Most people are so absorbed in the passport and tickets and reservations at the hotel that they don't think about health," said physician Phyllis Kozarsky, a consultant for the U.S. Centers for Disease Control and Prevention and a professor of medicine at Emory University in Atlanta.
Thinking about immunizations is not something travelers can consider on the way to the airport. Most inoculations should be planned at least four weeks before travel so the vaccines can become active in the body, said physician Kamaljit Singh, an infectious-disease specialist at Rush University Medical Center in Chicago.
Whether a traveler even requires a vaccine depends on the travel location, itinerary, lifestyle and season of travel, said Singh, who heads the Rush Travel Medicine and Immunization Clinic.
He added that an increasing number of people heading for more exotic locations has surprised him, and they are prime candidates for vaccinations.
"Are you staying in a five-star hotel and wearing suits and jackets or will you have on a backpack and climb on a bicycle?" Singh said, explaining that being out in the elements is more likely to require vaccinations.
A recent trip to China was all business for Chet Kondas, who traveled for nine days in May to major cities such as Beijing. Singh said business travelers such as Kondas usually do not require vaccinations.
Kondas wore a business suit all day, stayed in upscale hotels and spent most of his time indoors.
"We were going from one meeting to the next, and the lunches and dinners were really formal," said Kondas of Chicago.
Having considered the clean conditions he would be in, Kondas did not receive any vaccines before traveling but said he might for future trips. "We stayed in a very nice hotel," he said. "The only thing was you had to be careful about the [drinking] water.
"But travelers planning an outdoor adventure or time in rural areas are more likely to require vaccinations. Singh, for example, will be traveling to Uganda this summer to practice medicine in an underserved area.
His itinerary requires vaccinations against rabies, Hepatitis A, Hepatitis B, yellow fever and a polio booster. Additionally, travelers are advised to be sure they are up to date with shots of U.S.-recommended vaccines such as tetanus, Singh said.
Having as many vaccines as Singh is getting may seem excessive, but travel-medicine physicians argue that the shots protect against dangerous diseases. Typhoid, for example, is transmitted by contaminated food and water and is recommended for travelers heading to most foreign destinations, including Eastern Europe. Likewise, Hepatitis A is transmitted by food and water and is recommended for people traveling to those same places.
Hepatitis B is transmitted by blood and bodily secretions and is advised for patients who expect to receive a tattoo, have contact with needles or have sex with locals while traveling, Kozarsky said.
Other vaccines such as yellow fever and Japanese encephalitis are transmitted by mosquitoes, so if a person's travel itinerary won't lead them to infested places, such vaccinations may be unnecessary. But Kozarsky said medical professionals tend to recommend shots for travelers planning time in rural areas, such as a biking trip through Vietnam.
Rabies pre-exposure shots also may be recommended for travelers heading into rural areas or for travelers with children, who are more likely to pet animals and may not report a bite. But the pre-exposure vaccination does not eliminate the need for post-exposure shots.
The pre-exposure vaccination simply makes the post-exposure treatment easier to receive, Kozarsky said, because the pre-exposure vaccination contains a product that is not always available in countries such as China or India and is required for post-exposure treatment."You face the risk of rabies or having to leave the country and going to another country to find the medication," Kozarsky said.
One shot recommendation that may surprise American travelers is the polio booster. Polio has not been eradicated in other countries, Kozarsky said, but fortunately one booster covers a person for adulthood.
While some diseases can be prevented with vaccines, others can be treated only with medicine. Malaria, for example, does not have a vaccine, so travelers are given pills to take before, during and after travel as prevention. Again, Kozarsky said, a person's itinerary determines which drug will be used, because malaria parasites in some areas are resistant to certain drugs.
So travel-medicine specialists can help a traveler determine whether vaccinations are needed. According to Singh, this is what a traveler should explain to a doctor about the itinerary:
- Places the person will travel, including whether in cities or farming areas.
- The season.
- Lodging—for example, a hotel or a tent.
- Time to be spent outdoors.
Local clinics
Need malaria pills or a polio booster? Here are some travel medicine and immunization clinics in the Chicago area:
Healthy Trust Immediate Medical Care
342 S. Milwaukee Avenue
Wheeling, IL 60090
847-243-0333
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