Preperation for Travel / Immunization / Medical Kit

medical-kitEven though I feel that health care, dental care and eye care are excellent in Mexico, I suggest check-ups prior to your departure; make sure that you have appropriate health care insurance while you are away. As well, make sure that your immunizations are up to date, and, if you haven’t done so, prepare a medical kit of useful items. Your local travel clinic will be helpful in answering your questions about immunizations, whether it is updating previous immunizations, or recommending a necessary immunization. If you are traveling with medications, make sure they are in their original containers, with your physician’s name on the label.

There is no standard immunization recommendation for any destination. What is required is an individual risk assessment based on many factors, such as the individual traveler’s itinerary and health situation, with strict attention paid to the possible risks and benefits of each vaccine. For adult travelers, routine immunizations refer to booster doses of childhood vaccines commonly recommended for use in Canada. The only required vaccine, under the International Health Regulation is yellow fever. In Canada, this vaccine is available usually at your local travel clinic.

I won’t discuss the routine immunizations that I expect everyone to have had over the years, other than to mention that a booster of Tetanus-diphtheria is advised every 10 years, and a booster for polio once in adulthood.

Influenza: a yearly flu shot is strongly recommended for everyone over 65 and in particular, for those with chronic illness; we tend to think of the flu as a relatively trivial infection, but for those with medical problems, this can be a potentially fatal infection. There has also been some concern that we may be due for a worldwide pandemic similar to the Spanish flu of 1918, which claimed millions of lives, many of them healthy young adults. In the southern hemisphere, influenza occurs year round; because travel, especially long plane trips and cruises, increases the risk of respiratory infections, this vaccine is recommended for travelers leaving Canada in the fall.

immunisationHepatitis: there are three types of viral hepatitis – A, B, and C. Hepatitis A poses the greatest risk, but Hepatitis B and C pose the greatest hazard. Hepatitis A is highly endemic through the developing world and is spread person-to-person as well as by contaminated water (including ice cubes), food and shellfish.

This is the type of hepatitis which everyone associates with ‘jaundice’ it begins with a flu-like illness with fever, chills, loss of appetite and fatigue, then progresses to a situation where the eyes and skin begin to appear yellow; as well, the urine turns dark and the stools become pale; frequently, the patient recovers uneventfully after a few weeks. Hepatitis B can cause serious liver disease or liver failure; it is readily transmitted via contaminated needles, blood transfusions, sexual or intimate contact; the incidence is very high in some countries, so much so, that HepB is now a routine vaccination for children in Ontario.

Hepatitis C may be transmitted by inoculation (acupuncture, tattooing, blood transfusions, sharing needles), from person-to-person by fecal-oral contact, or by contaminated food or water. Like Hepatitis B, it frequently progresses to chronic hepatitis, which may lead to cirrhosis, and liver cancer; most people with Hepatitis C experience no symptoms and feel quite healthy; symptoms may not show up for 20 years or more. There is no vaccine for Hepatitis C.

There are combined vaccines for Hepatitis A and B, one being Twinrix, which involves a series of 3 doses, given over a 6 month period. I do feel it is most important to receive this vaccine. Many Canadians travel to ‘all-inclusive’ resorts, where they tend to eat and drink everything they have paid for. In spite of promises to the contrary, much more is included than just sand, surf and salsa – viruses and bacteria may also be included.

Other vaccines, like cholera, typhoid, and yellow fever, are not necessarily indicated unless you plan to be traveling in a rural area; your travel clinic will advise you of this. Dukoral is the only vaccine available in Canada to prevent traveler’s diarrhea caused by E.Coli; two doses are taken, orally, 1 week apart. It also protects against cholera, and is recommended primarily for travelers to Central and South America, the Caribbean, Southeast Asia, Africa, and Eastern or Southern Europe. For typhoid, there are 2 types of vaccine available in Canada – one oral, one injectable; both are 50-70% effective and recommended for those staying in endemic areas or venturing off the usual tourist routes. The vaccine for yellow fever is available at a travel clinic.

If you are spending more than 3 months in Mexico, it is a good idea to register with the Canadian embassy. This can be done online, and the web site is provided in the Useful Links section; this site is also an excellent source of information for travel anywhere in the world.

The following is a recommended checklist for a good general medical kit.
Sunglasses; sunscreen SPF = 15 or greater
Insect repellent with DEET 30%
Medic Alert tags for serious allergies or medical conditions
Medication in prescription bottles
Water purification supplies, if not readily available
A brief health history, with a list of your medication, your blood group, & names of physician & next-of-kin
Additional recommended medication:
Cipro 500mg tabs: 6 – 12 tabs, sufficient for 1-2 complete courses of treatment
Imodium and/or Pepto Bismol, although these can be purchased in Mexico
Antihistamines: ChlorTripolon, 4mg, or Benadryl, 25 or 50mg, for scorpion stings, or allergic reactions
Gravol for nausea & vomiting, or dizziness
Tylenol for aches and pains
Antibiotic ointment and eye drops: Polysporin is a good product
Tensor bandage, band-aids, a few 2×2 gauze for a dressing, tape
Thermometer, scissors, tweezers