Wednesday, December 06, 2006

Travel Vaccines for Brazil

Travel medications for Brazil are not dazzling but they can be confusing as the recommendations vary by the counties and regions. Malaria pills are not necessary for Sao Paulo. Yellow fever vaccine is also not required for Sao Paulo as long as you are traveling to Brazil from U.S/Europe and other areas which are not endemic for yellow fever. See chart below.

If you are going to Sao Paulo only then the following vaccinations are recommended by the Center for Disease Control.
-- Tetanus/pertussis/diphtheria (1 shot)--->if your last one was more than 10 years ago.
-- Measles (1 shot)--> one time booster if you were born after 1956 and if you cannot document that you are immune by having 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 it should not be given to pregnant women or to those with immunosupression. 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. OR 1 shot which is good for 2 years.
--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 vaccine may be given instead of individual A and B shots. This follows the same schedule as hepatitis B shots.

--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.

If you are going outside of Sao Paulo then it gets a little tricky. You will need all of the above vaccines, but in addition you will need the following:
--Malaria pills-- See Malaria Information for Tropical South America. The 2 most commonly prescribed malaria pills 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.
--Yellow Fever Vaccine -- See Requirements. These vaccines must be given at certified yellow fever vaccination centers so they cannot be given on-site for those of you who are Googlers. Refer to this link to find a location near you.

Depending on your itinerary another vaccine to consider is 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.

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.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.

4 comments:

Anonymous said...

Dear Dr. Razavi,
You don't need any vaccines to travel to Brazil, except if you plan to go to Amazonia and the north. Please don't misinform people! Best, Dr. Souza, Sao Paulo

Mark said...

Many of us can go to foreign climates and not be effected by the change.
But even in safe climates some of us can find ourselves weaker than in home, because excess heat different diets etc.
I for one have had vaccines for countries where it has just been a precuationary advice. Most people would never need it, an I probably did not need it also.
But occasionaly there are some of us, who's bodies react differently to a differnt climate.
So even if you don't need to. Sometimes it is better safe than sorry.

Mark

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Anonymous said...

PHORA-HR / SF-HR

Anonymous said...

Very informational and helpful for me! I am going to Brazil for a year in which I will be traveling throughout the country a lot. Also, Dr Souza, I am fairly certain they (Brazilian and Canadian officials) would not allow me to travel there without most of these vaccinations. Peace^^