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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 1.15, p 101). Travelers to tropical and subtropical areas often risk exposure to malaria, dengue fever, other vectorborne pathogens, leptospirosis, diarrhea, and other diseases for which vaccines are not available. For travelers to areas with endemic malaria, antimalarial chemoprophylaxis and insect precautions are vitally important (see Malaria, p 438). Attention to hand hygiene and choosing safer foods and beverages for consumption also can reduce travelers’ risk of acquiring other communicable diseases.
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View this table: [in a new window] | Table 1.15. Recommended Immunizations for Travelers to Developing Countriesa |
Up-to-date information, including alerts about current disease outbreaks that may affect international travelers, is available on the CDC Travelers’ Health Web site at wwwn.cdc.gov/travel/default.aspx or the WHO Web site at www.who.int/ith/. Health Information for International Travel (the "Yellow Book") is revised every 2 years by the CDC and is an excellent reference for travelers and for practitioners who advise international travelers of health risks. To enhance the usefulness of travel notices, the CDC Travelers’ Health Web site issues and removes travel notices under 1 of 4 levels: in the news, outbreak notice, travel health precaution, and travel health warning. Travel information and recommendations can be obtained from the CDC (877-FYI-TRIP). Local and state health departments and travel clinics also can provide updated information. Information about cruise ship sanitation inspection scores and reports can be found at www.cdc.gov/nceh/vsp/default.htm. In June 2007,
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