Travel Health

Advisory for passengers on Yellow Fever

Middle East Respiratory Syndrome (MERS)-  It is viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a coronavirus called MERS-CoV. Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath. About half of these people died.

http://www.cdc.gov/coronavirus/mers/

Jet lag — Older adults may have more severe jet lag and take longer to recover. Travelers can minimize jet lag by shifting to the local schedule as soon as possible. Travelers may be able to avoid jet lag by adjusting sleep schedules a few days before traveling.

Traveler's diarrhea — Contaminated food or water or anxiety and jet lag can contribute to traveler's diarrhea. It often strikes abruptly and causes four to five loose or watery bowel movements. In most cases, traveler's diarrhea will go away in a day or two without medical treatment. Most doctors don't recommend preventive medications such as antibiotics or bismuth subsalicylate (Pepto-Bismol), except in special circumstances. The best prevention is good hand hygiene and food and water safety. International travelers should drink only bottled beverages or liquids that have been boiled. 

Motion sickness — Travelers susceptible to motion sickness should consult a physician about over-the-counter or prescription medications. Some natural remedies have been shown to reduce symptoms, too. Options include acupressure wristbands, ginger tea or dietary supplements or aromatherapy.

Altitude sickness is caused by dry air, a decrease in oxygen, and low barometric pressure when travelled to a higher altitude than you're used to. As a result, you may have problems, such as headaches, dehydration, and shortness of breath. Some people are affected at 5,000 feet (1,524 meters), but others aren't affected until they reach altitudes of 10,000 feet (3,048 meters) or more.

Care before travel — Travelers of all ages travelling can benefit from a pre travel medical appointment, ideally four to six weeks before departure. The doctor will perform a physical exam and assess the health risks associated with travel plans.

About Isolation and Quarantine:

Isolation and quarantine are public health practices used to stop or limit the spread of disease.

• Isolation is used to separate ill persons who have a communicable disease from those who are healthy.
• Quarantine is used to separate and restrict the movement of well persons who may have been exposed to a communicable disease to see if they become ill.

Quarantine can apply to humans and animals as part of border control, as well as within a country.

• Carry a list of local doctors and hospitals at the destination.
• Review health insurance plan to determine what medical services it would cover during trip. Consider purchasing travel health and medical evacuation insurance.
• Carry a card that identifies, in the local language, your blood type, chronic conditions or serious allergies, and the generic names of any medications take.
• Some prescription drugs may be illegal in other countries. Call embassy to verify that all of your prescription(s) are legal to bring with you.
• Bring all the medicines (including over-the-counter medicines) you think you might need during your trip, including extra in case of travel delays. Ask your doctor to help you get prescriptions filled early if you need to.

Immunizations largely depends upon the area you are travelling. Specific vaccinations are required for specific countries and conditions. These include:

Common vaccinations include are:

• Tetanus
• Diphtheria
• Pertussis (whooping cough)
• Varicella (chickenpox)
• Measles
• Mumps
• Rubella
• Polio

Vaccination for travelers with special needs
Some additional vaccinations are recommended for travelers who are at risk of infection or other health problems. This includes people with asthma, respiratory and cardiac conditions, metabolic conditions (such as diabetes) and anyone over 65 years of age. Vaccinations include:

• Influenza
• Pneumonia

Vaccination for young travelers
Young people are also routinely offered vaccination against:

• Meningococcal C
• Hepatitis B
• Cervical cancer

Cholera vaccination is no longer recommended by the World Health Organization for any country. 

Vaccination for specific diseases

Hepatitis A

Information for hepatitis A includes:

• This is the most common vaccine-preventable disease in travelers.
• It is spread by contaminated food or water.
• The cause is a virus.
• Symptoms include fever, lack of energy (malaise) and jaundice (yellow skin color).
• Hepatitis A is rarely fatal.
• Symptomatic treatment is the only treatment available.
• Vaccination is safe and extremely effective.

Hepatitis B

Information for hepatitis B includes:

• This is spread by body fluid commonly through sexual intercourse or shared syringes but also by accident.
• It is caused by virus.
• Symptoms include fever, lack of energy (malaise) and jaundice (yellow skin color).
• Around half of all cases worldwide result in death.
• Vaccination is safe and extremely effective.

Typhoid

Information for typhoid includes:

• This is common in developing countries.
• The cause is a bacterium.
• Symptoms include fever, weakness, headache and sometimes a rash.
• Typhoid can be treated successfully with antibiotics.
• Vaccinations must be completed at least one week before travelling.

Rabies

Information for rabies includes:

• This is common to North, Central and South America, Europe, Africa and Asia.
• The cause is a virus passed on by a bite or scratch from an infected dog or any mammal that carries the virus.
• Symptoms include headache and fever, then convulsions and death.
• A three-dose vaccination is given over 3–4 weeks prior to travel.
• All animal bites and scratches should be immediately and thoroughly washed with soap and water for at least 10 minutes.
• Treatment after a bite from a possibly rabid animal involves a course of five vaccines and, if previously unvaccinated, an injection of immunoglobulin.

Meningococcal meningitis

Information for meningococcal meningitis includes:

• The cause is a virus spread by aerosol droplets.
• Symptoms include headache, fever, confusion and neurological damage.
• Treatment can only ease the symptoms.
• Vaccination is a legal requirement for some countries.

Tuberculosis

Information for tuberculosis includes:

• This is common in developing countries.
• The cause is a bacterium spread by aerosol droplets.
• Symptoms include persistent cough and fever.
• Treatment involves a prolonged course of antibiotics.
• Vaccination is recommended only for some travellers to high risk areas for prolonged periods and must be preceded by a special skin (Mantoux) test.

Japanese encephalitis

Information for Japanese encephalitis includes:

• This is present throughout Asia.
• The cause is a virus spread by infected mosquitoes.
• Symptoms include headache, fever, confusion and neurological damage.
• Treatment can only ease the symptoms.
• Three doses of vaccine are required well before you travel.

Yellow fever

• This is present in tropical South Asia and sub-Saharan Africa.
• The cause is a virus spread by infected mosquitoes.
• Symptoms include fever, headache, bloody vomiting, jaundice and death.
• The vaccination gives immunity for around 10 years.
• Vaccination is a legal requirement for some countries and certification can only be given by an authorized travel health clinic.

Infectious diseases for which there are no vaccines

Infectious diseases are generally transmitted by food, water or a lack of personal hygiene (for example, ‘gastro’, traveler’s diarrhea, giardiasis and amoebic dysentery) or by insects (for example, malaria and dengue fever). They can be life threatening. Your doctor will advise you on measures and medications that should be taken to help prevent these diseases. 

http://wwwnc.cdc.gov/travel/destinations/traveler/none/india
For more information on vaccination during travelling: http://wwwnc.cdc.gov/travel

Unclean food and water can cause travelers' diarrhea and other diseases. This can reduce by drinking safe water and safe food habits. Some of do and don'ts about good food habit are:

Eat

• Food that is cooked and served hot
• Hard-cooked eggs
• Fruits and vegetables should be clean and washed.
• Pasteurized dairy products

Don't Eat

• Food served at room temperature
• Food from street vendors
• Raw or soft-cooked (runny) eggs
• Raw or undercooked (rare) meat or fish
• Unwashed or unpeeled raw fruits and vegetables
• Unpasteurized dairy products

Drink

• Bottled water that is sealed
• Water that has been disinfected
• Carbonated drinks
• Hot coffee or tea
• Pasteurized milk

Don’t Drink

• Tap or well water
• Ice made with tap or well water
• Drinks made with tap or well water (such as reconstituted juice)
• Unpasteurized milk

Take Medicine

Talk with your doctor about taking prescription or over-the-counter drugs with you on your trip in case you get sick.

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent
• Use permethrin-treated clothing and gear (such as boots, pants, socks and tents). Do not use permethrin directly on skin.
• Stay and sleep in air-conditioned or screened rooms.
• Use a bed net if the area where you are sleeping is exposed to the outdoors.

http://wwwnc.cdc.gov/travel/page/avoid-bug-bites

• For protection against ticks and mosquitoes: Use a repellent that contains 20% or more deet for protection that lasts up to several hours.
• Always use insect repellent as directed.

www.who.int
www.cdc.gov
www.mdtravelhealth.com
www.worldtravelguide.net