By Bryan J. Alsip, MD, MPH, FACPM
and Brenda I. Lemke, MHA
Planning an international trip? Make sure you “know before you go!” Every year, approximately 27 million Americans will travel outside the United States. Many will be traveling to countries where special vaccinations and preventive medications are an important part of staying healthy.
The San Antonio Metropolitan Health District (Metro Health) knows how important it is to make the right travel accommodations for that special international trip. No
preparation is more important than protecting your health and that of your family. Ensuring that travelers are protected against serious infectious diseases during their stay in other countries is just as important as arranging airline reservations and hotel rooms. As a key component to travel plans, Metro Health would like to make prospective international travelers aware of the immunizations, consultative services and specialized medical expertise that we offer for international travel.
Staying healthy during foreign travel requires more than vaccinations. Careful planning is essential. International travelers are advised to contact the Metro Health Foreign Travel Clinics at least six (6) weeks prior to departure. This will ensure that an accurate assessment of travelers’ health needs is conducted and that travelers have adequate time to receive full protection from required or recommended vaccines. A foreign travel appointment consists of the following services:
• Counseling regarding the client’s immunization status and current health
• Counseling regarding specific activities planned and food/water consumption
• Administration of necessary vaccines (required or recommended by visiting country)
• Issuing International Health Certificates for yellow fever vaccinations and updating immunization records
• Issuing anti-malarial prescriptions
• Discussing other things you can do to keep yourself healthy while you travel.
There are many diseases for which even routine immunizations can be important for your travel. For example, often adults are not up-to-date on their tetanus-diphtheria series. Polio, which is absent in the United States, still exists in many developing countries and a booster is recommended for adults over age 18 when traveling to areas of risk: parts of Africa, Asia, the Middle East, and Eastern Europe. In the U.S., there is a recognized “flu season” but influenza can occur year round in the tropics and travelers to these areas should be vaccinated against influenza.
Additionally, there are many specific diseases for which vaccines are recommended to prevent being infected during travel. Hepatitis A and typhoid are frequently endemic in most developing countries and can be acquired by consuming contaminated food or water. Hepatitis B and rabies are serious diseases for which there are also effective vaccines. Is an infection of the liver that is spread through the use of contaminated needles, medical equipment, unprotected sexual contact and contaminated blood or blood products.
Rabies is much more common in many other parts of the world and the majority of those infections occur via dog or cat bites, or exposure to saliva. This is a serious and invariably fatal disease if prevention is not practiced.
Some vaccines are even mandatory for entry into certain countries. You must have (and carry with you) a certificate proving that you have been given the vaccine. Yellow fever is a viral disease spread by mosquito bites that occurs in sub-Saharan Africa and South America. Certain countries require an International Certificate of Vaccination against yellow fever. Travelers without this documentation can be subject to local re-vaccination, isolation or denial of entry.
Meningitis is a severe bacterial disease spread through respiratory droplets. Travelers going to sub-Saharan Africa or Saudi Arabia are at the highest risk. There are also other serious diseases for which vaccinations do not yet exist. Malaria and dengue fever are both serious and potentially fatal infections transmitted by mosquitoes. For malaria there are medications that travelers can take to greatly reduce their risk of being infected. Travelers should also utilize other methods to prevent being bitten by mosquitoes and other biting insects.
Travelers should have the following information with them at their first international travel appointment:
• Health information including any current medications or medical conditions
• A trip itinerary which includes all countries to be visited and duration of stay
• A listing of special activities planned
• Information regarding accommodations and transportation.
Metro Health operates two Foreign Travel Clinics. The Downtown Foreign Travel Clinic is located inside the Main Immunization Clinic at 345 W. Commerce. Vaccinations and information for international travel are available by appointment Monday through Friday, 8:00 am to 3:00 pm. One hour of free parking is available in the City of San Antonio Continental Lot on South Laredo Street. Travelers can call (210) 207-8872 to schedule an appointment or obtain additional information.
The second International Foreign Travel and Adult Immunization Clinic is located in the Valley View Shopping Center inside the City of San Antonio Service Center at 8523 Blanco Road at West Avenue. Vaccinations and information for international travel are available by appointment Monday through Friday, 9:00 am to 5:00 pm. Travelers can call (210) 207-8735 to schedule an appointment or obtain additional information for this clinic location.
If you need additional foreign travel information, please call the Centers for Disease Control and Prevention (CDC) Travelers Hotline number at 1 (877) FYI-TRIP (Atlanta, GA) or visit their website at www.cdc.gov/travel. In addition to the services offered through our Foreign Travel Clinics, regular childhood immunizations are offered at our public health clinics. For more information or to find the location of the SAMHD Immunization Clinics, please visit our website at www.sanantonio.gov/health/.
Dr. Alsip is the Assistant Director of Health for San Antonio. He received his Bachelor of Science degree from Cornell University, his Medical Degree from Georgetown University, and his Master of Public Health degree from Johns Hopkins University. Dr. Alsip is a Fellow of the American College of Preventive Medicine and has received numerous awards for scholarship and service.
Brenda I. Lemke, MHA currently serves as the Immunization Program Manager for the City of San Antonio’s Metropolitan Health District (SAMHD). Prior to joining the San Antonio Metropolitan Health District, Ms. Lemke completed her Bachelor’s degree at Trinity University in San Antonio.
Ms. Lemke has worked within the Immunization Division since the summer of 1996 when she started as a graduate school intern from Texas State University. During her career at the SAMHD, she has held several positions within the Immunization Division. This provided her training in all aspects of managing the Immunization Division.
