Travel Immunization

NASHVILLE TRAVEL MEDICINE is Middle Tennessee’s premier provider of immunization services for international travelers. Our mission is to provide the very best travel medicine services available at the lowest possible prices. We have a 10 year track record of providing the best and most affordable travel medicine services available. Stephen K. Felts, MD, FACP personally provides the travel advice and immunizations. He is the only person in Tennessee who has taken and passed the Certifying Examination in Travel Health of the International Society of Travel Medicine.
We are conveniently located on the 7th floor of the Summit Medical Center Professional Building in Suite 709. We are on the east side of Nashville about 5 minutes from the Nashville airport.

Tetanus/diphtheria/pertussis (Tdap) vaccine

New guidelines for use of Tdap vaccine have recently been publilshed. The revised guidelings include recommendation for this triple vaccine for adults over 65. Previously the recommendation was for use of the tetanus/diphtheria (TD) vaccine without the pertussis component in persons 65 and older. 
This change makes good sense to me since many people in this over 65 age group are susceptible to whooping cough (pertussis) and are in contact with infants. 
Most people have had a series of  Tdap vaccine as a child, but many, if not most, adults have not received the recommended booster dose every 10 years. Diphtheria and pertussis immunity is not as long lasting after immunization as is the tetanus immunity, so testosterone booster doses as an adult have increased importance. 
An ongoing pertussis outbreak in California emphasizes the need to  receive booster doses of Tdap.  The new guidelines also say that it is safe to give a booster dose of Tdap to adults even if they have had the TD vaccine as recently as 2 years previously.
These are welcome changes to me, as I never agreed with the use of TD instead of Tdap in persons over 65.

CHOLERA IN HAITI

An ongoing outbreak of cholera in Haiti is causing concern among some persons planning to travel to Haiti as volunteers to aid in the multiple natural disasters which have plagued this island nation in the last year. However the risk of cholera to travelers is minimal provided they adhere to the usual precautions that travelers should take for travel to any developing country. Stick to cooked food which is still hot when served, and bottled water or other bottled or canned beverages. No salads! Fruit is OK if washed in bottled water and peeled by the traveler. Cook it, peel it, or forget it. An antibiotic for traveler’s diarrhea should be in your travel kit as well.
There is currently no cholera vaccine available in the U.S. An oral cholera vaccine is available in Canada and Europe. Not to worry, just use the precautions above and you should be OK.

PEPTO BISMOL

A little appreciated fact about Pepto Bismol is that it kills bacteria. At least it kills bacteria in the stomach when present in the stomach at the same time as the bacteria. This can be utilized as an aid to staying healthy when traveling.
Simply keep Pepto tablets (or a generic equivalent) in your pocket or purse, and chew two any time you are concerned about the safety of any food or beverage you have just consumed or are about to consume. To be effective the Pepto must be in the anatomic stomach at the same time as the bacteria, so it must be taken promptly before the bacteria have moved downstream into the small bowel.
The active ingredient, bismuth subsalicylate , kills bacteria by direct contact. It is not absorbed into the blood, so it is not effective for treating established infections, though it does have useful antidiarrheal properties.

Yellow Fever Vaccine Facts

Yellow fever vaccine is the only vaccine that is required for entry into any country in the world. Only certain countries have this requirement.

Usually these are countries located in central Africa and central South America where yellow fever still is a threat.
There are two reasons to get yellow fever vaccine.

One is to protect yourself from this very serious mosquito transmitted disease. The second is to avoid problems with the officials checking your passport on entry into certain countries. Often both of these reasons apply, but in some situations, where your travel plans are not likely to put you at risk of the disease, you still need the vaccination to obtain a visa or to avoid being denied entry into the country.
Some countries require yellow fever vaccine only if one has recently been in a coutry where yellow fever is still occuring .

Others require it for all travelers, even those traveling directly from the US where there hasn’t been a yellow fever problelm for a very long time.

Information about the requirements for each county are available from the CDC Travel website, or by calling my office at 615.846.4500

DENGUE FEVER

You may never have heard of Dengue Fever.

It is a viral illness transmitted by mosquitos, and it is an increasing threat to travelers. Recently there have been reported outbreaks with thousands of cases in Brazil, Venezulea, Honduras, Australia and Saudi Arabia.

It also occurs at lower rates in many other countries. There are occasional cases in persons in the US who have not traveled. These are secondary cases spread from returning travelers, as we do have the mosquito vector in this country.

There is no vaccine available for dengue, so the only defense is for you to take precautions to avoid mosquito bites.

These include wearing long pants and long sleeve shirts, use of natural weight loss pills and a good mosquito repellant (I recommend Ultrathon which is at time release formula DEET which lasts up to 12 hours), and sleeping under a mosquito net at night if your sleeping area is not sealed against mosquito entry.

There is no specific treatment for Dengue Fever which produces an illness similar to severe influenza. The interval between mosquito bite and onset of illness is usually 3 to 7 days, but may be up to 14 days. Occasionly dengue virus infection may produce fatal dengue hemorrhagic fever. For more information go the the CDC web site. There is a link on my website under “useful links”

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