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Travel Medicine

Links to Vaccination information
Rabies | Typhoid | Hepatitis | Yellow Fever | Meningococcal

Rabies Vaccination Information

What is rabies?
Rabies is a rare viral infection that affects the brain. The virus is spread by infected animals when their saliva comes in contact with you through biting, scratching or licking. Animals which may carry rabies can include dogs, cats, foxes, skunks, raccoons, bats and cattle. However the types of animals which can most often be affected with rabies vary from country to country.

Are rabies vaccines effective?
Yes. Rabies vaccine given now before any potential contact with an infected animal may save your life and will reduce the number of injections you will require if you are exposed to rabies during your trip. Even if you have been vaccinated, prompt medical treatment will still be required if you are exposed to a potentially rabid animal.

Who should be vaccinated?

Think about receiving a rabies vaccination if:
1. you will be spending one month or more in countries where rabies exists;
2. you will be traveling in rural areas, away from a major medical center;
3. you will be working in a job that may expose you to rabies ( for example, the risk of getting rabies is greater for certain laboratory workers, veterinarians, animal control and wildlife workers, spelunkers, forest rangers and conservation officers.)

If you are going to be vaccinated, a series of 3 injections will be required. You will receive:
- two injections, one week apart;
- a third injection, two weeks after the second injection.

Even if you have received three injections, you must still se a doctor for prompt medical treatment if you have reason to believe that you have been exposed to rabies. Remember that not all animals that have rabies are mean and vicious. Some animals who have rabies are quiet and docile.

Who should not be vaccinated with Rabies Vaccine?
1. If you had an allergic reaction the last time you had a rabies vaccine;
2. If you are ill with an infection or fever. Wait until you are well before receiving the vaccine. Tell your doctor or nurse if you are allergic to bovine serum, polymxin, neomycin or thimerosal, or are presently taking corticosteriods, antimalarial drugs or have any diseases.

Are there any side effects?
You may have soreness, swelling and redness at the site of the injection. This is minor and does not last long. Some people feel tired or nauseous, and have headache, muscle ache or fever. Your doctor or nurse may recommend that you take acetaminophen if you have any of these symptoms. Call your doctor if these symptoms last for more than 2 days, or if you have any unusual symptoms.

Will I ever need another rabies vaccination?
A booster dose may be recommended after 2 years if you travel to an area where the risk of disease exists, or you are at continued risk of being exposed to rabies.

Important health tip
Vaccination is not %100 protective. If you are bitten or scratched by any animal that might have rabies, wash the wound immediately for several minutes with lots of soap and clean water. You must see a doctor immediately for treatment, even if you have been vaccinated.

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Typhoid Vaccination Information

What is typhoid fever?
Typhoid fever is a serious illness caused by a bacteria called Salmonella typhi. These bacteria are spread throughout contaminated drink, food or water and can be spread from person to person. They thrive in places in poor sanitation. Symptoms can include chills and fever (which can exceed 40 degrees C or 104 degrees F), headache, tiredness, dizziness, loss of appetite and nausea, stomach pains and constipation or diarrhea.

Is Typhoid vaccine effective?
Yes. The typhoid vaccine reduces your risk of becoming ill with typhoid fever.

Who should be vaccinated?
Anyone over 2 years of age who is traveling to a typhoid fever risk area should consider receiving a typhoid fever vaccine.

Your risk of becoming ill with typhoid fever is greater if:
1. You will be traveling to places off the beaten track;
2. You will be eating and drinking in places where food and drink may be contaminated
because of sanitation problems;
3. You have a weakened immune system - for example, if you have AIDS, are HIV positive, or
you are having chemotherapy;
4. You have low levels of gastric acid - for example, if you have had a gastrectomy, or if you take antacids or medication for ulcers.

Who should not be vaccinated?
You should not receive a typhoid vaccination:
1. If you are allergic to any ingredient of the vaccine: the VI antigen, the buffer solution, or the phenol preservative.
2. If you are ill with an infection or fever. Wait until you are well before having the vaccine. Tell your doctor or nurse if you are pregnant or think you might be. It may be recommended that you don't get the vaccine. Children younger than 2 years of age should not be vaccinated.

Are there any side effects?
Soreness, pain, swelling or some redness at the injection site may occur for 1 - 2 days. Some people may feel tired, or get headaches, nausea, muscle ache, or a fever. Your doctor or nurse may recommend that you take acetaminophen if you have any of these symptoms. Call your doctor if any of these symptoms last for more than 2 days, or if you have any unusual symptoms.

Will I ever need another typhoid fever vaccination?
Another vaccination is recommended after 3 years if you plan to travel again to wan area where the disease exists.

Important health tip
Vaccination is not %100 protective. It is important to practice safe food and water precautions. Ask your health care professional about methods to protect yourself from exposure to disease transmitted by consuming contaminated food and water.

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Hepatitis Vaccination Information

What is Hepatitis A?
Hepatitis A is a virus that is very common in developing countries where sanitation is poor. Travelers can get sick from hepatitis A by consuming contaminated food and water. The virus can also be spread from person to person. In adults, the infection usually results in liver disease, characterized by jaundice - a yellowing of the skin - that can last for a month or more. Other symptoms may include fatigue, nausea, stomach pains and general weakness. Children may show no symptoms at all.

Is the hepatitis A vaccine effective?
Yes. The vaccine reduces your risk of becoming ill with hepatitis A.
To provide long-term protection, two injections will be given:
1. One injection today
2. A second injection 6 to 12 months after the first injection.
Remember that this second injection is necessary for long-term (>10 year) protection.

Who should be vaccinated?
Individuals traveling to countries where hepatitis A is common should consider immunization. Immunization is especially recommended if you will be traveling to places off the beaten track.

Who should not be vaccinated?
You should not be vaccinated:
1. If you are allergic to any of the vaccine ingredients, such as neomycin.
2. If you are ill with an infection or fever. Wait until you are well before having the vaccine.
Tell your doctor or nurse of you are pregnant or think you might be. It may be recommended that you don't get the vaccine. Children younger than 12 years of age should not be vaccinated.

Are there any side effects?
Soreness or some redness at the injection site may occur for 1 - 2 days. Some people may feel tired, or get headaches, nausea, muscle ache or a fever. Your doctor or nurse may recommend that you take acetaminophen if you have any of these symptoms. Call your doctor if any of these symptoms last for more than 2 days, or if you have any unusual symptoms.

Will I ever need another Hepatitis A vaccination?
A booster dose is recommended between 6 and 12 months after having received the first dose for long-term (>10 year) protection.

Important health tip
Vaccination is not %100 protective. It is important to practice safe food and water precautions. Ask your health care professional about methods to protect yourself from exposure to disease transmitted by consuming contaminated food and water.

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Yellow Fever Vaccination Information

What is yellow fever?
Yellow fever is an infection caused by a virus. This virus is spread by the bite of an infected mosquito. The symptoms are similar to the flu: fever, chills, headache, muscle pains. Infection can cause liver and kidney failure.

Is vaccination effective?
Yes. Immunization reduces your risk of becoming ill with yellow fever.

Who should be vaccinated?
Canadians can get sick with yellow fever if they travel to these areas:

Yellow fever vaccination may be required for entry if you are traveling to, or transiting through, a country where the disease exists. If vaccination is required, your doctor or nurse will immunize you and then put an official stamp in your International Vaccination Certificate which proves that you have been vaccinated. This Certificate should be carried with your passport at all times. Your Certificate is valid for 10 years, beginning 10 days after you are vaccinated.

Who should not be vaccinated?
You should not receive the vaccine:
1. If you are allergic to eggs or chicken protein;
2. If you have a weakened immune system due to drugs (e.g. steroids), or have a generalized malignancy (cancer);
3. If you have had certain vaccines within the past month, or a blood or plasma transfusion within the last 3 months;
4. If you are ill with an infection or fever. Wait until you are well before receiving the vaccine. Yellow Fever Vaccine should not be given to children younger than 6 months of age. Tell your doctor if you are pregnant or think you might be. Pregnant women should not be immunized but exceptions may be made by a health care professional depending on the individual's risk factors.

Are there any side effects?
After 1 to 2 weeks, you may develop a fever, which may last 1-2 days. Your doctor or nurse may recommend that you take acetaminophen if you develop a fever. Call your doctor if your fever lasts for more than 2 days, or if you have any unusual symptoms.

Will I ever need another yellow fever vaccination?
If you plan to travel to another country where yellow fever exists, 10 years after receiving your vaccination, another yellow fever vaccination may be required.

Important health tip
Vaccination is not %100 protective. It is important to practice personal precautions to protect yourself from insect bites. Ask your health care professional about methods to protect yourself from exposure to diseases transmitted by insects. Wear protective clothing and use insect repellant.

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Meningococcal Vaccination Information

What is meningococcal disease?
Meningococcal disease is caused by several types of meningococcal bacteria. It can result in meningitis, a dangerous infection of the brain and the spinal cord. The bacteria is spread from person to person through coughing, sneezing or direct contact, especially in over-crowded areas. The early symptoms included fever, headache and neck stiffness. This makes it hard to tell meningitis from less serious disease. You can become ill very quickly from meningitis.

Is immunization effective?
Yes. Vaccination reduces your risk of becoming ill with meningococcal disease caused from A, C, Y and W-135 meningococcal bacteria.

Who should be vaccinated?
Anyone 2 years of age or older should consider vaccination if you are traveling to the meningitis belt of sub-Saharan Africa or to areas where meningococcal disease exists:

People traveling to Mecca for the annual Hajj must have proof of receiving the vaccination within the last 3 years in order to enter Saudi Arabia.

Who should not be vaccinated?
You should not receive the vaccination:
1. If you are allergic to any ingredient of the vaccine: the polysaccharide antigens, lactose, or the vaccine preservative thimerosal;
2. If you are ill with an infection or fever. Wait until you are well before having the vaccine.
Children younger than 6 months of age should not receive the vaccine.
Tell your doctor or nurse if you are pregnant or think you might be. Pregnant women should not be immunized but exceptions may be made by a health care professional depending on the individual's risk factors.

Are there any side effects?
Side effects may include mild tenderness, pain, swelling and some redness at the site of injection. These may last 1 to 2 days. Your doctor or nurse may recommend that you take acetaminophen if you have any of these symptoms. Call your doctor if any of these symptoms last for more than 2 days, or if you have any unusual symptoms.

Will I ever need another meningococcal vaccination?
A booster dose is recommended after 3 to 5 years if you are planning travel to an area where the risk of disease exists. Children may need a booster dose more often.

Important health tip
Vaccination is not %100 protective. It is helpful to stay away from over-crowded places and avoid contact with infected persons.

Links For Further Information on Vaccination and Diseases.

Center for Disease Control USA

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