jabs and tabs? India (including Goa) (Asia)
Advice for all destinations
The risks of health whilst travelling will vary between individuals and many issues need to be taken into account, e.g. activities abroad, length of stay and general health of the traveller. It is recommended that you consult your General Practitioner of Practice Nurse who will assess your particular health risks before recommending vaccines and / or antimalarial tablets. This is also a good opportunity to discuss important travel health issues including safe food and water, accidents, sun exposure and insect bites. Many of the problems experienced by travellers cannot be prevented by vaccinations and other preventive measures need to be taken.
Ensure you are fully insured for medical emergencies including repatriation. The T7 leaflet (from post offices) gives details of health care agreements between countries and is accompanied by an application form for the European Health Insurance Card (EHIC). The completed form must be submitted about 6 weeks before you plan to leave to allow the card to reach you on time. The EHIC entitles travellers to reduced-cost, sometime free, medical treatment in most European countries.
For Travel Safety advice you should visit the UK Foreign and Commonwealth Office website.
Immunisations
Confirm primary courses and boosters are up to date as recommended for life in Britain -including vaccines given to special groups because of the risks exposure or complications (e.g. hepatitis B for healthcare workers, influenza and pneumococcal vaccines for the elderly).
Course or boosters usually advised: diphtheria, tetanus; poliomyelitis; hepatitis A; typhoid.
Vaccines sometimes advised: hepatitis B; rabies; tuberculosis; Japanese B encephalitis
Yellow fever certificate required if over 6 months old and entering from, or being in transit through, and area with risk of yellow fever transmission within the previous 6 days.
Tetanus is contracted through dirty cuts and scratches and poliomyelitis spread through contaminated food and water. They are serious infections of the nervous system.
Typhoid, hepatitis A and Polio are spread through contaminated food and water. Typhoid causes septicaemia and hepatitis A causes liver inflammation and jaundice. In risk areas you should be immunised if good hygiene is impossible. Polio has in the past but also continues to cause crippling disease in those countries who have not managed to eradicate it.
Cholera is spread through contaminated water and food. More common during floods and rainy seasons. Those unable to take effective precautions, for example, during wars and when working in refugee camps and slums may consider vaccination.
Tuberculosis is most commonly transmitted via droplet infection. BCG vaccination is recommended for travellers under 16 years of age who will be living or working with local people for a prolonged period of time (three months or more). Following individual risk assessment, vaccination may also be considered for travellers under the age of 35 years who may be at high risk through their occupation abroad e.g. healthcare workers.
Diphtheria is also spread by droplets infection through close personal contact. Vaccination is advised is close contact with local personnel is likely.
Hepatitis B is spread through infected blood, contaminated, needles and sexual intercourse; it affects the liver, causes jaundice and occasionally liver failure. Vaccination is recommended for those at occupational risk (e.g. healthcare workers), for long stays or frequent travel to medium and high risk areas, for those more likely to be exposed such as children (from cuts and scratches) and those who may need surgical procedures.
Japanese B encephalitis is spread by mosquitoes. It is a serious infection of the brain and vaccination is advised for those in risk areas unable to avoid mosquito bites, staying for long periods (e.g. more than 4 weeks) or visiting rural areas.
Rabies is spread through bites or licks on broken skin from an infected animal. It is always fatal. Vaccination is advised for those going to risk areas that will be remote from reliable source of vaccine. Even when pre-exposure vaccines have been received urgent medical advice should be sought after any animal bite.
Malaria
Malaria is a serious and sometime fatal disease transmitted by mosquitoes. You cannot be vaccinated against malaria.
Malaria precautions
Malaria precautions are essential in all areas below 2000m, all year round. There is very low to no risk in Himachal Pradesh, Jammu, Kashmir and Sikkim, which are at high altitude (go to malaria risk map)
- Avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset, using repellents on exposed skin and, when necessary, sleeping under a mosquito net.
- Check with your doctor or nurse about suitable antimalarial tablets.
- Chloroquine together with proguanil is usually recommended for risk areas (except for Assam).
- For Assam where resistance is more widespread atovaquone /proguanil OR doxycycline OR mefloquine is still the first choice.
- If you have been travelling in a malarious area and developed a fever seek medical attention promptly. Remember malaria can develop even up to one year after exposure.
- If travelling to high risk malarious areas, remote from medical facilities, carrying emergency malaria standby treatment may be considered.
For further information visit; www.fitfortravel.nhs.uk
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