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General Advice For Travellers * |
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Before You Travel
If you are planning to travel internationally, you should contact a physician or travel medicine clinic at least 6
to 8 weeks before travel in order to allow enough time for any immunizations that may be required to be completed.
This is especially true for those planning travel to tropical areas or developing countries.
A health professional will be able to assess your individual need for immunizations or preventative medication
depending on your health situation, previous immunization history and your travel itinerary.
Recommended Immunizations- You should ensure that your routine immunizations- diphtheria,
whooping cough (pertussis), tetanus, polio, measles, mumps and rubella- are up-to-date. If you normally receive
influenza vaccine in Canada, it should be continued for travel.
- Immunizations to prevent typhoid and hepatitis A are recommended for travellers to areas where sanitary
conditions are poor.
- In travel to remote areas or where special risks exist, immunizations against meningitis, Japanese encephalitis,
European tick-borne encephalitis, hepatitis B or rabies may be recommended.
Yellow fever vaccination is mandatory for entry into some countries in Central Africa and South America. Travellers
to these countries must have a international certificate of vaccination to certify that they have had yellow fever
vaccination. An additional 102 countries, while not requiring proof of vaccination for travellers arriving direct
from Canada, do require a yellow fever certificate is there has been a stop-over in a country where yellow fever
occurs. More detailed information about yellow fever vaccination requirements by country is available.
Malaria
If you are travelling to a country or area where malaria occurs, you will need to obtain a sufficient supply of
antimalarial medication to begin taking the drug for a full week before departure, for the whole duration of travel
in the malarial area, and for 4 weeks after leaving the area.
The actual medication to be taken will vary depending on the particular strain of malaria present in the country or
area to be visited and whether or not resistance to drugs has developed.
Preventing malaria in travellers includes personal protective measures to reduce the risk of mosquito bites, as well
as the appropriate use of antimalarial medications. Travellers to areas where there is a risk of malaria should
consult a physician or travel medicine clinic in order to obtain individualized advice regarding malaria prevention
during travel.
More information and advice on malaria prevention is available.
Personal Medications
If you require medication for existing medical conditions, take a sufficient supply for all your needs during
travel. These must be in clearly labelled containers and a copy of the doctor’s medical prescription should be
carried. Essential medication should be divided and stored in two different pieces of luggage, so that if one piece
of luggage is delayed, lost or stolen, an alternate supply is available.
It is recommended that a medical certificate of explanation be carried, should a physician advise that a supply of
sterile syringes and needles be carried for use by qualified health personnel in an emergency situation.
The use of these sterile items will prevent the possible transmission of AIDS, hepatitis B and other diseases from
contaminated needles and syringes. However, in many countries where illicit drug trafficking is a problem, a traveller
found carrying syringes without adequate explanation and medical certification, can be in serious trouble with police
authorities.
Travel Health Insurance
More and more, provincial health plans are reducing coverage for out-of-country travel or imposing restrictions on
the coverage provided. You should arrange for private travel health insurance to pay for any costs which are not
covered by your provincial plan. Should an illness occur during travel, the costs which the uninsured traveller can
be required to pay may be thousands of dollars.
While En Route - If you are travelling to an area with malaria, be sure to take your antimalarial regularly. Failure to do so will lessen the protectiveness of the medication.
- To prevent dengue fever and malaria, avoid mosquito bites. Use insect repellents during the day and especially
between dusk and dawn. Sleep in well- screened or air conditioned accommodation or use bed nets, preferably
impregnated with an insecticide. Wear trousers and long sleeves at dusk wherever possible.
- When travelling to warmer or tropical climates, use sun block (SPF 15 or greater) regularly, especially if you are taking medications (such as tetracycline) which increase skin sensitivity to the sun.
Traveller’s diarrhea or “tourista” is usually caused by differences in water purity consumed while
travelling. The water in some countries can contain organisms which will cause diarrhea in those not accustomed to
them. Because Canada’s municipal water supplies are treated to remove most waterborne organisms, travellers
from Canada may experience diarrhea while travelling abroad if they consume local water, or food prepared with local
water in less developed countries.- To prevent traveller’s diarrhea, drink purified water or
commercially bottled beverages, and pasteurized milk and dairy products. Avoid ice, salads, re- heated foods, uncooked
shellfish and food from street vendors. Choose fruit that you can peel.
Other transmissible diseases can be prevented by taking some precautions.- Swim in fresh water
only if you know that it is free of biharzia (schistosomiasis), waterborne parasites found in the Caribbean, South
America, Africa, the Middle East and Southeast Asia. These parasites can penetrate unbroken skin and cause an
infection of the bowel or the bladder.
- To prevent sexually transmitted diseases such as gonorrhea, syphilis, hepatitis B and AIDS, use a condom if you
intend to have sex with strangers while travelling.
- AIDS and hepatitis B vary in occurrence from country to country. To prevent infection, do not share needles to
inject intravenous drugs. Injection drug use is not only a risk to health, it may also land you in serious trouble
with police authorities.
You should be safety and security conscious during travel. Economic conditions in lesser developed countries can
cause increased crime rates and tourists are often targeted.
- Do not walk alone in remote areas, back streets or beaches, where there may be risk of
personal attack or bag snatching. Valuables should be left at home or deposited in hotel safes. Travellers cheques,
cash, passports and tickets should not be carried in bags that can be snatched. The use of a body belt for these
essential travel items is strongly recommended.
- Do not ride in over-crowded vehicles or on motorcycles, especially at night outside of urban centres. If using
or renting motor vehicles ensure that they have seat belts, and use them.
When You Return- Take your antimalarial medication for the full course as prescribed.
- If you have been to an area where malaria occurs and you develop fever during the first year after return
(especially in the first two months) see your doctor immediately and remind him/her that:
- you have travelled to an area where malaria occurs;
- antimalarial medication does not guarantee absolute protection against malaria; and
- malaria must be ruled out by one or more thick and thin blood films.
Staying healthy during travel is usually a matter of common sense, with extra attention given to insect, food, water
and security precautions. With minimal alteration in lifestyle, your trip can be an exciting, healthy and rewarding
adventure.
Bon Voyage! Information for Travellers
Information for Travel Medicine Professionals
* Information provided by www.travelhealth.cgc.ca
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