immunisation for travellers to developing countries

IMMUNISATION FOR TRAVELLERS TO DEVELOPING COUNTRIES

INTRODUCTION

• Developing countries are in general those which have in most cases a medium to low standard of living with lesser degree of industrialisation.

• In the background of low standard of living & various other factors like high population growth,availability & accessibility of health care facilities; certain diseases pose a major threat in the developing countries.

• Travellers to the developing countries should hence be aware & cautious about them.

• Infections transmitted by feco oral route – Hepatitis A Typhoid Cholera• Insect borne infections – Malaria Dengue Japanese encephalitis Yellow fever Tick borne encephalitis.

• Infections via respiratory droplets : InfluenzaMeningococcal meningitisMeasles

• Blood borne infections :Hepatitis BHepatitis C

• EXOTIC INFECTIONS :RabiesSchistosomiasis(africa)Leptospirosis

Recommended vaccinations• National health & medical research council recommend

certain vaccination as routine for all travellers. These include –1. Tetanus2. Diptheria3. Pertussis4. Varicella5. Measles6. Mumps7. Rubella8. polio

• For travellers with special needs : influenza,pnemococcal infections.

ie, at risk individuals( pregnant women,children ,immunocompromised individuals.

Those suffering from asthma.Respiratory & cardiovascular problems.Metabolic diseases like DM.>65 yrs of age.

• OTHER VACCINES1. Hepatitis A & Hepatitis B.2. Typhoid3. Meningococcal meningitis4. Rabies5. J E6. Yellow fever.

• Ideally vaccination has to be started early, to minimise adverse effects at time of departure & to allow sufficient time for adequate immunity to develop.

• FACTORS CONSIDERED : Time between the initial presentation to departure Date & destination Length of stay Type of accomodation Previous vaccination status

PEOPLE AT RISK!

• Pregnant women• children• People with acute /chronic systemic

infections.• Immunocompromised individuals.• Children on long term steroid therapy.• Malignancies.

• Adults who are travelling are to be vaccinated according to schedule

• Children according to national immunisation programme.

TRAVEL VACCINES FOR CHILDREN

• HEPATITIS A : O.5ml IM at 0,1,6 months .• HEPATITIS B : 0.5 ml IM at 0,1,6 months• HAV & HBV COMBINED (twinrix ): 0.5 ml at

0,1,6 months.• JAPENESE ENCEPHALITIS : 1-3 yrs – 0.5ml SC; 0,7,28 days. >3 yrs – 1ml SC ; 0,7,28 days.

• MENINGOCOCCAL vaccine – 0.5ml SC. Indicated for > 2 yrs of age. Single dose Revaccinated 3-5 yrs if continued risk.

• RABIES – 1ml IM/SC at 0,7,28 days.

• TYPHOID – a) oral capsules(live attenuated) :1 capsule on day 1,3,5.[>6yrs]

b) Vi capsular polysaccharide : 0.5ml IM, single dose.[>2yrs]

• Yellow fever vaccine : 0.5ml IM/SCSingle dose.*contra indicated < 9 months of age.

• MMR – 0.5ml SC/IM.• INFLUENZA – a) flu shots – inactivated form ;

for >6 months old, regular dose.b) Nasal spray flu vaccine (live attenuated ) – 2

to 49 yrs.CHICKENPOX vaccine- Infants-1st dose at 12-15 months and 2nd 3

months after 1st dose

• >13 years and not previously vaccinated nor had chicken pox- 2 doses 28 days apart.

WHO Publication

• International travel and health advice is an yearly publication by WHO which gives guidance on main health risks to which travellers are exposed in different parts of the world and precautions to be taken.

THANK YOU