Family Travel Clinic

Diarrhea is the most common medical problem affecting travellers from developed to developing countries.  Symptoms of Travellers’ diarrhea can include abnormally frequent, loose bowel movements, abdominal cramps, nausea, bloating and fever. Cholera is a potentially more dangerous diarrhea illness. Symptoms can include very severe watery diarrhea. Both Travellers’ diarrhea and cholera can occur by consuming contaminated food or water. The oral vaccination, DUKORAL, reduces your risk of becoming ill.

The hepatitis A virus is transmitted when we eat or drink something that is contaminated with the virus. Raw or undercooked food, food handled by those who have not washed their hands, and water contaminated by human waste are often sources of the virus. Hepatitis A is the most common vaccine-preventable disease in travellers. Protection against hepatitis A is highly recommended when travelling to developing or endemic countries, particularly if visiting rural areas or places with inadequate sanitation facilities.

The hepatitis B virus is responsible for the most prevalent form of hepatitis in the world. The virus can be spread through sexual contact, through the exchange of blood or bodily fluids, or through objects contaminated by bodily fluids. Regardless of the destination, all people who may engage in practices that places them at risk for infection during travel should receive the vaccination.

Japanese encephalitis is a viral disease that is transmitted by mosquitoes. Epidemics of the disease occur in the late summer and early fall in temperate areas and sporadically throughout the year in tropical areas of Asia. Vaccination against the disease should generally be considered for travellers three months and older who will be spending a month or more in high prevalence areas during the transmission season, especially if travel will include rural areas.

While there is currently no approved vaccine against malaria, antimalarial medication is available for both adults and children You should alsotake precautions to prevent mosquito bites.

• Activities | When possible, avoid places and times when mosquitoes are most active. Try to avoid damp, wooded areas where mosquitoes live and breed, and stay indoors or take extra precautions during dusk and dawn.
• Clothing | Wear full-coverage clothing that protects against mosquito bites, such as long-sleeve shirts and full-length pants. Wear shoes and socks to protect your ankles and feet. Try to wear light-colored clothing as dark colors attract mosquitoes.
• Netting | Sleep in screened areas or under bed nets. Tuck mosquito netting under your mattress when sleeping. Mosquito netting should also be used over children in strollers. For the best protection, mosquito netting should have mesh large enough for air circulation, but small enough to keep out mosquitoes.
• Insect repellant | Apply an insect repellent containing up to 35% DEET to skin, clothing and bed nets.

Learn more about malaria on AboutKidsHealth.

Meningitis is an infection of the membranes that cover the brain and spinal cord. Meningitis is most common among children and people whose bodies have trouble fighting off infections. Meningococcal conjugate vaccine (MCV4) is the preferred vaccine for people 55 years of age and younger and prevents four types of meningococcal disease.

Rabies is an infection that is transmitted through the bite of an infected animal. Avoiding contact with animals, especially dogs and monkeys, will reduce the risk of contracting rabies. The rabies vaccine should be considered for travellers intending to live or work in areas where rabies is present and rabies control programs for domestic animals are inadequate, or where adequate and safe post-exposure management is not available. Children, especially those who are too young to understand the need to avoid animals, should also be considered for pre-exposure immunization. 

Typhoid fever is spread through contact with infected food and water. Vaccination against typhoid is recommended for travellers who will have prolonged exposure (more than four weeks) to potentially contaminated food and water, especially those travelling to smaller cities, villages or rural areas in countries with a high incidence of the disease. Individuals visiting families in such areas may be at particularly high-risk.

Yellow fever is transmitted through the bite of an infected mosquito. Immunization against yellow fever is recommended to all travellers nine months and older who are visiting or living in certain countries in Africa, Central America and South America where infected mosquitoes live and breed. A valid International Certificate of Vaccination is mandatory for entrance into certain countries in Africa and South America. Other countries have requirements for proof of immunization from travellers who have passed through yellow fever endemic zones. It is also recommended for travel outside of urban areas in countries that lie in the yellow fever endemic zones. The recommendation of yellow fever immunization will depend on the itinerary of the traveller and the specific requirements of the country to be visited (including stopovers).

Immunization during pregnancy requires careful evaluation of the potential risks of a vaccine-preventable disease versus the possible risks of vaccination for both the mother and the fetus. In general, vaccinations should be avoided in the first trimester. Live virus vaccines (such as oral typhoid) should be avoided in all trimesters.

An increasing number of Canadians are living with conditions that reduce immune competence, including organ transplantation, HIV infection, cancer, and treatment with corticosteroids or immunosuppressive agents. Travel-related risks for the immunocompromised traveler depend on the immune status of the person.

Living with a chronic health condition does not mean you should not travel. By planning ahead, you can enjoy your trip just like everyone else. 

• If your trip will take you outside of Canada, your first step should be to consult our travel clinic to see if you require interventions
• Carry a letter from your doctor explaining your condition and any medical supplies you may require
• Carry a record of all medications you take and the vaccinations you have had. Keeping this travel health record up-to-date will provide a convenient place to record this important information
• If you will cross time zones, ask your doctor or pharmacist for advice about whether you will need to adjust your medication dosing schedule
• Be sure to take enough extra medication to last in the event your return is delayed
• Arrange for health insurance before you depart