Far-Off Adventures – Vaccination and Foreign Travel

The time has finally come for the long-awaited trip out of the country. Plans started a long time ago: plane tickets, hotel reservations, car rentals, sightseeing plans. Suitcases are taken out of the attic to be packed and the excitement builds with each passing day. Everything is a go.

But wait, what about vaccines?

Is this one more prep that needs to be added to the “to do” list? Traveling out of the country can feel like an adventure to another planet. Images of exotic destinations along with new and curious foods dance on the pages of travel brochures. Anticipating the unexpected can be a challenge for even the most seasoned traveler. However, traveling with children adds an extra dimension to anxiety: the thought of your child getting sick in a foreign country is extremely scary. Your doctor is recommending a variety of vaccines. They are needed? How do you assess the risks?

Hepatitis B It is a viral infection that spreads through contact with blood. In the US, hepatitis B is found primarily in adults and is spread through close contact or by sharing needles used with illicit drugs. Hepatitis B is most common in the general population in East and Southeast Asia and in sub-Saharan Africa. Still, the risk of long-term complications is much lower than we are generally led to believe. More than 95 percent of people who contract hepatitis B fully recover, and an infection will result in lifelong immunity for that person. Unless you plan to spend extended periods of time in close contact with infected people, the risks of contracting hepatitis B while traveling are extremely small.

Polio It is an infectious disease caused by a virus that attacks the nervous system. The disease is seen mainly in children under five years of age; initial symptoms include fever, fatigue, headache, vomiting, stiff neck, and pain in extremities. Paralysis results in approximately 1 to 2 percent of children who contract the viral infection, although the vast majority fully recover from this paralysis. Some, however, go on to have a permanent disability for life.
Poliomyelitis is almost eradicated. Once common throughout the underdeveloped world, as of February 2006, only four countries still report isolated outbreaks: Nigeria, India, Pakistan, and Afghanistan. Additionally, there have been no cases of wild polio in the Western Hemisphere since 1991.

Vaccination of children against polio continues in the US, with 5 doses given before they enter school, (1) reasoning that until polio is completely eradicated, the risk of reintroducing polio into this country it’s “just a plane ride away.” However, an examination of the data reveals only six documented cases of imported polio between 1980 and 1998, the last in New York City in 1993. (2) The risk of contracting polio in the home is negligible; the risks abroad are almost the same.

tetanus is an acute spastic paralytic disease caused by a toxin released by the bacterium Clostridium tetani. The bacterium is found in soil and animal feces throughout the world. Neonatal tetanus is the deadliest and the type most often described in textbook tetanus cases. However, the vast majority of these cases occur after delivery and the use of non-sterile equipment to cut the umbilical cord. While other forms of tetanus are a serious illness, recovery is the norm. In other words, tetanus is not a uniformly fatal disease. If you are traveling to remote areas, such as backpacking in areas without medical care and clean water, you may want to carefully consider your tetanus status.

A word of caution, though: a tetanus shot doesn’t guarantee protection. In a study published by the CDC (Centers for Disease Control) in 1997, 13% of people who contracted tetanus received four or more tetanus shots.(3) Your best protection against tetanus is to thoroughly clean the wound with copious amounts of warm, soapy water and to stimulate profuse bleeding from the injury for a few minutes. Apply hydrogen peroxide to clean your wound, followed by a topical antibiotic ointment like Neosporin.

When traveling abroad, it’s possible to encounter some illnesses not typically seen in the U.S. The Centers for Disease Control lists the following infections as potential concerns for anyone traveling anywhere in the world:

typhoid fever, an acute febrile illness caused by the bacteria Salmonella typhi, is characterized by fever, headache, and an enlarged spleen. The greatest risk is for travelers to the Indian subcontinent and developing countries in Asia, Africa, and Central and South America, who will have prolonged exposure to potentially unrefrigerated food.

yellow fever is a mosquito-borne viral disease that can range in severity from a flu-like syndrome to severe hepatitis and hemorrhagic fever. The disease occurs only in sub-Saharan Africa and in rural and tropical South America.

japanese encephalitis, another mosquito-borne viral infection, is found throughout Asia, particularly in rural or agricultural areas of temperate China, Japan, Korea, and eastern Russia. The risk for short-term travelers to cities is very low.
For all of these potential infections, it’s important to get a natural mosquito repellant, one that’s free of DEET, the toxic additive found in most bug spray. , manufactured by Royal Neem. It is chemical free and contains many natural ingredients.

Hepatitis A It is a viral illness that has an onset of fever and diarrhea, followed a few days later by jaundice (which turns yellow). The disease varies in clinical severity from no symptoms to mild illness lasting one to two weeks. Although endemic throughout the world, hepatitis A can be prevented by carefully following hygiene and following some dietary recommendations:

1. Eat only cooked foods that are hot to the touch. Avoid eating food from street vendors.
2. Avoid eating raw fruits and vegetables unless you peel them yourself.
3. Drink only “safe” beverages: sealed bottled water, hot tea, coffee, beer, wine, and boiled water; Avoid drinking iced drinks.
5. Avoid eating raw or undercooked meat and seafood (risk of hepatitis).
6. Avoid tap water and be careful not to let shower water get into your mouth. When dining in restaurants, ask if the salad greens have been washed in boiled, distilled, or bottled water.
7. Avoid milk and milk products with unknown refrigeration standards.


Although the CDC recommends that all travelers get vaccinated when traveling abroad, it’s important to note that, with one exception, no vaccinations are required before traveling anywhere in the world—they are only “recommended.” You will not be required to have a vaccination record to enter a country, nor will you be required to obtain vaccinations to return home. The only exception is the Yellow Fever vaccine., which may be necessary if you are traveling to or from a South American or African country infected with yellow fever. Recommendations may vary from country to country; if such a destination is part of your travel plans, you should look up the yellow fever requirements for that specific country. (4)

I have been a globetrotter for most of my adult life. In the last 25 years, I have been fortunate to have traveled to more than 40 countries. I have never been asked for a vaccination record, nor have I felt the need for any vaccinations, even when traveling to remote and exotic destinations.

Last tip? Remember to pack your passport, sunglasses and favorite book. Have fun and don’t risk getting sick before going through multiple shots.

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