Travel Vaccines Dubai protect travellers from serious diseases. Depending where you travel, you might come in contact with disease that are rare in UAE. Getting vaccinated will help you keep safe and healthy while you are traveling. The World Health Organization (WHO) advises all travelers to consult their doctors 4-6 weeks before departure. During your vaccine consultation, we will cover all necessary vaccines for your destination, including malaria prophylaxis and travelers diarrhea.
Travel Vaccinations Dubai and Schedules
Unsure of which travel vaccinations you require? Don’t worry, Dr. Barbara Karin Vela will provide travel advice, travel vaccines and schedules to suit your individual needs.
Meningitis B
Meningitis B is caused by the bacteria, Neisseria meningitidis Group B.
Transmission
1 in 10 adults and 1 in 4 teenagers carry group B bacteria at the back of their throat. The bacteria can be spread through respiratory droplets by coughing, sneezing or by kissing.
Symptoms
Meningococcal infection can cause meningitis (inflammation of the lining of the brain and spinal cord), septicaemia (blood poisoning) or both. Symptoms can develop within hours and can be non-specific. It is much harder to identify the infection in babies as the typical features tend to be absent. The rash does not always occur. In children and adults symptoms can include:
– sudden onset of a high fever
– a severe headache
– dislike of bright lights (photophobia)
– vomiting
– painful joints
– fitting
– drowsiness that can deteriorate into a coma
In babies there may also be:
– high pitched moaning or whimpering
– blank starring, inactivity, hard to wake up
– poor feeding
– neck retraction with arching of the back
– pale and blotchy complexion
Septicaemia occurs if the bacteria enter the bloodstream. A characteristic rash develops and may start as a cluster of pinprick blood spots under the skin, spreading to form bruises under the skin. The rash can appear anywhere on the body. It can be distinguished from other rashes by the fact that it does not fade when pressed under the bottom of a glass (the tumbler test).
Treatment
The infection is treatable with antibiotics. Prompt treatment is essential as the bacteria spreads rapidly. Fatality occurs in about 10% of cases of meningitis and up to 50% of cases of septicaemia. Around 10% of survivors have a major disability as a consequence of the infection.
Prevention
Vaccination is now available against the common circulating strains of Neisseria Meningitidis. Dr. Barbara Karin Vela stocks the following vaccines:
– New-Group B Meningitis Vaccine. From 2 months of age.
– Meningitis ACW135Y vaccine-provides effective protection against the major strains occurring globally and is particularly important when travelling. This vaccine also provides protection against Meningococcal C strain.
Typhoid
Typhoid is an infectious disease caused by the bacteria Salmonella typhi which causes severe symptoms in the digestive system. It can be life-threatening, but if treated early antibiotics are effective.
Typhoid is found in countries with inadequate sanitation and is endemic in Indian subcontinent, South East Asia, parts of the Middle East, Central and South America and Africa. Around 22 million cases of typhoid fever and 220,000 deaths occur annually (WHO 2014).
Transmission
The disease is transmitted from human to human via ingesting contaminated food or drinking water or through poor personal hygiene, such as lack of hand washing. The bacteria is found in the faeces of infected individuals and 2-5% of those infected become long term carriers and excrete the bacteria in their faeces.
Symptoms
The incubation period is 10 to 20 days and depends on, among other things, how large a dose of bacteria has been taken in.
In the mild disease, the bacterium is eliminated very early in the course of the disease and there are perhaps only mild symptoms.
Symptoms can include high fever, diarrhoea or constipation, headache, rash and in severe disease multi-organ failure can occur. If untreated, the death rate is 20%, whereas prompt antibiotic treatment reduces this to less than 1%.
Treatment
Typhoid is treatable with antibiotics administered early on. Supportive treatment, such as rehydration are also important.
Prevention
Food and water hygiene measures while travelling are important as is maintaining personal hygiene.
Vaccination is available to those at risk of typhoid fever.
Hepatitis B
Hepatitis B is a viral infection that is found worldwide.
An estimated 350 million people are thought to be chronic carriers of the infection and 686,000 people die every year from the complications of hepatitis B infection (WHO data). The countries with the highest prevalence of infection include Africa and East Asia where 5-10% of the population are chronically infected with the disease. High disease prevalence also occurs in the Middle East, Southern and Eastern Europe and the Indian Subcontinent.
Transmission
Hepatitis B is spread through contaminated blood via sexual intercourse, needle sharing, blood transfusions and medical interventions. The virus can also be passed from mother to baby. Tattooing, body piercing and acupuncture are other ways in which the virus may be spread. The virus can survive outside the body for 7 days.
Symptoms
The incubation period for hepatitis B infection is long varying between 60-90 days. Most people do not develop symptoms of hepatitis B infection. If symptoms occur in the acute stage of infection, they consist of fever, nausea/vomiting, diarrhoea and abdominal pain. Jaundice may also occur. A small subset can develop fatal acute liver failure in the acute stage.
The acute illness lasts for about six months and the virus is cleared from the body in the majority of adults.
However, 5% of adults and 30-50% of children aged 6 years and below develop chronic disease, where the virus persists. Chronic infection with hepatitis B is associated with progressive liver disease (cirrhosis) and liver cancer.
Treatment
There is no treatment available for the acute illness. Treatment for those chronically infected with hepatitis B is aimed at reducing the progression to chronic liver disease (cirrhosis) and preventing liver cancer.
Prevention
Vaccination is the mainstay of prevention. The vaccine against hepatitis B has been around since 1982 and is part of the routine childhood immunisation programme in many countries around the world.
Travel Vaccines Dubai – Cholera
Cholera is an acute diarrhoeal infection, caused by the bacteria Vibrio Cholerae.
An estimated 1.3 million to 4 million causes of cholera occur per year with between 21,000 and 143,000 deaths. Outbreaks can occur in any world region, but are more prevalent in regions where access to clean water and sanitation is not available.
Transmission
Cholera is transmitted by drinking contaminated water or eating food contaminated by faeces, such as shellfish. Person to person contact can occur where there is poor hygiene.
Symptoms
The incubation period varies between 2 to 5 days, but symptoms can occur in hours. The majority of people infected with cholera do not have symptoms or have mild symptoms. However, they pass the bacteria in their faeces for up to 10 days and can spread the infection to others.
The symptoms of severe disease are sudden onset of profuse watery diarrhoea that can lead to death by severe dehydration and kidney failure. Untreated, the death rate is up to 50%, but with prompt and correct treatment, this fall to less than 1%.
Treatment
Cholera is an easily treatable disease. The prompt administration of oral re-hydration salts to replace lost fluids nearly always results in cure in mild to moderate cases. In especially severe cases, intravenous administration of fluids and antibiotics may be required to save the patient’s life.
Prevention
It is important to maintain food and water hygiene at all times while travelling, particularly so, if you are carrying out voluntary work or are in remote areas. The cholera vaccine is a safe and effective vaccine for those who are at increased risk of contracting this potentially life threatening illness.
Travel Vaccines Dubai – Japanese Encephalitis
Japanese encephalitis is a viral illness found throughout most parts of South and South East Asia.
Japanese encephalitis is the leading cause of viral encephalitis (inflammation of the brain) in children.
Transmission
The virus is transmitted by the bite of a mosquito, which feeds from dusk until dawn. Pigs and water birds act as sources of the virus. Thus, the infection is mainly found in rural and semi-rural areas. Transmission can vary by season in individual countries, with highest risk during rainy season. However, other countries have year round transmission.
Symptoms
Approximately 1 in 250 people became unwell after infection. Children and older adults are at higher risk of developing symptoms.
Symptoms include high fever, convulsions, headache and neck stiffness.
Up to 30% of cases are fatal and 30-50% of individuals who develop encephalitis have permanent neurological disability.
Treatment
There is no specific treatment for Japanese Encephalitis, only supportive care.
Prevention
The infection can be prevented by vaccination and mosquito bite prevention measures, such as effective insect repellent and mosquito nets.
Travel Vaccines Dubai – Yellow Fever
Yellow fever is a potentially life threatening viral illness that is found in tropical areas of Africa and South and Central America.
Transmission
It is transmitted by the bite of an infected mosquito. The mosquitoes feed during day light hours and are found in both urban and rural areas. Yellow fever cannot be transmitted directly form human to human contact. The mosquito that carries yellow fever virus is found in many countries of the world and thus, these countries have a potential to develop the disease in their mosquito population leading to outbreaks of this potentially deadly infection. Therefore, a number of countries, which do not have the disease may have a requirement for proof of vaccination against yellow fever before entry is allowed.
Symptoms
The incubation period from infection to developing yellow fever is 3 to 6 days.
Symptoms are divided into the acute phase and the toxic phase.
The acute phase presents with non specific symptoms of a viral infection such as high fever, headache, muscle ache, nausea and vomiting and loss of appetite.
Around 15% progress from the acute phase to the toxic phase. This consists of jaundice (yellow discolorations of the skin and eyes), liver and kidney failure, bleeding form the nose, eyes, stomach followed by death in 50% of cases within 10-14 days.
Symptoms include: high fever, generalised symptoms like violent headache, muscular pain, upset stomach and loss of fluid.
Treatment
There is no treatment for yellow fever infection. Supportive and intensive medical care is required in the toxic phase to allow the body to clear the virus itself.
Prevention
Yellow fever is entirely preventable illness. There is a safe and effective vaccine against the disease. In addition to vaccination, mosquito bite prevention measures, such as regular application of insect repellant, mosquito nets are also vital.
Travel Vaccines Dubai – Rabies
Rabies is an acute and fatal viral infection that causes inflammation of the spinal cord and the brain (encephalomyelitis). It is found in over 150 countries around the world and an estimated to cause tens of thousands of deaths in endemic countries. Children are especially vulnerable to rabies and 40% of bites occur in children under the age of 15 years. 95% of deaths from rabies occur in the Indian Subcontinent, Africa and South East Asia.
Transmission
Rabies virus is spread through contact with the saliva of an infected mammal. This is usually from a bite or scratch or from a licking broken skin. Although any mammal can spread rabies (including humans), the majority of cases are contracted from dogs. This is especially true in the Indian Subcontinent and South East Asia. In other countries, rabies can be spread by bats, monkeys and cats. Both domesticated and wild mammals can spread rabies infection.
Symptoms
The incubation for symptoms of rabies infection to develop varies considerably. The average duration is 1-3 months, but symptoms can develop in less than one week or more than 1 year from being bitten. Bites to the head and neck have a shorter incubation period than bites the the extremities.
Once symptoms have developed rabies is 100% fatal.
Rabies infection starts within non-specific early symptoms of fever, headache, muscle ache and loss of appetite. This is followed by either:
Furious rabies-the common form characterised by fear of water (hydrophobia), confusion, hyperactivity and death after a few days.
Paralytic rabies-slow paralysis of the muscles starting from the site of the bite followed eventually by death.
Treatment
Once symptoms occur, there is no treatment for rabies. The aim of medical management following a bite is to prevent the virus from entering the brain and spinal cord. This is known as post exposure prophylaxis and needs to be started as soon as possible after being bitten.
Post exposure prophylaxis:
– Immediate wound care
– Rabies Immunoglobuin-a blood product, usually obtained from human sources, which contains rabies antibodies.
– Active Rabies vaccination
Prevention
Rabies is entirely preventable. There is a safe and effective vaccine against rabies, which if the course is completed given prior to exposure, will:
– Prevent the risk of death by slowing virus progression to the brain and spinal cord.
– Eliminates the need for Rabies immunoglobulin-as you will have formed your own antibodies
– Reduce the number doses of vaccine (2 versus 5).
It is important to remember that any bite or scratch from a mammal in an endemic country could pose a risk of rabies infection. Therefore, avoid contact with domesticated and wild animals while traveling. Rabies infections causes animals to behave more aggressively and thus they are more likely to bite. It is particularly important to keep children away from animals and ensure that older children understand that they must report a bite as soon as possible for post exposure prevention to be carried out.
Travel Vaccines Dubai – Diphtheria Tetanus Polio (DTP)
Diphtheria is a highly infectious disease affecting the throat and upper airways, caused by the diphtheria bacterium.
The disease is found worldwide and high vaccination uptake is required to keep the rates of infection low. It is still prevalent in many countries due to low immunisation levels, especially the Indian Subcontinent, Central and South East Asia, Africa and South America.
Diphtheria Vaccine
Diphtheria is a highly infectious disease affecting the throat and upper airways, caused by the diphtheria bacterium. The disease is found worldwide and high vaccination uptake is required to keep the rates of infection low. It is still prevalent in many countries due to low immunisation levels, especially the Indian Subcontinent, Central and South East Asia, Africa and South America.
Transmission
Infection is spread person to person through coughing or sneezing.
Symptoms
Diphtheria is an extremely serious illness and treatment is required as soon as the disease is suspected to prevent fatality. The incubation period is 2-5 days and symptoms include fever, sore throat, enlarged glands in the neck. If not treated early, the infection can cause obstruction of the airway and is fatal in 5-10% of cases. Fatality rates are higher in young children and older adults. Damage to the heart muscle and nervous system can also occur with the illness. Travel Vaccines Dubai
Treatment
Intensive care support is required. Early administration of Diphtheria antitoxin helps reduce fatality, as does antibiotics.
Prevention
There is a highly effective vaccine against Diphtheria, which is included in the childhood immunisations programme of most countries.
Tetanus Vaccine
Tetanus is a life threatening infection caused by a bacteria that is found in the environment worldwide.
Transmission
The bacteria enters the body through skin wounds or cuts, especially soil contaminated wounds.
Symptoms
The incubation period is 4-21 days. Symptoms are due to muscles spasms and rigidity and include lock jaw and paralysis of the respiratory muscles. Death rates vary from 10% (if good intensive medical care is available) to 90%. Children and older adults are especially vulnerable.
Treatment
Treatment includes intensive medical care, tetanus Immunoglobulin and wound care.
Prevention
Vaccination is the mainstay of prevention as it is not possible to eradicate the bacteria from the environment.
Travel Vaccines Dubai – Polio
Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children. Since the launch of the Global Eradication Programme led by WHO, the incidence of Polio has fell by 99% since 1988. The disease is now endemic in 2 countries-Pakistan and Afghanistan. However, sporadic outbreaks still occur due to imported disease or as result of the oral polio vaccine virus reverting to infectious type.
Transmission
The virus is transmitted through the personal contact and contaminated food and water.
Symptoms
The virus spreads from the gut to the nervous system causing paralysis. Irreversible paralysis occurs in 1 in 200 cases of polio and the death rate is 5-10% due to respiratory failure.
Treatment
There is no treatment for polio infection and good supportive care is required.
Prevention
The success of the Polio eradication programme is related to widespread vaccination campaign.
When it comes to Travel Vaccines Dubai, speak to Dr. Barbara Karin Vela