Madison Medical Practice

Routine Vaccinations
These are the common vaccines recommended for adults and children. Many of these you have already been given or SHOULD have to stay healthy at home.

Tetanus Diphtheria (back to top)

Tetanus is a serious infection that causes progressive stiffness, rigidity, and spasms of skeletal muscle and can be fatal. Infection occurs with burns and "dirty" wounds or punctures (such as rusty nails, garden injuries or accidents).
Diphtheria is a disease that is caused by a bacteria infecting the skin or upper respiratory tract, which can be fatal. Early symptoms include sore throat, fever, nausea and chills.
Children receive tetanus/diphtheria/pertussis immunization as a part of their routine childhood vaccinations. A booster is routinely recommended for adults in the US every 10 years.
For the traveler:
Tetanus and diphtheria remain a global health problem. Immunization of international travelers is recommended before travel if their last immunization was 7-10 years ago.

Pertussis (Whooping Cough) (back to top)

Pertussis (also known as "whooping cough") is a highly contagious bacterial infection producing coughing, choking and vomiting, which can go on for weeks.
Pertussis vaccine is given to children as a part of the routine childhood vaccinations. However, protection diminishes after 10 years resulting in adolescents and adults to be susceptible to infection, as well as to spread the disease to others. A booster dose for adolescents and adults is now available. Protection is offered as a combination Tetanus Diphtheria Accellular Pertussis (Tdap) vaccine.
For the traveler:
It is important for international travelers to know their immunization record about pertussis. Adolescent travelers (i.e., between 11-18 years) should receive a pertussis booster for protection.

Haemophilus influenzae type B (back to top)

Haemophilus influenzae type b (Hib) infection is a highly contagious, severe bacterial infection that can cause meningitis, pneumonia, septic arthritis, inflammation of the throat and tissues.
Hib vaccine is another routine childhood immunization in the US. Hib is rare after 5 years of age, therefore older children and adults in the US do not routinely need this vaccine.
For the traveler:
However, Hib is common in may countries of the world, therefore certain older children and adults may need to be immunized if they are considered at increased risk for the disease. Travelers with sickle cell disease, diabetes, kidney disease, and spleen removed, or those with severely compromised immune systems (e.g., HIV, after organ transplant, on any chronic immunosuppressive therapy, or receiving chemotherapy) should be immunized before international travel.

Hepatitis B (back to top)

Hepatitis B (HBV) is an infection of the liver, caused by a virus that can lead to cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. The risk of Hepatitis B infection exists worldwide, including here in the US.
Hepatitis B infection is spread by use of contaminated needles, razors, dental and medical equipment, tattooing and body piercing devices, unprotected sexual contact with infected individuals and from contaminated blood and blood products. Perhaps more frightening is the fact that if you are infected with HBV (and you may not even know it), you can pass on this deadly disease to someone else by intimate person-to-person contact or sharing razors.
Hepatitis B vaccination is now part of the routine childhood immunization program. Since there is no cure for this potentially deadly disease, it is recommended that adults also get vaccinated. Immunization consists of 3 doses given over a 6 month period ... and is highly effective.
For the traveler:
If you have not been vaccinated against Hepatitis B, the 3-dose vaccination series is recommended for travelers to certain countries, particularly for extended stays, or if you plan certain activities.

Measles/Mumps/Rubella
(MMR) (back to top)

Measles, mumps and rubella (German measles) are highly contagious infectious diseases associated with childhood. The occurrence of these has decreased dramatically in the US due to the routine childhood immunization with MMR vaccine. Adults born after 1957 may not have been fully immunized to current standards and may need an additional dose(s).
For the traveler:
These diseases continue to be spread in developing countries that do not have routine childhood vaccination programs. Outbreaks also occur in developed countries if children are not routinely immunized. It is important for travelers to know their medical history about receiving the MMR vaccination or if they had each of these diseases as children. If it is not known, then travelers to endemic or epidemic areas may need to have blood work (serology) and/or be vaccinated before travel

Polio (back to top)

As of 1955, vaccination against polio became a routine childhood immunization in the US. Vaccination is a series of 3 doses of either injectable or oral polio vaccine. The success of the vaccination program is underscored by the fact that the last case in the US was over 21 years ago.
For the traveler:
While polio is considered to be eliminated here in the US, polio still exists in many developing countries in Africa, Asia, the Middle East and Eastern Europe. It is a viral disease that can be easily spread by contaminated food and water or by respiratory contact.
Adults over the age of 18 and anyone who did not complete the 3-dose vaccination series should receive a polio booster vaccine if traveling to an area where polio disease is a risk.

Influenza (Flu) (back to top)

Influenza is a highly contagious respiratory disease that can quickly become widespread. Symptoms include a sudden fever, body aches, sore throat and hacking cough.
A "flu shot" is recommended annually since the type (or strain) of influenza virus changes year to year. So each year, a vaccine is developed to protect against that year's strain.
For the traveler:
While in the US there is a recognized "flu season", influenza can occur year round in tropical areas. International travelers should be vaccinated against influenza due to the nature of travel and close contact with people who may be infected.

Pneumococcal (back to top)

Pneumococcal pneumonia is a bacterial infection. The infection occurs person-to-person via droplets in the air and by direct contact.
Children in the US receive pneumococcal vaccine as a part of their routine childhood immunizations.
The adult pneumococcal vaccine is routinely recommended to certain individuals based on their age and medical history.
For the traveler:
Likewise, certain international travelers may be at risk for the disease. Based on your age, medical history and itinerary, we will discuss if you should get this vaccine.

Varicella (Chicken Pox) (back to top)

Varicella is a highly contagious viral infection. Although it is a mild disease in a healthy child, chicken pox can lead to serious infections of skin lesions, pneumonia, dehydration, inflammation of the brain and liver disease. As a result, the varicella vaccine is now part of the routine childhood vaccinations in the US since 1995. Prior to that time, children who came down with the infection developed lifetime immunity.
For the traveler:
Chicken pox is a worldwide problem. International travelers who do not know if they have had the disease may need to have blood work (serology) and/or the two dose vaccination.

Recommended Vaccinations
These are vaccines important to staying healthy while traveling. Which ones you need will be determined by your itinerary and planned activities.

Hepatitis A (back to top)

What it is:
Hepatitis A is an infection of the liver caused by a virus. Th symptoms are a sudden fever, discomfort, loss of appetite, nausea and dark urine. While the illness is usually mild, it can be severe Symptoms last about 2 weeks, but complete recovery takes 8 weeks.
How you get it:
Hepatitis A infection is spread through contaminated food or water and by person-to-person contact with an infected person. Travelers in countries with poor or less developed sanitation systems are at the greatest risk for infection.
How to protect yourself:
Getting the Hepatitis A vaccine is a good start. In addition, when you are traveling, it's always good to be "Food-wise and Water-smart" and ALWAYS practice good personal hygiene (especially hand washing).

Hepatitis B (back to top)

What it is:
Hepatitis B is also an infection of the liver, caused by a virus. However, Hepatitis B is a much more serious and deadly disease than Hepatitis A. Hepatitis B causes a very serious liver infection that leads to permanent liver damage, liver cancer and death.
How you get it:
Hepatitis B infection is spread by use of contaminated needles, razors, dental and medical equipment, tattooing and body piercing devices, unprotected sexual contact with infected individuals and from contaminated blood and blood products.
How to protect yourself:
If you have not been vaccinated against Hepatitis B, the 3-dose vaccination series is recommended for travelers to certain countries for an extended stay, or if you plan certain activities. If your departure will not allow the routine 6-month vaccination schedule, an accelerated schedule can be used to provide sufficient protection.

Typhoid Fever (back to top)

What it is:
Typhoid fever is an infection caused by a bacteria that invades the digestive tract. The key symptom of typhoid fever is a prolonged high fever, but it's often accompanied by a headache, discomfort, cough and loss of appetite. Diarrhea, from mild to severe, may or may not occur.
Treatment for typhoid fever may require antibiotics, and even hospitalization in severe cases.
How you get it:
Like Hepatitis A, travelers get typhoid fever from contaminated food or water due to poor sanitation or person-to-person contact with an infected person. Typhoid fever is present worldwide, although the highest risk is in the Indian subcontinent and parts of Central and South America. As a result, typhoid fever can be a risk for many travelers.
How to protect yourself:
Again, getting the typhoid fever vaccine is a good start. But it's still important to be "Food-wise and Water-smart".

Rabies (back to top)

What it is:
Rabies is a serious infection caused by a virus in the saliva of an infected animal. The virus attacks nerves and muscles throughout the body. There is no cure for rabies and it is usually fatal.
How you get it:
The rabies virus exists in most countries of the world. Most infections are caused by dog bites. However, many other animals including cats, monkeys, tigers, rabbits, rats, mongoose and squirrels are also known to carry rabies.
How to protect yourself:
Even though it is a serious disease, rabies is not a common travel-acquired infection. As a rule of thumb, travelers should avoid any animals that could potentially pass on rabies. However, in some cases we may recommend the 3-dose pre-exposure vaccine series for high risk travelers.

Meningococcal Meningitis (back to top)

What it is:
Meningitis is a bacterial disease spread through the air by droplets of contaminated respiratory secretions (e.g. coughing or sneezing) or through person-to-person contact (e.g. kissing, sharing drinking glasses, intimate contact). Symptoms of this disease are sudden fever, intense headache, nausea and vomiting, and stiff neck. Treatment includes strict isolation and antibiotics with supportive measures for shock and other complications.
How you get it:
Travelers going to sub-Saharan Africa or Saudi Arabia 'are at the highest risk. Widespread epidemics are known to occur, especially during the dry winter months. The disease is highest among diverse populations mixing or living in crowded conditions (i.e., religious pilgrimages, military institutions, students living in dormitories).
How to protect yourself:
A vaccine that protects against the most common "types" of meningococcal meningitis is available if you are traveling to an area of increased risk.
For specific travelers, vaccination is a REQUIREMENT.

Yellow Fever (back to top)

What it is:
Yellow fever is a viral disease caused by the bite of one species of mosquito. Yellow fever typically occurs in sub-Saharan Africa and tropical South America where epidemic can occur. Symptoms of illness range from "flu-like" symptoms to severe fevers with the discharge of blood. Yellow fever can be fatal.
How you get it:
Certain areas of the world are considered yellow fever endemic areas because yellow fever is so widespread that there is a very high risk of travelers coming in contact with infected mosquitoes. In these areas, the highest risk of infection occurs during the rainy and early dry seasons.
How to protect yourself:
Protection from yellow fever is two-fold: (1) getting the yellow fever vaccine before you travel and (2) carefully following the personal protective measures (PPM) against insect bites while you're traveling. The need for the vaccine will be based on your itinerary. Vaccination will be RECOMMENDED for some areas of travel and REQUIRED for others.
For entry into some countries, yellow fever vaccination is a REQUIREMENT.

Japanese Encephalitis (back to top)

What it is:
Japanese encephalitis is a viral infection caused by the bite of another species of mosquito. Symptoms can either be mild fever and headache, or can they can be severe with a high fever, headache, neck stiffness, disorientation, tremors and coma. There is no treatment for the disease and it can be fatal.
How you get it:
Japanese encephalitis is found in parts of Asia and the Indian subcontinent. Depending on the region where you will be traveling, the risk increases during different times of the year. Increased risk is also associated with monsoons and irrigation of rice-paddy fields. Your risk is also increased if you will be spending more than 2 weeks in an "endemic area" (i.e. an area where the disease is so widespread that there is a great risk of contact with infected mosquitoes) particularly if this area is rural.
In addition, activities such as biking, hiking, and extended outdoor exposure can put unprotected travelers at a higher risk for Japanese encephalitis.
How to protect yourself:
If you will be at risk for Japanese encephalitis, the 3-dose vaccine series may be recommended.

Required Vaccinations
These vaccines are mandatory for entry into certain countries. You will be given a certificate proving that you have been vaccinated that you will need to carry with you.

Yellow Fever (back to top)

Entry requirement:
Certain countries REQUIRE an International Certificate of Vaccination against yellow fever for travelers coming directly from the US, as well as those travelers coming from a country known to be infected with yellow fever. Travelers who DO NOT present the International Certificate of Vaccination to prove that they have been vaccinated against yellow fever may be subject to local re-vaccination, medical follow-up, or isolation. In some countries, unvaccinated travelers are denied entry.

Meningococcal Meningitis (back to top)

Entry requirement:
Vaccination is not OFFICIALLY required for the infected areas known as the "meningitis belt" of sub-Saharan Africa. However, the Saudi Arabia Embassy REQUIRES that pilgrims participating in the Hajj and Umra pilgrimages in Saudi Arabia be vaccinated and have proof of vaccination (the same form used for proof of yellow fever). Pilgrims participating in the pilgrimage are at a higher risk of meningococcal disease and are required to obtain the quadrivalent (A,C,Y, W-135) form of the vaccine.

You should call the office before stopping in to be certain
that we have the vaccine you need.

Call (212) 686 5800 to schedule an appointment or
get your questions answered.

You may also email us.

Disclaimer:

All of the documents contained in this web site are presented for information purposes only.
The material on this site is in no way intended to replace professional medical care or attention by a qualified practitioner.
All the material on this web site cannot and should not be used as a basis for diagnosis or choice of treatment.