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MEDICAL & EMERGENCY INFO

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The following is presented as an overview and not as an official guide.  Make sure you consult a physician or specialist for requirements.  Carry your medicines on the plane so they are with you during the flight and with you if your luggage is lost.

The Basics

Inoculations aren't required for travel in many locations, such as Europe or North America.  However, it's a good idea for everyone to inoculate against:

  • Tetanus - Inoculation is good for 10 years, but a booster at 5 years is recommended if you've had dirty wound or cut exposed to animal waste.  Tetanus is a bacteria carried in dirt and waste.

  • Diphtheria

  • Polio - If you had a polio vaccination more than 10 years ago, the booster is good for life and is provided at no charge as part of the provincial Medical Services plan.  It just makes good sense to cover this one off.

  • Measles

Treating Traveller's Diarrhea

Your doctor might prescribe cipro (ciprofloaxacin) as a medication to bring along for use in quickly combatting diarrhea contracted during your travels.  Consider taking Dukoral by Sanofi Pasteur before your trip, if you are heading to an area where local foods typically cause traveller's diarrhea.  Doctors frequently recommend it and use it themselves when travelling.  It's a raspberry flavored vaccine that you drink before your trip.  It provides protection from E coli for 3 months and from cholera for 2 years.  It does not prevent all types of traveller's diarrhea, so it's important to take steps to avoid contaminated food and drink.

Avoiding Traveller's Diarrhea

  • Don't drink unsealed bottled water or take ice in your drinks.

  • Avoid salads as these may have been washed in unsafe water.

  • Wash your hands or use sanitizer before touching any food.

  • Eat cooked foods immediately and avoid reheated food.

  • Don't eat raw seafood.

  • Avoid tap water for brushing your teeth.

  • Consider using ElectroLyte Gastro, a non prescription powder added to water and used to balance electrolytes and keep you healthy.  It comes in small travel packets.

If you still get sick, fluid intake and imodium for those over 12 is recommended.  If you are still having trouble a good multi-spectrum drug such as a cipro prescription can provide rapid relief.

Infections

Your doctor might prescribe amoxicillin as a medication to bring along for use in combatting bacterial infections contracted during your travels.

Required Inoculation for Specific Countries:

  • Yellow fever - Yellow fever is a virus transmitted by the bite female yellow fever mosquitoes (Aedes aegypti) in tropical South America and tropical Africa. These mosquitoes bite during the day.  Many countries in or near the tropics require an International Certificate of Vaccination against yellow fever. Some countries require the certificate based on the country you have come from. For example, you do not need a yellow fever certificate to enter Tanzania from Amsterdam, but you will need one on your return trip if your flight stops in Kenya. The most confusing part is that the World Health Organization designates Tanzania as a yellow fever zone.  So, it's easier to get the injection than it is to confirm you need it.  The immunization is effective 10 days after injection and is valid for 10 years.

  • Meningococcal disease - This is transmitted by bacteria and affects a narrow band of countries in tropical Africa where inoculation is required.

Other Worthwhile Vaccinations

  • Hepatitis A - Given in 3 doses with the second dose at 1 month and the third at 6 months.  The efficacy 2 - 4 weeks after the inoculation is 94%, 99% and 100% for Twinrix, which also covers Hep B in the same inoculation.  An inoculation for Hep A is good for about 20 years.  Hep A is found in the feces of people with Hepatitis A and is usually spread by close personal contact (including sex or sharing a household).  It can also be spread by eating food or drinking water contaminated with Hepatitis A.

  • Hepatitis B - Given in 3 doses with the second dose at 1 month and the third at 6 months.  The efficacy 2 - 4 weeks after the inoculation is 31%, 78% and 98% for Twinrix, which also covers Hep A in the same inoculation.  The inoculation can also be done in an accelerated method at 0, 7 and 21 days, plus a fourth inoculation at 12 months.  The accelerated method isn't frequently recommended, but it can be useful protection for Hep B when you don't have much time in advance of your travel, as you reach a higher efficacy much more quickly.  An inoculation for Hep B is good for about 15 years.  Hepatisis B is found in blood and certain body fluids. Exposure to infected blood in any situation can be a risk for transmission.

  • Malaria - carried by female anopheles mosquitoes in tropical countries such as Africa.  These mosquitoes are very large and transmission only occurs within 20 minutes of having bitten someone who already has malaria.  The prevention includes the drug Malarone, staying inside at dusk and dawn, wearing protective clothing, sleeping under a treated insect net and using a DEET repellent.

  • Typhoid fever - Typhoid fever or typhoid is transmitted by the ingestion of food or water contaminated with the feces from an infected person. It is only transmitted between people and does not affect animals. The two recommended vaccines for typhoid are the live, oral Ty21a vaccine (Vivotif Berna) and injected Typhoid polysaccharide vaccine (Typhim Vi by Sanofi Pasteur or Typherix). Both the oral and the injected version are roughly 50% to 80% effective.  Typhoid immunization is good for about 2 years by injection and 5 years if taken orally.  The oral method is a bit more challenging as it's taken in 4 doses taken every other day and you can't eat two hours before or one hour after it's ingested.  You also have to keep the serum refrigerated..

  • Cholera - an intestinal infection brought on by fecal matter contaminating food and water due to poor sanitation.  It primarily occurs in refuge camps.  Dukoral provides oral protection against cholera for a couple of years.

General Advice on Protection from Mosquitoes

  • Use mosquito nets while sleeping.

  • Outside use insect repellants and light colored clothing that covers as much of your skin surface as possible.

  • Use 30% DEET on exposed skin surfaces and apply this after your sun screen has been applied and had 10 - 30 minutes to absorb and dry.

  • Don't use scents and perfumes.

  • For malaria, take pills like Malarone as well.

Wondering what's recommended for a specific country?  We think the Net Doctor - Country Guide is a great resource for answering this question. 

The best site for information on the above diseases is the Centers for Disease Control and Prevention.

Want to go over your vaccination needs with a professional and obtain an International Vaccination Certificate?  We recommend looking locally for a travel medicine and vaccination center in your area.  The most common example of an inoculation requiring an International Certificate is yellow fever.  These professional centers will provide a proper document, signed by the administrator of the vaccine and stamped with an internationally approved seal.  The certificate can then be carried with your passport.  Many other vaccinations such as Hep A, Hep B and tetanus can also be arranged through the Centre, through your family doctor or a walk in clinic.