Travel safe: Get these vaccinations - Business of Life

As his colleagues scrambled to get their yellow cards just before their trip to Central and South America, R. Bhattacharjee sat happy. He had got his card—a euphemism for the mandatory yellow fever vaccination certificate—a couple of years earlier when he had travelled to Senegal and Nigeria.

“The vaccination is valid for 10 years and has to be taken at least 10 days before the trip,” Bhattacharjee, head of exports (marketing) at Tata BP Solar recounts. “And yes, you can’t just walk into a clinic asking for the shot. It’s available only at specific centres designated by the government.”

Also See Yellow fever vaccination centres in India (PDF)

Illustration by Jayachandran / Mint

Vaccinations tend to be the last thing on your to-do list while planning a trip to a foreign country. But whether it’s a business trip or a vacation, it makes sense to do a quick recce on how well prepared you are.

After all, nobody wants to fall sick when travelling abroad. Also, medicines are usually more expensive there, travel insurance may not cover them, and running around for a doctor can ruin your holiday.

“People travelling to exotic locations are prime candidates. Students planning to study in foreign universities or those going abroad to work also need to check their inoculation records to see if they are up to date,” says V. Ramasubramanian, senior consultant, infectious diseases and travel medicine. He runs the Boosters clinic in Chennai, which focuses on adult vaccination and travel-related health care.

A jab in time

The first step is to ensure whether your routine immunizations—diphtheria, whooping cough (pertussis), tetanus, polio, measles, mumps and rubella—are up to date.

“In India, there is no concept of vaccinating adults. Also, certain vaccinations received as a child do not give lifelong immunity, so boosters are required at intervals. Then there are vaccines such as for varicella (chickenpox), typhoid which were not available earlier,” says Sushum Sharma, vaccination consultant and head of the preventive health programme at Max Healthcare, New Delhi.

So, most people wake up to the idea of vaccinating themselves only when they are planning to go abroad, he says.

Study safe

Most universities in the US require foreign students to be inoculated against measles, tetanus, tuberculosis, flu and diphtheria. “In recent years, US universities have also been advising students to get the meningococcal vaccination as it easily spreads in dormitories and hostels,” says Dr Ramasubramanian. “Some universities also recommend hepatitis A and typhoid shots,” he says, adding that patients at his clinic also ask for vaccinations against chickenpox, poliomyelitis and hepatitis B.

Work and play safe

Whether a traveller requires a vaccine depends on the destination, duration of the trip and time of travel. If it’s just a week-long business trip where you will be meeting clients at five-star hotels in the city, you do not need to worry about inoculations. However, if your trip involves spending some days travelling all over the country or in crowded places, a shot or two may just keep diseases such as Japanese encephalitis or yellow fever at bay.

The CDC website (see Surf, below) lists country-specific inoculations for travellers. These are advisory in nature. “The only mandatory shots are for yellow fever if you are travelling to certain countries in Africa, Central America and South America. Saudi Arabia is the only country which requires visitors to be vaccinated against meningococcal diseases,” says Dr Sharma. Some African countries advise vaccination against cholera.

Some commonly recommended travel immunizations include:

• Yellow fever*– Africa, Central and South America

• Meningitis* – Saudi Arabia

• Hepatitis A or B – Mexico, Central and South America, Africa, West Asia, the Caribbean, eastern and southern Europe

• Choler a – Central Africa

• Typhoid – Asia, Africa, Russia and CIS countries

• Japanese encephalitis – South-East Asia

• Influenza – US, Europe

SOME USEFUL TIPS

• Start preparing for your vaccinations at least eight weeks before your vacation. Some vaccinations need four-six weeks for the antibodies to develop in your body. You may also need multiple doses, in which case the process may take several weeks.

• Check with the embassy of the country you are planning to visit if any medical precautions or vaccinations need to be taken.

• Tell your doctor if you are allergic to eggs. Vaccinations for yellow fever and chickenpox contain egg protein. Your doctor should be alerted about all allergies you are prone to.

• Take the time to gather records of the immunizations you have had and when they were taken. For mandatory vaccinations such as those for yellow fever or meningitis, ensure that the vaccination certificate is kept along with your passport and other travel papers.

• If you suffer from any moderate to severe illness, consult your doctor before taking any shots. Diabetics, for example, will need a different schedule. If you are pregnant, several vaccinations may be contraindicated.

• Avoid taking vaccinations if you are on antibiotics as the shots may not be so effective.

• If you are going to be away from medical care for at least 48 hours, you must take a tetanus shot.

• For children, while vaccinations are important when travelling, the schedule may vary. For example, children below nine months of age do not require yellow fever vaccinations.

• Yellow fever vaccinations must be given at an officially designated Yellow Fever Vaccination Centre, and the certificate must be validated at the same centre. These centres are in New Delhi, Mumbai, Kolkata, Chennai, Kochi, Panaji, Hyderabad, Lucknow, Pune, Visakhapatnam, Marmugao and Porbander.

• Vaccinations that are based on live vaccines need to be spaced out. For instance, the yellow fever and cholera vaccines need to be taken either on the same day or at least three weeks apart.

• The influenza vaccine is administered in one or two injections in October and November, prior to the flu season , with a maximum duration of effectiveness of six months. Each year, the vaccine contains the influenza virus strains that are felt to be the most prevalent.

• Each university abroad may have a different immunization requirement. Check with the university and have the relevant papers ready when applying.

• Rabies pre-exposure shots may be recommended if you are likely to handle animals, or for children who may pet animals and may not report an injury. However, that does not eliminate the need for post-exposure shots.

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Doctors have warned those suffering from knee pain to be extra cautious during winters. “Pains are caused when the weather affects the cartilage in the knee. It accumulates water when unhealthy and its shock absorbing function becomes less good, causing pain,” says Kaushal Malhan, consultant surgeon at Mumbai’s Wockhardt Bone and Joint Hospital. “The drop in pressure causes the body’s tissues to expand, causing the already inflamed areas to swell more and increase pain,” said Nilen Shah, orthopaedic consultant and knee surgeon at Bombay Hospital and Medical Research Centre. PTI

Eat

Johnny Bowden, a US-based nutritionist, calls cabbage “the most important (vegetable) in the world from the point of view of nutritional benefits and cancer-fighting ability”. Cabbage possesses phytochemicals, including sulforaphane, which studies suggest protects the body against cancer-causing free radicals, and indoles, which help metabolize estrogens. It’s also an excellent source of vitamins K and C, and a very good source of dietary fibre, vitamin B6, folate, manganese and Omega 3 fatty acids. The sulphuric compounds in cruciferous vegetables, the family which cabbage belongs to, are the source of many of their nutritional attributes, but they also lead to bad smells if the vegetables are overcooked. When cooked properly, cabbage develops a sweet, fragrant flavour and aroma. Martha Rose Shulman / © 2008/ The New York Times

Know

Swiss researchers have reported in the journal ‘Thorax’ that a Caesarean delivery is linked to a much higher risk of asthma in babies as compared to those born vaginally. In a study of nearly 3,000 children, the researchers found that 12% had been diagnosed with asthma by the age of eight. In that group, those born by C-section were nearly 80% more likely than the others to develop asthma. The explanation may be that a vaginal birth “primes” a baby’s immune system by exposing it to bacteria as it moves through the birth canal.