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Immunizations - travel vaccinations - Management
What general advice can I give to someone who is travelling overseas?

  • Reassure the person that the overall risk of contracting infectious diseases from abroad is very low if safeguards are taken.
  • Childhood vaccinations should be up to date, as many of these are required for overseas travel.
  • Advise that the risk of contracting an infectious disease abroad depends upon:
    • The region visited — the risk may vary from country to country, and prevalence may vary within countries.
    • The length of stay — the longer the stay, the greater the risk of exposure.
    • The time of stay — some diseases are more prevalent at certain times of the year (e.g. the rainy season).
    • The type of holiday or work — in general, people are more at risk in rural areas than in urbanized or developed areas. Hence backpacking may be more dangerous than a package holiday, and work in rural or wild areas is often particularly high risk.
    • The age and health of the traveller — some people may be more susceptible to infections, and some vaccines have contraindications.
  • Advise that the most common infectious diseases contracted abroad cannot effectively be vaccinated against.
    • Travellers' diarrhoea may occur in up to 50% of visitors abroad and can generally be prevented by avoiding contaminated food and drink. For more information see the CKS topic on Diarrhoea - prevention and advice for travellers.
    • Malaria is one of the more common serious acute infectious diseases that is contracted from abroad. About 2000 people return to the UK with the illness each year, and most of these could have avoided infection with the proper use of chemoprophylaxis. See the CKS topic on Malaria prophylaxis.
    • Sexually transmitted infections are commonly contracted abroad. Some areas, such as Thailand, sub-Saharan Africa and the Indian subcontinent, are endemic with HIV. Sexually transmitted infections including HIV occur worldwide. Some areas, such as Asia and sub-Saharan Africa have a high incidence of HIV in the local population.
    • Parasitic infestation (e.g. onchocerciasis, loiasis, schistosomiasis) may present long after the patient has returned. Schistosomiasis may also present acutely a few weeks or months after exposure, but presentation can be delayed for much longer.
  • Inform the person that health provision in developing countries may be inadequate or difficult to access. Travel health insurance is essential.
Basis for recommendation
  • The basis for these recommendations is expert opinion from the published medical literature [DH, 2006c; NaTHNaC, 2010b].

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