question and answer
Travelling: when are vaccines needed?
December 2006
"Should a vaccine against traveller's diarrhea be prescribed to all individuals going to developing countries?" asks SAKINA RAJ, MD, of Calgary, AB.
Assessment before leaving for developing countries requires a detailed evaluation including current health, exposure risks, vaccination review and provision, and education regarding prevention and self-treatment of travel-related diseases. It's impossible to make universal recommendations. For example, a business traveller staying in an urban first-class hotel for a short while will have a dramatically different risk from that of an aid worker who may live in remote areas with lower levels of hygiene for a prolonged period of time. Before offering travel-specific vaccines, it's important to ensure that the patient's routine immunizations are up-to-date -- i.e. tetanus, diphtheria, polio, pertussis, measles-mumps-rubella. I believe the vaccine you may be referring to is the oral, inactivated cholera vaccine that also provides moderate protection against traveller's diarrhea, enterotoxigenic Escherichia coli. It's not currently recommended for the majority of individuals. When in doubt, I'd recommend referral of patients to be assessed by a doctor experienced in pre-travel medicine. KL
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