Travel risks: Which patients need specific guidance? Part 1, immunization

Ensure that a prospective traveler's routine immunizations are up-to-date. Booster doses for some primary immunizations are recommended before international travel. For example, adults born after 1957 who plan to travel to developing countries will need a second dose of measles vaccine if they lack serum antibody titers. The CDC recommends hepatitis A immunization for all international travelers except those going to Canada, Australia, New Zealand, Japan, or Western Europe. Typhoid vaccination is recommended for persons traveling for 3 or more weeks in areas where the disease is endemic. Consult specific CDC recommendations for the destination countries (available at www.cdc.gov/travel). The oral typhoid vaccine is well tolerated and provides protection for 4 to 5 years. There has been a resurgence of yellow fever in Africa and South America in recent decades; vaccination is required for entry into certain countries.