Download Health Information for Travel to Nicaragua

Health Information for Travel to Nicaragua
(These recommendations are taken from the CDC web site:
For more information, visit http://www.cdc.gov/travel/camerica.htm)
BEFORE coming to Nicargua, it is important to visit your health care provider at
least 6 WEEKS before your date of departure to get the proper vaccines and
medications. Below is a summary of health care recommendations. These
recommendations are not written to scare you, but to prepare you, and to help you
to prevent the most common illnesses that affect travelers to Nicaragua.
Remember that an ounce of prevention is worth a pound of cure. Or as the health
promoters we work with will say, “Better safe than sorry!”
Also, just a note: As in the majority of illnesses of the world, the infectious
diseases described below tend to preferentially attack the poor because of their
poor state of nutrition and living in substandard conditions. Those who are well
nourished have good immune systems, and therefore are less likely to contract
these illnesses.
Malaria and Malaria Prophylaxis (Prevention)
Malaria is a serious parasitic disease that is common in Central America. It is
transmitted by the female Anopheles mosquito which tends to be most active from
dusk to dawn.
To prevent malaria, one most avoid being bitten by
the infected mosquito and also take Chloroquine
prophylaxis. In certain parts of the world, the
malaria form is resistant to chloroquine, but not in
Nicaragua. Therefore, chloroquine is the medication
we use to prevent malaria in Nicaragua.
Visit your health care provider, and get enough
medication of Chloroquine. The medication
schedule is as follows:
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An Anopheles freeborni
mosquito takes a blood meal.
The adult dose is 500 mg chloroquine phosphate once a week.
Take the first dose of chloroquine 1 week before arrival in the malaria-risk
area.
Take your dose once a week, on the same day of the week, while in the risk
area.
Take your dose once a week for 4 weeks after leaving the risk area.
Chloroquine should be taken on a full stomach to lessen the risk of nausea
and stomach upset.
In addition, take precautions to avoid being bitten by the mosquito. These
precautions are listed below in the staying healthy section.
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Traveler’s Diarrhea and Hepatits A
Both Hepatitis A and traveler’s diarrhea are transmitted through the feces of those
who are infected. Infection can result from exposure to contaminated water, ice, or
shellfish harvested from sewage-contaminated water, or from fruits, vegetables, or
other foods that are eaten uncooked and that were contaminated during
harvesting or subsequent handling.
To avoid infection, travelers are also be advised to avoid drinking beverages (with
or without ice) of unknown purity, eating uncooked shellfish, and eating uncooked
fruits or vegetables that are not peeled or prepared by the traveler personally.
Recommended Vaccinations
1. Hepatits A Vaccine is highly recommended if coming to Nicaragua
To have a 94% - 100% immunity to Hepatitis A, one needs to get the vaccine at
least 2 WEEKS before traveling to Nicaragua. In the most ideal situation, one
should be vaccinated for Hepatitis A at least ONE MONTH prior to coming to
Nicaragua.
The second vaccination dose for long term protection against Hepatitis A is
recommended 6 to 18 months after the initial dose.
2. Hepatitis B is highly recommended for those working in the health care
professions or staying longer than six months.
Hepatits B is a viral infection of the liver that is transmitted through contact with
blood or bodily fluids of infected persons. Therefore, it can be transmitted through
contact with infected blood such as in the health care professions, tattooing or
cosmetic surgery, IV drug use, unprotected sexual contact or exposure to wounds
of those who are infected.
3. Mumps, measles, rubella vaccine (MMR) – you have probably been vaccinated
against mumps, measles and rubella. Nicaragua is an area that still has mumps,
measles and rubella. Please make sure you have had your two vaccinations of
MMR before you come if you are less than 39 years old.
4. Typhoid Vaccine - Typhoid fever is an acute, life-threatening febrile illness
caused by the bacterium Salmonella enterica Typhi.
Typhoid vaccination is not required for international travel, but CDC recommends it
for travelers to areas where there is a recognized risk of exposure to S. Typhi.
Risk is greatest for travelers to the Indian Subcontinent and other developing
countries in Asia, Africa, the Caribbean, and Central and South America. Travelers
who are visiting relatives or friends and who may be less likely to eat only safe
foods (cooked and served hot) and beverages (carbonated beverages or those
made from water that has been boiled) are at greater risk. Vaccination is
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particularly recommended for those who will be traveling in smaller cities, villages,
and rural areas off the usual tourist itineraries, where food and beverage choices
may be more limited. Travelers have acquired typhoid fever even during brief visits
of <1 week to countries where the disease is endemic. While immunization is
recommended, travelers should be cautioned that none of the available typhoid
vaccines is 100% effective, nor do they provide cross protection against other
common causes of gastrointestinal infections. Typhoid vaccination is not a
substitute for careful selection of food and drink.
Preventable Insect Borne Illnesses
Dengue- a virus causing fevers and body aches transmitted by a mosquito called
Aedes Aegypti. This mosquito is most active a few hours before dusk, and also
during the early morning hours.
Leishmaniasis – a parasitic disease transmitted by the sand fly that causes skin
sores and also organ damage. It is most active from dusk to dawn.
Chagas disease- a parasitic disease cause by the “kissing bug” found in the adobe
homes, straw huts, and mud homes. It can cause enlargement of the heart, colon
and esophagus. It can be prevented by not sleeping in substandard conditions,
such as in adobe huts, or structures with thatched roofing.
Protect Yourself from Food Borne Illnesses
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Wash hands often with soap and water! Especially BEFORE YOU EAT and
AFTER YOU USE THE BATHROOM. If hands are NOT visibly soiled
(meaning no pieces of dirt, etc.. on your hand), then you can use hand
sanitizer.
Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or
bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not
possible, make water safer by BOTH filtering through an “absolute 1-micron
or less” filter AND adding iodine tablets to the filtered water. “Absolute 1micron filters” are found in camping/outdoor supply stores.
Eat only thoroughly cooked food or fruits and vegetables you have peeled
yourself. Remember: boil it, cook it, peel it, or forget it.
Don’t eat food purchased from street vendors.
Don’t drink beverages with ice.
Don’t eat dairy products unless you know they have been pasteurized.
Protect Yourself from Mosquito Bites
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Pay special attention to mosquito protection between dusk and dawn. This is
when the type of mosquito whose bite transmits malaria is active.
Wear long-sleeved shirts, long pants, and hats.
Use insect repellents that contain DEET (diethylmethyltoluamide).
Read and follow the directions and precautions on the product label.
Apply insect repellent to exposed skin.
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Do not put repellent on wounds or broken skin.
Do not breathe in, swallow, or get into the eyes (DEET is toxic if swallowed).
If using a spray product, apply DEET to your face by spraying your hands
and rubbing the product carefully over the face, avoiding eyes and mouth.
DEET may be used on adults, children, and infants older than 2 months of
age. Protect infants by using a carrier draped with mosquito netting with an
elastic edge for a tight fit.
Children under 10 years old should not apply insect repellent themselves. Do
not apply to young children’s hands or around eyes and mouth.
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To avoid getting sick...
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Take your Chloroquine to prevent malaria
Don’t share needles with anyone.
Don’t handle animals (especially monkeys, dogs, and cats), to avoid bites
and serious disease.
Don’t swim in fresh water. Salt water is usually safer.
To prevent fungal and parasitic infections, keep feet clean and dry, and do
not walk barefoot.
What you need to bring with you:
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Long-sleeved shirt, long pants, and a hat to wear while outside whenever
possible, to prevent illnesses carried by insects
Insect repellent containing DEET.
Flying-insect spray or mosquito coils to help clear rooms of mosquitoes.
The product should contain a pyrethroid insecticide; these insecticides
quickly kill flying insects, including mosquitoes.
Over-the-counter antidiarrheal medicine to take if you have diarrhea.
Iodine tablets and water filters to purify water if bottled water is not available
Sunblock, sunglasses, hat (wide brimmed hat to prevent sunburns)
Prescription medications: make sure you have enough to last during your
trip, as well as a copy of the prescription(s).
Mosquito netting to put over your bed. Preferably treated.
AFTER YOU RETURN HOMEContinue taking your antimalarial drug for 4 weeks
(chloroquine, doxycycline, or mefloquine) or seven days (atovaquone/proguanil)
after leaving the risk area.
Malaria is always a serious disease and may be a deadly illness. If you become ill
with a fever or flu-like illness either while traveling in a malaria-risk area or after
you return home (for up to 1 year), you should seek immediate medical attention
and should tell the physician your travel history.
If you have any other illnesses, also PLEASE let your health care provider know
that you have been to NICARAGUA.
Last updated 4.16.07 from CDC website: http://www.cdc.gov/travel/camerica.htm
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