Hepatitis B
The disease hepatitis B can be contracted from being bitten or scratched at school ( this is why hepatitis B immunisation is given to all children in America at birth and has been for more than 10 years ).It can also be acquired at birth from and infected mother or from breast feeding. There is a 10-20% mortality from acute liver damage and then it can cause liver cancer and progressive liver damage for life .For this reason it is an important cause of death in developing countries.
The immunisation which is very safe and effective is given at time zero, 1 month and at 6 months (it is recommended to children from 1 years old only). A fourth dose is generally given in 5 years.
It can be safely combined with hepatitis A (both are killed, mercury free vaccines) and given using the same time schedule.
Hepatitis A is usually a less serious disease than B rarely causing death but is much more easily caught usually from contaminated water or food.
I have been giving hepatitis B immunisation at my clinic to children now for over 7 years and I now give both as combined hepatitis A and B immunisation particularly if foreign travel is considered.
Hepatitis A
Hepatitis A is spread though contaminated food and water and can cause inflammation of the liver and jaundice. It occurs throughout the world and vaccination is advised when good standards of hygiene cannot be guaranteed. One dose may give protection for one year. To increase the length of protection to at least 10 years, a second dose will be required. It is recommended to children from 1 years old only.
Typhoid Fever
Typhoid fever is also spread through contaminated food and water and can result in severe illness in some individuals. It can occur worldwide and vaccination is recommended for travellers to areas where sanitation and hygiene is very poor. The vaccine can be given from 18 months of age and lasts for 3 years.
Yellow Fever
Yellow fever is spread by mosquitoes. It is a serious, sometimes fatal, illness. It occurs in parts of tropical South America and sub-Saharan Africa . The vaccine can be given from 9 month of age, lasts for 10 years and should be given at least 10 days before travel. Yellow fever vaccination is mandatory for travel to some countries.
You will not be allowed to enter these countries without a valid international certificate of vaccination.(The yellow fever vaccine can only be administered at a registered yellow fever clinic)
Meningococcal meningitis
Meningococcal meningitis is a bacterial infection that is spread by droplets form an infected person’s nose and throat. It occurs most frequently in sub-Saharan Africa and vaccination is particularly recommended for those who are going to live and work for more than 4 weeks. Vaccination against the meningococcal strains A,C,W and Y is mandatory for entry to Saudi Arabia
Rabies
Rabies is fatal disease spread by the saliva of infected animals. It is present in many countries but is as higher risk in some developing countries. If you are travelling in rural areas of high-risk countries away from medical care, then you should consider vaccination before you go and avoid touching any local animals, even if they appear healthy. If you are bitten abroad you should seek medical attention immediately -even if you have been vaccinated. The course consists of 3 injections over 3-4 weeks.
Japanese Encephalitis
Japanese Encephalitis is a life- threatening viral disease which affects the brain. The virus is spread by mosquitoes in South East Asia and the Far East . The risk of infection is greatest during , or just after, the wet season. The vaccine is recommended for travellers who will be staying for a month or longer, especially if travel will include rural areas. Vaccination can be given from one year of age and 2 or 3 doses are given over 2-4 weeks.
Diphtheria/tetanus/Polio
Everyone should have completed a course of the these vaccinations . Ensure that boosters are up-to-date before travelling to certain destinations.
- Polio: for travel to areas where polio still occurs such as Africa and
- Diphtheria: for travel to developing countries or Eastern European destinations.
- Tetanus: for travellers to remote locations or locations without access to good medical care
Tick –Borne Encephalitis
Tick –Borne encephalitis is a viral infection spread by ticks and occurs in the summer months in forested areas of central of eastern Europe and Scandinavia . Vaccination is recommended for those who will spend prolonged periods in infected areas or those who will be camping or working in forest during the summer months.
Malaria Prevention
Malaria is a serious disease that is transmitted by mosquito bites. It can occur in many tropical destinations. There is no vaccination available, so prevention consists of a combination of preventive medication and avoidance of mosquito bites.
Avoid being bitten by insects wherever possible; use insect repellents, wear light, loose clothing and sleep under a mosquito net if your accommodation is not air-conditioned. Seek advice on the most appropriate anti-malarial medication to suit your needs from your doctor.
Remember that anyone who has visited a Malarious country should mention this to their doctor if they develop a high fever up to two years after travelling.
How to take Malarone paediatric tablets:
In order to prevent malaria, it is important that the child starts taking Malarone paediatric tablets 1 or 2 days before travelling to a country or countries where there is a risk of catching malaria through being bitten by infected mosquitoes. Malarone Paediatric tablets should be taken each day while in these countries and for 7 days after returning home. If the trip will include visits to some areas or countries where malaria is a problem and also to some where it is not a problem, it is important to continue to take malarone paediatric until 7 days after leaving the last area or country where malaria can be caught.
Usually, malarone paediatric tablets should not be taken for more than 28 days.
| Weight (kg) | Number of Malarone Paediatric tablets |
| 11-20 21-30 31-40 | 1 Malarone Paediatric tablet daily 2 Malarone paediatric tablets as a single dose dialy 3 Malarone paediatric tablets as a single dose daily |
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