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Section 1. Active and Passive Immunization
IMMUNIZATION IN SPECIAL CLINICAL CIRCUMSTANCES
International Travel
Children and adolescents should be up-to-date on routinely recommended immunizations before international travel. In addition, travel requires consideration of additional vaccines to prevent hepatitis A, yellow fever, meningococcal disease, typhoid fever, rabies, and Japanese encephalitis. Vaccines may be required or recommended depending on the destination and type of international travel (see Table 1.14, p 94). Travelers to tropical and subtropical areas often risk exposure to malaria, dengue fever, leptospirosis, diarrhea, and other diseases for which vaccines are not available. For travelers at risk, malaria chemoprophylaxis, insect precautions, and care in hygiene associated with food and liquids are other important preventive behaviors (see Malaria, p 414).
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An excellent source of information is Health Information for International Travel (the "Yellow Book") published every 2 years by the CDC as a reference for people who advise international travelers of health risks. Every other week, the CDC also publishes a Summary of Health Information (the "Blue Sheet"), which lists areas experiencing yellow fever and cholera and provides any changes in recommendations reported by the CDC and WHO for entry into certain countries. Travel information and recommendations can be obtained from the CDC by fax (888-232-3299) or telephone recording (877-394-8747, or 877-FYI-TRIP) or online at (www.cdc.gov/travel). The Yellow Book and Blue Sheet also can be located on the CDC Web site. Local and state health departments and travel clinics also can provide updated information.
RECOMMENDED IMMUNIZATIONS
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Infants and children embarking on international travel should be up-to-date on receipt of recommended immunizations appropriate for their age. These include
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