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Preparing patients to travel abroad safely. Part 2: Updating vaccinations.
Can Fam Physician. 2000 Mar; 46:646-52, 655-6.CF

Abstract

OBJECTIVE

To provide, for family physicians without access to a travel clinic, evidence-based recommendations on vaccinating infants and children, adults, pregnant women, and immunocompromised patients traveling to non-Western countries.

QUALITY OF EVIDENCE

Searches were undertaken of MEDLINE from 1990 to November 1998 (372 articles); the Cochrane Collaboration Library; publications of the National Action Committee on Immunization and the Committee to Advise on Tropical Medicine and Travel in Canada Communicable Disease Reports; the Canadian Immunization Guide; and Laboratory Centre for Disease Control, United States Centres for Disease Control, and World Health Organization websites. Evidence-based statements, randomized controlled trials, systematic reviews, and meta-analyses were selected. Vaccination recommendations are based on this evidence.

MAIN MESSAGE

Physicians should complete vaccination schedules for children whose primary series is incomplete and vaccinate unvaccinated adults. Hepatitis A is widespread, and travelers to areas where it is endemic should be vaccinated. The elderly should be vaccinated against influenza and pneumococcal disease. Pregnant women should receive vaccines appropriate to their trimester. Immunocompromised patients should be vaccinated, but BCG and live vaccines are contraindicated. Travelers to areas where meningitis, typhoid, cholera, Japanese encephalitis, and rabies are endemic should be vaccinated if they are likely to be exposed. Those traveling to areas where tuberculosis is endemic should take precautions and should have skin tests before traveling and 2 to 4 months after return.

CONCLUSIONS

Family physicians can administer all necessary vaccinations. They can advise pregnant women and immunocompromised people about the balance of risk of disease and benefits of vaccination.

Authors+Show Affiliations

Memorial University of Newfoundland, St John's. rogert@morgan.ucs.mun.ca

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10752003

Citation

Thomas, R E.. "Preparing Patients to Travel Abroad Safely. Part 2: Updating Vaccinations." Canadian Family Physician Medecin De Famille Canadien, vol. 46, 2000, pp. 646-52, 655-6.
Thomas RE. Preparing patients to travel abroad safely. Part 2: Updating vaccinations. Can Fam Physician. 2000;46:646-52, 655-6.
Thomas, R. E. (2000). Preparing patients to travel abroad safely. Part 2: Updating vaccinations. Canadian Family Physician Medecin De Famille Canadien, 46, 646-52, 655-6.
Thomas RE. Preparing Patients to Travel Abroad Safely. Part 2: Updating Vaccinations. Can Fam Physician. 2000;46:646-52, 655-6. PubMed PMID: 10752003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preparing patients to travel abroad safely. Part 2: Updating vaccinations. A1 - Thomas,R E, PY - 2001/2/7/pubmed PY - 2001/2/7/medline PY - 2001/2/7/entrez SP - 646-52, 655-6 JF - Canadian family physician Medecin de famille canadien JO - Can Fam Physician VL - 46 N2 - OBJECTIVE: To provide, for family physicians without access to a travel clinic, evidence-based recommendations on vaccinating infants and children, adults, pregnant women, and immunocompromised patients traveling to non-Western countries. QUALITY OF EVIDENCE: Searches were undertaken of MEDLINE from 1990 to November 1998 (372 articles); the Cochrane Collaboration Library; publications of the National Action Committee on Immunization and the Committee to Advise on Tropical Medicine and Travel in Canada Communicable Disease Reports; the Canadian Immunization Guide; and Laboratory Centre for Disease Control, United States Centres for Disease Control, and World Health Organization websites. Evidence-based statements, randomized controlled trials, systematic reviews, and meta-analyses were selected. Vaccination recommendations are based on this evidence. MAIN MESSAGE: Physicians should complete vaccination schedules for children whose primary series is incomplete and vaccinate unvaccinated adults. Hepatitis A is widespread, and travelers to areas where it is endemic should be vaccinated. The elderly should be vaccinated against influenza and pneumococcal disease. Pregnant women should receive vaccines appropriate to their trimester. Immunocompromised patients should be vaccinated, but BCG and live vaccines are contraindicated. Travelers to areas where meningitis, typhoid, cholera, Japanese encephalitis, and rabies are endemic should be vaccinated if they are likely to be exposed. Those traveling to areas where tuberculosis is endemic should take precautions and should have skin tests before traveling and 2 to 4 months after return. CONCLUSIONS: Family physicians can administer all necessary vaccinations. They can advise pregnant women and immunocompromised people about the balance of risk of disease and benefits of vaccination. SN - 0008-350X UR - https://www.unboundmedicine.com/medline/citation/10752003/Preparing_patients_to_travel_abroad_safely__Part_2:_Updating_vaccinations_ L2 - http://www.cfp.ca/cgi/pmidlookup?view=long&pmid=10752003 DB - PRIME DP - Unbound Medicine ER -