Vaccinations and Malaria Prophylaxis for IHOP and IHE Students

ADDITIONAL VACCINES:

Japanese encephalitis: common mosquito-borne viral encephalitis found in Asia. Use insect precautions. A vaccine is also available.

Meningococcus: While the quadrivalent vaccine Meningococcal Polysaccharide Vaccine (Groups A,C,Y,W-135) is the only vaccine licensed in the US, students should be aware of the fact that Meningococcal Conjugate C vaccine is widely used in the UK, and bivalent Meningococcal Polysaccharide (Groups A, C) is widely used in Europe, the Middle East, and Africa. WHO reports an increasing incidence of W-135 disease associated with seasonal outbreaks in sub-Saharan Africa and the annual Hajj (Saudi Arabia). Students should seek immunization with the quadrivalent vacccine as appropriate.

Polio: While poliovirus has been declared by the WHO to be "Eradicated" in the Western Hemisphere, Western Pacific, and Europe, it is still transmitted in many developing countries. Therefore, a polio booster (IPV=inactivated polio vaccine) would be recommended for Kenya, Ghana and Tanzania.

Rabies: Students are advised to seek professional medical consultation after any animal bite in a rabies-endemic area. Rabies is also transmitted by monkeys, livestock, bats, etc.

Tetanus: If it has been ten years or more since last dose.

INFECTIOUS DISEASES NOT VACCINE PREVENTABLE PRESENT AT SOME OF CLINICAL TRAINING SITES:

Cholera: an acute intestinal infection. Most infected persons have no symptoms or only mild diarrhea. However, persons with severe disease can die wtihin a few hours after onset due to loss of fluid and salts through profuse diarrhea and vomiting. The best protection is to avoid consuming food or water that may be contaminated with feces or vomit from infected persons.

Dengue Fever: a virus transmitted by mosquito bites in endemic areas. Use insect precautions.

HIV: practice universal precautions and safe sex.

Leishmaniasis: a parasitic infection transmitted by sand flies. Reduce contact with sand flies by avoiding outdoor activities from dusk to dawn. Also use insect precautions, including bed nets and window screens.

Lymphatic Filariasis: a parasitic infection transmitted by mosquito bites in endemic area. Use insect precautions.

Plague: a zoonosis involving rodents and their fleas. Humans are incidental hosts and are usually infected by the bite of rodent fleas. Plague can also be acquired by direct contact with infectious materials or inhalation of infective respiratory droplets. Use insect precautions.

Onchocerciasis: a parasitic infection transmitted by black flies during the day near rapidly flowing rivers and streams. Avoid black fly habitats and use use insect precautions.

Schistosomiasis: a blood fluke infection. Avoid fresh-water wading or swimming in rural areas of endemic areas of Africa and South America. Know how to prepare safe drinking water. Be aware of local area risk.

Traveler's diarrhea: the most common illness affecting travelers. Avoid eating foods or drinking beverages purchased from street vendors or other establishments where unhygenic conditions may be present. Avoid eating raw or undercooked meat or seafood. Avoid eating raw fruits and vegetables unless you peel them yourself. Avoid tap water, unpasteurized milk and dairy products if they are not known to be safe.

Trypanosomiasis (sleeping sickness): a parasitic infection transmitted by the tsetse fly. Avoid areas of heavy infestation. Wear clothing of wrist and ankle length that is made of medium-weight fabric in neutral colors that blend with the background environment.

NOTE ON ANTIMALARIALS:

Note that mefloquine (Larium) has a revised package insert and warning about possible neuropsychiatric side effects. It is recommended to do a pre-travel trial on mefloquine at therapeutic levels (using the mefloquine loading dose regimen) to test individual tolerance, in the month prior to travel, so there is time for the drug to wear off, and to select an alternative antimalarial if this is necessary.