Travelling: when are vaccines needed?
"Should a vaccine against traveller's diarrhea be prescribed to all individuals going to developing countries?" asks SAKINA RAJ, MD, of Calgary, AB.
Assessment before leaving for developing countries requires a detailed evaluation including current health, exposure risks, vaccination review and provision, and education regarding prevention and self-treatment of travel-related diseases. It's impossible to make universal recommendations. For example, a business traveller staying in an urban first-class hotel for a short while will have a dramatically different risk from that of an aid worker who may live in remote areas with lower levels of hygiene for a prolonged period of time. Before offering travel-specific vaccines, it's important to ensure that the patient's routine immunizations are up-to-date -- i.e. tetanus, diphtheria, polio, pertussis, measles-mumps-rubella. I believe the vaccine you may be referring to is the oral, inactivated cholera vaccine that also provides moderate protection against traveller's diarrhea, enterotoxigenic Escherichia coli
. It's not currently recommended for the majority of individuals. When in doubt, I'd recommend referral of patients to be assessed by a doctor experienced in pre-travel medicine. KL