Considerations for Traveling to Tropical areas of the world
(Updated Aug 26,2005)
Travelers to tropical and subtropical areas such as Africa and South America may encounter several types of health dangers. The following is a brief summary of groups of concerns. Tetanus/Diptheria (Td) boosters for Td are recommended if not received within the last 10 years. Polio (IPV) vaccine may be recommended for areas of the world where polio still occurs

Insect transmitted Diseases
Malaria is a mosquito borne illness that is found in some parts of Africa and South America. Symptoms sometimes start off subtly but may quickly progress, which can lead to multi-organ failure and even death. A prescription for an appropriate antimalarial medication as well as utilizing effective mosquito precautions will be recommended for those going to infected areas.

Dengue Fever is a mosquito-transmitted disease that is found in parts of Asia, Africa and the Americas. The number of cases of Dengue fever has been increasing, especially in tropical and subtropical areas of Central and South America. A severe form of this illness is called Dengue Hemorrhagic Fever which can cause shock and in some cases, death. Mosquito precautions and prevention are the key, as there is no vaccine to protect against this disease.

Yellow Fever is a severe viral illness transmitted by a certain type of mosquito and is endemic in the tropical areas of equatorial sub-Saharan Africa and tropical South America. Some countries require proof (yellow fever card) of vaccine given before allowing entry into the visiting country. Yellow Fever vaccines are $75 and are valid internationally for 10 years.

Many other insects including other mosquitoes, flies and ticks also transmit other diseases.

African and South American Sleeping Sickness (Trypanosomiasis) are two examples and are transmitted by tsetse flies and "kissing bugs", respectively. Precautions to minimize bites are important, as no vaccine exists for these diseases. It is important for travelers to take general precautions against all insect bites.

Food Borne illnesses- several infections or parasites may be transmitted through food. We have immunizations to protect against Hepatitis A and typhoid but these are only 2 of the possible infections. Travelers are always recommended to be careful of what they eat and drink.

Hepatitis A is a virus that may make some severely ill. Rarely death occurs from infection. One dose of the vaccine protects for at least 12 months. A second booster will give longstanding immunity.

Typhoid is less common but causes a very serious disease. The risk varies among travelers with those going "off the beaten path" most at risk. The injectable vaccine protects for 3 years Typhoid is $35/dose.

Traveler's Diarrhea is acquired through contaminated food and water. It is the most common disease-affecting travelers. Symptoms vary from mild-severe. Treatment and strategies to help decrease ones risk will be discussed during the consultation visit.

Diseases acquired from People:
Tuberculosis is acquired through cough droplets from infected people. (Mantoux) skin test is performed to diagnose tuberculosis and is sometimes done before travel to establish a baseline but is generally not required.

HIV (Human Immunodeficiency Virus) is very high worldwide. Travelers must always be careful of blood and bodily fluid fluid exposures and all types of sexually transmitted diseases.

Hepatitis B is a viral illness acquired through blood, infected needles and bodily fluids. It is highly recommended for long-term travelers and those at high risk. At least 2 doses are given before travel. Cost of Hep B $30/dose. Twinrix is $59/dose (this is a combination hepatitis A and B vaccine).

Meningitis is a contagious respiratory disease causing inflammation of the lining of the brain and spinal cord leading To rapid death or permanent brain damage. The largest and most frequently recurring outbreaks have been in the "African Meningitis Belt". The multivalent meningitis vaccine may be recommended for tropical travelers.

Influenza, pneumonia, and varicella are also sometimes recommended for susceptible travelers especially for those with pre existent medical problems.

Animal to People Diseases:
Rabies is present in many poorer countries and travelers should know what to do if bitten.

Altitude Illnesses may be a concern for those travelers going to areas higher than 2400m above sea levels. A medication to help prevent this illness may be recommended Travelers should be aware of symptoms to recognize early Altitude Illnesses.