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Travel Vaccination. Dr. Samra A Yasin Petersfield Surgery 15 th September 2000. Important notes. Each travel vaccines should be given 10 days (preferrably 3 weeks) from another in order to identify a source of reaction (if any)

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travel vaccination

Travel Vaccination

Dr. Samra A Yasin

Petersfield Surgery

15th September 2000

important notes
Important notes
  • Each travel vaccines should be given 10 days (preferrably 3 weeks) from another in order to identify a source of reaction (if any)
  • Live vaccines must be administered atleast 3 weeks apart or on the same day
  • Inactivated vaccines can be given simultaneously with another vaccine but only at a different site (pain, adverse reaction..)
  • Vaccination course must be complete before travel in order for the immunity to develop (Japanese encephalitis vaccines – 4 weeks for immunity)
vaccines
Vaccines
  • Inactivated Vaccines
    • Diphtheria Toxoid }and
    • Tetnus Toxoid }combination
    • Pertussis }vaccines
    • Poliomyelitis (Injectable)
    • Haemophilus influenza b (HIB)
    • Influenza
    • Hepatitis A
    • Typhoid Injectable
    • Meningococcal Meningitis
    • Tick borne Encephalitis
    • Hepatitis B
    • Rabies
    • Cholera
  • Live Vaccines
    • Measles }
    • Mumps } and MMR
    • Rubella }
    • Oral Poliomyelitis
    • Oral Typhoid
    • BCG (TB)
    • Yellow Fever
pregnancy and immunisation
Pregnancy and Immunisation
  • MMR
    • NO
  • Yellow fever and Polio
    • Only if substantial risk of exposure (2nd and 3rd trimester only)
  • Influenza
    • Inactivated vaccine safe during any stage of pregnancy
  • Inactivated viral or bacterial or toxoid (Hep A & B, Rabies, Injectable Typhoid, meningococcal, pneumococcal, tetnus – diphtheria toxoid)
    • No evidence of risk to unborn babies
yellow fever
Yellow fever
  • Acute viral illness, transmitted by mosquito
  • Incubation period ( 3 – 6 days)
  • Synmptoms
    • Fever, Headache, Bleeding gums, Jaundice
  • Who needs protection
    • Age > 9 m, Travelling through endemic areas
    • NB: a valid certificate of vaccination is compulsory for entry into certain countries
  • Vaccine
    • Can only be administered in designated centres
    • Live attenuated vaccine
    • Protection starts 10 days after injection, Certificate valid for 10 years.
  • Dose
    • 1 dose of 0.5mL (sc)
  • Who not to vaccinate
    • Children < 9m, Pregnancy and breast feeding, Hypersensitivity to Egg protein
    • Acute febrile illness, Immunosupression e.g. HIV and malignancy
typhoid
Typhoid
  • Danger Areas
    • Indian subcontinent, Central and South America, Eastern Europe
  • Vaccine
    • Injectable
      • 2 doses 4-6 wks interval between doses, reinforced after 3 years
      • 1-10 yrs: 0.25mL sc / im
      • >10 yrs: 0.50 mL sc / im
    • Oral
      • 3 doses of 1 capsule on alternate days
      • Reinforced annually
hepititis a
Hepititis A
  • Acute viral infection
    • Incubation period: 15-40 days
  • Dose
    • 2 doses of 0.5mL im at 2-4 wk. intervals
    • Single booster after 6-12 m of initial course gives immunity for 10 years
hepititis b
Hepititis B
  • Viral infection
    • Incubation period: 40 - 160 days
  • Dose
    • Up to 12 yrs: 3 doses 0.5mL im, at 0, 1 and 6m
      • 1 booster at 3-5 years
    • > 12 yrs: 3 doses 1.0mL im, at 0, 1 and 6m
      • 1 booster at 3-5 years
tick borne encephalitis
Tick-borne encephalitis

Unlicenced vaccine

  • Viral Infection
    • Transmitted by the bites of infected ticks
    • Endemic in the forest part of Europe and Scandinavia
  • Dose
    • No lower age limit
    • 4 doses of 0.5mL sc or im at 0, 4 and 12 weeks, then 9 - 12 months
    • Booster after 3 years
rabies
Rabies
  • Serious Viral infection
  • Transmitted by the bite of rabid animal
  • Dose:
    • No lower age
    • 3 doses of 1.0ml sc or im or 0.1ml id
    • Interval between doses at 0, 7 and 28 days
    • Booster after 2 –3 years if contnued exposure is required
slide13
BCG
  • Is given only if no BCG scar and skin test is negative
  • Dose
    • Single dose of 0.1mL sc
tetanus
Tetanus
  • Toxin from clostridium tetani
  • Who Needs
    • All adults and children who have not previously received immunisation should receive a primary course
    • Patients without a booster dose in the last 10 years
    • Additional booster doses may be required for travellers to remote areas specially if taking part in high risk activities
    • Road Traffic accidents
    • Penetrating or deep wounds
  • Dose
    • 3 doses at 4 weeks interval
    • At school entry (3 years after last dose)
    • At school leaving (10 years after primary course)
    • Further booster after 10 years
poliomyelitis
Poliomyelitis
  • Enterovirus
  • Who
    • Patients who have not received primary immunisation
    • Booster doses for adults travelling to endemic areas e.g. Asia, Africa, E Europe
    • After primary immunisation, protection is life long
    • People at special risk may receive booster every 10 years
  • NB:
    • If necessary to administer more than 1 live vaccine they must be given simultaneously at different sites
    • or (in theory) be separated by a period of 3 weeks
meningococcal infection
Meningococcal Infection
  • Endemic areas
    • Tropical Africa, Asia, Saudia Arabia (certificate required)
  • Dose
    • > 2m: One dose 0.5mL sc or im
    • Booster every 3 years
diphtheria
Diphtheria
  • Travellers who have not received the vaccine in the last 10 years
japanese encephalitis
Japanese encephalitis
  • Viral encephalitis, transmitted by the bite of infected rice field breeding mosquito, infected birds and animals specially pigs as a reservoir for the arbovirus
  • Endemic in South East Asia and the Far East
  • Dose
    • < 3 yrs: 3 doses of 0.5mL sc at 7, 14 and 28 days
      • Booster after 2 – 4 years
    • > 3 years: 3 doses of 1.0mL sc at 7, 14 and 28 days
      • Booster after 2 – 4 years
malaria
Malaria
  • Malignant Malaria (P. Falciparum)
    • In most parts of the word is resistent to Chloroquine
    • Quinine, Mefloquine, Malarone (Proguanil) can be given instead
  • Benign Malaria (P.Ovale, P.Malariae, P.Vivax)
    • Chloroquine is the drug of choice
    • P.Malariae: Chloroquine alone is adequate
    • P.Vivax and P.Ovale: Primaquine is required for radical cure to kill the parasite in the liver
  • Length of prophylaxis
    • Should be started 1 week (preferrably 2-3 wks for mefloquine) before travel into endemic area.
    • If not then must be 1-2 days before travel
    • Should be continued after arrival back in UK
  • Pregnancy
    • Avoid travel during pregnancy, otherwise Chloroquine and Proguanil may be given in usual doses
    • Mefloquine must be avoided in the first trimester