By Dr Frederico Capulong Dimatatac
Principal Resident Physician
Department of Infectious Diseases
Institute of Infectious Diseases and Epidemiology (IIDE)
Tan Tock Seng Hospital
The number of people crossing international borders has continued to increase substantially. In 2015, there were 1.2 billion travelers worldwide. This figure is projected to increase to around 2 billion by 2030. Whether the purpose of travel is for tourism, business, research, studies, mission work, medical tourism or visiting friends and relatives, protecting the health of travelers and preventing the importation of infectious diseases is of utmost importance.
For more information or appointments, please call THVC at 6357 2222 or email to THVC@ttsh.com.sg.
Various factors contribute to the risk of travel-related diseases, such as traveller’s age and health, destination, length of trip, itineraries, purpose of travel, and use of preventive measures. Travelers should visit the doctor one month before the trip, as some vaccines require a few weeks to be completed or become effective.
The common vaccines prescribed are as follows:
- Hepatitis A is transmitted from person to person through a fecal-oral route and consumption of contaminated food and water. Hepatitis A vaccine is given in 2 doses at least 6 months apart for long lasting protection.
- Diphtheria, Tetanus, and Pertussis (DTP). In Singapore, one dose of DTP is given at age 11. Booster doses should be given every 10 years, even for adults.
- Typhoid is transmitted from the consumption of contaminated food and water. Two vaccines are available. Inactivated vaccines are given as an injection while the live typhoid vaccine is taken orally every other day for a week. Booster doses are given every 2 and 5 years respectively, for people who remain at risk.
- Yellow Fever (YF) is an acute viral hemorrhagic fever transmitted by the bite of an infected Aedes Aegypti mosquito. Vaccination is recommended for people aged 9 months and older travelling to areas at risk of yellow fever in Africa and South America. The vaccine confers lifelong immunity.
- Rabies is transmitted from the bites or scratches of infected animals – mainly, from dogs. Cats, monkeys, bats, and other mammals can also transmit the infection. Three doses of pre-exposure prophylaxis are given at Days 0, 7, 21 or 28. For postexposure prophylaxis, a person who has never been vaccinated should receive 5 doses of rabies vaccine given at Days 0, 3, 7, 14, 28. WHO category 3 exposure should require Rabies Immunoglobulin. People previously vaccinated should receive 2 doses of the rabies vaccine (Days 0, 3).
- Japanese Encephalitis (JE) vaccine is recommended for travellers spending at least 1 month in endemic areas of Asia and parts of the Western Pacific. Travellers visiting endemic areas with ongoing outbreaks or rural areas for less than a month should be vaccinated. Two vaccines are currently available. Imojev is a single dose vaccine while Ixiaro is given in 2 doses, 4 weeks apart.
Other vaccines including meningococcal, polio, influenza, malaria prophylaxis and prevention of traveller’s diarrhoea and altitude illness should be discussed thoroughly. Travellers with special needs, infants and children, pregnant, and the immunocompromised, can be referred to Travellers Health and Vaccination Clinic (THVC) in Tan Tock Seng Hospital.