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1622 travelers to Venezuela will need vaccinations for hepatitis Atyphoid feverand yellow feveras well as medications for travelers’ diarrhea. Many will require malaria prophylaxis. Travelers should be sure they are fully immunized against measles.
Other immunizations and medications may be necessary depending upon the circumstances of the trip and the medical history of the traveler, as discussed below.
Insect repellents are recommended, haceta conjunction with other measures to prevent mosquito bites. All travelers should visit either a travel health clinic or their personal physician weeks before departure. Malaria occurs in Angel Falls. Travelers’ diarrhea is the most common travel-related ailment. The cornerstone of prevention is food and water precautionsas outlined below. All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool.
A quinolone antibiotic is usually prescribed: Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Alternative regimens include a three day course of rifaximin Xifaxan mg three times daily or azithromycin Zithromax mg once daily.
MD Travel Health – Venezuela – vaccinations, malaria, safety, and other medical advice
Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. An antidiarrheal drug such as loperamide Imodium or diphenoxylate Lomotil should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate Lomotil and loperamide Imodium should not be given to children under age two.
Most cases of travelers’ diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential. If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought. Though effective, antibiotics are not recommended prophylactically i. In general, the risk of malaria is greatest between February and August, especially after onset of the rainy season in late May.
Mefloquine is taken once weekly in a dosage of mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure. Mefloquine may cause mild neuropsychiatric gzceta, including nausea, vomiting, dizziness, insomnia, and nightmares. Yaceta, severe reactions occur, including depression, anxiety, psychosis, hallucinations, and seizures.
Mefloquine should not be given to anyone with a history of seizures, psychiatric illness, cardiac conduction disorders, or allergy to quinine or quinidine.
Side-effects, which are typically mild, may include abdominal pain, nausea, vomiting, headache, diarrhea, or dizziness. Serious adverse reactions are rare. Doxycycline is effective, but may cause an exaggerated sunburn reaction, which limits its usefulness in the tropics.
Long-term travelers who will be visiting malarious areas and may not have access to medical care should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical care within 24 hours. See malaria for details. Symptoms of malaria sometimes do not occur for months or even years after exposure. For further information about malaria in Venezuela, including maps showing the risk of malaria in different parts of the country, go to the Pan American Health Organization and the World Health Organization.
Measles vaccine is recommended for any traveler born after who does not have either a history of two documented measles immunizations or a blood test showing immunity see “Recent outbreaks”. Many adults who had only one vaccination show immunity when tested and do not need the second vaccination. Although measles immunization is usually begun at age 12 months, children between the ages of 6 and 11 months should be given an initial dose of measles vaccine before traveling to Venezuela.
If single-antigen measles vaccine is unavailable, MMR should be given. Children greater than 12 months of age should receive two doses of MMR, separated by at least one month, before going to Venezuela. Measles vaccine should not be given to pregnant or severely immunocompromised individuals. The government of Venezuela recently announced that all Venezuelan nationals and foreign residents living in Venezuela, over the age of six months, who leave Venezuela and travel outside the Americas through international airports or ports, must be in possession of a certificate of vaccination documenting that they have been vaccinated against measles and rubella.
Persons without a certificate will be vaccinated on-site. Although this only applies to Venezuelan nationals and foreign residents living in Venezuela, it would be prudent for all travelers to carry documentation of measles and rubella vaccination. For further information, go to Health Canada.
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Hepatitis A vaccine is recommended for all travelers over one year of age. It should be given at least two weeks preferably four weeks or more before departure. A booster should be given months later to confer long-term immunity.
Two vaccines are currently available in the United States: Side-effects, which are generally mild, may include soreness at the injection site, headache, and malaise. Older adults, immunocompromised persons, and those with chronic liver disease or other chronic medical conditions who have less than two weeks before departure should receive a single intramuscular dose of immune globulin 0.
Travelers who are less than one year of age or allergic to a vaccine component should receive a single intramuscular dose of immune globulin see hepatitis A for dosage in the place of vaccine.
Typhoid vaccine is recommended for all travelers, with the exception of short-term visitors who restrict their meals to major restaurants and hotels, such as business travelers and cruise passengers. It is generally given in an oral form Vivotif Berna consisting of four capsules taken on alternate days until completed. The capsules should be kept refrigerated and taken with cool liquid. Side-effects are uncommon and may include abdominal discomfort, nausea, rash or hives.
PDFgiven as a single dose. Adverse reactions, which are uncommon, may include discomfort at the injection site, fever and headache. The oral vaccine is approved for travelers at least six years old, whereas the injectable vaccine is approved for those over age two. There are no data concerning the safety of typhoid vaccine during pregnancy. The injectable vaccine Typhim Vi is probably preferable to the oral vaccine in pregnant and immunocompromised travelers.
Yellow fever vaccine is recommended for travelers greater than nine months of age, with the following exceptions. For those whose itinerary is limited to the following areas – the states of Aragua, Carabobo, Miranda, Vargas, and Yaracuy, and the Distrito Federal see map – the vaccine should be considered only for those at increased risk due to prolonged travel, heavy exposure to mosquitoes, or inability to avoid mosquito bites.
In recent years, yellow fever has been reported from the states of Amazonas, Bolivar, Zulia, and Tachira, as well as Marguerita Island. A yellow fever outbreak was reported in June from the Venezuelan-Colombian border see “Recent outbreaks” below.
PDF must be administered at an approved yellow fever vaccination centerwhich will give each vaccinee a fully validated International Certificate of Vaccination. Yellow fever vaccine should not in general be given to those who are younger than nine months of age, pregnant, immunocompromised, or allergic to eggs.
It should also not be given to those with a history of thymus disease or thymectomy. Reactions to the vaccine, which are generally mild, include headaches, muscle aches, and low-grade fevers. Serious allergic reactions, such as hives or asthma, are rare and generally occur in those with a history of egg allergy. Hepatitis B vaccine is recommended for all travelers if not previously vaccinated.
Two vaccines are currently licensed in the United States: Recombivax HB Merck and Co. A full series consists of three intramuscular doses given at 0, 1 and 6 months. Engerix-B is also approved for administration at 0, 1, 2, and 12 months, which may be appropriate for travelers departing in less than 6 months. Side-effects are generally mild and may include discomfort at the injection site and low-grade fever. Severe allergic reactions anaphylaxis occur rarely.
Rabies vaccine is recommended for travelers spending a lot of time outdoors, for travelers at high risk for animal bites, such as veterinarians and animal handlers, for long-term travelers and expatriates, and for travelers involved in any activities that might bring them into direct contact with bats. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites. A complete preexposure series consists of three doses of vaccine injected into the deltoid muscle on days 0, 7, and 21 or Side-effects may include pain at the injection site, headache, nausea, abdominal pain, muscle aches, dizziness, or allergic reactions.
Any animal bite or scratch should be thoroughly cleaned with large amounts of soap and water and local health authorities should be contacted immediately for possible post-exposure treatment, whether or not the person has been immunized against rabies.
Cholera vaccine is not generally recommended. Cholera outbreaks have occurred in the past, but no cases were reported for the years and Most travelers are at extremely low risk for infection. Two oral vaccines have recently been developed: These vaccines, where available, are recommended only for high-risk individuals, such as relief workers, health professionals, and those traveling to remote areas where cholera epidemics are occurring and there is limited access to medical care.
The only cholera vaccine approved for use in the United States is no longer manufactured or sold, due to low efficacy and frequent side-effects. Polio vaccine is not recommended for any adult traveler who completed the recommended childhood immunizations. Polio has been eradicated from the Americas, except for a small outbreak of vaccine-related poliomyelitis in the Dominican Republic and Haiti in late An outbreak of Chagas disease was reported from Venezuela in the first three weeks ofcausing cases.
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No further information is available. In Aprilan outbreak of Chagas disease, causing four cases, was reported from Caracas, probably due to consumption of contaminated watermelon juice in the Mercado de Coche market. In Novemberan outbreak of Chagas disease, presumably food-borne, was reported from Junin municipality in the Andean region, near the border with Colombia. A total of six cases were identified, one fatal.
In Maya Chagas outbreak was reported from a neighborhood in Caracas, causing 15 confirmed cases. The source of the outbreak was not determined.
In Aprila Chagas outbreak gaceya reported from Chichiriviche de la Costa, in the western part of the state of Vargas.
The outbreak appeared to have been caused by contaminated guava 612. A school outbreak caused by contaminated fruit juice was reported in December see ProMED-mailDecember 26,and April 6, Sporadic cases of Chagas disease, which are usually transmitted by triatomine insects, are also reported from Venezuela, mostly from the northern half of the country.