Vaccinations when traveling abroad

The list of mandatory vaccinations for international travelers is down to one - against yellow fever - for those travelling to endemic areas. Saudi Arabia requires vaccination against meningococcal infection (types A, C, Y and W-135) for those performing the Hajj.

A number of countries require a vaccination certificate only for persons entering from endemic areas, exempting travellers from non-endemic countries and those entering for no more than 2 weeks.

General vaccination recommendations for travelers from Russia

Region	Hepatitis A	Polio	Japanese encephalitis	Meningitis	Typhoid fever	Yellow fever
Africa Central.	+	+		+	+	+
Africa East	+	+		+	+	+
Africa North	+	+			+
Africa South	+	+			+
Africa West	+	+		+	+	+
Asia East	+		+		+
Asia South	+		+		+
Asia South-East	+		+		+
Pacific Islands	+				+
Caribs	+				+	+
America Central.	+				+	+
South America	+				+	+
Hindustan	+		+		+
Middle East	+			+	+

For those traveling abroad, especially to exotic countries, the most relevant is hepatitis A. Some travel agencies have begun to offer tourists this type of vaccination, it is important that they are done by everyone, as they provide protection against hepatitis A after 7 days. For those visiting rural areas of developing regions, it is useful to be vaccinated against typhoid fever, and for those traveling to Central and West Africa, India and Pakistan, to administer one dose of the polio vaccine. Do not forget about vaccinations against influenza - it is very easy to become infected with the flu on airplanes, airports and other crowded places.

Information on the epidemiological situation in different regions can be obtained on the Internet. The most comprehensive site is the CDC, Atlanta: "Yellow Book", updated every 2 years, and "Blue Sheets" - supplements to the "Yellow Book with data on outbreaks of infectious diseases". Information is also provided by the WHO International Society of Travel Medicine (www.istm.org).

And traveling in Russia requires no less attention to infections, especially hepatitis A, endemic in rural areas, and tick-borne encephalitis, common in the taiga and forest zones.

When traveling abroad, families with children must be fully vaccinated according to the Calendar; it is advisable to vaccinate children aged 1 year according to an accelerated schedule: hepatitis B - 3 vaccinations with an interval of 1 month, DPT - 3 vaccinations with a monthly interval and revaccination after 6 months, poliomyelitis - IPV - 3 vaccinations with a monthly interval. When traveling to a region endemic for measles, the measles vaccine should be administered to a child starting from the age of 6 months (with subsequent vaccination after one year), and a child over 1 year old, vaccinated once, should be given a 2nd dose of the vaccine. Influenza split and subunit vaccines can be administered from the age of 6 months. Older fully vaccinated children are given all missing vaccines at the same time; such experience has been accumulated in Russia in relation to children adopted by foreigners.

Early symptoms of damage by biological and/or chemical agents

Symptoms	Biological or chemical agent
Respiratory: Influenza	Smallpox, tularemia, Q fever, Rocky Mountain fever
Pharyngitis	Ebola, Lassa fever
Shortness of breath, stridor	Anthrax
Pneumonia	Plague, tularemia, Q fever, hantavirus
Bronchospasm	Nerve poisons
Cutaneous: Vesicles	Smallpox
Petechiae, purpura, bullae	Ebola, Lassa, Rocky Mountain fever
Ulcers	Anthrax, tularemia
Burns	Mustard gas
Vascular: collapse, shock	Ricin, hantavirus
Bradyarrhythmia	Nerve poisons
Bleeding	T-2 toxin
Neurological: Hypotension	Botulism, nerve poisons
Fasciculations	Nerve poisons
Disorientation, coma	Ebola fever
Cramps	Nerve poisons
Meningitis	Anthrax
Renal: oliguria	Hantavirus
Gastrointestinal: Abdominal pain, vomiting of blood, melena	Anthrax
Diarrhea	Shiga toxin, staphylococcal enterotoxin

Bioterrorism and vaccination

For the purposes of bioterrorism, it is likely that several highly virulent pathogens will be used, including those with changes in their basic properties and sensitivity to antibiotics. These are the pathogens of smallpox, plague, anthrax, botulism (toxins), hemorrhagic fevers (Ebola, Lassa, Marburg), tularemia, Venezuelan equine encephalitis, glanders, melioidosis, influenza, and typhus. Less likely is the use of pathogens of brucellosis, Japanese encephalitis, yellow fever, cholera, tetanus toxins, and diphtheria.

Smallpox virus is candidate #1, due to its long (17 days) incubation period, infected individuals will spread it widely. It is apparently available not only in Russia and where it is preserved in the collection; reversion of smallpox vaccine virulence, change in the properties of monkeypox and rodent pox viruses are also possible. Mortality among those not vaccinated against smallpox reaches 52%, among those vaccinated more than 20 years ago - 11.1%, and among those vaccinated less than 10 years ago - 1.4%, so the infection is dangerous for those vaccinated (before 1980) as well, but they will probably tolerate revaccination better. Mass vaccination is fraught with an "epidemic of side effects", including fatal cases. WHO strategy - epidemiological surveillance: finding patients and vaccinating contacts. It is important to create a safe vaccine - oral smallpox vaccine is being tested in Russia.

A biological attack is likely during an outbreak of diseases with similar general symptoms (fever, headache, vomiting, diarrhea).

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ]