What You Need to Know About Travel Vaccines
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We've reached the peak summer travel season, and the Centers for Disease Control and Prevention (CDC) is reminding anyone planning a trip to Europe to have a measles shot.
“Most measles cases in the United States are the result of international travel,” said Gary Brunette, M.D., M.P.H., chief of CDC’s travelers’ health program. “Travelers get infected while abroad and bring the disease home. This can cause outbreaks here in the United States.”
So far, 15 European countries have reported outbreaks since 2016. The CDC has issued travel advisories for five of them: Belgium, France, Germany, Italy, and Romania. (Indonesia, Guinea, and the Democratic Republic of the Congo have measles-related travel advisories in effect as well.)
Measles is one of the most contagious of all infectious diseases. It's spread through the cough or sneeze of an infected person.
Symptoms include rash, high fever, cough, runny nose, and red, watery eyes. In rare cases, the disease can cause brain swelling and can be fatal.
Roughly 92 percent of American children are inoculated against measles by the time they're 3 years old, but that still leaves a significant chunk of the population not vaccinated.
The CDC advises anyone who isn’t protected against measles, either through vaccination or past infection, to get vaccinated before traveling overseas. You'll need to see your doctor at least four to six weeks before you leave. That's because it may take that much time to complete a full course of the vaccine and to give your body time to build up immunity in response to the shot.
Of course, measles isn't the only disease you need to worry about if you're traveling abroad. Here's a look at all the shots you should consider before you go.
Other Routine Shots
Before any international trip, you should make sure you're up-to-date on all of your routine vaccines, not only measles-mumps-rubella (MMR) but also diphtheria-tetanus-pertussis (DTP), varicella (chickenpox), polio, and your yearly flu shot.
Some of these diseases are quite rare in the U.S. thanks to good vaccine coverage of children here. But the CDC says these same diseases can be much more common in other countries, including areas where you wouldn’t normally worry about travel-related illnesses. Being up-to-date on your routine vaccines will give you the best protection against these illnesses.
Yellow Fever
Yellow fever is spread by the Aedes aegypti mosquito (the same one that spreads Zika, dengue, and chikungunya). Although the virus was eradicated from much of the world in the mid-1900s, it has re-emerged in recent years in parts of Africa and South America, including, most recently, Brazil.
According to the CDC, the vaccine that's typically used to prevent the yellow fever virus will be mostly unavailable through mid-2018 due to production delays. To cover the shortage, the CDC and the Food and Drug Administration will turn to a different yellow fever vaccine.
This other shot is already approved in 70 other countries around the world and is thought to be just as safe and effective as the shot the U.S. usually relies on. But it hasn't been approved by FDA yet, so availability in the U.S. will be limited.
If you're traveling to a country where yellow fever is spreading or to a country that requires all visitors to have a yellow fever shot, be sure to plan ahead. Unlike other travel shots, the yellow fever vaccine is only available at specially designated clinics. Because of the shortage, there will be far fewer clinics this summer than usual.
You definitely don't want to skip this shot. Yellow fever is a serious disease. The CDC estimates that it can be fatal in 15 to 20 percent of cases. Find out where the nearest clinic is (you can search online here) and make sure you budget enough time to visit.
Hepatitis A and B
Hepatitis A is a virus that causes liver disease. It spreads through contaminated food and through physical contact with an infected person, especially if the infected person doesn't wash his or her hands properly after using the bathroom. It's common among people who travel to developing countries, particularly those who visit rural areas, though it can also be spread in more modern tourist accommodations.
The vaccine to prevent this virus—given in two doses, six months apart—is 100 percent effective, according to the CDC.
Hepatitis B is a different but related virus that passes through blood, semen, and other body fluids. It can disappear after just a few weeks or it can linger for a lifetime, potentially causing liver disease and cancer.
This virus occurs in nearly every part of the world, but it's most common in Asia, Africa, South America, and the Caribbean. Travel-related cases are generally rare but can result from unprotected sex, intravenous drug use, and blood transfusions.
The vaccine for hepatitis B is more than 90 percent effective. It's usually given in three doses spread across six months, but ask your doctor for an accelerated schedule if your travel plans require it.
Typhoid
Typhoid fever is a serious disease caused by the bacteria salmonella typhi and spread through contaminated food and water. In rare cases, it can be fatal. Typhoid is rare in developed countries like the U.S. but common in most of the rest of the world, especially South Asia. The U.S. sees about 300 travel-related cases of typhoid fever every year.
The vaccine for typhoid fever is available as a pill and an injectable. The pill contains live but weakened bacteria and is given in four doses: One capsule is taken every other day for a week. The injectable contains killed bacteria and is given in one dose. Both are usually administered about two weeks before traveling.
The CDC concedes that the typhoid vaccine in any form is only about 50 to 80 percent effective. You should still get it before traveling to an endemic region. But you should also take basic precautions with the food you eat while traveling, sticking to bottled water in places where the tap water is questionable, for example.
Rabies
Rabies is a disease caused by a virus that spreads through the saliva of infected animals. The most common sources of human infection are licks, bites, and scratches from infected dogs. But bats, foxes, raccoons, and mongooses have also been known to pass the disease to humans. Prevention of this disease is especially important because once contracted, it's almost always fatal.
Rabies is found all over the world except in Antarctica. In most developed countries, including the U.S., the risk of human infection is low because the virus is rare in domestic animals. But in much of Africa, Asia, and Latin America, rabies in dogs is still a problem.
If you're traveling to a country where the virus is prevalent in dogs, or if your itinerary will bring you into contact with wild animals like bats and other carnivores, you should consider getting a rabies shot before you travel. It's given in three doses over three weeks.
It's important to note that even if you've had your rabies shots, you should still seek immediate medical treatment if you're bitten or scratched by an animal while traveling. You can't be too careful when it comes to rabies prevention.
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