Vaccinations and Medications (4–6 weeks we leave)
Routine vaccines:
- influenza
- chickenpox (or varicella)
- polio
- measles/mumps/rubella (MMR)
- diphtheria/pertussis/tetanus (DPT)
Vaccine-Preventable Diseases:
- Hepatitis A or immune globulin (IG)
- Hepatitis B
- Typhoid
- Rabies
- Japanese encephalitis
- Polio
- atovaquone/proguanil
- doxycycline
- mefloquine (primaquine in special circumstances and only after G6PD testing).
- Note: Chloroquine is NOT an effective antimalarial drug in India and should not be taken to prevent malaria in this region.
You should purchase your antimalarial drugs before travel. Drugs purchased overseas may not be manufactured according to United States standards and may not be effective. They also may be dangerous, contain counterfeit medications or contaminants, or be combinations of drugs that are not safe to use.
Halofantrine (marketed as Halfan) is widely used overseas to treat malaria. CDC recommends that you do NOT use halofantrine because of serious heart-related side effects, including deaths.
If you have visited a malaria-risk area, continue taking your antimalarial drug for 4 weeks (doxycycline or mefloquine) or seven days (atovaquone/proguanil) after leaving the risk area. Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever or flu-like illness either while traveling in a malaria-risk area or after you return home (for up to 1 year), you should seek immediate medical attention and should tell the physician your travel history.
Items to Bring With You
- Prescription medicines you take every day
- Antimalarial drugs
- Medicine for diarrhea, usually over-the-counter.
- Iodine tablets and portable water filters to purify water if bottled water is not available.
- Sunblock and sunglasses for protection from harmful effects of UV sun rays.
- Antibacterial hand wipes or alcohol-based hand sanitizer containing at least 60% alcohol.
To prevent insect/mosquito bites, bring:
- Lightweight long-sleeved shirts, long pants, and a hat to wear outside, whenever possible.
- Flying-insect spray to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
- Bed nets treated with permethrin, if you will not be sleeping in an air-conditioned or well-screened room and will be in malaria-risk areas.
Other Diseases Found in South Asia
- Dengue fever has caused epidemics in most South Asian countries. In 2005-2006, an outbreak of chikungunya affected thousands of persons in India.
- Filariasis is common.
- A sharp rise in the incidence of visceral leishmaniasis has been observed in several South Asian countries.
- Cutaneous leishmaniasis is present in Afghanistan (where it has infected US troops).
- Japanese encephalitis occurs widely except in mountainous areas of South Asia. Protecting yourself against insect bites (see below) will help to prevent these diseases.
- Leptospirosis, a bacterial infection often contracted through recreational water activities in contaminated water, is common in tropical areas of the South Asia region.
- Indigenous wild polio was present in 2005-2006 in India, Pakistan, and Afghanistan; cases from Bangladesh and Nepal were confirmed in 2005-2006.
- Measles occurs in the South Asia region and can be a source of infection for unvaccinated travelers.
- Highly pathogenic avian influenza (H5N1) continues to cause outbreaks in domestic and wild bird populations and has caused human cases in several South Asian countries. Avoid all direct contact with birds, including domestic poultry (such as chickens and ducks) and wild birds, and avoid places such as poultry farms and bird markets where live birds are raised or kept.
Staying Healthy During Your Trip
Prevent Insect Bites
- Using insect repellent (bug spray) with 30%-50% DEET. Picaridin, available in 7% and 15% concentrations, needs more frequent application. There is less information available on how effective picaridin is at protecting against all of the types of mosquitoes that transmit malaria.
- Wearing long-sleeved shirts, long pants, and a hat outdoors.
- Remaining indoors in a screened or air-conditioned area during the peak biting period for malaria (dusk and dawn).
- Sleeping in beds covered by nets treated with permethrin, if not sleeping in an air-conditioned or well-screened room.
- Spraying rooms with products effective against flying insects, such as those containing pyrethroid.
Prevent Animal Bites and Scratches
- Be sure you are up to date with tetanus vaccination.
- Do not touch or feed any animals, including dogs and cats. Even animals that look like healthy pets can have rabies or other diseases.
- Help children stay safe by supervising them carefully around all animals.
- If you are bitten or scratched, wash the wound well with soap and water and go to a doctor right away.
- After your trip, be sure to tell your doctor or state health department if you were bitten or scratched during travel.
Be Careful about Food and Water
- Wash your hands often with soap and water, especially before eating. If soap and water are not available, use an alcohol-based hand gel (with at least 60% alcohol).
- Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, learn how to make water safer to drink.
- Do not eat food purchased from street vendors.
- Make sure food is fully cooked.
- Avoid dairy products, unless you know they have been pasteurized.
- Diseases from food and water often cause vomiting and diarrhea. Make sure to bring diarrhea medicine with you so that you can treat mild cases yourself.
Avoid Injuries
- Not drinking and driving.
- Wearing your seat belt and using car seats or booster seats in the backseat for children.
- Following local traffic laws.
- Wearing helmets when you ride bikes, motorcycles, and motor bikes.
- Not getting on an overloaded bus or mini-bus.
- Hiring a local driver, when possible.
- Avoiding night driving.
Prevent Altitude Illness and Sunburn
- If you visit the Himalayan Mountains, ascend gradually to allow time for your body to adjust to the high altitude, which can cause insomnia, headaches, nausea, and altitude illness.
- Use sunblock rated at least 15 SPF, especially at high altitudes, where the risk of sunburn is greater.
Posts
