by Wherever you travel, whatever the purpose of your trip, knowing the likely health risks at your destination – and how to minimize them – is a vital part of ensuring a successful and enjoyable time away.
A specialist travel clinic is a good place to start, to carefully review your past vaccination coverage and any additional vaccinations you may need. Some destinations require proof of vaccination against dangerous endemic diseases, such as yellow fever, upon entry into the country, and some disease prevention regimes begin long before the day of departure, so it’s important to be aware of sensible precautions while looking forward to. your journey.
Here are the most common diseases that travelers may encounter abroad, how and when to vaccinate against them, and how to mitigate the risks of illness on vacation.
In this guide:
Typhoid
Areas of risk: Africa, the Indian subcontinent, South and South East Asia and South America
Method of inoculation: Vaccine (injection or oral medication) every three years
When to get vaccinated: At least one month before travel
What is typhoid?
Salmonella bacteria cause typhoid, fever, diarrhea (or sometimes constipation) and potentially serious complications. Drug resistance can make it difficult to treat.
What is known about the typhoid vaccine
It must be updated every three years. If you hate needles, an oral typhoid vaccine is available as an alternative.
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Hepatitis A
Areas of risk: Africa, Asia, the Middle East, and Central and South America
Method of inoculation: Injection
When to get it: Two weeks before travel
What is hepatitis A?
Hepatitis A is a viral infection of the liver – and complications such as liver failure increase with age. The good news: hepatitis A is now rare in travelers since vaccines became available in the 1990s.
What do you know about the hepatitis A vaccine
Your first dose lasts for a year; the second dose extends this to more than 20 years.
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Yellow fever
Areas of risk: Sub-Saharan Africa, South America, Central America and Trinidad in the Caribbean.
Method of inoculation: Injection
When to get it: More than 10 days before travel
What is yellow fever?
Yellow fever is a viral infection spread by mosquitoes in Africa and Latin America. Although named after the yellowness caused by liver failure and jaundice, the virus attacks every system in the body. It occurs in sudden, unpredictable outbreaks with periods of inactivity.
What do you know about the yellow fever vaccine?
The vaccine is only given in officially authorized vaccination centers. There is a live, weakened virus that may have adverse effects in older groups or people with various pre-existing medical conditions, so a careful risk assessment is essential. Yellow fever vaccination certificates are valid for life – but are only valid for 10 days after vaccination. Some experts recommend booster doses at 10 years for those at continued high risk.
Expert tip: Travelers coming from yellow fever zones are often required to show proof of vaccination as a condition of entry to countries where mosquitoes can spread yellow fever – to prevent the spread of the disease – so check the requirements carefully.
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Rabies
Areas of risk: Asia, Africa, and Central and South America
Method of inoculation: Three jobs for pre-travel vaccinations
When to get it: At least eight weeks before travel
What is rabies?
Rabies is a fatal viral infection of the brain and nervous system. All bites, licks and scratches by dogs (or other mammals, including monkeys, cats and bats) must be treated as a potential rabies risk. Rabies occurs in most countries, and animal bites are among the most common reasons travelers need medical care abroad.
What is known about the rabies vaccine
Ideally, three doses of vaccines are needed, over three weeks. Pre-travel vaccination does much of what is needed if caught while on holiday: cleaning the wound to prevent infection and promote healing, and booster doses of vaccine as soon as possible.
Without prior vaccination, treatment is more complex and urgent: injection of rabies immune globulin (RIG) – a product containing antibodies that neutralize the rabies virus that is often not available in countries with the highest risk – into the area of the bite. This treatment is followed by an accelerated vaccine course, which can throw your itinerary into the chaos of medical appointments.
Expert tip: Do not handle animals while traveling. Stray dogs are a particular danger: they are not pets, can be territorial, and should not be approached. Shyness can be a sign of rabies, and sick or injured animals should not be touched. And famous “monkey temples” should only be seen from afar.
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Malaria
Areas of risk: Parts of Africa and Asia, Central and South America, the Dominican Republic and Haiti, parts of the Middle East, and some islands in the Pacific Ocean
Method of inoculation: Tablets or capsules
When to get it: Talk to a doctor four to six weeks before travelling
What is malaria?
Malaria parasites are transmitted through Anopheles mosquitoes. Symptoms include fever, chills, aching muscles and joints, headache, abdominal pain, diarrhea and jaundice – if left untreated, it can lead to loss of consciousness, coma and possibly death. The onset of symptoms can be delayed for weeks, when the travel link can be forgotten. (Read more about rising cases of malaria in our guide to preventing the disease when abroad.)
What is known about antimalarial treatments
Antimalarial tablets or capsules, Malarone and doxycycline, are usually taken once a day before, during and after travel.
Expert tip: If you become ill after returning home, always tell your doctor that you are away so they can carry out appropriate tests for malaria.
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Dengue fever
Areas of risk: Parts of Africa and Asia, Central and South America, the Caribbean, Pacific islands, and some southern areas of North America. (However, the geographic range of dengue is expanding as warmer temperatures create more favorable conditions, with occasional cases even in southern Europe.)
Method of inoculation: Vaccine injection (for high-risk travelers only)
When to get it: Talk to your doctor more than three months before traveling if you are at high risk of illness
What is dengue?
Dengue is the most common mosquito-borne viral infection in the world. Also known as “bone-breaking fever”, symptoms include a rash, and pain in the muscles, joints and behind the eyes. There are four different types – infection with one strain only provides partial protection against future infection with another strain. Subsequent infections can be more serious.
What is known about the dengue vaccine
A dengue vaccine was recently approved in the UK, given in two doses, three months apart; if this is not practical, an initial dose provides 80 percent protection. Some experts are concerned about the possibility of an increased risk of severe dengue in the future, so they only recommend vaccinating travelers with a previous dengue infection – so it’s best to talk to your GP or specialist travel health under any concern.
Expert tip: The best way to prevent dengue infection is to prevent mosquito bites.
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How to protect yourself on your travels
We all want our travels to be relaxing and care-free: a proactive approach to health, prevention and your own safety is key to its success. Follow these tips to stay safe on vacation.
Avoid biting
Protecting yourself from insect bites is a good way to avoid some of the diseases detailed above – as well as the nuisance of the bites themselves. In fact, careful insect precautions can reduce the number of bites by 90 percent or more: used together, bite prevention measures, vaccines and anti-malarial medication are a powerful combination.
When outside at times when mosquitoes are biting, cover up and use insect repellents containing 50 percent DEET on clothing and exposed skin (repellents containing picaridin are also effective). Clothing can be sprayed with permethrin, which is safe for humans but a contact killer for insects. When sitting outside, burn mosquito coils to keep mosquitoes away. Indoors, in screened or air-conditioned rooms, use spray insecticides along with plug-in insect killers. At night, if mosquitoes can enter your accommodation, sleep under a bed net equipped with an insecticide.
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Food and water hygiene
There is no polite way to say this: food, water and hands contaminated directly or indirectly with faeces spread diarrheal diseases, viruses, parasites, bacteria and their toxins. The risk rises with hot temperatures and poor hygiene, and it can be extremely difficult to avoid when you’re out and about (on a recent trip to the United States, my pride was severely affected by a bout of Shigella dysentery, traced to an outbreak due to contamination.guacamole – although rapidly tested and treated).
Fresh, thoroughly cooked food, served hot, is safest. Don’t forget to wash your hands often, and use hand sanitizers or wipes. Buffets – especially at hot temperatures and when flies are present – are very risky; choose freshly cooked food instead. In case of poor hygiene, avoid salads and raw food.
A tough but effective call for hot climates: avoid ice in drinks and stick to bottled water. And to be prepared for worst-case scenarios, travel with a medical kit containing diarrhea treatment, oral rehydration tablets and antibiotics.
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Information to tell your doctor
The best way to ensure you are protected before any foreign travel is to speak to a doctor, sharing your upcoming itinerary and any high-risk activities planned – such as animal encounters or wilderness trips. Your doctor can also help identify any routine vaccines required, such as measles, diphtheria, whooping cough, tetanus, polio and more common illnesses such as Covid and flu.
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Where to learn more
For more information visit Travel Health Pro and Fit For Travel.
Dr Richard Dawood is a specialist in Travel Medicine at Navy Street Clinic
