MENINGOCOCCAL AND TRAVELLERS’ VACCINATIONS

The increase in international tourism has created demandfor vaccination to protect against travel-associatedillness. The decision to vaccinate travellers involvesrisk-benefit assessment. Most currently used travelvaccines include the meningococcal vaccine, yellow fevervaccine, typhoid vaccine, and Japanese encephalitisvaccine.This review addresses the limitations posed by themeningococcal polysaccharide vaccine, the differentquadrivalent meningococcal conjugate vaccines available,the current recommendations in children and adults andthe development of new meningococcal B vaccines.This review also addresses the current recommendationsfor yellow fever vaccines, new typhoid conjugate vaccines,changing epidemiology of Japanese encephalitis (JE), andnew recommendations for the JE vaccines.

Travel Medicine in Primary Care

International travel is growing despite economic and geographical challenges. Travellers should seek pretravel advice 4 to 6 weeks before departure. Required immunisations include yellow fever and meningococcal vaccines. The common recommended immunisations are based on risk assessment. These include typhoid, cholera, hepatitis A, Japanese encephalitis and rabies vaccine. Common illnesses in returned travellers are mainly due to gastrointestinal diseases, febrile diseases and dermatologic diseases. Evaluation of the travel-related illness requires an understanding of geographical distribution of infections, risk factors for transmission of infection, incubation periods of common infections, clinical presentation and appropriate laboratory investigations. Syndromic approach to the evaluation of illness in a returned traveller is important for post-travel diagnosis.