The 10 most important vaccinations for an overland trip

by | Trip Planning | 0 comments

Anna is a doctor, in particular a pediatrician. In her opinion, vaccinations are an easy step to prevent damage to your body – and to the body of a baby or a immunodeficient child. Both could not get any vaccination (yet). If you are healthy and keep in mind staying healthy (workout, healthy food, non-smoking etc.), you can copy with vaccinations without a problem (besides a painful shoulder or a short fever).
We know, it is a widely discussed topic and there are many anti-vaxxer out there. But from Anna’s point of view, it was clear that we take all the vaccinations the pharma industry can offer.
After some trips in regions suspect to health, Anna already got many vaccinations and only needed some booster. But Heiner almost started from the beginning and got painful shoulders several times in the last months before starting our trip. In our case Anna’s health insurance paid for all the vaccines, Heiner had to pay for his own because of his private health insurance. But of course he saved the medical treatment with his private doctor at home.

Not only the medical and traveling experiences from Anna but mostly the very helpful support and advice from the Institute of Tropical Medicine at UKD in Dusseldorf, where we went to university, led us to the following list of vaccinations we identified as important for an overland trip:

Hepatitis A
PathogenHepatitis A virus;
worldwide, mainly developing countries
Transmissionfecal-oral (contact-/smear infection); human to human, water/food
CharacteristicsIncubation 15-50 days; mostly asymptomatic, sometimes general malaise, fever, gastrointestinal afficition, jaundice
Initial immunication2 injections:
Day 0 - after 6-12 months
Boosternone, protection for around 25 years

Pathogen of Hepatitis A
Lizenziert unter Gemeinfrei über Wikimedia Commons

Hepatitis B
PathogenHepatitis B virus;
worldwide
Transmissionmainly blood-blood; pre-/perinatal
CharacteristicsIncubation 45-180 days; depending on immune defense, acute icteric hepatitis/acute anicteric hepatitis/asymptomatic; potential chronification
Initial immunicationusually in childhood (in Germany 3-4 injections as infant); without initial immunication as child 3 injections:
Day 0 - after 4 weeks - after 6 months
Boosterusually none; maybe necessary in case of low titer of antibodies

Pathogen of Hepatitis B
Lizenziert unter Gemeinfrei über Wikimedia Commons

Japan B-Encephalitis
PathogenJapan Encephalitis virus (Flavi virus);
Asia
Transmissionmosquito bite (reservoir pigs, birds)
CharacteristicsIncubation 5-15 days; mostly asyptomatic or mild malaise, seldom severe fever, headache, chills, myalgia, seizures, coma
Initial immunicationDay 0 - 28
Boosterafter 2 years
Measels
Pathogenmeasels virus;
worldwide, mostly Africa and Asia
Transmissiondroplet-/smear infection from infected person
CharacteristicsIncubation 8-10 days (exanthem after 14 days); beginning with fever, cough, rhinitis, conjunktivitis and enanthem with Koplik spots; after 3-7 days macula-papulous exanthem beginning retroauricular; compliactions: bacterial superinfection, postinfectious encephalitis, after 6-8 years rarely "SSPE - subacute sclerosing panencephalitis"
Initial immunicationusually in childhood: age 11-14 months - second injection age 15-23 months (in combination with mumps, rubella and varicella);
every adult born after 1970 (>18 years of age) without initial immunication as child, unknown immunication or only 1 injection as child: 1 injection
Boosternone

Pathogen of Measels
Lizenziert unter Gemeinfrei über Wikimedia Commons

Meningitis ACWY
PathogenNeisseria meningitidis, 12 different sero types: i.a. A, B, C, W135, Y;
worldwide, A, W, X in so called meningitis belt sub-Saharan Africa and Asia
Transmissionclose contact to infected person, contact-/smear infection (oropharyngeal secretion)
CharacteristicsIncubation usually 3-4 days; ca. 60% meningitis, ca. 30% sepsis; beginning with malaise, then fever, severe headache, chills and vertigo; later neck stiffness and vomiting, seizures, coma; DIC and multi-organ failure
Initial immunicationusually 1 injection
Boosternone, protection for 3 years

Pathogen of Meningitis
Lizenziert unter Gemeinfrei über Wikimedia Commons

Rabies
PathogenRabies virus;
worldwide, mainly Africa and Asia
Transmissionbite from infected animal (i.a. dog, cat, fox, bat) or contact saliva to injured skin or mucosa
CharacteristicsIncubation usually 3-6 weeks; 1. stadium: headache, malaise, painful bite wound, 2. stadium: hydrophobia, muscle cramps, paralysed cranial nerves; 3. stadium: coma, respiratory paralysis, death after max. 7 days
Initial immunicationDay 0 - 7 - 21 (28)
Boosterafter around 2-5 years
Tetanus (lockjaw)
PathogenClostridium tetani;
worldwide
Transmissioncontaminated dust/dirt into wound
CharacteristicsIncubation 3 days-3 weeks; due to toxine neurological disorder with severe, painful muscle cramps, high rate of mortality.
Initial immunicationusually in childhood (in Germany 4 injections as infant); without initial immunication as child 3 injections:
Day 0 - after 4-8 weeks - after another 6-12 months
Boosterevery 10 years

clostridium tetani
Lizenziert unter Gemeinfrei über Wikimedia Commons

Tick-borne Encephalitis (TBE)
PathogenTBE virus (Flavi virus);
Southern Germany, Eastern Europe, Asia
Transmissiontick bite
CharacteristicsIncubation 7-14 days; mainly asymptomatic; seldom mild, flu-like beginning, after 1 week meningitis, encephalitis, myelitis
Initial immunicationDay 0 - after 1-3 months - after another 9-12 months (depending on age and manufacturer)
Boosterevery 3-5 years
Typhus
PathogenSalmonella enterica serotype Typhi resp. Paratyphi A, B and C; worldwide, especially Africa, South America, Southeast Asia
Transmissionfecal-oral; mainly contaminated water and food
CharacteristicsIncubation ca. 3-60 days; malaise, progressively high fever, headache, somnolence, abdominal pain, first constipation, later diarrhea; seldom roseola (efflorescence of the skin); complications like intestinal perforation
Initial immunication1 injection
Boosterprotection for 3 years (around 60%)
Yellow fever
PathogenYellow fever virus (Flavivirus);
tropical and subtropical areas of South America and Africa
Transmissionmainly transmitted through the bite of the mosquito Aedes aegypti (urban cycle), besides that there is a sylvatic cycle (forest cycle or jungle cycle), where Aedes africanus (in Africa) or mosquitoes of the genus Haemagogus and Sabethes (in South America) serve as vectors; in Africa there is a third cycle, intermediate cycle, between the jungle and urban cycles
CharacteristicsIncubation 3-6 days; mostly mild infection with fever, headache, chills, back pain, fatigue, loss of appetite, muscle pain, nausea, and vomiting; rare cases with second, toxic phase with multiple bleeding and liver damage
Initial immunication1 injection
Boosternone, sometimes booster after 10 years required

Pathogen of Yellow fever
Lizenziert unter Gemeinfrei über Wikimedia Commons

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This list might not be complete. It also depends on the region you are traveling to.
Be aware that this isn’t a medical advice you should rely on. Please go to a doctor specialized in tropical diseases/travel health before your trip for individual consulting before every trip! The vaccination recommendation, especially during childhood, are based on the recommendation of the German STIKO.

Of course, always keep in mind during traveling:

„Peel it, cook it, or forget it!“

and sufficient protection against insect bites.

Reference: www.rki.de

This is the third stage of our Trip Planning Series. You can read all stages here.

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