1. IMMUNISATION FOR TRAVELLERS
TO DEVELOPING COUNTRIES

2. INTRODUCTION
• Developing countries are in general those
which have in most cases a medium to low
standard of living with lesser degree of
industrialisation.
• In the background of low standard of living &
various other factors like high population
growth,availability & accessibility of health
care facilities; certain diseases pose a major
threat in the developing countries.

3. • Travellers to the
developing countries
should hence be aware
& cautious about them.

4. • Infections transmitted by feco oral route –
 Hepatitis A
 Typhoid
 Cholera
• Insect borne infections –
 Malaria
 Dengue
 Japanese encephalitis
 Yellow fever
 Tick borne encephalitis.

5. • Infections via respiratory droplets :
Influenza
Meningococcal meningitis
Measles
• Blood borne infections :
Hepatitis B
Hepatitis C

6. • EXOTIC INFECTIONS :
Rabies
Schistosomiasis(africa)
Leptospirosis

8. Recommended vaccinations
• National health & medical research council
recommend certain vaccination as routine for all
travellers. These include –
1. Tetanus
2. Diptheria
3. Pertussis
4. Varicella
5. Measles
6. Mumps
7. Rubella
8. polio

9. • For travellers with special needs :
influenza,pnemococcal infections.
 ie, at risk individuals( pregnant women,children
,immunocompromised individuals.
Those suffering from asthma.
Respiratory & cardiovascular problems.
Metabolic diseases like DM.
>65 yrs of age.

10. • OTHER VACCINES
1. Hepatitis A & Hepatitis B.
2. Typhoid
3. Meningococcal meningitis
4. Rabies
5. J E
6. Yellow fever.

11. • Ideally vaccination has to be started early, to minimise
adverse effects at time of departure & to allow
sufficient time for adequate immunity to develop.
• FACTORS CONSIDERED :
 Time between the initial presentation to departure
 Date & destination
 Length of stay
 Type of accomodation
 Previous vaccination status

12. PEOPLE AT RISK!
• Pregnant women
• children
• People with acute /chronic systemic
infections.
• Immunocompromised individuals.
• Children on long term steroid therapy.
• Malignancies.

13. • Adults who are travelling are to be vaccinated
according to schedule
• Children according to national immunisation
programme.

14. TRAVEL VACCINES FOR CHILDREN
• HEPATITIS A : O.5ml IM at 0,1,6 months .
• HEPATITIS B : 0.5 ml IM at 0,1,6 months
• HAV & HBV COMBINED (twinrix ): 0.5 ml at
0,1,6 months.
• JAPENESE ENCEPHALITIS :
 1-3 yrs – 0.5ml SC; 0,7,28 days.
 >3 yrs – 1ml SC ; 0,7,28 days.

15. • MENINGOCOCCAL vaccine – 0.5ml SC.
 Indicated for > 2 yrs of age.
 Single dose
 Revaccinated 3-5 yrs if continued risk.
• RABIES – 1ml IM/SC at 0,7,28 days.

16. • TYPHOID – a) oral capsules(live attenuated) :1
capsule on day 1,3,5.[>6yrs]
b) Vi capsular polysaccharide : 0.5ml IM, single
dose.[>2yrs]
• Yellow fever vaccine : 0.5ml IM/SC
Single dose.
*contra indicated < 9 months of age.

17. • MMR – 0.5ml SC/IM.
• INFLUENZA – a) flu shots – inactivated form ;
for >6 months old, regular dose.
b) Nasal spray flu vaccine (live attenuated ) – 2
to 49 yrs.
CHICKENPOX vaccine-
Infants-1st dose at 12-15 months and 2nd 3
months after 1st dose

18. • >13 years and not previously vaccinated nor
had chicken pox- 2 doses 28 days apart.

19. WHO Publication
• International travel and health advice is an
yearly publication by WHO which gives
guidance on main health risks to which
travellers are exposed in different parts of the
world and precautions to be taken.

20. THANK YOU