. The Japanese encephalitis is mostly common in rural areas throughout South East Asia, the Pacific Islands and the Far East.

Symptoms: Mostly it is only flu-like symptoms however, although very rarely, the infection can spread to the brain and cause confusion, inability to speak, inability to move certain body parts.

Vaccination: 3 doses at days 0, 7 and 28. Or 2 doses given preferably 4 weeks apart. One booster is recommended 12–14 months after last dose to last the protection for 3 years.
Effective 10 days after the last dose. 
Protection: 3 years
Where: Japanese encephalitis vaccine is available only at authorised clinics.

Yellow fever

Yellow fever is a viral infection spread by a certain type of mosquito. Mainly Africa, South America and parts of the Caribbean are effected.

Symptoms: The initial symptoms are high temperature, headache, vomiting, muscle pain, including backache, loss of appetite. 15% of people develop more serious problems such as yellowing of the skin, and whites of the eyes, bleeding from the mouth, nose, eyes, blood in your vomit and stools, which might end deadly.

Vaccination: 1 dose
Effective 10 days after the vaccination. 
Protection: 10 years
Where: Yellow Fever vaccine is available only at authorised clinics.
Important: Certain countries require a yellow fever vaccination certificate for travellers arriving from countries with risk of yellow fever transmission. Therefore ALWAYS carry that yellow booklet, the "International Certificate of Vaccination or Prophylaxis (ICVP)".

Malaria

Malaria parasite is transmitted by female Anopheles mosquitoes, which bite mainly between dusk and dawn. There is no risk of malaria in many tourist destinations in South East Asia, the Caribbean and Latin America. But the Malaria risk is very high in Africa and India. The risk of infection is at highest at the end of the rainy season.

Symptoms: High temperature, sweats and chills, headaches, vomiting, muscle pains, diarrhoea. Symptoms usually appear 7 days after infection but in some cases it might take up to 3 months or even longer.

Protection: There is no vaccination against Malaria but there are various methods to reduce the risk.

Light and loose fitting clothes

Loose-fitting long trousers and long sleeves will make it harder for a mosquito to bite thanks to the air between the cloths and your skin. It is way easier for a mosquito to bite through tight cloths.

Mosquito Net

Most hotels in tropical areas will offer it anyway but it doesn’t harm to bring your own. I have one Mosquito Net which is big enough for a double bed and super light and easy to pack in so that it doesn’t take too much space in my bag. Air-conditioned rooms will also keep the mosquitos away.

Mosquito Repellent with DEET

The regular mosquito repellents won’t stop any type of infectious mosquitos. So make sure to have a DEET based Mosquito Repellent Spray. Apply it several times during the day, especially at dawn and dusk.

Take anti-malarial pills

There are many in the market but I rather write about the one I took myself when I visited Kenya. It is called Malarone and you start with it the day before you arrive your destination, take it daily during your stay, and for seven days after you leave. The pills don’t have any serious side effects, besides on your budget! The pills are pretty expensive (12 pills for ~70€).

Stand–by emergency treatment (SBET)

For most travellers it is very likely to find medical treatment within 24 hours after the first symptoms appear. But if your itinerary brings you to a remote and isolated area, you rather carry antimalarial drugs for self-treatment, the so called “stand–by emergency treatment”.

Alternatives

I read about homeopathic remedies, garlic, tea tree oils, etc. which help to prevent mosquito bites. It might be true but it is scientifically not proven. If you’re in South East Asia you can try it out as it is not an area with risk of Malaria, but I wouldn’t risk it when visiting Africa. It is a serious disease which caused almost half a million of deaths in 2015. Don’t take any risks.

Read more about Malaria at WHO.

Dengue Fever

And again… an infected mosquito transmits the virus.

Symptoms: High temperature, headache, pain behind the eyes, muscle and joint pain. Symptoms usually appear 3-14 days after the infective bite.  Visit a doctor, drink a lot of water, use paracetamol to reduce the fever and rest till you overcome dengue fever.

Protection: There is no vaccinations or any specific medicine to treat dengue. DEET based repellents will help here too.

When visiting your doctor 

The risk of the diseases varies a lot depending on your itinerary, even within the same country.

Inform your doctor about your itinerary

• Where do you travel? In rural and/or urban areas?
• When do you travel? In rainy or dry season?
• How long do you stay?
• Type of accommodation
• Outdoor activities such as camping, hiking, trekking
• Do you work or volunteer in medical facilities?
• Do you have contact with animals?

Most importantly inform your doctor about your health conditions

• Are you pregnant?
• Do you plan to be pregnant?
• Are you breastfeeding?

How to reduce risk of infection

None of the vaccines or medicines can deliver 100% protection. So you rather be careful not to get infected at first place. Here are some tips how to reduce the risk of getting infected.

• Cook it, boil it or peel it!
• Eat in places where you observe a high circulation of customers, which mostly means good quality and most importantly fresh food which was not stored for long.
• Don’t drink tap water. I don’t even drink filtered water.
• Avoid drinks with ice cubes in it
• Wash your hands before and after eating and after visiting the bathroom for obvious reasons. My point is, in developing countries it is not usual to find soap in public bathrooms. So carry your own soap, anti bacterial hygiene gel and wet wipes.
• Apply DEET based mosquito repellent to protect yourself against any infectious mosquitos.
• Don’t wear flip flops when you walk in rural areas. A roasted nail through your flip flop does not only cause pain but also an open wound which can easily get infected.
• I know it is hard but avoid getting close to animals such as dogs, monkeys, racoons, birds, etc.
• Don’t have unprotected sex under no circumstances!

For authorised information about all diseases visit the web page WHO.

Safe travels!

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