Tuesday, June 20, 2006

From the CDC to Caribbean Travelers...

Health Information for Travelers to Countries in the Caribbean
On This Page
Vaccines for Your Protection
Diseases Found in the Caribbean
Other Health Risks
What You Need To Bring With You
Staying Healthy During Your Trip
After You Return Home
For More Information

Travel Notices in Effect
Malaria, Great Exuma, Bahamas: Recommendations for Travelers(Released June 16, 2006)
U.S. Department of State
See all Traveler's Health travel notices


Vaccines for Your Protection: The Caribbean

Routine Vaccinations
Check with your healthcare provider: you and your family may need routine as well as recommended vaccinations.
Before travel, be sure you and your children are up to date on all routine immunizations according to schedules approved by the Advisory Committee on Immunization Practice (ACIP). See the schedule for adults and the schedule for infants and children. Some schedules can be accelerated for travel.
See your doctor at least 4–6 weeks before your trip to allow time for shots to take effect. If it is less than 4 weeks before you leave, you should still see your doctor. It might not be too late to get your shots or medications as well as other information about how to protect yourself from illness and injury while traveling.
Recommended Vaccinations and Preventive Medications
The following vaccines may be recommended for your travel to The Caribbean. Discuss your travel plans and personal health with a health-care provider to determine which vaccines you will need.
Hepatitis A or immune globulin (IG).Transmission of hepatitis A virus can occur through direct person-to-person contact; through exposure to contaminated water, ice, or shellfish harvested in contaminated water; or from fruits, vegetables, or other foods that are eaten uncooked and that were contaminated during harvesting or subsequent handling.
Hepatitis B, especially if you might be exposed to blood or body fluids (for example, health-care workers), have sexual contact with the local population, or be exposed through medical treatment. Hepatitis B vaccine is now recommended for all infants and for children ages 11–12 years who did not receive the series as infants.
Malaria: if you are traveling to a malaria-risk area in this region, see your health care provider for a prescription antimalarial drug. For details concerning risk and preventive medications, see Malaria Information for Travelers to the Caribbean.
Rabies, if you might have extensive unprotected outdoor exposure in rural areas, such as might occur during camping, hiking, or bicycling, or engaging in certain occupational activities.
Typhoid, particularly if you are visiting developing countries in this region. Typhoid fever can be contracted through contaminated drinking water or food, or by eating food or drinking beverages that have been handled by a person who is infected. Large outbreaks are most often related to fecal contamination of water supplies or foods sold by street vendors
Yellow Fever, for travelers to Trinidad and Tobago
As needed, booster doses for tetanus-diphtheria and measles.
Required Vaccinations
None.


Diseases found in the Caribbean (risk can vary by country and region within a country; quality of in-country surveillance also varies)

The preventive measures you need to take while traveling in the Caribbean depend on the areas you visit and the length of time you stay. You should observe the precautions listed in this document in most areas of this region.
Malaria
An Anopheles freeborni mosquito takes a blood meal.
Malaria is always a serious disease and may be a deadly illness.
Humans get malaria from the bite of a mosquito infected with the parasite. Prevent this serious disease by seeing your health care provider for a prescription antimalarial drug and by protecting yourself against mosquito bites (see below). All travelers to malaria-risk areas in Haiti and the Dominican Republic, including infants, children, and former residents of these islands, should take an antimalarial drug. All travelers to Haiti are at risk for malaria, except no risk in the cruise port of Labadee (Labadie). Travelers to rural areas of the Dominican Republic are at risk for malaria, with the highest risk in provinces bordering Haiti. In addition, risk in all areas of La Altagracia Province, including resort areas (Updated October 21, 2005). There is also malaria risk on Great Exuma Island, Bahamas (Updated June 16, 2006). Travelers to malaria-risk areas in Haiti, Dominican Republic, and The Bahamas should take chloroquine to prevent malaria.
For additional information on malaria risk and prevention, see Malaria Information for Travelers to the Caribbean.
There is no risk for malaria in: Anguilla (U.K.), Antigua & Barbuda, Barbados, Bermuda (U.K.), Cayman Islands (U.K.), Cuba, Dominica, Grenada, Guadeloupe, Jamaica, Martinique (France), Montserrat (U.K.), Netherlands Antilles, Puerto Rico (U.S.), St. Kitts & Nevis, St. Lucia, St. Vincent & the Grenadines, Trinidad & Tobago, Turks & Caicos (U.K.), Virgin Islands (U.K., U.S.).
Yellow Fever
Yellow fever is present only in Trinidad & Tobago in this region. A certificate of yellow fever vaccination may be required for entry into certain countries in the region if you have visited Trinidad & Tobago or an endemic area in South America or sub-Saharan Africa. For detailed information, see Comprehensive Yellow Fever Vaccination Requirements. Also, find the nearest authorized U.S. yellow fever vaccine center.
Food and Waterborne Diseases
Avoid buying food or drink from street vendors, because it is relatively easy for such food to become contaminated.
Make sure your food and drinking water are safe. Food and waterborne diseases are the primary cause of illness in travelers. Travelers’ diarrhea can be caused by viruses, bacteria, or parasites, which are found throughout the Caribbean and can contaminate food or water. Infections may cause diarrhea and vomiting (E. coli, Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage ( hepatitis). Illness caused by a parasitic worm (Angiostrongylus cantonensis) can occur in this region. People can get infected by eating raw or undercooked snails or slugs that are infected with the parasite.
Additional information: see the Safe Food and Water page for a list of links.
Other Disease Risks
Dengue is transmitted by mosquitoes in this region. Protecting yourself against insect bites (see below) will help to prevent this disease.
Cutaneous larval migrans is a risk for travelers with exposures on beaches and leptospirosis is present. Eosinophilic meningitis caused by Angiostongylus cantonensis occurred in travelers to Jamaica. Anthrax occurs in Haiti. Other infections that tend to occur more often in longer-term travelers (or immigrants from this region) include lymphatic filariasis (Dominican Republic and Haiti), cutaneous leishmaniais (Dominican Republic), tuberculosis (Haiti), HIV (Haiti), and hepatitis B (Haiti and the Dominican Republic). There remains very limited risk of schistosomiasis in few areas. Other hazards for travelers include toxic fish poisoning


Other Health Risks

Injuries
Motor vehicle crashes are a leading cause of injury among travelers. Protect yourself from motor vehicle injuries: avoid drinking and driving; wear your safety belt and place children in age-appropriate restraints in the back seat; follow the local customs and laws regarding pedestrian safety and vehicle speed; obey the rules of the road; and use helmets on bikes, motorcycles, and motor bikes. Avoid boarding an overloaded bus or mini-bus. Where possible, hire a local driver.


What You Need To Bring With You

Long-sleeved shirt, long pants, and a hat to wear whenever possible while outside, to prevent illnesses carried by insects (e.g., malaria, Dengue, filariasis, leishmaniasis, and onchocerciasis).
Insect repellent containing DEET.
Bed nets treated with permethrin. For use and purchasing information, see Insecticide Treated Bednets on the CDC malaria site. Overseas, permethrin or another insecticide, deltamethrin, may be purchased to treat bed nets and clothes.
Flying-insect spray to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
Iodine tablets and portable water filters to purify water if bottled water is not available. See Preventing Cryptosporidiosis: A Guide to Water Filters and Bottled Water for more detailed information.
Sunblock, sunglasses, and a hat for protection from harmful effects of UV sun rays. See Skin Cancer Questions and Answers for more information.
Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s) or letter from your health-care provider on office stationery explaining that the medication has been prescribed for you.
Always carry medications in their original containers, in your carry-on luggage.
Be sure to bring along over-the-counter antidiarrheal medication (e.g., bismuth subsalicylate, loperamide) and an antibiotic prescribed by your doctor to self-treat moderate to severe diarrhea. See suggested over-the-counter medications and first aid items for a travel kit.


Staying Healthy During Your Trip

Travelers should take the following precautions
To stay healthy, do...
When using repellent on a child, apply it to your own hands and then rub them on your child. Avoid children's eyes and mouth and use it sparingly around their ears. Wash your hands often with soap and water or, if hands are not visibly soiled, use a waterless, alcohol-based hand rub to remove potentially infectious materials from your skin and help prevent disease transmission.
In developing countries, drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, learn how to make water safer to drink.
Take your malaria prevention medication before, during, and after travel, as directed. (See your health care provider for a prescription.)
To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot, even on beaches.
Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.
Protect yourself from mosquito insect bites:
Wear long-sleeved shirts, long pants, and hats when outdoors.
Use insect repellents that contain DEET (N, N-diethylmethyltoluamide). For more information about insect repellents and correct use, see What You Need to Know about Mosquito Repellent on the CDC West Nile Virus site.
If no screening or air conditioning is available: use a pyrethroid-containing spray in living and sleeping areas during evening and night-time hours; sleep under bed nets, preferably insecticide-treated ones.
If you are visiting friends and relatives in your home country, see additional special information about malaria prevention in Recent Immigrants to the U.S. from Malarious Countries Returning 'Home' to Visit Friends and Relatives on the CDC Malaria site.
Do not
Do not eat food purchased from street vendors or food that is not well cooked to reduce risk of infection (i.e., hepatitis A and typhoid fever).
Do not drink beverages with ice.
Avoid dairy products, unless you know they have been pasteurized.
Do not swim in fresh water to avoid exposure to certain water-borne diseases such as schistosomiasis. (For more information, please see Swimming and Recreational Water Precautions.)
Do not handle animals, especially monkeys, dogs, and cats, to avoid bites and serious diseases (including rabies and plague). Consider pre-exposure rabies vaccination if you might have extensive unprotected outdoor exposure in rural areas. For more information, please see Animal-Associated Hazards.
Do not share needles for tattoos, body piercing or injections to prevent infections such as HIV and hepatitis B.


After You Return Home

If you have visited a malaria-risk area in Haiti or the Dominican Republic, continue taking your chloroquine for 4 weeks after leaving the risk area.
Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever or flu-like illness either while traveling in a malaria-risk area or after you return home (for up to1 year), you should seek immediate medical attention and should tell the physician your travel history.


For More Information

For more information about these and other diseases, please check the Diseases page and CDC Health Topics A-Z
Diseases

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