Do I need travel jabs?

No one likes a needle, but when you're planning a holiday, check whether you need travel vaccinations before you go. By Fiona Cullinan

Whether you want to rough it like Bruce Parry or swan around the world like Paris Hilton, getting your holiday health prep wrong could give you a lot more to worry about than a night on the bathroom tiles with the Aztec two-step. But travel immunisation advice is both confusing and changeable.

 

Some diseases only flare up in the rainy season or occur in certain parts of a country. Others tend to lurk in lakes, rivers, lowlands, forests or rural areas.

 

To add to the problem, travel vaccinations may be listed as ‘usually advised' or ‘sometimes advised' - leaving you to decide.

 

Go on a five-star honeymoon in Bali, for example, and you won't need a Japanese encephalitis vaccination. Go off the beaten track as a backpacker and you probably will.

 

Whether you need a full set of jabs or just a first-aid kit depends not just on where you go but when, how long for, the type of travelling you'll be doing and your immunisation history.

 

The good news is that, depending on your particular combination of risk factors, you may not need to become a human dartboard.

 

The bad news is that without planning well ahead, you could be leaving yourself open to diseases that are not only nasty but long-lasting and life-threatening.

 

 

How far ahead do I need to book travel jabs?

Thanks to the UK's childhood vaccination programme, it's likely you'll only need a booster for some travel jabs and some of these can be taken right up to the time of travel.

 

But the general recommendation is to visit your GP or travel clinic 8 weeks beforehand in case you do need a full course of injections and to allow time for immunity to develop. Vaccines can take several weeks to become effective as they trigger the immune system to produce antibodies - see below for an idea of how far ahead to plan.

 

Spreading out injections over time will also spread the expense, as some travel jabs incur a charge. The yellow fever vaccination costs around £45, for example, while malaria tablets are expensive and can add up on longer trips.

 

 

Top five travel jabs

Diphtheria

The disease: A serious throat infection that causes breathing problems. Left untreated, it can be fatal. It is spread by close contact with carriers, eg, sharing water bottles or kissing.

Plan ahead: Visit your GP 4-6 weeks ahead of travel. Book a booster if you haven't been vaccinated in last 10 years. Diphtheria, tetanus and polio vaccines are now combined in a single injection.

 

Tetanus

The disease: A bacterial infection contracted through cuts contaminated by soil or dirt. It affects the nervous system, leading to muscle spasms and possible death.

Plan ahead: See diphtheria.

 

Polio

The disease: Poliomyelitis is spread by contact with human faeces, normally through contaminated food and water or person-to-person contact. It attacks the nervous system and can ultimately cause paralysis.

Plan ahead: As for diphtheria.

 

Hepatitis A

The disease: Severe infection of the liver, contracted through contaminated food and water. Symptoms include fever, stomach upset and pain, diarrhoea and vomiting. There is no treatment, only prevention.

Plan ahead: The vaccine should be given at least two weeks before travelling to allow immunity to develop. Two injections 6-12 months apart protects for up to 20 years. If you only have the first one, protection lasts around 12 months.

 

Typhoid

The disease: This salmonella infection causes diarrhoea, fever and a long-lasting illness that can be fatal. It's spread by contact with human faeces, via contaminated food and water or poor sanitary conditions.

Plan ahead: Ideally book your jab at least one month in advance to allow time to develop full immunity. One injection protects for about three years but it's not 100% effective so also keep a clean hygiene regime. You'll need a booster dose after three years.

 

Five more exotic travel immunisations

Japanese encephalitis

The disease: A mosquito-spread virus with, at best, no symptoms, at worst, brain swelling, brain damage or death. Immunisation is often recommended for longer stays and rural visits to Southeast Asia, the Far East and tropical north-east Australia.

Plan ahead: The full course is three injections across a period of 4-5 weeks, plus 10 days to allow for immunity to develop. Which means starting the course 6-8 weeks ahead of travel. Protects for up to two years

 

Tick-borne encephalitis

The disease: As above but carried by ticks and found in forested areas in Europe, Scandinavia, the former Soviet Union and China. Recommended for those hiking or camping in affected areas during late spring/summer.

Plan ahead: Visit your GP at least 4-6 weeks ahead of travel for minimum protection. Two doses given across 1-3 months gives immunity for about one year; three doses over 6-12 months give protection for up to three years.

 

Meningococcal disease

The disease: Potentially fatal meningitis and blood poisoning are the result of close contact with an infected person. Often recommended for backpackers in areas such as sub-Saharan Africa, Nepal, northern India or Hajj trips to Saudi Arabia. There are multiple strains so even if you've been UK-vaccinated in childhood, you may still need a travel jab.

Plan ahead: One type of vaccine protects against four strains of the disease for about five years. Should be given at least 2-3 weeks before travel.

 

Rabies

The disease: An incurable disease that infects the spinal cord and brain, leading to muscle spasms, phobia of water, convulsions, madness and death. It's spread through an infected bite or scratch from a rabid animal - including dogs, bats, monkeys and cats.

Plan ahead: Pre-exposure treatment reduces the need for more severe post-exposure treatment. A full course involves three injections across 4-5 weeks. A booster is available - to be taken every 2-3 years, or 2-5 years depending on the vaccine used.

 

Yellow fever

The disease: A potentially fatal mosquito-spread virus with symptoms including headache, fever, vomiting, jaundice and bleeding. It's only found in sub-Saharan Africa and South America but you may need to have it in order to transit through or travel to some countries.

Plan ahead: Book your jab at least 10 days before travelling to allow your body to develop full immunity. One injection lasts about 10 years, after which you will need a booster.

 

 

Is there a vaccine for malaria?

Sadly no, although potential vaccines are in clinical trials.

 

The World Health Organisation estimates that 30,000 international travellers contract malaria every year with many falling victim to the myths surrounding the disease. So don't be taken in by travel gossip - anti-malarials are effective (90-100%), you can be infected in the dry season, and, for the record, gin and tonic sundowners won't stop you catching it!

 

Protection includes both old-fashioned bite avoidance and malaria prophylaxis.

 

Tablets range from anti-malarials such as Malarone, Mefloquine and Chloroquine to Doxycycline, which is an antibiotic. These must be taken before, during and after entering the malarial zone - so plan ahead as some need to be started several weeks ahead of travel.

 

No drug is 100% effective, though, so try to avoid getting bitten. Cover up, particularly between sunset and sunrise when the mozzies are most active. Invest in insect repellents, anti-mozzie room plug-ins and mosquito coils. And pack a good mosquito net - do a check for holes if you're getting an old one out of the closet.

 

Avoiding bites even in daytime is a good habit to get into. Mozzies are the rats of the insect world and also carry diseases such as dengue and chikungunya fever - neither of which has a vaccination option.

 

Fiona Cullinan has been bitten by a dog, a monkey - and various travel bugs - and apparently has enough rabies antibodies to last her a lifetime. She writes about travel dress codes around the world at What to Wear Where.

 

Further information

This feature does not constitute medical advice. See your GP for advice and to check that you are up to date with your vaccinations.

 

You'll find more on travel immunisation at:

● NHS Fit for travel - travel health information for people travelling abroad from the UK with latest travel-health news. www.fitfortravel.nhs.uk/

● At www.fitfortravel.nhs.uk/news/index.htm#news108 - what disease is currently striking where!

● National Travel Health Network and Centre for health advice by country: www.nathnac.org/ds/map_world.aspx

● NHS - www.nhs.uk/Conditions/Travel-immunisation/Pages/Introduction.aspx?url=Pages/what-is-it.aspx

● World Health Organisation - malaria advice and list of endemic countries: www.who.int/malaria/malariaandtravellers.html

● Create an online health brief at MASTA: www.masta-travel-health.com

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