Q&A on Travel Vaccination
By Dr Keith Wong, Matilda Medical Centre    

The most carefully planned holiday‚ business trip or adventure travel may be ruined by a preventable illness. Just as you put time and effort into your trip planning, you must also protect your health while abroad.
 
What vaccinations should you take before you go?

• Hepatitis A - Recommended for all travelers.
• Typhoid - Recommended for all travelers.
• Hepatitis B - Recommended for: prolonged stays, frequent short stays in high risk countries, adventure travelers, those who have the possibility of having a new sexual partner during stays and travelers with high potential to seek medical care in local facilities. Short-stay travelers who desire maximum pre-travel preparation should also consider such protection. Increased awareness is recommended regarding safe sex and body fluid/blood precautions.
• Japanese encephalitis - Consider for: prolonged stays or frequent short stays in high-risk areas as well as shorter rural visits by those with extensive outdoor exposure, such as hikers and adventure travelers.  Insect precautions are also recommended at night.
• Influenza—Travelers who wish to decrease the risk of influenza or non-specific respiratory illness should consider the influenza vaccine.  

Do I need to take malaria tablets?
Yes, medicines that protect against malaria include mefloquine (Lariam), doxycycline or atovaquone/proguanil (Malarone). Primaquine may be used in special circumstances (G6PD testing is required).

What can I do while I am there?
Evening and nighttime insect precautions are also recommended. Universal precautions should be taken, such as accommodation with air-conditioning or mosquito netting and wearing light coloured trousers and long-sleeve clothing. 

What medicines, first aid equipment and other items should I take?   
Below is a list of items suggested for your trip abroad. Take medications with you that you are used to taking at home. Some of these require a doctor’s prescription. Discuss the use of these items with your doctor before travel, and make a note of when and how to use them.
1.       Paracetamol (Calpol, Tempra, Tylenol)
2.       Rehydration salts
3.       Disinfectant (Dettol, Betadine or Savlodil)
4.       Band-aids
5.       Sunscreen (Factor 15 for body and higher for face)
6.       Sunburn lotion (Calamine)
7.       Eye and ear drops for nose and eye cleaning
8.       Antihistamines for skin allergies (Piriton)
9.       Antibiotics
10.    Splinters, forceps and scissors
11.    Insect repellent
12.    SOS wrist band for existing illnesses
13.    List of emergency numbers and contact persons   
14.    Record of blood group

What about parasitic diseases?
There are several ways to combat potentially dangerous parasitic diseases:
1.       Practice good hygiene. Wash hands thoroughly with soap and water. Wash hands after using the toilet and before handling or eating food (especially for persons with diarrhea). Wash hands after every diaper change with children, even if you are wearing gloves. Protect others by not swimming if you are experiencing diarrhea (essential for children in diapers). 

2.       Avoid water that might be contaminated. Do not swallow recreational water and do not drink untreated water from shallow wells, lakes, rivers, springs, ponds and streams. Do not drink untreated water during community-wide outbreaks of disease caused by contaminated drinking water. Do not use untreated ice or drinking water when traveling in countries where the water supply might be unsafe.

3.       If you are unable to avoid using or drinking water that might be contaminated, make the water safe to drink by doing one of the following:

• Heat the water to a rolling boil for at least one minute.
• Use a filter that has an absolute pore size of one micron or smaller, or one that has been NSF rated for "cyst removal.”
• If you cannot heat the water to a rolling boil or use a recommended filter, then try chemically treating the water by chlorination or iodination. Using chemicals may be less effective than boiling or filtering because the amount of chemicals required to make the water safe is highly dependent on the temperature, pH and cloudiness of the water.
•        Avoid food that might be contaminated.  

What if I need a blood transfusion while traveling abroad?
 Transfusion should be required only in rare and unexpected situations of massive hemorrhage, such as severe trauma, gynecologic and obstetric emergency or gastrointestinal bleeding. Not all developing countries have accurate, reliable and systematic screening of all blood donations for infectious agents such as malaria, HIV, and hepatitis viruses, which can result in transfusion-related transmission of these infections.  Travellers should, however, carry a medical card or other document, showing their blood group and information about any current medical problems or treatment.

What are symptoms of diseases I should be aware of when I return to HK?
Headache, malaise, myalgia  (muscular aches), anorexia, recurring high fever, rigors, drenching sweats, watery diarrhea and abdominal pain.