Travel Medicine (cont.)

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Meningococcal meningitis

Meningococcal meningitis is an infection of the lining and fluid around the brain and spinal cord. The cause is a bacterium called Neisseria meningitides. The disease can be quite severe or even fatal. The infection is spread from person to person by close contact through coughing or sneezing or other respiratory means.

Meningococcal meningitis occurs at low rates throughout the world, including the United States. However, some countries have high rates of disease and pose a special risk to travelers. This includes many countries in the "meningitis belt" of sub-Saharan Africa. Saudi Arabia has experienced outbreaks when pilgrims travel to religious sites.

There are two effective vaccines to prevent meningitis. The choice of vaccine depends on the age of the patient. The vaccines are synthetic (meaning that they do not contain live infectious agents). They should not be given to people who have previously had a neurological illness called Guillain-Barré syndrome. Vaccination is now routinely recommended for adolescents and college freshmen in the United States. It is also recommended for travelers who are going to areas that have high rates of infection. Vaccination is required for pilgrims to religious sites in Saudi Arabia, and proof of vaccination (preferably an International Certificate of Vaccination) will be required at the border. The vaccination is effective for three to five years (depending on which of the two vaccines is given), after which revaccination may be recommended for travelers who travel to areas with high rates of infection.

Yellow fever

Yellow fever is caused by a virus that attacks the liver. In many people, the disease is mild and goes away. In others, the liver can fail or internal bleeding can occur which can lead to death. Yellow fever is spread by the bite of a mosquito.

Yellow fever occurs in areas of sub-Saharan Africa, Central America, and South America. Not all countries in these areas have yellow fever. Even within a country, some areas may have yellow fever while others do not.

There is a very effective vaccine available to prevent yellow fever. It contains a live virus that has been modified ("attenuated") to make it safer. Vaccine side effects are usually mild. Rarely (a few cases per million doses), the vaccine virus can spread and cause severe disease. Patients with suppressed immune systems (for example, people with certain chronic diseases, HIV infection, or who are receiving cancer chemotherapy) should not receive the live vaccine.

Vaccination is recommended for travelers who will be exposed to yellow fever. The vaccine may be required for entry into some countries. Check the CDC web site to see if vaccination is required for your trip. If you get vaccinated, you should receive an International Certificate of Vaccination, signed and validated with the center's stamp where the vaccine was given. Take the certificate with you on your trip. You may need it to enter your destination country. This certificate is valid for 10 years. The vaccine is given at local health departments and travel clinics. To find a place to get yellow fever vaccine, go to

Medically Reviewed by a Doctor on 4/30/2014

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