Bulletin No. 21
December 7, 1984
Health Hints for International Travelers

Certain vaccinations are required by some countries under International Health Regulations of the World Health Organization (WHO). Additional measures, including vaccinations, to reduce illness among travelers, their families, and home communities, are not required under international health regulations but are strongly recommended to protect the health of travelers.

Under International Health Regulations, countries may require vaccination against only two diseases, cholera and yellow fever. Some countries require these vaccinations of all travelers. Other countries require vaccination against these diseases only if a traveler arrives from an infected area. Fortunately, risk of acquiring cholera and yellow fever is very small. Smallpox disease has been eradicated. The last case of smallpox occurred in 1977. Smallpox vaccination is not required by any country. While not a requirement, travelers should be certain that they and their families are up-to-date on routine immunizations such as diphtheria, tetanus, polio, measles, and rubella. No vaccinations are required to return to the United States.

Of great concern is the possibility that travelers to certain countries may contract malaria, a parasitic infection transmitted through the bite of an infected mosquito. All travelers, regardless of age, visiting areas where risk exists for malaria transmission, should take prophylactic medication, even for visits as brief as one night. Additional protection is afforded by avoiding exposure to mosquitoes by sleeping in well-screened areas or under mosquito netting, wearing clothing that covers arms and legs, and by use of mosquito repellents. Your physician can prescribe appropriate medication that usually must be taken once a week during, and for six weeks after, exposure.

Travelers to other countries often become ill with traveler's diarrhea - an acute intestinal disease that develops after leaving home. Numerous bacteria, parasites, and viruses may cause diarrheal illness. Personal hygiene is of utmost importance in preventing traveler's diarrhea and is assisted by good sanitation.

Beverages should be selected with care. Those likely to be safe include tea and coffee made with boiled water, canned or bottled carbonated beverages, and beer and wine. Ice can be contaminated if the water source is contaminated and should be avoided. In a pinch, tap water uncomfortably hot to touch is usually safe. Food should also be selected with care.

In areas where hygiene and sanitation are poor, travelers should avoid raw food such as salads and uncooked vegetables. They should only eat fruit that they peel themselves.

Unfortunately, some travel agents and tourist companies provide out-of-date, incorrect, or misleading information about health requirements and preventive health measures. Accurate information is readily available from your physician or public health department. Your physician or health department can review your specific itinerary, and can consider the areas of the world you will visit and the nature and duration of your travel. Recommendations can then be made to ensure maximum health protection to you and your family during your trip.

(Health Information For International Travel, 1984 Morbid Mortal Wkly Rep. (Supp) Vol. 33, August 1984)

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