Picture it. You've packed your suitcase and checked off every item on your list. You are ready to enjoy yourself on your well deserved trip abroad. Think you might be forgetting something? Of course you are! Did you remember to get your shots?
According to Physician, UWI Lecturer and Wellness Consultant Dr. EM Davis, and Specialist Medical Officer, Insect Vector Control Division, Ministry of Health Dr Clive Tilluckdharry, international travel has become more risky due to increased frequency of global travel.
"Airplane air" is known to be responsible for acute and chronic respiratory problems from nasal stuffiness through sore throats, post nasal drips to influenza and other more serious conditions like 'SARS' (which stands for Severe Acute Respiratory Syndrome - a contagious disease that is caused by the SARS Coronavirus (SARS CoV) and typically leads to a potentially fatal form of pneumonia)," they explained.
With more than 60 years of experience (combined), the seasoned doctors added that since the discovery of HIV, viruses and other pathogens have been changing rapidly and have a much greater effect on humans than ever before.
"People are living longer now, and the elderly are more susceptible to infections as their immune systems are less robust," said Dr. Tilluckdharry.
"Protection is needed from outbreaks of disease. A common piece of advice now is, 'If there is a vaccine available, take it!'" added Dr. Davis.
However, they quickly added that this saying does not apply to persons over 60 years of age when speaking of yellow fever (since such persons may have received multiple boosters during their lifetime). In this case there is a greater risk of side effects. However, they pointed out that there is a growing trend of thought that encourages older persons to get their flu shots; the reason being again that older persons are more susceptible to the flu and its complications.
WHY IMMUNISE?
Still not clear as to why you should be immunised before travelling? The medical experts said that active immunisation is required for several reasons:
�2 Immune systems of humans decline in function with age
�2 Prophylactic or personal protection measures may be ineffective in certain infections
�2 Indiscriminate use of antibiotics causes increased resistance of the offending agent and the antibiotics become less able to combat the condition.
"One should keep up-to-date with immunisation for personal protection," the team again insisted.
WHICH VACCINES DO I NEED?
So what exactly can you be immunised against? According to the Ministry of Health's website http://www.health.gov.tt, free vaccines are provided to prevent the following diseases: Tuberculosis (TB), Poliomyelitis, Diphtheria, Pertussis, Tetanus, Measles (Rubeola), Mumps (Parotitis), Rubella (German Measles), Viral Hepatitis B, Haemophilus Influenzae type B, Yellow Fever, Pneumococcal Disease, Varicella (Chicken Pox), Rotavirus Enteritis, Rabies, Meningococcal Disease, Viral Hepatitis A, Influenza.
One viral infection which many may be familiar with is 'Bird Flu' (a subtype of the Influenza A virus which can cause illness in humans and many other animal species). This viral infection has caused several deaths in China recently. According to Drs. Davis and Tilluckdharry, "So far there has been no human to human contamination, and the fatalities have been due to direct contact with the affected birds. However, there are specific vaccines certain travellers must get. People going to Mecca must get the Meningitis shot. Those going to India and Brazil must get Yellow Fever shots. Tourists who are nature lovers should get their rabies shot, especially when venturing in forests and areas where there are bats. This shot, however, is not available to the general public in Trinidad.
SEEK PROTECTION FROM MALARIA
When travelling to other countries, it is important that you be immunised against diseases spread by mosquitoes.
"Treatment for malaria disrupts the life cycle (of the parasite) and so prevents the mosquito parasite (plasmodium) from maturing. Dengue and malaria have multiple strains which are infectious and it is difficult to find a vaccine for these conditions. Effective protection is given against malaria using chloroquin-based tablets, but they must be taken at specific times, commencing even before one enters the area of possible infection. Most persons affected with malaria are guilty of either not taking the medication or not taking it as directed! Some mosquitoes are not affected by chloroquin (chloroquin resistant), used in the treatment of malaria, and these have to be fought using another type of medication which does not contain chloroquin," they said in a combined explanation.
As for Dengue, no vaccine has been developed. However, the doctors advised that persons should take precautionary measures such as wearing light-coloured, long-sleeved clothing (mosquitoes like darker colours and exposed skin), using insect repellant and mosquito nets and trying to avoid going to areas that are endemic for Malaria and Dengue.
Dr. Tilluckdharry said, "Evidence of vaccination against Yellow Fever, requiring a specially designed card, bearing an official signature and stamp, is mandatory for some countries, and visitors can be denied entry. This vaccine is one of the international requirements (from the World Health Organisation) for travellers. Yellow fever is endemic in Trinidad and Tobago, hence proof of vaccination is required when travelling to countries with or without yellow fever. However, certain countries may not require that travellers get this vaccine."
Dr. Davis added, "The Commonwealth of The Bahamas, for example, no longer requires persons journeying from Trinidad and Tobago to that country to have the yellow fever vaccine. This is because since 1981 there has not been a single case of the disease reported in Trinidad and Tobago."
However, as previously mentioned, India and Brazil require that tourists get this vaccine. It is also important to note that persons allergic to eggs and chicken will not be able to take this vaccine, therefore, such persons should try to protect themselves as much as possible from being bitten by mosquitoes. For more information on vaccinations required for travellers, persons can call Insect Vector Control or the County Medical Office for advice. Some tablets used to treat some of the infections mentioned here are also distributed by these offices.
Dr. Davis and Dr. Tilluckdharry further explained, "Some treatment modalities use self-innoculation, in which a person is injected with the same offending agent/toxin that would normally produce the disease, in this case an attenuated amount is contained in the innoculation, and this stimulates the normal immune system to produce antibodies to fight it off. This confers protection to the individual against the said disease."
WHERE CAN ONE GO FOR THEIR SHOTS?
According to both doctors, immunisations and vaccines may be readily administered in Trinidad and Tobago's local public and private health centres and offices. Individuals should exercise personal responsibility regarding immunisation and vaccine schedules, practise a healthy lifestyle, exercise regularly, eat properly and try to get six to eight hours of sleep per night in order to build one's immune system and ultimately be protected against diseases.