Hepatitis A

Hepatitis A is a serious liver disease caused by the hepatitis A virus. Hepatitis is found in the stool of persons with hepatitis A. It is usually spread by close personal contact and sometimes by eating food or drinking water containing the virus (fecal-oral route). Up to 20% of people who contract hepatitis A often have to be hospitalized. A person who has hepatitis A can easily pass the disease to others within the same household. The vaccine is recommended for all travelers visiting developing countries such as those located in Central or South America, Mexico, Asia (except Japan), Africa, and Eastern Europe.

Symptoms of Hepatitis A:  mild “flu-like” illness, jaundice (yellow skin or eyes), severe stomach pains and diarrhea.

Hep A is a 2 shot series. The initial dose provides adequate antibodies in 2 weeks after the injection, and a second dose given 6 months after the first dose will confer a 20 year protection.


Hepatitis B

Hepatitis B is a serious disease caused by the hepatitis B virus that affects the liver. It is transmitted by contact with blood or body fluids containing the virus. People who are infected can spread Hepatitis B to others, even if they don’t appear sick. Hepatitis B causes sever liver infection and can progress to chronic liver disease and cancer. The vaccine is recommended for prolonged travel, adventure travelers, persons who have unprotected sex, acupuncture, tattoos or a high probability of needing medical care in local healthcare settings.

The vaccine is a three dose series (0, 1 and 6 months) with adequate protection after two doses, the third dose provides lifelong immunity. In certain cases, an accelerated dose schedule may be available.


Twinrix

This vaccine combines the hepatitis A and hepatitis B vaccines together. The benefit of this vaccine is that you receive protection against both Hep A and Hep B with 3 shots, rather than 5 separate shots.

Three doses are given at 0, 1, and 6 months and confer lifelong protection. In certain cases, an accelerated dose schedule may be available.


Typhoid

Typoid fever is a bacterial disease that results in diarrhea or constipation, headache, abdominal pain, and high fever. It is transmitted through consuming contaminated food or water. Left untreated, it can be fatal. The vaccine is recommended for travel destinations where typhoid is common.

The vaccine is available in two forms, a single dose injectible killed virus vaccine that provides two years immunity or a 4 dose oral (pill) modified live vaccine that provides five years immunity.


Yellow Fever

Yellow fever is a serious disease caused by the yellow fever virus. It is spread through the bite of an infected mosquito and cannot be spread directly from person to person. It is found in certain parts of Africa and South America.

Yellow fever can cause: fever and flu-like illness, jaundice (yellow skin or eyes), liver, kidney, respiratory and other organ system failure and death. People with yellow fever disease usually have to be hospitalized.

Proof of Yellow Fever vaccine may be required for entry into certain countries and must be given 10 days before entry into those countries. The vaccine is a single dose and provides 10 years immunity.


Meningitis

Meningitis is a bacterial infection that affects the lining of the brain. It is transmitted through contact with carriers through coughing, sneezing, kissing or improperly cleaned utensils. The vaccine is recommended for persons who live in close contact with others as in dorms or barracks. Also it is recommended for persons travelling to the ‘meningitis belt’ in sub-Saharan Africa or for pilgrims to the Hajj.

The vaccine is a single dose and protects against 4 types of the meningitis bacteria.


Meningitis B

Serogroup B meningococcal disease is relatively rare. Outbreaks have recently occurred at several U.S. colleges. CDC wants people to have access to serogroup B meningococcal vaccines to help prevent this uncommon, but serious illness. The current recommendation provides access and allows clinicians and parents to weigh the risk of the disease and the risks and benefits of vaccination. Available data suggest these vaccines are safe and provide protection, but that protection decreases fairly quickly after vaccination.


Rabies

Rabies is a virus that causes series disease in humans. It is transmitted through bites or scratches of infected, bats, dogs, cats, raccoons, foxes or skunks. If untreated the disease is fatal. The pre-exposure vaccine is recommended for persons working with animals, young children in certain destinations, extensive outdoor activities in rural areas. Persons who receive the pre-exposure vaccine and who have a potential rabies exposure will still require post exposure vaccine but only two of the four post exposure doses.

The pre-exposure vaccine is a three dose series (0, 7day, 21-28 days).


Japanese Encephalitis

Japanese Encephalitis (JE) is a viral disease that affects the brain and is transmitted by the mosquito. The risk of JE is very low for most travelers. The vaccine is recommended for persons travelling to rural agricultural areas of India and Southeast Asia. Most people infected with JE virus don’t have any symptoms at all. For others, JE virus infection can cause illness ranging from fever and headache to severe encephalitis (brain infection).

The vaccine is a two dose series for persons over 17 years of age (0 and 28 days).


Polio

Polio is a viral illness that causes paralysis. It is contracted through contaminated food or water. Polio vaccine is considered a routing vaccine in the US. It is recommended that a one-time adult booster is received for individuals travelling to India, parts of Africa and the Middle East.


Tetanus/diphtheria/pertussis (whooping cough)

Tetanus (Lockjaw) causes painful muscle spasms, usually all over the body. It can lead to tightening of the jaw muscles so the victim cannot open his mouth or swallow. It is contracted through cuts or wounds.

Diphtheria causes a thick covering in the back of the throat. It can lead to breathing problems, paralysis, heart failure, and even death. It is spread by respiratory secretions.

Pertussis (Whooping Cough) is a highly contagious respiratory disease. It causes severe coughing spells, vomiting, and disturbed sleep. It can lead to weight loss, incontinence, rib fractures and passing out from violent coughing.

These three diseases are all caused by bacteria. Everyone should receive a primary Tdap series and a booster every 10 years. Tetanus vaccine provides protection for 10 years.


HPV Vaccine (Human Papilloma Virus - several cancers and genital warts)

HPV Vaccine is an inactivated vaccine to prevent cervical, penile, oral, throat, tongue, tonsil, and anal cancers, and genital warts caused by HPV. It is currently recommended for girls and women ages 11-26, and boys and men ages 11-21. Cervical cancer is the 2nd leading cause of cancer deaths among women in the world. 50% of sexually active men and women are infected with HPV at some time in their lives.

Two doses are given 6 to 12 months apart for children 11-14. A third dose is required if the series is started at ages 15-26. The duration of protection is expected to be long lasting.


Tuberculin Skin Testing

“TB” is short for tuberculosis. TB disease is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal.  TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with active TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.

The TB skin test (Mantoux tuberculin skin test) is performed by injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm.


Measles, Mumps and Rubella (MMR)

The measles virus causes rash, cough, runny nose, eye irritation, fever and can lead to ear infection, pneumonia, seizures, brain damage, and death. The mumps virus causes fever, headache, and swollen glands; it can lead to deafness, meningitis (infection of the brain and spinal cord covering), infection of the pancreas, painful swelling of the testicles or ovaries, and, rarely, death.

The rubella (German Measles) virus causes rash and mild fever; and can cause arthritis. If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects. These diseases are common in developing countries and used to be common in the U.S., but increased immunization rates have lowered the prevalence. The MMR vaccine is recommended for those born in 1957 or later without a history of disease or 2 adequate doses of live vaccine at any time during their life.
The MMR confers lifetime protection after 1-2 injections.


Influenza (Flu)

Influenza (the flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death. Symptoms can include fever, headache, muscle aches, and lung infection. People over age 50, young children, and people with certain health conditions, are at high risk for serious flu complications.

Yearly flu vaccine is recommended for everyone age 6 months and older.


Pneumonia

Pneumonia is caused by bacteria transmitted from person to person through droplets and can lead to serious infections of the lungs (pneumonia), blood (bacteremia), and the covering of the brain (meningitis). Two pneumonia vaccines are recommended for people age 65 and older; Prevnar 13 and Pneumovax 23.

1 dose of each vaccine for most adults.


Varicella (Chicken Pox)

Varicella (chicken pox) causes rash, itching, fever, and tiredness. It can lead to severe skin infection, scars, pneumonia, brain damage, or even death. It can also re-emerge years later as a painful rash called shingles. Non-immune adults are at increased risk of severe illness. The vaccine is recommended for all persons who have not had chickenpox.

2 doses are given 4-8 weeks apart for persons 13 years and older, which confers lifetime protection.


Herpes Zoster (Shingles)

Shingles, also known as zoster or herpes zoster, is a painful skin rash with blisters caused by the varicella zoster virus, the same virus that causes chickenpox. Nearly 1 out of every 3 people in the United States will develop shingles. Anyone who has recovered from chickenpox may develop shingles, but the risk increases with age, and chronic conditions that suppress the immune system.

There is a new and improved shingles vaccine, Shingrix, which is a two dose series given 2-6 months apart.