VACCINES

CHOLERA

Cholera is an infection of the the intestine that is caused by bacteria called vibrio Cholerae. This infection can cause severe diarrhea and dehydration. Cholera can be treated with oral rehydration salts and fluids. Cholera is caused by the consumption of food or water contaminated with the bacterium Vibrio cholerae.

The risk of contracting cholera is generally very low and for many traveler’s prevention can be achieved
through following food and water recommendations while traveling. However, Dukoral can provide extra
protection while traveling to under-developed countries.

Antibiotics such as ciprofloxacin or azithromycin are effective in treating traveler’s diarrhea. It can be appropriate to carry an antibiotic with you while you travel so that you can self treat in the case that you develop traveler’s diarrhea and your Calgary Travel Clinics pharmacist can prescribe you antibiotic to treat traveler’s diarrhea.
Loperamide (Imodium®) is an option to reduce diarrhea and can be tried for first 24 hours to self-treat non-infectious diarrhea.

CHOLERA VACCINE

Dukoral® is an oral and drinkable vaccine that is used to decrease your risk of developing cholera.
Dukoral® is given as two doses given at least 1 week apart. It is recommended to start Dukoral® at least 3 to 4 weeks before traveling to protect you from developing cholera.
Dukoral® can also help protect you against traveler’s diarrhea caused by E. coli. For protection against traveler’s diarrhea (not cholera) you can take the first dose as late as 2 weeks before traveling and the second dose 1 week before traveling and be protected.
If you have used Dukoral® within the past 5 years, only booster dose is required to provide protection.

DIPHTHERIA & TETANUS

Diphtheria is caused by bacteria which affect respiratory system. The bacteria infect the airways and the throat. Diphtheria can be life threatening if not treated in timely fashion.

Tetanus is caused by a bacterial spore that enters the body through an injury cut in the skin. Main source of Tetanus spores are dust, dirt, and manure and are therefore ubiquitous in nature. You can also get Tetanus by stepping on sharp objects, such as a rusty nail, however it can also spread by wounds that are less deep and severe. Unlike many other illnesses, tetanus is not contagious and cannot be spread from person to person.

Everyone is highly recommended to get vaccinated against tetanus and diphtheria, including construction workers, people dealing with metal, caregivers and travellers.

Most Canadians have been vaccinated against tetanus and diphtheria in childhood. If you have not been vaccinated for tetanus and diphtheria, talk to Calgary Travel Clinics Pharmacist to get vaccination

Individuals who were vaccinated previously require a single booster dose of combination vaccine for tetanus and diphtheria every 10 years.

HEPATITIS A

Hepatitis A is caused by oral route like contaminated food, water which is carrier to transfer virus into our bodies and cause inflammation of the liver which usually resolves with the help of our immune system; however, Hepatitis A can cause serious complications in some people. Hepatitis A may be prevented by vaccination and it is recommended that travelers to most countries outside Canada are vaccinated. Vaccination is particularly important for people traveling to rural areas or areas with poor sanitation like in developing countries.

Havrix® and Avaxim are vaccines to prevent Hepatitis A and are given as two doses at least 6 months apart. The first dose will provide you will short term protection against Hepatitis A and the second dose will provide protection for 10 to15 years or more depending on antibodies at the time of screening through blood work.

Twinrix® is a vaccine for Hepatitis A and Hepatitis B and is given as 3 doses. After the first dose is given at 0 month, the second dose will be given after 1 month and the third after 6 months from the first dose. The final dose provides protection for 10 years or more.
It is recommended that travellers must receive 2 doses of Twinrix® before traveling. If you do not have at least 1 month to get the first two doses, you can receive a “fast track” schedule that involves 4 doses whereby the first two injections are given 7 days apart.

HEPATITIS B

Hepatitis B is a viral disease of the liver that can cause short term or lifelong infection and complications.
Hepatitis B can be prevented through vaccination. It is recommended that people traveling to most countries outside of Canada are vaccinated against Hepatitis B.
Hepatitis B is spread through contact with body fluids like blood and instruments contaminated with blood containing Hepatitis B. Contact with contaminated surgical or tattoo instruments or sexual intercourse are examples of ways Hepatitis B can be contracted.
Hepatitis B vaccination is provided to students in Alberta in Grade 5. Close to ninety percent of vaccine recipients will be immune to Hepatitis B for life, However, some people do not respond to the vaccine. It is possible to have bloodwork done to see if you are immune to Hepatitis B or if a booster may be needed.

If you have not been vaccinated for Hepatitis B in the past, or, are unsure if you have been vaccinated you can safely use the EngerixB® vaccine. The EngerixB® vaccine protects against Hepatitis B and is given as a course of 3 injections. After the first injection, the second dose is given after one month and the third is given 6 months after the original dose. If you complete this injection regimen, you will be protected against Hepatitis B for 10-15 years or more.
Twinrix® protects against both Hepatitis B as well as Hepatitis A. It is given as 3 a course of 3 injections. After the first injection, the second dose is given after one month and the third is given 6 months after the original dose. Completion of the Twinrix® vaccination regimen will provide protection for 20 years or more against Hepatitis A and Hepatitis B.

MALARIA

Malaria is caused by the mosquito carries Parasites called as Plasmodium. Most Asian, African and some South American Countries including Caribbean are at risk of Malaria.

You can protect yourself and family members from malaria by taking Antimalarial medication such as
Malarone® or doxycycline before, during, and after you travel to protect you from developing malaria.

Malaria Prevention Tips:

Air-conditioned accommodations can decrease the risk of mosquito bites

Use mosquitoes’ nets if your accommodations don’t have air conditioner or
appropriate screens or windows. These nets have usually been treated with insecticide and need to
be retreated every 6 months.
Insect repellant such as containing at least 25% DEET. DEET is safe to use if the instructions are
followed carefully and appropriately.
Wear loose fitting and light-colored clothing including long pants and long shirts if possible.
Ensure you are using effective insect repellants. Some products such as citronella candles and tea
tree oils are not considered appropriate nor effective.

MENINGOCOCCAL MENINGITIS

Meningitis is an acute infection of the central nervous system caused by several strains of a bacterium called Neisseria meningitidis

Transmission
Transmission is by direct contact, which includes saliva droplets and discharges from the nose and throat of an infected person. Some individuals do not develop the disease at this point but become carriers and propagators of the bacteria. Following contact with the bacteria, the incubation period is 2 to 10 days (3 to 4 days on average) before symptoms appear. The disease confers temporary immunity against the infecting strain.

Visitors arriving for Umrah, Hajj or for seasonal work in Hajj zones, are required to submit a valid vaccination certificate with a tetravalent (ACYW135) meningococcal vaccine administered no less than 10 days prior to arrival to Saudi Arabia.

MENINGOCOCCAL VACCINES

The meningococcal vaccines prevent against the most common types of bacteria that cause meningitis, but do not protect against all types of bacteria that can cause meningitis.
Most people have received a series of vaccines for meningococcal meningitis in childhood and therefore further vaccination is generally not needed for travellers.
Individuals over the age of 24 who did not receive a booster as a teenager should receive a booster dose
Individuals who are at high risk of developing meningococcal disease should receive 2 doses given 8 weeks apart and a single booster every 5 years.
Travelers to Saudi Arabia going to the Hajj or Umrah are required to have vaccination for meningococcal meningitis within the past 10 days to 3 years.

Consult with Calgary Travel Clinics Pharmacist for vaccinations required before going for Hajj or Umrah.

RABIES

Rabies is transmitted through the bodily fluids of infected animals. The virus, which is spread through
bites, scratches, or a contact with infected bodily fluids, must enter the body through broken skin or pass through a mucous membrane (e.g., eyes, nose, mouth). In North America, animals most likely to spread rabies are bats, raccoons, skunks, and foxes, while in developing countries, where widespread vaccination of domestic animals is not as prevalent, close to 90% of rabies cases are caused by exposure to rabid dogs. A rabid animal usually exhibits unusual behaviour (e.g., a wild animal not fearful of being approached or domestic animal that attacks without being provoked).

Rabies is a viral disease that is spread to humans by animals that are infected with the rabies virus. The
virus is found in animal saliva and can be spread to humans through animal bites, scratches, or licks over compromised human skin through cuts or exposed mucous membranes.

RABIES VACCINE:

Pre-Exposure Dosage:
Primary Vaccination Three doses of IMOVAX® Rabies are required. One dose of 1.0 mL is to be given intramuscularly on each of days 0, 7 and 21. Booster Doses The booster dose of 1.0 mL of vaccine should be administered intramuscularly
After completion of a full series of 3 injections, a booster dose will be required 1 year after the injections if there is risk of re-exposure to the rabies virus. Most people will have protection for 5 years after completing the initial series of 3 injections followed by 1 booster dose one year after the initial series of injections.
It is important to seek immediate medical attention after contact with an animal that may have rabies whether you have had the series of vaccines or not.

TYPHOID

Typhoid is caused by bacteria called Salmonella typhi. The risk of developing typhoid exists in many parts of the world including Africa, Asia, and Latin America. In addition, small outbreaks have occurred in some countries of Eastern Europe. Health Canada recommends people traveling to Asia , Africa and south America are vaccinated for typhoid. The risk of developing typhoid increases with the length of your travels and in areas with poor sanitation. The vaccine for typhoid may also be considered for people who travel regularly, are traveling to developing countries, or are traveling for extended periods of time.

Typhoid caused by the consumption of food and water that is contaminated with the bacteria Salmonella typhi.

TYPHOID VACCINE:

Vivotif is oral vaccine and dose should be taken every other day to finish full course of 4 capsules.
Immunization should be completed at least 1 week prior to exposure to Salmonella Typhi. Booster dose – every 7 years, if repeated or continued exposure.

Typhim is IM injection used as single dose to protect against Typhoid. However, these vaccines should be completed 2 to 3 weeks before traveling to develop immunity against Salmonella Typhi. Immunization should be completed at least 2 weeks prior to exposure to Salmonella Typhi. Booster dose – every 3 years, if repeated or continued exposure

YELLOW FEVER

Yellow fever is a disease that is present in close to 50 countries and is spread by mosquito bites like malaria. Travelers to certain countries are advised to be vaccinated for yellow fever before entering the country. Before traveling, make sure that you are vaccinated if any of the countries in your itinerary require vaccination. The countries that require yellow fever vaccination are in sub-Saharan Africa and tropical South America. Calgary Travel Clinics will provide you with a card as proof of vaccination that you can bring with you on your travels.

YELLOW FEVER VACCINE:

The YFVAX® vaccine is used to protect from yellow fever, is given as a single dose, and is effective for a lifetime.