What should every traveler find out about before their vacation?
In addition to the obvious, such as visa obligations, the entry regime and the security of the situation, it is no less important to inform yourself about the health risks of traveling abroad. Above all, therefore, about what communicable diseases occur in the given country, how to protect against them and whether vaccination against some of them is not available.
A traveler with a more serious chronic illness taking medication should inquire whether such a trip poses a risk of aggravating his or her conditions. If a chronic illness worsens abroad, not all travelers can get adequate professional medical care.
What specifically do most travelers forget before going on vacation?
Often our clients/travellers leave vaccinations to the last minute. Some important vaccines are administered in multiple doses, and just before departure, the traveler does not have time to inoculate against certain diseases. We recommend coming for a pre-trip consultation at least 1.5 to 2 months before your planned departure. Then not only will all the important vaccinations be done, but it’s also time to prepare, for example, a travel first aid kit.
Is there something that continues to amaze you as an infectious disease specialist?
Sometimes I come across the same prejudices or misconceptions about the effect and safety of vaccines and antimalarials. Some travelers strongly underestimate the risk of some infectious diseases (e.g. viral hepatitis type A or typhoid fever). With insufficient prevention, they not only threaten themselves, but (given the fact that these are interpersonally transmissible diseases) also their surroundings, in case of illness after returning.
What vaccinations should people receive before traveling?
So, when traveling basically anywhere, the traveler should at least be vaccinated against viral jaundice type A, that’s probably the absolute minimum. In tropical areas, especially in countries with low hygiene standards, we recommend vaccination against typhoid fever. These infections are mainly transmitted by ingestion of contaminated food or water.
If I take the popular Vietnam as an example, we still recommend vaccination against rabies there, especially for travelers on their own axis, “backpackers”. If the traveler wants to see off the “beaten tourist track”, for example, he rents a scooter and goes around the countryside. There is a greater risk of being attacked or injured by local dogs, cats or monkeys.
If we go to tropical or subtropical areas regularly, we can recommend vaccination against Dengue fever. However, the general recommendations are only indicative, what to prepare for and possibly inoculate before the trip depends a lot on the specific destination, the length and nature of the stay, the type of meals and also on the health status of the traveler himself.
Are there any special health conditions or risks we should consider before traveling and getting vaccinated?
It probably depends mostly on my health and age. A small child or a chronically ill senior has different risks associated with traveling than a healthy young adult. The specifics are pregnant women. Some vaccines can only be applied from a certain age, pregnant women are usually not even vaccinated with inanimate vaccines (apart from vaccination against covid, flu and whooping cough).
If I have a more serious chronic condition and am taking medication, I should definitely consult with an expert before traveling, ideally my treating physician and a travel medicine expert. It is important to pack enough of your medication with you.
Are there any contraindications or side effects that one should expect after vaccination?
After vaccination, local reactions are the most common, i.e. soreness, or slight swelling or redness in the area of vaccine application (most often the deltoid muscle). General reactions may also occur, such as fatigue, headaches, increased temperature or (rarely) fever. It is therefore important to follow a certain regimen for a few days after vaccination – avoid significant physical activity, do not overdo it with alcohol, etc. Vaccination contraindications include an acute febrile illness or a state of convalescence after such an illness.
Furthermore, an allergic reaction after the same vaccine or a known allergic reaction to one of the components of the vaccine. Pregnancy is a contraindication for some (mainly live) vaccines.
Is there anything a traveler should know about local epidemics or diseases that are current in the area? Where can this information be found?
The traveler should definitely have at least a basic awareness of the health risks in that destination. Some trusted internet sources offer such basic information, but it’s probably best to consult a travel medicine expert. It is also advisable to check on the website of the Ministry of Foreign Affairs whether there are any warnings issued about traveling to the selected country (epidemic, deterioration of the security situation, natural disaster, etc.).
Is it necessary to renew any vaccinations or supplementary doses during the trip or after returning?
Certainly. As I said, some vaccines are multi-dose and some require a booster dose every few weeks or months to ensure long-term protection.
Are there alternative options for disease prevention if some vaccinations are not suitable for a person for some reason? Or is it better to always avoid the destination?
If you mean alternative options for prevention, such as homeopathic preparations or “grandmother’s” advice and various herbal preparations, then you definitely cannot rely on them. I can use them as a supplement, but they do not replace full-fledged prevention procedures, such as vaccination, antimalarial chemoprophylaxis or the use of strong repellents or insecticides.
If, for example, I am traveling to Kenya, where there is a high risk of malaria, then in addition to using repellents designed against tropical blood-sucking insects and sleeping under a mosquito net, the key is the preventive use of antimalarials, i.e. a drug that is poisonous to the malaria parasite and will either completely prevent the infection or reduce course of the disease and prevent severe complications or death. Tropical malaria is a big problem in Africa and the risk of infection is high, it is a life-threatening disease.
However, if I travel to a country with a low risk, for example the aforementioned Vietnam, then I can do without antimalarials and a strong repellent will suffice as a prevention of mosquito-borne infections.
Of course, there are destinations that are downright risky for certain people and you need to consider whether to travel to such a country at all. Let us take the aforementioned Kenya as an example, because of the occurrence of malaria and yellow fever, it is downright dangerous for a pregnant woman, where we cannot give a live vaccine against yellow fever, and in addition, malaria is much worse in pregnant women, and there is also a risk of fetal death.
What is the procedure if a person gets sick during the trip, even though I have been vaccinated?
Above all, it depends on the character and intensity of the symptoms. For example, such a common traveller’s diarrhea can usually be overcome by the traveler himself with the help of self-medication with recommended medications. On the contrary, if I have high fevers with chills, chills and general malaise, I should visit a local medical facility as soon as possible (preferably a hospital in a big city), it could be dangerous malaria or Dengue fever. If I get sick soon after returning, it could still be some “exotic” disease and I need to visit the infectious disease clinic.
Can a person be “revaccinated” in the sense that he travels very often and gets vaccinated against, for example, 20 different diseases?
We cannot overdose on vaccines. If the recommended vaccination schedules and intervals between individual vaccines are followed, possible contraindications are taken into account, then vaccination is safe. Vaccination does not burden the organism in any way, on the contrary it stimulates our immune system against specific diseases and thus represents the most effective form of primary prevention ever.
Is there such a thing as “travel” vaccinations for pets?
It certainly exists, such vaccination is usually required abroad to prevent the importation of infectious animal diseases. Of course, our animal friends can also get some kind of infection. I would recommend consulting a vet well in advance of going on an adventure abroad with my animal companion.
Infectious disease specialist. How to protect yourself and what are the consequences? Pavlína Horáková
