Wednesday, March 22, 2006

Travel Vaccine Recommendations for India

Dear Googlers,

Before packing for the beautiful country of India please consider the following Center for Disease Control recommendations:

--Tetanus-diphtheria-pertussis (1 shot)--->if your last one was more than 10 years ago.

--Polio (1 shot)--> one time only needed as an adult.

--Measles (1 shot)-->one time booster if you were born after 1956 and if you cannot document that you are immune by haveing received either 2 doses of MMR (measles/mumps/rubella) vaccine or by history of having had the disease. A blood test can also be done to see if you have had the vaccine. Please note that measles is a live vaccine and that it should not be given to pregnant women or to those with immunosuppression. Also women are advised not to get pregnant for 4 weeks after receiving the MMR.

Typhoid (4 pills)--->which are taken 1 every other day, and will be good for 5 years. It should be taken at least 2 weeks before the trip. Note that these pills should be refrigerated, and that this is also a live vaccine.

Hepatitis A (2 shots) --->ideally the first dose should be given 4 weeks prior to your trip to be maximally protected. You will need a second shot in 6-12 months to be protected long term.

Hepatitis B (3 shots)---> 2 of which are given 4 weeks apart and the third is given in 6 months. You should complete the first 2 shots before departure. This is especially recommended if you might be exposed to blood or body fluids (for example, health-care workers), have sexual contact with the local population, or be exposed through medical treatment.

A combination shot of hepatitis A and B vaccines may ge given in 1 shot instead of individual A and B shots.

--Malaria Pills-- 2 most commonly prescribed are the following but only one is needed:
>Malarone(atovaquone and proguanil hydrochloride)---taken one a day starting one day before entering India and continuing every day until 7 days after you have left India.
>Lariam (Mefloquine)--- taken one a week, starting one week before entering India and continuing for 4 weeks after leaving India. This is not recommended for people with depression. It has also been associated with vivid dreams.
See Malaria Information for Travelers to South Asia.

Ciprofloxacin or equivalent antibiotic to have just in case of traveler's diarrhea. If diarrhea occurs and is lasting more than 24 hours or is associated with blood or fever then take one tablet of Cipro twice a day for 3 days.

Depending on your itinerary other vaccines to consider are:
Japanese encephalitis, if you plan to visit rural farming areas and under special circumstances, such as a known outbreak of Japanese encephalitis.
Rabies, if you might have extensive unprotected outdoor exposure in rural areas, such as might occur during camping, hiking, or bicycling, or engaging in certain occupational activities.

TB (tuberculosis) test should be considered after your trip especially if you visit India frequently or if you are staying there for one month or longer.

Over the counter medications to consider depending on your needs:
Imodium for diarrhea.
Diphenhydramine(Benadryl) for allergic reactions, motion sickness, nausea, and as sleep aid.
Hydrocortisone for skin reactions.
Sudafed for congestion, especially if before a flight.
Acetominophen(Tylenol), Ibuprofen(Advil) or other anti-inflammatory medication.
DEET containing mosquito repellant.

Additional information: see the Safe Food and Water page for a list of links. Consider DEET permeated clothing, and wearing long sleeves and pants when outside at dusk or dawn which are feeding times for mosquitos.

Please consult your doctors for any specific questions or if you are pregnant.
And if you really want to avoid the vaccines then check with your doctor, parents, or your old records to see if any of your shots are documented and up to date.

Photographer:Maurice Crosby Photography Ltd. Date:1955 Fonds/Collection:Maurice Crosby Reference no.:accession no. 1997-254/003, nos. 4-5


fbum said...

Certainly is medicine for thought. What I mean to say is, the idea that we have to, or choose to take these meds, these precautions to proptect ourselves from one another, from different locations around the globe.

Michael Comglas said...

Wow that's very important things we should do before travelling. However, I never did this kind of things.
HHmmmmmmm I'd better start now.

I wrote some stuff about traveling too. about Hong Kong

Check out my blog

BellaLelia said...

I've been to India and totally agree. Let's just say that sanitation isn't a high priority in India. Beautiful, yes - Clean, no.

Sanetti said...

India is so beautiful that I have had great difficulty describing it in less than a thousand words.

While I did take all of the precautions reccomended here and I had no health issues whatsoever, I must agree that the potential for infection does exist.

I traveled to Mumbai, Delhi, New Delhi, and the road to Agra to see the Taj Mahal and I'm still moved almost a year later. I'm returning in the 2nd week of May and will take the same precautions once more.

While I would never argue the beauty of India and particularly the wonderful, warm people I think you would all be smart to get vaccinated.

Most important...don't drink the water. Bottled only. I'm amazed at the Indian peoples and a visit will change you forever. This is not a country to miss in your lifetime! You will not see so much beauty, tragedy, romance and true caring anywhere else in the world.

diana charles said...

Well, I remember when my 17 year old daughter was going to the States to study, I had a whole lot of advice for her- don't accept any drinks which you haven't seen opened or made in front of you(rape-dates), don't walk in Central Park late at night( my cousin was mugged),avoid saying- 'super size it at Wendy's or McDonald's- unless you want to become obese and at cardiac risk- I suppose every country has its own problems. And in India we are blessed with an innate immunity, since we are born here.Even Indians who live abroad and come back home for a short period tend to fall ill easily, so why should we get mad about medical advice given as a precautionary measure.
The only thing is that tourists shouldnt get put off by the number of innoculations and precautions and miss this incredible experience that is India.As they say in Goa, as a greeting and farewell- DEO BOREM KORUN- May God Bless you.

Maninder said...

hey all you wonderful peole plannng to over to India for a vacation. You anytime helpline in India is hers.
I have travelled alomost all over India, and can arrange your bookings, hotels, and any toher assistance. I can also be your guide ..
all are most welcome is my id

Ramana said...

nice ! very good list ! please follow his suggestions and enjoy the trip ! Before coming to india JUST you have to have approximately 6 to 8 shots in 2 weeks time, and after you are here JUST 10 to 15 pills per day, enough. You will enjoy the trip since you will be always under drowsy state like a drunker with medication. Happy yawning!!!

Nephi said...

Leaving for India in a week, staying for four months, doing anthropology research. Thanks for the list! I knew what shots I needed but some of those other tips I wouldn't have come up with!

india said...

Check out this introduction article on India:
* 1 Political India
* 2 Demography
* 3 Economy
* 4 Sports
* 5 Holidays

BigM said...

Dear Dr. Razavi,

I'm a retired physician and just started blogging. This is my maiden trip on blogger earth. I'm fascinated by your blog spot. I wonder what specialty your interest is?

Dr. Taraneh Razavi said...

Internal medicine.

Amal Pillai said...

Dear Dr. Razavi,

A doctor friend of mine tells me that Ciplo 500mg tablets (available under the brand name Ciplox in India) is advised twice a day for 5 days (and not 3 days).

Is there any specific reason that you recommend 3 days ?

Dr. Taraneh Razavi said...

Hi Amal,

The standard of practice in the medical community here states that Cipro should be used for 3 days in these circumstances. This is also confirmed in Dr. Richard Thompson's book Well on the Road - A Practical Guide for the International Traveler, 2002.

Thank you for visiting the blog.

easycruise said...

Wow, thats alot of shots! Still, deft worth it :)

Shawn said...

I think this recommendation should go to all those who are traveling to other countries. It's definitely better to be safe, right? By the way, I've got an excellent view here in bed and breakfast in paris.

Annerose said...

These comments have been invaluable to me as is this whole site. I thank you for your comment.

Blackpool Hotels said...

Traveled to Mumbai, Delhi, New Delhi, and the road to Agra to see the Taj Mahal and I'm still moved almost a year later. I'm returning in the 2nd week of May and will take the same precautions once more.

While I would never argue the beauty of India and particularly the wonderful, warm people I think you would all be smart to get vaccinated.

blackpool hotels

Anonymous said...

vaccines are kewl.


MarkH said...

Travel can be a pain but today I am happy when I arrive (in one piece) with most of my luggage. You are welcome to use my forum for any travel relate news.

My Travel Forum

Anonymous said...

I am traveling to india and nepal in december and January for 2 weeks. I am staying in 5 star hotel and 5 star train journey. I am wondering with the colder weather, if I still need Malaria pills.

Anonymous said...

I forgot to say i will be in the north of India and Katmandu

Mehmet said...


Is Meningitis vaccine required for India? And if so, is Meningitis C sufficient?



Deep Sea said...

Came across your blog while googling for info on hospitals in Delhi where I could take shots/ get vaccinated against Hepatitis A, polio, typhoid and meningitis. I am travelling to East Africa in just over a week.
Would you have any info at all? If yes, would be great if you could email or send a msg through my blog posts.

Matt said...

Hi there - traveling to Bangalore for a business trip soon. All shots in order, your list is quite comprehensive and clearly stated. Thank for you that.

One question: any suggestions on how to obtain Cipro as a prophylactic request? In US, it is extremely difficult to obtain prescription medication without present illness. Also, what do you think of Lomotil instead of Immodium?

Thank you.

Dr. Taraneh Razavi said...

Matt, it may be easier to obtain prophylactic medication by visiting a Travel Clinic. I think that Lomotil can be substituted for Imodium, however, Imodium is over the counter and easier to obtain.

Garry said...

all these recommendation are really useful for us .next time i will keep in my mind because this is really useful
Visit here for cheap tickets to india

Anonymous said...

Form N600

Toby M. said...

Thank you Ms. Rizvi. Thanks for your endeavor and what else you the most beautiful doctor I've seen till the date. :)


Ann @ Wellness Philippines said...

Thanks for the good information you've shared here.

reesan to live! said...

hello dr,

I'm Puja. Want to visit India with my 2 yr old son. Ive completed all his vaccinations till date. Should I give him Hepatitis B - 2 shots before planning to travel or 1 shot is enough.??

Dr. Taraneh Razavi said...

Hi Puja. Generally the first shot may offer some immunity, but the vaccine is most effective after the second shot.