Ajit Johal BSc (Pharm) RPh BCPP CDE CTH
Founder and Clinical Director, Travel Rx Education INC
Dr. Brian Aw
Medical Director of the International Travel Clinic,
Ultimate Health Medical Centre
It’s good to be a global explorer, but best to do it safely. Before leaving, learn what precautions to take, including vaccinations.
While travelling abroad is fun and exciting, it comes with certain health risks. COVID-19 continues to be a public health concern, so travellers should be aware of their destination’s rules on vaccinations, testing, and any other precautions before leaving for their trip. But there are other types of health risks, such as food and water borne illnesses, as well as animal and mosquito-borne illnesses, for travellers to be aware of.
Awareness of the risks for rabies and mosquito-transmitted diseases is critical
Rabies is a significant and often overlooked animal-borne disease that is fatal. It occurs on all continents except Antarctica and is transmitted via exposure to the saliva of an infected animal, typically through licks, bites, or scratches. Though rare in Canada, thanks to our excellent prevention and control programs, rabies is prevalent in Asian and African countries where it is transmitted mostly by dogs. “Tourists going to these regions may be at risk,” says Dr. Brian Aw, Medical Director of the International Travel Clinic, Ultimate Health Medical Centre.
There are also several mosquito-borne diseases that pose risks for travelers, such as yellow fever, found in certain South American and African countries and Japanese encephalitis, a viral disease occurring in Asia. “Though rare, the case fatality for Japanese encephalitis can be as high as 30% in severe cases, with survivors having serious long-term neurological and mental complications,” says Dr. Aw. Other diseases transmitted by mosquitoes include malaria, dengue, chikungunya, and zika. “Zika has the ability to be vertically transmitted through the placenta and can affect newborn babies with serious conditions like microcephaly, or small head,” says Ajit Johal, Founder and Clinical Director of Travel Rx Education INC.
How travelers can reduce their risks of becoming infected
Travelers can take steps to protect themselves against rabies and mosquito-borne illnesses. Travelers can reduce their risks of getting rabies by avoiding touching or feeding unknown, stray or wild animals. A pre-exposure vaccine against rabies is recommended if planning a trip to Asia or Africa where you’ll be exposed to dogs and have limited access to healthcare. “The non-vaccinated traveler has a higher risk of fatality without prompt treatment and needs human rabies immune globulin, a human by-product, as well as post-exposure vaccines,” says Dr. Aw. “For the pre-vaccinated traveler, the treatment regimen is much simpler, requiring only two shots of inactivated rabies vaccine,” he says. Regardless of whether you’ve been vaccinated or not, it’s critical to get prompt medical attention if bitten.
First-line mosquito precautions include avoiding exposure and bites. “That’s things like using mosquito repellant, wearing light-coloured long-sleeved clothing and knowing when and where the mosquitoes are most active,” says Johal.
Another line of defense is vaccinations and medications to reduce the risk of mosquito-bornes diseases. “Vaccines are crucial, particularly when there are no effective treatments for the disease such as Japanese encephalitis and yellow fever,” says Dr. Aw. Fortunately, there are vaccines available for both diseases. Malaria can be prevented with medication, and for other mosquito-borne diseases such as dengue, zika and chikungunya there are currently no available vaccines, so travelers should take extra precautions to avoid mosquito exposure.
Travelers should bring their itinerary so the clinician can review it and assess the risks, provide information on the vaccine options, and advise on the destination country’s vaccine requirements.
Reducing your travel health risks starts with consulting your healthcare provider or a travel clinic well before departure. “Ideally, it should be four to six weeks in advance because some vaccines require multiple doses,” says Johal. “Travelers should bring their itinerary so the clinician can review it and assess the risks, provide information on the vaccine options, and advise on the destination country’s vaccine requirements,” he says.
Travelers can also visit https://howtotravelnow.ca/ for more information and resources to ensure a healthy and enjoyable trip.