Common Travel Vaccines: Where and When You Might Need Them

Today’s blog is going to be full of information so buckle up! This topic actually came by request from a good friend of mine, after she was asking about dengue fever.

I’m going to be talking about each disease and infection briefly, but if there is a certain one you have a question about or want me to dive into more let me know in the comments!

Before I get started I want to advise people on two general things.

1. Stay up to date on your vaccinations (tetanus, polio, measles etc.) as you could be at risk for them worldwide. Contact your doctor to get vaccination records if needed.

2. Evaluate your risk. This means taking into consideration: where you are going, how long you are going for, what activities you will be partaking in, and what your current health status is. This one will be the theme of this whole blog actually.

Remember if you prefer to watch you can always check out my Youtube channel. Now let’s get to it!

Hepatitis A

Hepatitis A is a liver infection which usually last a few weeks to a few months but does not become chronic (as opposed to hepatitis B which I will mention next).

It is contracted via the oral-fecal route (ie. feces making it’s way into what we consume), and most commonly occurs in Africa, Asia, and South and Central America. Since this is common in many places, it’s important to consider for travel purposes.

In both 2018 and 2019, about 200 cases of hep A were documented in Ontaria, majority of which were related to travel overseas. Important to note is that everyone recovered!

Hepatitis A is something you should worry about if you are travelling somewhere you know hygiene will be more of a concern, especially if you are already at risk for liver issues.

Hepatitis B

Now hep B is something a little more serious if contracted, often causing lifelong severe symptoms and cirrhosis. Hep B is something you could contract not only while abroad, but actually at home (and in Canada for my Canadian readers).

Hep B is roughly 100 times more infectious than HIV/AIDS…which is why it’s something you want to protect yourself from. The good thing is that it’s contracted by an exchange of body fluids, usually by contaminated medical items or through sexual contact. So, not as easily contracted like hep A.

The other good thing is here in Ontario, teens are given this vaccine. A good idea would be to double check your immunization history to make sure you have gotten it, and if you haven’t make an appointment to see if your doctor can provide you with one.

Meningitis (all types)

Meningitis is an infection of the neural tissue lining (either your spinal cord or your brain), spread through droplets (sneezing or coughing).

The first symptoms are fever, drowsiness, vomiting, stiff neck and photophobia (sensitivity to light). Meningitis can cause lifelong damage or death in about 10-20% of those who are infected.

The highest risk area for meningitis is the subsaharan African belt (below)

Fun fact: Meningitis vaccines are actually required to enter Saudi Arabia (if travelling for pilgrimage) due to outbreaks that occurred there in the early 2000’s.

Generally, the incidence rate of meningitis infection is 0.04/100,000 people per month of stay. Which roughly would equal out to 0.00048% of people each year. Another important thing to note is that people 19 or under are at higher risk.

The majority of children will receive a meningitis vaccine (if living in Ontario) so again, double check your vaccination records for this one.

Cholera

Cholera is a bacterial infection which can cause severe diarrhea and dehydration, transmitted by food or water, raw seafood or shellfish in particular.

Cholera infections are most common in Haiti and the Dominican Republic, but also occurs some areas in subsaharan Africa and South America.

Dukoral is a common travel vaccine given to prevent traveller’s diarrhea but it also provides protection from cholera for up to two years!

But according to a lot of studies, the risk of severe symptoms from cholera is quite low. According to the ECDPC, about 75% of people infected with cholera will have mild or no symptoms, and only recommends travellers who are relief workers to get vaccinated, rather than travellers in general.

Remember, keep in mind the destination, and also the time you are going for—understand your risk! Either way, Dukoral is very widely accessible, and can provide protection.

Japanese Encephalitis

Japanese encephalitis (JE) is a neurological infection contracted via nighttime mosquitoes. Yes, there is a difference between daytime and nighttime mosquitoes.

The infection is similar to West Nile (which my Canadian readers might be familiar with) and can be quite severe if you get infected. High fever, tremors, paralysis, vomiting…About 50% of people who contract JE have long lasting neurological effects.

The places where you are most at risk for JE are Asia and South East Asia such as: Thailand, Indonesia, Vietnam, China, and India. The overall incidence of JE infection among travellers from non-endemic countries (ie. people from outside Asia visiting) is quite low. There is less than 1 case for every 1 million travellers.

Because of this low risk, and the high cost of the vaccine (if looking to get it here in Canada it will cost a few hundred dollars), a lot of people travelling to Asia for short periods don’t get it. I would worry about it more say if you are travelling to high risk areas for a long time, and know you will be exposed to nighttime mosquitoes more frequently.

Here’s a special pro-tip, courtesy of my travel doctor at the Complete Traveler’s Clinic in Toronto.

Because I knew I was going to Asia for a long time, and since I like to spend a lot of time in jungles and rural areas where I really can’t avoid getting bitten by mosquitoes, my travel doctor gave me this suggestion.

When I flew to Sri Lanka, I went to a hospital and checked to see if they had this vaccine available. They did and happily took me in for a visit. At that time, it cost me about 30 CAD (including the hospital fees), and so I saved myself a few hundred dollars.

If you are thinking about getting vaccinated for JE you can ask your travel doctor about this to see if it might be available in the destination you are travelling to.

Typhoid Fever

Typhoid fever is an infection which can result in a fever up to 40 degrees, and other flu like symptoms. It is spread through unclean water and food, most common in South and South East Asia.

About 70 cases of typhoid fever are reported by Canadians each year. The infection is fatal in about 16% of people if left untreated. So if you are travelling to a place where you know you are at risk, and know that medical care might not be as available (some rural areas) then this is something you might need to consider.

The good thing is that there are vaccines available which you can get before travelling, which give you protection for 2-3 years. A while ago I got Vivaxim, a combined vaccine for hep A and typhoid fever, which might be a good option for you as well.

Yellow Fever

Yellow fever is a viral infection carried by daytime mosquitoes, causing headaches, vomiting, and other flu-like symptoms. Incidence of yellow fever is most common in South America and Tropical Africa. To travel to some specific areas and countries, you might be required to present a yellow fever vaccine certificate to enter (especially if you have travelled to risk areas prior to arriving)

Usually people recover from yellow fever, but about 15% develop serious symptoms, and about 20-50% of those serious cases will be fatal. So yes, it’s pretty serious.

Generally the risk of contracting yellow fever is low, but keep it in mind depending on where you are going, and if you are going to be at a high exposure to those day time mosquitoes.

Yellow fever vaccines are widely available, but you might need to go to specific clinic to receive the vaccine certificate which you can use for border entry purposes (so double check if you need this!).

Dengue Fever

Dengue fever is caused by a viral infection from daytime biting mosquitoes. The symptoms include fever, vomiting, eye pain, and rashes but usually subsides within a few days. Some people end up with hemorrhagic fever which can be fatal though.

The higher risk areas for dengue are in South East Asia, Africa, South America and the Caribbean.

About 50-100 Canadians get dengue each year, and with proper medical care, all people survive. Though this doesn’t seem like too high of a number, I’ve actually met several people throughout my travels who have gotten dengue before (obviously those were people that survived).

The crappy part is that there is no vaccine available for dengue fever. After doing some searching online, I did notice there were some places in the world with a vaccine for dengue on trial studies, but as of right now, for my Canadian friends, there is nothing you can do to protect yourself ahead of time from this one. Though I did want to include it on my list since I had a friend ask me about it, and also because it is something that I think travellers should be aware of, considering that I’ve bumped into a handful of people who have gotten it.

The only thing you can do to avoid this one is to avoid getting bitten by mosquitoes. Which in my opinion, can be nearly impossible in some locations. No matter how long your sleeves and pant legs are, and how much repellent you use, sometimes the mosquitoes are just out of control.

Malaria

Malaria is caused by a parasite carried by mosquitoes, resulting in flu like symptoms, and causing kidney failure, seizures and death if left untreated. The higher risk areas for malaria are tropical regions in Africa, South and Central America, India, and South East Asia.

About 300-1000 Canadian travellers get malaria each year…which to me, is a lot higher of an incidence than many of the other things I’ve talked about today. Which is why it’s something you want to consider if you think you’ll be hanging around a lot of mosquitoes during your trip.

There are actually many different anti-malarial drugs available, which is good. The issue with them is that they can be spooky and expensive.

Spooky firstly, due to the strange side effects. I’ve heard of a lot of people getting nightmares and night terrors taking them, and also causing insomnia in others. I haven’t had either happen to me, but they made me VERY nauseous, so do remember to take them with food!

Anti-malarial drugs can be expensive because you have to take them throughout, and often before and after you leave the risk area. Which means for a longer trip, those drugs are going to cost you.

There are many different types and the dosage and regimen for them varies. Make sure to get some advice from a travel doctor if you need anti-malarial drugs, especially if you are travelling for a long time. There are certain types of drugs that aren’t so safe to be taken long term.

That’s it for today’s blog! I know it was heavy on the information today, but I hope you find it helpful. If there are other diseases you want me to cover, or if you want more information about the costs of certain vaccines (I know I didn’t talk about this much), let me know in the comments!

Remember to keep this list handy while planning your next trip. Keep in mind the destination, the specific areas you are going to (rural areas and cities have different risks!) and your current health status while determining your risk of any disease.

After considering those things, you will have a better idea if getting protection makes sense for you. At the very least you will be aware of your risk. Remember to always speak to a travel doctor after doing some of your own research so you get some professional advice!

Thanks so much for reading everyone, I hope you have an amazing week!

Much love,

Dee